Irish journal of medical science
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Chronic schizophrenia is challenging to manage in primary care. ⋯ GPs require appropriate back up from specialist services to enable their management of chronic schizophrenia.
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Gastrointestinal stromal tumour (GIST) has many modes of presentation. This is the first reported GIST presenting as an acute abdomen. ⋯ GISTs arise from the gastrointestinal tract, omentum, and mesentery. Presentation is generally non-specific and it is rare for them to present acutely. Management should include staging to exclude any metastatic spread.
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Since 1998, Irish general practice has developed 11 out-of-hours co-operatives, covering almost 40% of the population.The co-operatives vary in terms of triage mechanisms, treatment centres and domiciliary visits but no data exist on their role in the management of emergencies in the community. ⋯ Clarification is urgently required of the extent to which GP co-operatives and ambulance services support each other. Examples include procedures for passing calls between services, mutual understanding of each others roles and development of common procedures.
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The Medical Council in Ireland is currently implementing Competence Assurance Structures (CAS). Peer review has been proposed as a tool to measure physician competence. ⋯ The majority of physicians practising in Ireland would favour a peer review system of competence assurance. The financial implications, and structure, of such a system would need to be explored prior to implementation.
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The intravenous infusion of atrial (ANP) and brain (BNP) natriuretic peptides have been shown to increase urinary albumin excretion in type 1 diabetes. ⋯ Plasma concentrations of ANP and BNP are elevated in some patients with type 1 diabetes. Plasma ANP concentrations are closely related to UAER and elevated plasma concentrations are associated with poor glycaemic control and systemic hypertension. Plasma BNP concentration is related to LVMI.