Irish journal of medical science
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We describe a 90-year-old woman with right upper limb monoparesis secondary to varicella zoster virus infection as a result of extensive inflammatory involvement of the entire brachial plexus at root level. To our knowledge, this is the first report of entire brachial plexus involvement in a living patient of such advanced age. Despite a delay in presentation and thus initiation of treatment, a favourable clinical response was observed.
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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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To date, there is no information on anaesthetists' practice of chronic pain management in the Republic of Ireland. ⋯ One-third of consultant anaesthetists in the Republic surveyed incorporate chronic pain in their practice and their pattern of practice is widely diversified.
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Previous audits of stroke care in 2002 and 2005 in our institution recommended organised and specialised care of stroke patients. A stroke unit was therefore established in June 2008. ⋯ The stroke unit has greatly improved the care of acute stroke patients. Further areas for improvement are highlighted.
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Review Case Reports
Male lupus: a diagnosis often delayed--a case series and review of the literature.
Systemic lupus erythematosus (SLE) is an auto-immune disease that is characterised by autoantibody production. Male lupus is rare, apart from at either end of the age spectrum. ⋯ Our patients presented in middle age and tended to develop haematological abnormalities, renal involvement and neurological manifestations which preceded the onset of their skin and joint complaints. Our patients accrued damage rapidly and overall did badly. They tended to respond sub-optimally to standard treatments. These cases highlight the need an increased awareness that male SLE patients present with a wide variety of symptoms, and that they accrue damage quickly. There is a need for timely diagnosis and appropriate initiation of treatment. This may help avoid preventable organ damage and increase the survival of men with SLE.