Irish journal of medical science
-
The human body consists of water, proteins, lipids, carbohydrates, and minerals that build cells, tissues, and organs. In healthy people, the content of these molecules remains nearly constant. The body mass index (BMI) is commonly used to classify abnormal body composition among adults. According to the WHO, a high BMI is a major risk factor for many diseases. Bioelectrical impedance analysis is a commonly used method for assessing body composition in clinical practice and medical research. ⋯ The BMI is useful to provide a warning of excessive fat content in overweight and obese women, whereas among normal weight and underweight women, it may mask various types of body composition defects.
-
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.
-
Endometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not. ⋯ Endometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.
-
Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability. Its diagnosis, classification and management are complex. There is a paucity of data on the standard of COPD management in Irish general practice. ⋯ This study provides a comprehensive snapshot of care in Irish general practice for patients with COPD prior to introduction of the Chronic Disease Management programme (CDM).
-
With among the lowest urologist per population ratios in Europe, the demand for urology specialist review in Ireland far exceeds supply. Lower urinary tract symptoms (LUTS) account for a significant number of referrals. The traditional paradigm of every patient being reviewed in a consultant-led clinic is unsustainable. New models of care with nurse-led clinics represent an opportunity to optimise limited resources. ⋯ Introduction of a CNS-led LUTS clinic has significantly reduced the number of patients requiring follow-up in general urology clinics, representing a quality improvement in service provision.