This Month’s IMJ

July/August 2017 Vol 110 Number 7

IMJ Commentary

Residents Rosters: Reversal to Longer Hours in the US 

JFA Murphy


Delirium and the acute hospital system of the Republic of Ireland: Challenges, solutions and opportunities.

 JM Fitzgerald

Original Papers

Effect of the 2008 economic crisis on the cardiovascular mortality of the Irish population: an ecological 12 year study of a heart-broken Celtic Tiger

Osman and Osman report that there was a 17.2% in cardiovascular deaths during the financial crisis years.  The authors suggest that the increased mortality may be related to sudden job loss and economic difficulties.

Maternity ultrasound in the Republic of Ireland 2016: a review

Hayes-Ryan et al report on the availability of fetal anomaly ultrasound scanning in the 19 Irish obstetric units.  The service is offered routinely in 7/19 (37%) Units, selectively in 7/19 (37%) Units, and never in 5/19 (26%) Units. There is a marked geographical variation with 100% availability in Dublin and a 38% availability outside Dublin. The authors point to the current deficiencies in obstetric ultrasound.

Age adjusted D-dimer for exclusion of pulmonary embolism: a retrospective cohort study

Monks et al studied the age adjusted D-dimer (AADD) levels in relation to the exclusion of pulmonary embolism.  The sensitivity of AADD was 0.96 and its specificity was 0.12.

Food allergy emergencies in children – to what extent are early years services prepared? A cross-sectional survey

MacGiobuin et al report on a survey of food allergies in young children.  The prevalence was 3%.  In early years services, written action plans were available in 47% of facilities.  The important role of GPs is emphasised.

Investment in epilepsy monitoring units improves epilepsy care – experience in a regional neuroscience centre

 McGinty et al describe the clinical value of video-EEG in the management of epilepsy.  It is part of a newly opened epilepsy monitoring unit (MU). In 115 video-EEGs, 100 (87%) were deemed diagnostically conclusive.  The authors conclude that the EMU is a more effective method of conducting inpatient video-EEG.

Opportunity costs in paediatric training: the specialist registrars experience

O’Neill et al surveyed the career aspirations and work/life balance of 53 paediatric SpRs.  The majority (86%) had a definite career plan.  86% intended undertaking fellowship training.  74% stated that the training was undertaken at a significant personal cost.  50% experienced negative feelings which lingered after work.  The authors that trainees would benefit from more communication and counseling when required.

The uptake of human papillomavirus vaccine in Irish schools: the impact of disadvantage

Migone et al report on the HPV vaccine Gardasil uptake in 577 schools.  The uptake was 83.7%.  Disadvantaged schools had lower uptakes 79.4%.  The authors point out that high HPV vaccine uptake is important to ensure that inequalities in cervical cancer morbidity and mortality are addressed.

Case Reports

Epithelioid Angiomyolipoma – a case report and review of the literature

Keane et al describe a case of epithelioid angiomyolipoma.  It presented as a left renal mass on a PET/CT scan.  The patient had a background history of breast carcinoma.  A partial nephrectomy was performed.

Proliferative myositis of the latissimus dorsi presenting in a 20-year old male athlete

 McHugh et al report describe a rare benign tumour in the upper back termed proliferative myositis (PM).  Surveillance is the preferred option with reports suggesting PM spontaneously regresses.

Harlequin Ichthyosis – a case report

Ugezu et at describe an infant with Harlequin Ichthyosis.  The infant died at age 11 days.  Its incidence is 1 in 300,000 live births.  It is autosomal recessive.  Mutation in the ABCA 12 gene affects the transport of epidermal lipids across cell membranes.

Research Correspondence

Pelvic and acetabular trauma care in Ireland: the past, present and future

 Queally et al describe the role of the National Centre for Pelvic and Acetabular Surgery.  A major challenge is the management of immediate catastrophic bleeding in severe pelvic injuries.The authors state the importance of instituting mechanical stability.

Letters to the Editor

Reclassification of Category 1-Caesarean

J Rafi

2015-2016 Influenza Season in an Irish Regional Paediatric Unit: Importance of Influenza Vaccination Highlighted

G Ryan, A Cleary, D Keady, NM Allen, E Moylett

Echo Requests in light of Appropriate Use Criteria

F Rathore, C Mc Creery, M Omar, F Masood, G Ward, K McElhinney, B Chan