Irish journal of medical science
-
Meta Analysis Comparative Study
Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation? Direct and network meta-analyses.
Atrial fibrillation is the most common arrhythmia in clinical practice and is a major contributor to mortality. Recently, several studies have reported different results for treatments aimed at reducing the risk of postoperative AF. ⋯ The network meta-analysis revealed no significant differences among eight types of BB treatments but did provide a ranking. BB treatments could significantly reduce the occurrence of post-CABG AF. Insufficient evidence was available to show that one BB treatment was more effective than the others were. According to our network meta-analysis, bisoprolol and landiolol+bisoprolol are better alternatives compared with the other treatments.
-
GISTs are the most common mesenchymal neoplasms of the gastrointestinal tract. The last 20 years have been revolutionary in the understanding of these tumours and began with the discovery of c-KIT, a proto oncogene that when mutated forms the molecular basis for the growth and development of these malignancies. ⋯ These novel agents have significantly reduced the frequency of disease recurrence and dramatically improved survival, and serve as a model for the study of targeted therapies in other solid tumors. We present a review of gastrointestinal stromal tumours and consider the current evidence based detection and management of these unique tumors.
-
Continuous subcutaneous insulin pump therapy (CSII or pump therapy) is a well-recognised treatment option for Type 1 diabetes mellitus (T1DM) in paediatrics. It is especially suited to children because it optimises control by improving flexibility across age-specific lifestyles. The NICE guidelines (2008) recognise that pump therapy is advantageous and that it should be utilised to deliver best practice. In Ireland, the National Clinical Program for Diabetes will increase the availability and uptake of CSII in children and thus more clinicians are likely to encounter children using CSII therapy. ⋯ This review addresses the principles of insulin pump management in children which all health care professionals involved in caring for the child with diabetes, shoud be familiar with.
-
Surgical procedures to correct larger curve magnitudes >70° in patients with adolescent idiopathic scoliosis (AIS) are still common; despite their increased complexity, limited research has assessed the effect of preoperative curve severity on outcomes. ⋯ Surgeons can expect a longer surgical duration, greater intraoperative blood loss and double the blood product transfusion risk when performing PSF procedures on AIS patients with curves greater than 70° vs. those ≤70°. Surgical correction for curves >70°, often as a result of lengthy surgical waiting lists, also incurs added expense and results in a partial delay in early functional recovery.
-
Biography Historical Article
Wilde's worlds: Sir William Wilde in Victorian Ireland.
Other contributors to this collection have evoked the disparate worlds inhabited by Sir William Wilde. ⋯ A variety of close British Isles parallels can be drawn between Wilde and his cohort in the medical elite of Dublin and their clinical peers in Edinburgh and London both in terms of clinical practice and self-presentation and in terms of the social and political challenges facing their respective ancient regime hegemonies in an age of democratic radicalisation. The shared ideological interests of Wilde and his cohort, however, were also challenged by the socio-political particularities and complexities of Ireland during the first half of the nineteenth century culminating in the catastrophe of the Great Famine. William Wilde saw the practice of scientific medicine as offering a means of deliverance from historical catastrophe for Irish society and invoked a specifically Irish scientific and medical tradition going back to the engagement with the condition of Ireland by enlightened medical men in the seventeenth and eighteenth centuries.