Irish journal of medical science
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Patient knowledge of perioperative care, particularly the role of the anaesthetist, appears limited. ⋯ Patients' knowledge of perioperative care is limited, with very little change during hospital stay. Novel educational approaches may be required to increase basic medical knowledge.
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Concern about delay in the treatment of serious head injury may result in unnecessary transfer to neurosurgical units for scanning and neurosurgical assessment. ⋯ A CT scan and image-link facility permitting remote neurosurgical advice allows the majority of patients with head injury to be safely managed in well-equipped regional units without onsite neurosurgical expertise.
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Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome. ⋯ The results demonstrate the high mortality and prolonged hospital stay for stroke patients in this area and emphasise the need for co-ordinated stroke care and regular audit to ensure most effective use of hospital resources.
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Comparative Study
A comparison of papaveretum-promethazine with morphine-ondansetron for patient-controlled analgesia.
Patient-controlled analgesia (PCA) with intravenous morphine is commonplace. Antiemetics are often added to reduce side-effects. In our institution an unusual combination of papaveretum-promethazine is in use. ⋯ Papaveretum-promethazine appeared to be effective for PCA. This combination is also much less expensive than morphine-ondansetron. A previously described synergistic interaction between promethazine and opiates may be a factor in its success. Further evaluation of these drugs in PCA is warranted.
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Several new derivatives of sulphasalazine that make use of its active moiety, 5-aminosalicylic acid (5-ASA), have been introduced for the treatment of inflammatory bowel disease (IBD). In rats short term intravenous administration of 5-ASA has been associated with nephrotoxicity. A number of cases of nephrotoxicity have been reported recently in IBD patients taking oral maintenance treatment with 5-ASA compounds. ⋯ Systemic absorption of 5-ASA from sulphasalazine and olsalazine is relatively low. However, pH-dependent mesalazine formulations may release their contents rapidly in the small intestine and proximal colon resulting in higher plasma and urinary concentrations of free 5-ASA. The effects of free 5-ASA on renal function in the human require further evaluation.