Irish medical journal
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Irish medical journal · May 2006
Case ReportsThe role of endobronchial electrocautery in the management of malignant airway obstruction.
Bronchoscopy has evolved well beyond a simple look-see examination, with new interventional techniques becoming more commonly employed. So-called interventional bronchoscopy implies the use of bronchoscopy as a therapeutic, in addition to diagnostic, tool. ⋯ There is minimal morbidity associated with this technique. It is anticipated that interventional bronchoscopy will continue to revolutionise management of such conditions in the future, and become a necessary facility in all pulmonary medicine units.
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Irish medical journal · May 2006
Audit of the management of patients admitted with community acquired pneumonia.
Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. There is evidence that guidelines do guide and standardise management, but with less measurable effect on outcome. We prospectively audited the management of CAP in patients admitted to a Dublin hospital during the winter of 2003/04. ⋯ Appropriate antibiotic therapy was instituted within 8 hours of presentation in 123 (75.0%) cases. The rate of use of a severity assessment score to stratify patients with CAP based on recognized guidelines is low in our hospital. Despite this, the overall mortality rate of 8.5% is comparable with previous results.
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Irish medical journal · Apr 2006
Outcome of accident and emergency room triaged patients with low risk non-variceal upper gastrointestinal haemorrhage.
An acute upper gastrointestinal haemorrhage (UGIH) is an expensive healthcare problem estimated to cost more than 2.5 billion dollars per annum in the United States. Recent British Society of Gastroenterology (BSG) guidelines (2002) advise that patients with low risk non variceal UGIH have a benign outcome and may be suitable for a relatively short hospital stay with attendant economic saving. We evaluated current clinical experience, endoscopy findings and length of hospital stay in our hospital. ⋯ The mean hospital length of stay (LOS) was 4.16, costing in excess of 1002,840 Euro. Following routine clinical practice for low risk non variceal UGIH, the subsequent duration of hospital stay was unnecessarily prolonged and costly. This highlights the need to initiate change, to monitor resource utilisation and implement early hospital discharge in appropriate patients.