Irish journal of medical science
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Enhanced recovery programmes have been studied in randomised trials with evidence of quicker recovery of gut function, reduced morbidity, mortality and hospital stay and improved physiological and nutritional outcomes. They aim to reduce the physiological and psychological stress of surgery and consequently the uncontrolled stress response. The key elements, reduced pre-operative fasting, intravenous fluid restriction and early feeding after surgery, are in conflict with traditional management plans but are supported by strong clinical evidence. Given the strength of the current data enhanced recovery should now be the standard of care.
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Depression is a very prevalent mental disorder affecting 340 million people globally and is projected to become the leading cause of disability and the second leading contributor to the global burden of disease by the year 2020. ⋯ The presented evidence suggests that exercise and physical activity have beneficial effects on depression symptoms that are comparable to those of antidepressant treatments.
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The Confidential Enquiry into Maternal and Child Health (CEMACH) reported outcomes of pregnancies in women with pre-gestational diabetes (PGDM) in the UK (n = 3,733). This study aimed to compare CEMACH outcomes with PGDM pregnancies in Dublin. ⋯ These results serve to underline the continued importance of multidisciplinary care for pregnant women with diabetes.
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Randomized Controlled Trial
Are postoperative drains necessary with the Karydakis flap for treatment of pilonidal sinus? (Can fibrin glue be replaced to drains?) A prospective randomized trial.
Different surgical techniques for pilonidal disease have been described in the literature. In this study, our aim was to evaluate the influence of routine cavity drainage in the Karydakis flap technique. ⋯ We recommend the use of fibrin sealant with Karydakis flap procedure, but further studies are needed to confirm this conclusion.
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Review Case Reports
Renal epithelioid angiomyolipoma without obvious local progress in 10 years: a case report and literature review.
Epithelioid angiomyolipoma (eAMLoma) is an uncommon renal mesenchymal tumor with malignant potential. It is composed of tumor cells arranged in an epithelioid manner. Differential diagnosis from renal cell carcinoma is often challenging because of its epithelioid morphology. ⋯ The tumor was positive for Desmin, Hmb45, and Sma. We recommend surgical treatment and a follow-up regimen similar to that for renal carcinoma. There was no recurrence and metastases after 1-year follow-up.