Irish medical journal
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Irish medical journal · Oct 2003
Case ReportsPaediatric near-drowning: mortality and outcome in a temperate climate.
The decision whether to continue to resuscitate the paediatric victim of near-drowning is influenced by potential poor neurological outcome. A low core body temperature at presentation is frequently cited as a reason to continue resuscitation. We report the case of an 11 month old infant admitted to the intensive care unit following near-drowning and a prolonged resuscitation. ⋯ The mortality was 23%. The incidence of a persistent vegetative state was 15%. Asystole, immersion time greater than 15 minutes, resuscitation time longer than 30 minutes, the administration of epinephrine, and a low core body temperature were associated with a poor outcome.
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Irish medical journal · May 2003
Case ReportsLumbar Chance fracture associated with use of the lap belt restraint in an adolescent.
The use of the 2-point seat belt or lap belt in motor vehicles, particularly to restrain young rear seat passengers, remains an issue of some concern. The occurrence of lumbar spinal flexion-distraction injuries in lap belt restrained children and adolescents during road traffic accidents is a well known phenomenon, but is still occurring. ⋯ We present the case of a Chance fracture sustained by a 15 year old girl, involved in a motor vehicle collision, while wearing a lap belt. We emphasise the need to develop safer seat belt designs for juvenile car passengers.
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Irish medical journal · Apr 2003
Causes of sensitisation in patients awaiting renal transplantation in Ireland.
Sensitisation to HLA antigens, formed as a result of transfusion, previous allografts or pregnancy, remains a significant problem in transplantation. The aim of this study was to define the causes of sensitisation of potential renal allograft recipients in Ireland in the post-EPO era. A retrospective survey of all patients who were active on the renal transplant waiting list during 1996 was performed evaluating the panel reactive antibodies (PRA), history of sensitising events, and waiting time for transplantation. ⋯ The percentage of patients who had been transfused in the 1996 cohort (71%) was similar to the percentage of patients transfused on the waiting list in August 1999 (75%). These data demonstrate that transfusion remains an important cause of sensitisation, despite the use of EPO. Measures to further reduce the use of transfusion or the use of immunosuppression at the time of transfusion in potential allograft recipients may be of value in the future.