Irish journal of medical science
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Review Meta Analysis
Evaluating the safety profile of anti-platelet therapy in patients undergoing elective inguinal hernia repair: a systematic review and meta-analysis.
There remains no consensus surrounding the safety of prescribing anti-platelet therapies (APT) prior to elective inguinal hernia repair (IHR). ⋯ This study illustrates the safety of continuing APT pre-operatively in patients undergoing elective IHR, with similar rates of haemorrhage, reoperation, and readmission observed. Clinical trials with larger patient recruitment will be required to fully establish the safety profile of prescribing APT in the pre-operative setting prior to elective IHR.
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Review Meta Analysis
Evaluating the safety profile of anti-platelet therapy in patients undergoing elective inguinal hernia repair: a systematic review and meta-analysis.
There remains no consensus surrounding the safety of prescribing anti-platelet therapies (APT) prior to elective inguinal hernia repair (IHR). ⋯ This study illustrates the safety of continuing APT pre-operatively in patients undergoing elective IHR, with similar rates of haemorrhage, reoperation, and readmission observed. Clinical trials with larger patient recruitment will be required to fully establish the safety profile of prescribing APT in the pre-operative setting prior to elective IHR.
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Meta Analysis
A systematic review and meta-analysis assessing the use of tranexamic acid (TXA) in acute gastrointestinal bleeding.
Gastrointestinal bleeding results in significant morbidity, cost and mortality. TXA, an antifibrinolytic agent, has been proposed to reduce mortality; however, many studies report conflicting results. ⋯ TXA does not reduce mortality in patients with acute upper or lower gastrointestinal bleeding and may confer an increased risk of seizures. The authors do not recommend the use of TXA in acute gastrointestinal bleeding.
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Palliative radiotherapy (PRT) is commonly used to treat symptoms of advanced cancer. PRT has been associated with elevated 30-day mortality (30DM). A Rapid Access Palliative Clinic (RAPC) can streamline the treatment process for patients receiving treatment. ⋯ Referral rates to SPC services and documentation of performance status were low in our 30DM retrospective review cohort. The RAPC facilitated quick treatment turnaround, fewer hospital visits and referral to SPC services.
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Surrogacy is a form of assisted human reproduction whereby a surrogate woman carries a pregnancy for a commissioning couple or individual. There are two types of surrogacy, traditional and gestational. Worldwide we have seen a rapid increase in the use of surrogacy. Despite this, there is a lack of consensus internationally on the laws governing surrogacy. In Ireland, surrogacy remains largely unregulated. Currently, there is no specific legislation for surrogacy. This review aims to discuss its current regulatory status and associated ethical issues. ⋯ Surrogacy has raised several ethical issues. There are issues surrounding autonomy of the surrogate and commissioning couple, child welfare, exploitation and commodification, non-maleficence and justice. There are also significant legal concerns with surrogacy. It is neither legal nor illegal in Ireland. This creates challenges for the commissioning couple particularly in terms of custody of the child.