Irish journal of medical science
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The community level of disability and social deprivation may result in an emergency hospitalisation; we have examined the annual admission incidence rate for emergency medical conditions in relation to the community prevalence of such factors. ⋯ Local catchment area disability prevalence rates in addition to social deprivation factors are an important determinant of the annual incidence rate of emergency medical admissions.
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Patients with 'suspected viral encephalitis' are frequently empirically treated with intravenous aciclovir. Increasing urea and creatinine are 'common', but rapidly progressive renal failure is reported to be 'very rare'. ⋯ Liaison neurologists and general physicians need to be aware that aciclovir may cause AKI attributed to distal intra-tubular crystal nephropathy. Daily fluid balance and renal function monitoring are essential because AKI may arise even with intensive pre-hydration. Prognosis is good if identified early and actively treated.
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Rubella is caused by the rubella virus, a single-stranded RNA virus of the Togaviridae family. The most severe complications of rubella in adult women occur during pregnancy when infection can lead to miscarriage, stillbirth or congenital rubella syndrome. Antenatal rubella susceptibility screening is no longer performed in England, Scotland or Wales but continues in Northern Ireland. ⋯ This study has identified an increase in women who are rubella susceptible and women with equivocal rubella antibody levels. International evidence suggests that rubella serology is unreliable and antenatal screening does not confer any benefit to women during their current pregnancy. Consideration should be given to re-direct resources currently utilised for antenatal screening to facilitate the vaccination of pre-pregnancy and postpartum women and also to opportunistically offer vaccination to all women of childbearing age.
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Deregulation of cell cycle takes place during the development of many cancers as well as pancreatic ductal adenocarcinoma (PDA), which develops from precursor lesions, most frequently including pancreatic intraepithelial neoplasia (PanIN). ⋯ p16, p21, and p53 proteins play an important role in the deregulation of the cell cycle and participate in the development of pancreatic intraepithelial neoplasia. Immunohistochemical evaluation of their expressions may be helpful in the diagnosis of PanIN.
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With increasing surgeon experience, the use of laparoscopic radical nephrectomy (LRN) in large and locally advanced renal tumours (T3a) is gaining favour in urological practice. There are limited studies reporting surgical outcomes in such groups. The aim of this study was to review our experience with LRN in these patients. ⋯ Our study shows that LRN has equivalent perioperative outcomes and safety in larger and locally advanced renal tumours.