Irish journal of medical science
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The management of breast cancer has evolved in the last 40 years to now encompass not only treating the cancer in the most effective way, but also to detect and treat cancers before they can pose a risk to patients. This evolution in therapy and diagnostics has moved away from treating patients with the maximum amount of therapy they can tolerate towards a new paradigm where patents receive the minimum treatment to be most efficacious.
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As all tertiary paediatric hospitals are based in the capital of Dublin, it is therefore necessary for general surgeons in centres outside of Dublin to undertake routine elective and emergency paediatric surgery to provide children with care close to home. The aim of this study is to assess the volume and type of procedures this entails. ⋯ The range of procedures in general paediatric surgery is small with only five procedures representing the majority of all elective and emergency procedures performed. This suggests that a period of specialist paediatric surgery training would enable more general surgeons to provide this vital service.
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This study was performed to test the hypothesis that urinary levels of L-carnitine and its derivatives are enhanced in children and adolescents with hypertension and also check if analyzed parameters may serve as early markers of subclinical renal damage. ⋯ The results of this study do not explain the increased urine levels of L-carnitine. The most likely reason for excessive urinary loss was disturbed renal tubular reabsorption. It is possible to hypothesize that in hypertensive adolescents subclinical kidney dysfunction occurs. It is proposed that studies examining the concurrent plasma and urine concentration of L-carnitine and correlation with acknowledged proximal tubular markers are needed.
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Comparative Study
Double-balloon enteroscopy in Ireland in the capsule endoscopy era.
The availability of double-balloon enteroscopy (DBE) and small bowel capsule endoscopy (SBCE) in Ireland has revolutionised our approach to the diagnosis and treatment of small bowel disorders. ⋯ SBCE as a screening tool prior to DBE is extremely valuable and increases the diagnostic yield considerably as a consequence of a high negative predictive value.
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Infrapatellar branch of saphenous nerve (IPBSN) is more prone for injuries during various surgical interventions of the knee. The aim of this study was to know the course and branching pattern of the IPBSN and describe its anatomical variations. ⋯ By enriching the knowledge of these variable anatomical position of the IPBSN, surgeon can try to minimize the risk of nerve damage by avoiding the high risk zones while performing medial knee incision, blind puncture or an arthrotomy thus avoiding the unwanted complications.