Irish journal of medical science
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Comparative Study
A national model of care service for professionals dealing with sudden infant death.
Sudden Infant Death Syndrome (SIDS) is any death occurring in an infant or young child which is unexpected by history and in which a thorough post mortem examination fails to demonstrate an adequate cause of death. The National Sudden Infant Death Register collects information on all sudden unexpected deaths in infants and young children occurring in Ireland. In this study, a comparison was made between parent's experience of professional services in the aftermath of their child's death both before and after the implementation of a National Model of Care for professionals in 1995. ⋯ Specifically, we need to address the fact that 16 per cent of parents still report a difficulty in obtaining post-mortem information. Almost 40 per cent said they had little input into how their child was dressed or laid out at this highly emotive time. Over one-third of parents stated they were concerned about how few of their primary health providers, namely general practitioners and public health nurses called to visit them in the aftermath of this tragic event.
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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.
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Mesenteric venous thrombosis, "the great mimicker", is a very rare disorder in pregnancy and the puerperium, particularly when not associated with any pre-existing thrombophilia or autoimmune states. We describe a patient requiring a resection of 150 cm of gangrenous small bowel after uncomplicated elective Caesarean section. The only risk factor for thrombosis was recovery from an elective Caesarean section, a condition classified by the Royal College of Obstetricians and Gynaecologists as "low risk". ⋯ In all cases of MVT anti-coagulation is the basis of treatment. Patients who are not anti-coagulated after surgery have a recurrence rate of 25 per cent compared with 13 per cent of heparinised post-operative patients. As no other pre-existing cause for MVT was found, management was with warfarin for 6 months, the oral contraceptive pill was contraindicated and heparin prophylaxis was recommended for future pregnancies.
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To profile those over 65 yr admitted to an acute geriatric medical service. To identify and assess their undernutrition risk and quantify the nutritional intervention they received. ⋯ The risk of undernutrition on admission to hospital and during treatment is an indicator of the need for nutrition services and nutritional screening for all acute medical services for older people.
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Case Reports
Anaphylaxis due to suxamethonium--manifested at induction of anaesthesia by bradycardia and cardiac arrest.
This case report describes an unusual presentation of a severe anaphylactic reaction following induction of anaesthesia in an elderly male patient. Full recovery followed protracted resuscitation.