Irish journal of medical science
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Adults ageing with HIV and on antiretroviral therapy have a greater burden of chronic diseases compared with adults without HIV as reported by Althoff et al. (Curr Opin HIV AIDS 11:527-36, 2016). Therefore, it is important in this clinically stable HIV+ population to monitor and evaluate their risk of chronic kidney disease and intervene when appropriate. The European AIDS Clinical Society (EACS) advise that yearly screening for CKD with eGFR calculation and spot urine protein measurements should be performed (European AIDS Clinical Society Guidelines 2018). The Centre for Excellence for Health, Immunity and Infection (CHIP) have created a validated study calculator to estimate a patient's risk for CKD as reported by Mocroft et al. (PLoS Med 12(3):e1001809, 2015). ⋯ Although this audit was small and with limitations, it highlights the importance of collecting relevant and accurate patient data annually to estimate and mitigate the risk of chronic kidney disease in patients with HIV.
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Patients' satisfaction reporting is important for assessing the quality of care in surgical practice. Post-discharge questionnaire reporting is considered best practice; however, the logistics of this method remains problematic. ⋯ There were no significant differences in reporting between pre- and post-discharge questionnaire responses. As pre-discharge reporting is more efficient, less costly and has a higher response rate, this should be considered the preferred practice in patient satisfaction assessments.
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Increasing numbers of young adults with life-limiting conditions are living into adulthood and consequently making the transition from children's to adult services. A poorly planned transition is associated with adverse outcomes such as non-adherence to treatment and loss to follow-up, together with negative social and emotional outcomes. However, there is little descriptive data on how organisations are currently managing transition. ⋯ The findings demonstrate that caring for young adults with life-limiting conditions presents a considerable challenge to organisations and that transition from children's to adult services is an important part of this challenge.
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Integrating theoretical and practical knowledge and stimulating students' active learning is the most important task of modern and high-quality healthcare education. By analyzing clinical cases, undergraduate medical students are trained to make accurate diagnoses, to choose appropriate therapy based on laboratory results and on adequate diagnostic tests. ⋯ Clinical case presentation has a learning potential and facilitates positive interaction between instructors and students and supporting students to become reflective and competent physicians.
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Tobacco is the leading cause of preventable death in Ireland; half of all long-term smokers die prematurely from smoking-related diseases. Achieving 'Tobacco Free Ireland' (a smoking prevalence of less than 5%) will require the prevention of smoking initiation and the promotion of smoking cessation. ⋯ This study highlights the need to strengthen smoking cessation in Ireland to increase the number of smokers that successfully quit and achieve a Tobacco Free Ireland. The development and implementation of National Clinical Guidelines for the Diagnosis and Treatment of Tobacco Addiction will play a key role in this.