Irish journal of medical science
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Randomized Controlled Trial
Efficacy of uvulopalatopharyngoplasty combined with oral appliance in treatment of obstructive sleep apnea-hypopnea syndrome.
This study aimed to investigate the efficacy of UPPP combined with an oral appliance (OA) in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). ⋯ The long-term efficacy of the combined UPPP and OA for the treatment of OSAHS was higher than that of pure UPPP treatment.
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Comparative Study
The accuracy of magnetic resonance imaging in prostate cancer staging: a single-institution experience.
Magnetic resonance imaging (MRI) has a wide reported variation in sensitivity and specificity for staging prostate cancer (PCA). ⋯ MRI may be reliable for excluding ECE and SVI in PCA patients where the lesion is visible on MRI. It has a good diagnostic ability for ECE, but is less accurate for identifying SVI. This article supports the use of MRI in the preoperative evaluation of PCA.
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Although the General Medical Council has published guidelines for procedural consent, there is evidence to suggest that deficiencies still occur in completion demographics, documentation of procedural risks and information regarding alternative therapies. We assessed the accuracy and completeness of vascular consent within our unit. ⋯ Vascular consent is a complex process involving a number of discussions and meetings with patients. Our unit has demonstrated compliance of nearly 90% for all consent-related processes and remains consistent with current GMC guidance. However, further improvement including the documentation of intended benefits, provision of additional written information whilst reducing the use of abbreviations is desired.
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High incidence of difficult or failed intubation in obstetric patients is still a major problem to challenge anaesthesiologists. Although the probability of difficult intubation is impossible to predict preoperatively, some simple, practical bedside tests may help. This study used five simple tests in an attempt to better evaluate airway changes in pregnant women before and after delivery. ⋯ Within 24 h after delivery, Mallampati scores changed in one-third (n 21, 36.6%) of the patients. Significant differences between the two measurements of thyromental and sternomental distances, mouth opening, and the degree of neck extension confirm difficult airway management in pregnant women.
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Haemoglobin (Hb) variants are genetic variations in the globin genes that code for an abnormal globin protein structure. The prevalence of Hb variants has increased in Ireland due to the number of emigrants from Africa and Southeast Asia. The rate of incidentally detected Hb variants, in laboratories employing HPLC to measure HbA1c, has increased in parallel. The presence of a Hb variant can compromise HbA1c measurement and interpretation. In such cases, HbA1c cannot be used to diagnose diabetes or to assess concordance with glycaemic targets. ⋯ Hb variants may invalidate the results of HbA1c analysis and could result in a missed diagnosis or a misdiagnosis of diabetes or mismanagement of a patient with diabetes mellitus. It is, therefore, imperative that a comment alerting the requesting clinician to the presence of the Hb variant is appended to the HbA1c result.