Irish journal of medical science
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There are conflicting data in the literature about the sensitivity of sestamibi scintigraphy in parathyroid tumour localisation in primary hyperparathyroidism (PHPT). ⋯ Sestamibi scintigraphy was more likely to be positive in younger patients without nodular thyroid disease who have larger parathyroid adenomas with more severe hyperparathyroidism.
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Calf swelling is a common clinical presentation with a wide and varied differential diagnosis. The Morel-Lavallee is a rare cause of subcutaneous swelling, caused by post-traumatic shearing of the hypodermis from the underlying fascia. The potential space so created fills with blood, lymph and necrotic fat giving specific findings on MR evaluation. ⋯ The Morel-Lavallee lesion is a rare but important cause of calf swelling. MRI is the mainstay of diagnosis and treatment includes both surgical and minimally invasive modalities.
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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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Case Reports
Serotonin syndrome in an orthopaedic patient secondary to linezolid therapy for MRSA infection.
A 67-year-old patient was admitted for incision and drainage of a recurrent methicillin-resistant Staphylococcus aureus (MRSA) hip abscess. Linezolid therapy was initiated postoperatively. ⋯ Citalopram was stopped and resolution of symptoms occurred within 48 h of discontinuing the offending agent. The symptoms observed in our patient were consistent with the Sternbach criteria for serotonin syndrome.
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The aim of this study was to determine what made people want to change their choice of general practitioners (GP). Furthermore, the study aimed to correlate the perceived quality of patient-GP communication with the motives inducing individuals to change their doctors. ⋯ These findings suggest several actions to improve the doctor-patient relationship, including training for physicians to develop their communication skills; involving public health operators in helping to understand the rights and obligations of patients and doctors; and a reorganization of the GP's workload.