Irish journal of medical science
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Several studies have shown a reduction in the rate of thromboembolic events with LMWH thromboprophylaxis in patients immobilised in lower limb cast. However, the literature is limited on the use of rivaroxaban in this setting. Therefore the aim of this study was to assess the associated impact of rivaroxaban on the incidence of venous thromboembolism in trauma patients with lower limb cast immobilisation. ⋯ This study has shown that rivaroxaban is associated with a significant reduction in the risk of VTEs in patients with lower limb cast immobilisation without increasing the risk of bleeding or associated untoward effect. Lower limb immobilisation is high risk factor for VTE per se. However, there is still limited data in the literature to make further recommendations.
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Screening for developmental hip dysplasia (DDH) continues to evolve with the use of ultrasound (US) in either selective or universal screening methods. The possibility of delayed evidence of DDH, and thus the need for radiographic follow-up at a later stage of development have been suggested by some authors. ⋯ Eight percent of patients with a normal screening US had evidence of DDH at time of radiograph at 6 months, reflecting 34% of all our DDH cases for the year. Based on these findings, patients in our hospital network undergo radiographic evaluation at 6 months even if the initial screening US is normal.
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This study aimed to investigate the longitudinal changes and risk factors of anxiety and depression, as well as their values in predicting major adverse cardiovascular events (MACE) occurrence in coronary heart disease (CHD) patients. ⋯ Anxiety and depression are common and progress sustainably with female, diabetes, and higher Gensini score as their independent risk factors; meanwhile, depression but not anxiety may predict increased accumulating MACE occurrence in CHD patients.
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In patients with obesity (PwO) and heath care providers (HcPs), there appears to exist a discrepancy between recognition of obesity as a disease and the underlying biology of the disease. This is evident when considering PwO and HcPs appear to agree obesity is a disease but position lifestyle related factors as the main barriers to treatment with "eat less and move more" considered the best treatment approach. This does not align with current evidence regarding obesity treatments and the underlying pathophysiology. An understanding of PwO beliefs and perceptions may facilitate improved communication strategies with regard to the underlying pathophysiology of obesity as a disease. This has the potential to lead to improvements in both prevention and treatment strategies. Therefore, we evaluated PwO beliefs and perceptions of obesity as a disease, obesity causation and obesity treatment recorded during clinical evaluation. ⋯ PwO appear to have conflicting beliefs regarding obesity as a disease and the underlying biology. This has the potential to hinder attempts to treat the disease via lifestyle intervention and may also reduce likelihood to consider alternative treatment options. These beliefs and perceptions need to be explored further, along with those of HcPs, policy makers and the general public. Collectively this may facilitate changing the narrative around obesity as a disease and positively impact both the prevention and treatment of this disease.
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There is no randomized controlled trial that demonstrated the efficacy of antiviral therapy against COVID-19 yet. However, physicians are prescribing different drugs to a large part of COVID-19 population in the hope they will cure them. This does not reflect the evidence-based medicine approach. What we need is more evidence-based knowledge about what routine care practices we should to apply to ameliorate symptoms of patients and fight COVID-19 pathology.