Irish journal of medical science
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Review Case Reports
Eosinophilic granulomatosis with polyangiitis as a rare cause of the syndrome of inappropriate antidiuretic hormone secretion.
Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare multisystem necrotizing vasculitis that involves small- to medium-sized blood vessels. We report a rare case of syndrome of the inappropriate antidiuretic hormone (ADH) secretion (SIADH) secondary to EGPA. A 53-year-old man applied with complaints of pain in the large joints and morning stiffness in knee for 2 months. ⋯ There is only four other documented cases of SIADH associated with EGPA. We hypothesized that blood supply to the hypothalamus and/or posterior hypophysis might be affected from EGPA vasculitis. Here, in this case, with effective treatment of EGPA, SIADH was resolved which implies a causality between two conditions.
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No other systematic review presented the effectiveness of pelvic floor muscle training (PFMT) in individual with stroke. ⋯ The results demonstrated that PFMT had positive effects in terms of daytime urination frequency and incontinence. Although some studies have reported positive effects on symptoms, function, strength, and endurance, the generalizability of these results is controversial. Further studies should assess the quality-of-life and function with urinary incontinence and stroke-specific tools.
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Review
Behaviour, Belief and Impairment (BBI): a diagnostic procedure for eating disorders in primary care.
Eating disorders are becoming increasingly prevalent, especially among adolescents. Recognition and assessment of their clinical presentation can be challenging for clinicians in primary care settings, where consultation time is short and experience with eating disorders is limited. The early detection and appropriate referral of adolescents with eating disorders are essential for timely management. ⋯ The authors propose a unique model of assessment entitled Behaviour, Belief and Impairment or BBI, which provides a simple, time-efficient assessment that can assist in the early detection of an eating disorder. The BBI assessment model conceptualises eating disorders in three domains: the observed behaviour, the underlying belief of the patient that drives the behaviour and the subsequent physical or psychological impairment.
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The chronic nature of multiple sclerosis (MS) affects patient's activities of daily living (ADL) and quality of life (QOL). Nursing interventions based on patients' active participation in goal-setting can be beneficial in improving ADL and QOL. ⋯ Given the results, TGA could effectively promote mutual goal attainment, QOL, and IADL for PwMS during the COVID-19 pandemic.
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Dental services in Ireland are delivered in a mixed public-private system but the majority of dental care is paid for out-of-pocket by individuals. Ireland is not unusual in the global context where public subsidisation for oral healthcare is limited in many countries. This is despite the fact that oral health plays an important role in well-being and despite international evidence on the negative impact of user fees on utilisation of beneficial healthcare. However, there has been little up-to-date assessment of the prices faced by individuals for a range of non-acute care services in Ireland, including dental care. This paper presents an up-to-date assessment of private dental prices in Ireland for a range of preventive, primary, and complex services based on a nationally representative survey. ⋯ Results showed that in addition to there being an uneven supply of dentists across the country, dental prices also vary with some notable variations by region and type of service. In particular, dental practices located in border counties, and those in rural areas typically show lower mean prices relative to non-border counties and urban areas. These factors need to be considered when planning how to reduce inequalities in access to oral health services in Ireland.