Irish journal of medical science
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During 2009, there were 3.3 million outpatient attendances at outpatient clinics across Ireland. Up to 20 % of these are directed towards ENT services. ⋯ This study demonstrates poor compliance rates with the introduced ICGP standardised referral form, which has implications for the accurate grading of referral letters received.
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Review Case Reports
The challenges of managing refractory oesphageal lichen planus.
Lichen planus is an inflammatory mucocutaneous disorder, often idiopathic. It is postulated that the characteristic skin lesions arise from a T cell mediated autoimmune response against basal keratinocytes. Oral mucosal involvement can occur in up to 70 % of cases of cutaneous disease however, oesphageal involvement is rare. ⋯ Oesphageal lichen planus is rare, often unrecognised and can be resistant to treatment. However, diagnosis is crucial as malignant transformation of longstanding ulcerative lichen planus may occur.
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It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. ⋯ This review aims to examine the interplay between co-morbid physical and mental health conditions, identify the physical health conditions particularly associated with severe affective and psychotic illness and briefly discuss interventions and recommendations in this area. As people with severe mental illness die 10-20 years younger than their peers, with much of this premature mortality due to cardiovascular disease, this topic is emerging as one of great importance amongst clinicians and policymakers internationally.
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In recent years hypertonic saline has attracted increasing interest in the treatment of traumatic intracranial hypertension, and has a number of documented and theoretical advantages over other hyperosmolar agents. To date, no consensus has been achieved on the safest and most effective HTS concentration for administration. ⋯ No associated harmful biochemical or haematological abnormalities were noted. In conclusion, highly concentrated 30 % HTS appears to be both effective and safe in the management of refractory intracranial hypertension.
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This study aimed at investigating the clinical characteristics of malignancies associated with pregnancy and to provide information for the development of suitable strategies of treating maternal malignancies. ⋯ The management of malignancies associated with pregnancy is a challenge for doctors and patients. It should be based on histological subtype, disease stage, gestational age, obstetrics complications, and patient's preference regarding continuing the pregnancy.