Irish medical journal
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Irish medical journal · Oct 2008
Assessment of fibromyalgia & chronic fatigue syndrome: a new protocol designed to determine work capability--chronic pain abilities determination (CPAD).
The objective was to design a protocol to assess work ability in people suffering ill-defined painful and disabling disorders, the outstanding prototype of which is fibromyalgia/chronic fatigue syndrome (FM/CSF). Following an extensive literature search, the mos appropriate components of current methods of assessment of physical and cognitive abilities were incorporated into the protocol, occasionally with appropriate modification to suit the specific requirements of the individual. The initial part of the assessment consists of a standard history taking, principally focusing on the patient's self-reported physical and cognitive abilities and disabilities, as well as the completion of established pain and fatigue scales, and relevant disability questionnaires. ⋯ The designed system produces reliable, consistent and reproducible results. It also proves capable of detecting any inconsistencies in patient input and results, in addition to being independent of any possible assessor bias. A new protocol has been designed to determine the working capability of individuals who suffer from various chronic disabling conditions, and represents a significant step forward in a difficult but rapidly expanding area of medical practice.
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Irish medical journal · Oct 2008
Management of acute procedural pain in the neonatal intensive care unit (NICU).
Neonates experience pain and may be more sensitive to it. Our objective was to assess pain management strategies in Irish neonatal units. We performed a cross-sectional telephone survey of all twenty neonatal units in the Republic of Ireland. ⋯ Three units used breast-feeding (15%) for heal lancing, IM injections and venepuncture. Most units (60%) stated emergency situations as the main reason for not using analgesia. Despite growing evidence supporting neonatal pain experience and increased sensitivity, neonates are not often afforded the benefits of intervention in Irish NICUs.
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Irish medical journal · Oct 2008
Poisoning in older adults: the experience of the national poisons information centre.
Data regarding the incidence, morbidity, and mortality of poisoning in older adults are limited. A retrospective review of enquiries to the National Poisons Information Centre, involving adults aged over-65 years, was conducted from 2001-2003 inclusive. Information on poisoning circumstances, patient demographics, type and number of agent(s), symptoms, enquiry source, location, and route of exposure was collated. 575 adults over-65 years of age were poisoned during the study period. 37.2% (n=214) of poisonings were intentional, 54.4% (n=313) were unintentional, in 5.6% (n=32) of cases the circumstances were unknown, and 2.8% (n=16) were requests for information only. 70.3% (n=404) of poisonings involved pharmaceuticals, 29.0% (n=167) chemicals, and 0.7% (n=4) foreign bodies. ⋯ Overall, 301 (52.3%/) older adults were symptomatic and there were 5 fatalities. Substantial morbidity and mortality occurred following poisoning in older adults. Poison prevention strategies are needed to reduce toxic exposures.
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In Europe injury is the leading cause of death in those aged between 1 and 14 years. In Ireland over 800,000 people are aged less than 14 years. There is currently no national trauma register to collect data on the morbidity and mortality associated with major trauma in the paediatric population in Ireland. ⋯ Road traffic accidents (n=69) and thermal injuries (n=49) represented the majority of admissions. 68% (n=47) of the vehicle occupants in this study were either unrestrained or incorrectly restrained. Most patients (n=133) had an in patient stay of <50 days, with only 4 patients staying >100 days. 14 patients died. A paediatric trauma register as well as a level 1 paediatric trauma centre are required in Ireland.