Irish journal of medical science
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Rheumatic disease (RD) patients when family planning must consider fertility, disease activity, and management from preconception to lactation. A clear understanding is necessary, especially for those receiving disease-modifying antirheumatic medications. Previous studies have highlighted unmet needs in the care of women with RDs with reproductive healthcare needs. This study describes the first published standardized reproductive care pathway for women with RDs and the outcomes of this approach. ⋯ We describe the first published evidence-based integrated multidisciplinary reproductive care pathway for women with RDs and the results of this approach. Seventy percent of women successful in trying to conceive delivered a healthy baby, and 90% of patients were 'very satisfied' with the service.
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Tobacco is the leading cause of preventable death in Ireland; half of all long-term smokers die prematurely from smoking-related diseases. Achieving 'Tobacco Free Ireland' (a smoking prevalence of less than 5%) will require the prevention of smoking initiation and the promotion of smoking cessation. ⋯ This study highlights the need to strengthen smoking cessation in Ireland to increase the number of smokers that successfully quit and achieve a Tobacco Free Ireland. The development and implementation of National Clinical Guidelines for the Diagnosis and Treatment of Tobacco Addiction will play a key role in this.
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It is well documented that medical students struggle to bridge the theory-practice gap. Competently integrating classroom-taught skills into the clinical setting is a challenge. ⋯ The module descriptor devised can be used as a template for further curricular reform. Simulation-based teaching is feasible in the undergraduate setting and may ease the transition to postgraduate teaching modalities.
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Following oesophagectomy, the most concerning complication is that of anastomotic leak (AL). Prompt diagnosis and intervention are crucial to facilitate an optimal outcome. Other complications, particularly respiratory, are not infrequent. Early identification of AL versus other sources of the inflammatory response can be problematic. ⋯ Elevated CRP may be a useful marker in facilitating the prompt diagnosis of AL following oesophagectomy. Serial CRP may not contribute to identifying lower respiratory tract infections, partly as a result of the pro-inflammatory response following surgery.
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Integrating theoretical and practical knowledge and stimulating students' active learning is the most important task of modern and high-quality healthcare education. By analyzing clinical cases, undergraduate medical students are trained to make accurate diagnoses, to choose appropriate therapy based on laboratory results and on adequate diagnostic tests. ⋯ Clinical case presentation has a learning potential and facilitates positive interaction between instructors and students and supporting students to become reflective and competent physicians.