Irish medical journal
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Irish medical journal · Oct 2003
A prospective analysis of inpatient consultations to a gastroenterology service.
The provision of a formal consultation service for inpatients between subspecialists is little studied. We prospectively surveyed the pattern of inpatient consultations from hospital-based generalists and surgeons to the gastroenterology (GI) service for inpatients in a large urban teaching hospital over a 5 month period. There are two GI consultants/attendings and five GI registrars/fellows on the service. ⋯ Subspecialty consultation provides an expert opinion, encourages discussion and learning, and improves patient care. In our experience, the provision of specialist advice and reassurance often speeded up a patient's work-up and expedited discharge. However, evaluating referral patients and subsequently providing ongoing inpatient and outpatient care and provision of endoscopy for these referrals contributes significantly to the workload of the GI service.
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Irish medical journal · May 2003
Case ReportsLumbar Chance fracture associated with use of the lap belt restraint in an adolescent.
The use of the 2-point seat belt or lap belt in motor vehicles, particularly to restrain young rear seat passengers, remains an issue of some concern. The occurrence of lumbar spinal flexion-distraction injuries in lap belt restrained children and adolescents during road traffic accidents is a well known phenomenon, but is still occurring. ⋯ We present the case of a Chance fracture sustained by a 15 year old girl, involved in a motor vehicle collision, while wearing a lap belt. We emphasise the need to develop safer seat belt designs for juvenile car passengers.
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Irish medical journal · Apr 2003
Causes of sensitisation in patients awaiting renal transplantation in Ireland.
Sensitisation to HLA antigens, formed as a result of transfusion, previous allografts or pregnancy, remains a significant problem in transplantation. The aim of this study was to define the causes of sensitisation of potential renal allograft recipients in Ireland in the post-EPO era. A retrospective survey of all patients who were active on the renal transplant waiting list during 1996 was performed evaluating the panel reactive antibodies (PRA), history of sensitising events, and waiting time for transplantation. ⋯ The percentage of patients who had been transfused in the 1996 cohort (71%) was similar to the percentage of patients transfused on the waiting list in August 1999 (75%). These data demonstrate that transfusion remains an important cause of sensitisation, despite the use of EPO. Measures to further reduce the use of transfusion or the use of immunosuppression at the time of transfusion in potential allograft recipients may be of value in the future.