Irish journal of medical science
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Randomized Controlled Trial
Effects of intravenous and mask induction on post-operative emergence delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy.
Emergence delirium occurs in children during recovery from general anesthesia. The aim of the study was to examine the effects of mask and intravenous sevoflurane anesthesia induction on emergence delirium in children undergoing tonsillectomy with or without adenoidectomy. ⋯ Mask induction for pediatric patients undergoing tonsillectomy with or without adenoidectomy increased Pediatric Anesthesia Emergence Delirium scores more than intravenous induction.
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Good clinical record-keeping is central in ensuring patient safety and effective communication between healthcare professionals. Poor communication is the root cause of many adverse events in medicine. ⋯ The use of the educational tool and a formal training session significantly improved the quality of notes written for surgical inpatients. Junior doctors do not feel adequately trained in this area. The authors recommend that formal training in record-keeping be included in all hospital induction programmes.
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Breast cancer is genetically heterogeneous, and parellel multi-gene sequencing is the most cost- and time-efficient manner to investigate breast cancer predisposition. Numerous multi-gene panels (MGPs) are commercially available, but many include genes with weak/unproven associaton with breast cancer, or with predisposition to cancer of other types. This study investigates the utility of a custom-designed multi-gene panel in an Irish cohort with breast cancer. ⋯ Using multi-gene panels enables rapid, cost-effective identification of individuals with high-risk cancer predisposition syndromes. However, this approach also leads to an increased amount of uncertain results. Clinical management of individuals with particular genetic variants in the absence of a matching phenotype/family history is challenging. Further population and functional evidence is required to fully elucidate the clinical relevance of variants in genes of uncertain significance.
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The novice anaesthesiology trainee must rapidly assimilate the cognitive, technical and non-technical skills necessary to competently respond to critical events in their new role. Providing trainees with the safe and controlled environment of high-fidelity patient simulation is one method to compensate for gaps in trainee experience, offering the potential for effective training. An anaesthesiology boot camp was set up to increase the knowledge, clinical, technical and non-technical competencies of the novice trainee, creating a framework for their future learning and practice. Anaesthetic nurses also attended to incorporated teamwork and collaboration into the boot camp. ⋯ We have created the first Irish anaesthesiology boot camp, demonstrating the important role that simulation has in enhancing medical education. Our results showed both knowledge attainment and participant satisfaction in this method of learning. Anaesthesiology boot camps are the ideal method to provide novice trainees with a framework for their initial introduction into anaesthesia.
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Review Historical Article
Impact of the 2016 World Health Organization Classification of Tumours of the Central Nervous System: an Irish experience.
The 2016 World Health Organization Classification of Tumours of the Central Nervous System Tumours represents the most significant update to neuro-oncological tumour classification to date, compared with previous updates. This update reflects the substantial advances in molecular and genetic understanding of both adult and childhood brain tumours which have occurred in recent years. These advances have meant that an increasing array of molecular tests are required to definitively classify a tumour, allowing for a more precise integrated pathological diagnosis, but at the expense of a more challenging pathology workup. We review the changes incorporated into the 2016 classification and describe the impact of these changes in an Irish neuropathology laboratory.