This Month’s IMJ

May 2017 Volume 110, Number 5

IMJ Commentary

Paediatric Workforce in the UK and the Wider Implications

JFA Murphy


A Practical Approach to Hypothyroidism and Pregnancy

V O’Dwyer, M Hatunic

Original Papers

Vaccine-Preventable Admissions to an Irish Paediatric Intensive Care 

Y Doyle, M Healy, C McMahon, S Crowe
Doyle et al report a series of ICU admissions for vaccine preventable infections.  The toll was considerable.  Among the 39 children in the study there were 5 deaths.  There were 4 deaths from pneumococcal disease and 1 death from pertussis.  Other complications encountered in the cohort were skin loss, digit loss, and neurological injury.

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An exploratory service-based study of Deliberate Self-Harm (DSH) in Ireland: ‘A hidden population’?

P Quinn, P Surgenor, S McGilloway

Quinn et al describe a cohort of 832 patients with DSH.  The predominant group was female, under 25 years, with a history of cutting (73%).  Suicide ideation (42%) and suicide attempt (35%) were common associations.

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Comparing cardiovascular risk factors, disease and treatment in participants with rheumatoid arthritis and without arthritis in a population based study 

N O’Driscoll, N Kennedy, S Anjum, A Fraser, A Hannigan

O’Driscoll et al found that in a cohort of 457 patients with rheumatoid arthritis there were higher rates of obesity, physical activity, and hypertension.

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Investigation and diagnostic formulation in patients admitted with transient loss of consciousness. 

R Briggs, T Coughlan, J Doherty, DR Collins, D O’Neill, SP Kennelly.

Briggs et al examined 80 patients with transient loss of consciousness (T-LOC).  88% had a ct scan, more than half being unnecessary.  Half of the EEGs and 82% of the Doppler studies were not clinically indicated.  The conclusion is that many patients are subjected to unnecessary tests when they present with T-LOC.

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The Hidden Burden of Outpatient Repeat PSA Testing in a Prospective Cohort 

Browne E, O’Kelly F, Lundon D, Daly P, Galvin D, Hegarty N, Connolly S, O’Malley K.

Browne et al have analysed the tests other than PSA that carried out by GPs prior to referral to the Urologist.  The common additional tests were a renal profile and a Hb FBC.  The authors discuss who should be responsible communicating with the patients and acting on these additional results.

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The use of cold coagulation for the treatment of cervical intraepithelial neoplasia

 Wyse A, Seah W A, O’Neill J. Byrne P

Wyse et al describe the use of cold coagulation in the treatment of cervical intraepithelial neoplasia.  The initial findings are that cold coagulation is as effective as LLETZ.

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Absorbable Polydioxanone (PDS) suture provides fewer wound complications than polyester (ethibond) suture in acute Tendo-Achilles rupture repair.

M N Baig, J G Galbraith, I Yousaf, Robert Din.

Baig et al describe the treatment of 53 patients with ruptured tendo Achilles.  The authors compared the use of Polydioxanone and Polyester sutures.  Those treated with Polydioxanone fared better with lower infection rates and a superior Boyden score.

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A Multicentre Study of Thromboprophylaxis in Pregnancy. 

MP Crowley, C Noone, JR Higgins, S O Shea

Crowley et al describe a study in which the charts of 540 women across 16 hospitals.  73.9% were on the correct thromboprophylaxis but 49% were underdosed.

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I Still Haven’t Found What I’m Looking For….. Bono, Google and Glaucoma Awareness. 

C Lyons, R Ellard, E McElnea, D Townley.

Lyons et al describe how there was a 5 fold increase in Google searches when Bono revealed that he had Glaucoma.  This surge in public interest was far in excess of that generated by the 2014 Glaucoma Awareness week.  The piece highlights the impact of celebrity disclosure.

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Case Reports

A Case of Autoimmune Pancreatitis Presenting as a Deterioration in Glycaemic Control in a Patient with Pre-Existing Type 2 Diabetes

Forde H, Slattery D, Swan N., Smith D

Forde et al report the development of autoimmune pancreatitis in a Diabetic type 2 patient with worsening hyperglycaemia.

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Amniotic band syndrome with pseudoarthrosis of tibia and fibula: A case report

A Ananthan, G Athalye Jape, J Du Plessis, P Annear, R Page, S Rao

Ananthan et al describe a case of amniotic band syndrome (ABS) in a 29 week gestation infant. There was a deficiency of the mid to distal tibia and fibula with pseudoarthrosis.  Following excision of the constricting band there was considerable improvement in bone growth.

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Short Report

Life After the Event: A Review of Basic Life Support Training for Parents Following Apparent Life-Threatening Events and Their Experience and Practices Following Discharge

Macken WL, Clarke N, Nadeem M, Coghlan D

Occasional Piece

Adult attention deficit hyperactivity disorder and driving – risk, medication and fitness to drive 

K-F K Suen, D O’Neill

Letters to the Editor

Immigrant health: laboratory reference ranges may differ from indigenous population’s with potential for misinterpretation  

G Masukume

A retrospective review of the management of patients with hidradenitis suppurativa in the Belfast health and social care trust, Northern Ireland

W Abdelrahman, R Dawson, C McCourt

World-class healthcare – the children of Ireland deserve no less

P Greally, S Walsh, C Martin, A Foran, O Smith, S Sheehan, E Curtis, A Nicholson,