Irish journal of medical science
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Brain natriuretic peptide (BNP) may help general practitioners (GPs) to "rule-out" heart failure (HF) and reduce referral burden on specialist assessment clinics. ⋯ Availability of BNP to GPs would improve referral patterns but with high risk of delayed diagnosis. The data underline the need for a shared-care approach to the new diagnosis of HF.
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Primary bone lymphoma (PBL) is a rare condition and accounts for less than 2% of adult lymphomas and 3% of all primary bone malignancies. Because of the rarity of this disease, there is a lack of prospective randomised clinical trials and hence optimal treatment is uncertain. ⋯ Combined modality therapy, i.e. chemotherapy followed by radiotherapy, is the preferred treatment option unless adverse neurology or an unstable fracture presents first.
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Laparoscopic cholecystectomy has been performed as a day-case procedure for over a decade. This procedure can be associated with a high incidence of pain and post-operative nausea and vomiting (PONV). There is a paucity of information regarding the post-discharge care of these patients. ⋯ The incidence of PONV post-discharge suggests that adding an antiemetic to our take-home analgesic packs may improve patient comfort. The 2-day supply of diclofenac and co-codamol could also be extended as 65% of patients had moderate to severe pain. The information gathered shows the importance of post-discharge follow-up of ambulatory surgery patients.
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Faecal incontinence resulting from obstetric injury is a socially disabling condition with a significant impact on quality of life. Sacral nerve stimulation (SNS) is a relatively new treatment modality, which offers patients a potential for improved continence. ⋯ SNS offers improvement in continence and quality of life in patients with faecal incontinence whose only other option might otherwise be a permanent colostomy.