Irish journal of medical science
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The diagnosis of multiple sclerosis (MS) is based on a history consistent with demyelination of the central nervous system and corresponding physical signs on examination. However, this diagnosis is supported radiologically using magnetic resonance imaging (MRI). At present, MRI serves as the most reliable and widely available biomarker for the practising clinician to measure disease activity and treatment response in MS. As MRI remains central to both the diagnosis and management of MS, this paper provides proposed guidelines for its use in routine clinical practice.
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Nitric oxide (NO) has diverse roles as a biological messenger. [1] Topically applied nitrate donors cause relaxation of the internal anal sphincter (IAS) and facilitate healing of anal fissures [2,3]. Systemic nitrates are commonly used for the treatment of ischaemic heart disease, yet the effects of systemically administered nitrates on the smooth muscle of the IAS are unknown. ⋯ Systemic nitrates significantly inhibit internal anal sphincter function.
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Adductor canal block (ACB) and local infiltration anesthesia (LIA) are both widely accepted techniques for postoperative pain control without quadriceps weakness after total knee arthroplasty (TKA). However, the above techniques are insufficient in efficacy or duration. ⋯ Overall, as compared with ACB or LIA, ACB plus PCI appeared to provide more ideal analgesia and patient satisfaction in the first 24 h after operation.
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Case Reports
Physical activity and advanced cancer: the views of oncology and palliative care physicians in Ireland.
Physical activity (PA) levels play an important role in maintaining the quality of life and enhancing the physical function of advanced cancer patients. A brief exercise prompt by physicians can increase PA levels of patients diagnosed with cancer. ⋯ The results of this study identify a need for physician education on providing PA recommendations for patients with advanced cancer. Concerns over the prescription of PA to patients with bone metastases highlight the need to disseminate the evidence on the benefits of PA for patients with metastatic cancer to healthcare professionals.