Irish journal of medical science
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Internationally, the number of computerised tomographic pulmonary angiographies (CTPAs) being performed to rule out pulmonary embolism (PE) has caused some concern. ⋯ Application of the PERC rule, as per the ACP guidelines, would have reduced the number of CTPAs performed by 32 (6%) without missing any patient with a proven pulmonary embolus.
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Osteoarthritis is a significant cause of chronic pain in the elderly population with hip osteoarthritis as one of the main causes of functional disability and joint pain in adults older than 55 years. Recently, platelet rich plasma (PRP) injections have been introduced for treatment of osteoarthritis. The aim of this systematic review is to assess its effectiveness in the management of hip osteoarthritis. ⋯ PRP was shown to improve patient outcome scores at follow-up at 6 and 12 months; however, there was no significant difference seen between patients treated with PRP or hyaluronic acid alone. Following this systematic review, we cannot currently recommend the use of intra-articular injections of PRP for the treatment of hip OA. Given that intra-articular steroid injections are the only such injection recommended by international guidelines for the treatment of hip OA, further studies comparing PRP to steroid would be of benefit to determine the value of PRP injections in hip OA.
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To report the advice consultants wish they had received on their appointment and to see if that advice differs by gender, or length of time since appointment. ⋯ The emergence of 'self-care' and 'work-life balance' as the top pieces of advice suggests that consultants regret that they have not looked after their health. The fact that 'self-care' was significantly less likely to feature among consultants more than twenty years in practice may point to generational differences.
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Because of the uncertainty in the appropriate initial loop diuretic dose in acute decompensated heart failure (ADHF), the risk of acute kidney injury (AKI) is believed to be increased with the high dose of initial intravenous (IV) loop diuretic. ⋯ In patients with ADHF, the initial high dose of IV loop diuretics is associated with an increased risk of developing AKI.