Irish journal of medical science
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The use of continuous subcutaneous insulin infusion (CSII) in the management of paediatric patients with type 1 diabetes mellitus (T1DM) has increased substantially in the last decade. The aim of this study was to evaluate and compare glycaemic control in a population of paediatric patients with T1DM before commencing CSII compared with 2 years after commencing CSII. ⋯ CSII commencement is associated with significantly improved glycaemic control most notably in the first 6 months after CSII commencement. There is association between CSII commencement and increased BMI noted to be statistically significant in the second year.
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This study aimed to compare the incidence of major adverse cardiac and cerebrovascular events (MACCE) after coronary artery bypass graft (CABG) or after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in unprotected left main coronary artery disease (ULMCAD) patients complicated with chronic kidney disease (CKD). ⋯ CABG could be considered as the preferred treatment strategy compared with PCI with DES in ULMCAD patients complicated with CKD.
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There are no previously published reports regarding the epidemiology and characteristics of moyamoya disease or syndrome in Ireland. ⋯ Moyamoya is rare but occurs in Caucasians in Ireland. It most commonly presents with ischaemic symptoms. Surgical intervention in the form of direct and indirect bypass is an effective treatment in the majority of cases.
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Electroanatomical mapping systems (EMS) reduce fluoroscopy dose for the ablation. Higher costs and longer procedure times are the drawbacks associated with EMS. Our objective was to validate the efficiency of the EMS. ⋯ Ablation without fluoroscopy is a technique as safe and effective as the conventional technique. Our study suggests that the radiation dose delivered to the patient and staff might be reduced, without increasing the total procedure time, being even more efficient.
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We assess the requesting patterns and overall utility of MRI scans in our institution over a 6-month period for knee pain in an elderly population. ⋯ We suggest that all elderly patients with knee pain undergo plain radiographs before MRI scan and only those with locking should be considered for an MRI scan at all. Primary care physicians are overusing MRI as an imaging modality in this cohort at a cost of over €30,000 per year to our institution.