Irish journal of medical science
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In Irish orthopaedic centres without dedicated spinal services, the care of patients is facilitated through tertiary referral centres in Dublin, Cork & Galway. The outpatient waiting list for elective spinal opinion remains lengthy and challenging. Previous practice in University Hospital Waterford (UHW) necessitated an assessment with a local non-spinal orthopaedic specialist following a GP referral, incurring up to a 2-year wait prior to subspecialist spinal referral. These patients subsequently incurred a further wait for an appointment at the tertiary referral centre. A novel virtual spine clinic in collaboration with the Mater Misericordiae University Hospital (MMUH) was developed to fast-track this process. ⋯ This novel pathway is efficient for orthopaedic units without a dedicated spinal service. This can easily be replicated across other orthopaedic centres with minimal cost implications.
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There is a paucity of research reporting the long-term outcomes of older adults who have completed geriatric rehabilitation following COVID-19. ⋯ Multidisciplinary rehabilitation for older adults with acute COVID-19 infection can assist patients to return to their premorbid functional ability. On discharge from rehabilitation, ongoing follow-up of older adults is recommended to assist them to negotiate and manage ongoing symptomatology such as breathlessness or fatigue.
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Methotrexate (MTX) is used in clinical practice as a medical treatment option in patients with early pregnancy complications like ectopic pregnancy. ⋯ The efficacy of medical treatment with systemic MTX for confirmed tubal ectopic pregnancy in our hospital is in line with national and international standards. Careful consideration should be given to treating caesarean scar pregnancy and persistent pregnancy of unknown location with systemic MTX. Systemic MTX use guided by clinicians specialised in early pregnancy complications and safe medication practices may improve treatment success and reduce adverse events.
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Worldwide, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) caused by human papillomavirus (HPV), a sexually transmitted virus, is increasing. This increase has yet to be demonstrated in an Irish cohort. ⋯ In our institution, the number of patients with OPSCC is increasing due to an escalation in cases associated with HPV. Population-level interventions such as vaccination programs may alter the current increase in the incidence of these tumours.
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Medical procedures in the field of electrocardiology belong to a large group of cardiological procedures. Performing them involves exposure to ionizing radiation. In this study, five medical procedures in the field of electrocardiology performed in three medical facilities were analyzed in terms of patients' exposure to ionizing radiation. ⋯ This is reflected, for example, in the high coefficient of variation for doses in RF ablation. The type of X-ray machine used during the procedure also influences the dose values. Although the exposure of patients undergoing electrocardiological procedures to ionizing radiation is much lower than in the case of cardiac vascular procedures, it may reach a similar level, especially in the case of implantation of devices regulating the correct functioning of the heart.