Irish journal of medical science
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The objective of the study was to investigate the association between mitochondrial DNA (mtDNA) mutations and essential hypertension (EH). ⋯ We believed that the 7471delC may impair the mitochondrial functional and played an active role in the pathogenesis of EH in this pedigree. The 7471delC may be a novel risk factor for maternally transmitted EH.
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The Acute Surgical Assessment Unit (ASAU) in University Hospital Limerick (UHL) has provided a solution to overcrowding and long waiting times since centralization of emergency services to UHL. Recognising the importance of its evolving role, the ASAU in UHL has recently undergone a major revamp to ease the pressure in the overcrowded emergency department (ED). This included a new purpose state-of-the-art-built unit and equipment, improved staffing levels and use of a Kaizen Lean system to identify key area of delays and inefficiency with subsequent implementation of suggestions derived after Kaizen Lean. Patient satisfaction reporting was analysed in the older building and subsequently in the new site post Kaizen Lean to complete a closed-loop audit. The aim of the study was to examine patient satisfaction response rates with the ASAU prior to and following Kaizen Lean implementation and transfer to a new purpose-built unit. ⋯ A Kaizen Lean approach improved the transition of an ASAU to a new purpose-built unit and further improved overall patient satisfaction with services of the ASAU.
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There is increasing evidence to implement multiparametric magnetic resonance imaging (mpMRI) for biopsy-naive men with clinically suspected prostate cancer (PCa). This will reduce the number of unnecessary trans rectal ultrasound biopsies (TRUS-Bx) performed and reduce the number of indolent cancers diagnosed. ⋯ Pre-biopsy mpMRI for clinically suspected prostate cancer is emerging as a standard of practice in Ireland. International guidelines are also changing to reflect latest clinical trial evidence. Private health insurance providers should amend their policies to reflect current clinical practices already adopted in the public sector.
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Historical Article
Malignant but not maleficent: acute leukaemia as a possible explanation of disease and death in vampire victims.
A considerable amount of research has been put into the explanation of the origin of the vampire myth by focussing on possible symptoms of the vampire; however, very little attention has been given to the victims. ⋯ Victims in the gothic vampire novels from the nineteenth century could very likely be inspired by real-life acute leukaemia patients.
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A growing body of evidence indicates the benefits of early diagnosis of rheumatoid arthritis (RA) and prompt treatment with disease-modifying anti-rheumatic drugs (DMARDS) in terms of relieving symptoms, improving prognosis, and reducing long-term complications. There is however some controversy over the most beneficial method of imaging in providing accurate early diagnosis. Though current practice favours clinical and radiological assessment, this is increasingly supplemented by ultrasound techniques (and, to a lesser extent, CT and MRI scanning). While EULAR and ESSR favour the use of ultrasonography (US) as the first-line investigation in cases of suspected RA, a recent NICE review upholds the traditional place of plain film radiographs of hands and feet to detect erosions as early signs of synovitis. This review considers the evidence for US in the early diagnosis of RA and the case for it becoming the primary assessment modality in rheumatology clinics. ⋯ This review of relevant studies indicates that US should become accepted as the investigation with the most favourable balance of benefits to risks in the early diagnosis of RA. Given the continuing controversy surrounding studies of different imaging techniques in RA, further research into the diagnostic role of US in RA is indicated.