Irish journal of medical science
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The true incidence of sepsis in surgical cohorts in Ireland remains unclear. According to inpatient audits, patients in surgical diagnostic groups (DRG) who developed sepsis had a longer length of stay and higher mortality rate compared with medical DRG patients who developed sepsis. ⋯ Sepsis was under-documented, and barriers exist with use of the national sepsis screening form. Frailty, which is a sepsis risk factor, should be assessed pre-operatively to maximise prevention.
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Historically, high negative appendicectomy rates (NAR) were acceptable to offset the risks of perforation, previously exceeding 20%. With improved imaging and clinical scoring algorithms, there is growing demand for lower negative appendicectomy rates. The objectives were to (1) establish the NAR in our institution and (2) correlate clinical parameters and imaging modalities with histological findings. ⋯ There is no consensus on defining a negative appendicectomy or for imaging modality utilisation. CT imaging is the most sensitive and should be used in cases of diagnostic uncertainty. A standardised algorithm regarding the workup of patients with RIF pain along with a consensus on the use of imaging will further reduce negative appendicectomy rates.
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Bladder carcinoma is one of the most commonly diagnosed cancers worldwide; however, various studies have reported on marked international variation in incidence and mortality rates. The aim of this study was to report national figures on incidence, survival and risk factors of bladder cancer. This retrospective review is the first to offer a comprehensive analysis of incidence rates, mortality and potential risk factors in the Irish population from 1994 to 2015. ⋯ The overall incidence of bladder cancer in Ireland has fallen, in line with reducing smoking rates. Our data reflects international trends in incidence, survival and contributing risk factors.
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Breastfeeding rates in Ireland are among the lowest in the world; thus, it is important to understand what knowledge and skills exist and what are the education needs of dietitians. There has been no Irish research on dietitians' perception of their role in promoting, protecting and supporting breastfeeding. ⋯ Further examination of the role of the dietitian and the establishment of expected competencies would provide a clear framework for future training and education of dietitians towards increasing breastfeeding prevalence in Ireland.
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The aim of this study was to determine the difference in proportion of shoulder MRIs that influence the management plan of shoulder patients based on whether MRI was ordered by a shoulder specialist, orthopaedic surgeon or primary care provider prior to referral to a specialist. ⋯ With less than 25% of primary care-ordered shoulder MRIs influencing clinical management, questions must be raised about the indications for MRI. Greater than 50% of referrals contained no documented physical examination, suggesting that MRI is being relied upon for assessment. If access to private MRI was to be rationalized, perhaps shoulder specialist-ordered CT and X-ray could be covered by insurance providers. Currently, they are not covered in our system, yet are more likely to influence clinical management than primary care-ordered MRIs, which are currently covered by insurance without restriction on indications.