September 2017 Vol 110 Number 8

IMJ Commentary

Brain Injury in Term Infants:  The ‘Each Baby Counts’ Programme

JFA Murphy, Editor

Editorial

Adenotonsillectomy for obstructive sleep apnoea in children with Down Syndrome – No magic bullet.

Al-Shidanhi K, McNally P

Original Papers

Hospital resource utilisation by patients with community-acquired pneumonia.

McCarthy et al have reviewed 50 hospital admissions of patients with community-acquired pneumonia (CAP).  The estimated cost per patient was €14,802.  More efficient use of resources can be achieved by discharge planning and fewer in-hospital ward transfers.

Cancer Incidence and Mortality due to Excess Body Weight in Ireland: An analysis of 10-year data.

Collins et al using the population attributable fraction (PAF) have calculated that 4.5% of cancers in Ireland are due to excess body weight (EBW).  This represents 800 new cancers and 300 cancer deaths.  The greatest risk is the upper digestive tract and the endometrium.

A Retrospective Audit of In-Hospital 30-day Mortality from Acute Myocardial Infarction in Connolly Hospital Blanchardstown

Hensey et al undertook an audit of 42 patients who were HIPE coded as having died within 30 days from an acute myocardial infarction (AMI).  Following the audit 23 patients (54.8%) were confirmed as having had an AMI.  With this adjustment the 30-day post AMI death rate was 4.14 per 100 cases.

Three year Experience of Non Melanoma Skin Cancer in a General Practice

Maguire and Maguire report 58 patients with non-melanoma skin cancer.  82% of cases were treated in the surgery and 18% were referred because central facial site and larger site.  The authors conclude that the majority of non-melanoma skin cancers can be managed safely without referral.

Investigating the perceived benefits, barriers and beliefs towards physical activity in pregnancy among women with gestational diabetes mellitus

Hurst et al surveyed 46 women with gestational diabetes.  The women showed an awareness of the importance of diet in control of the condition.  In relation to exercise, lack of time and fatigue were frequently quoted.  The authors stress the importance of exercise, given that 40% of women with gestational diabetes may develop type-2 diabetes within 4 years

Hidradenitis Suppurativa and Crohn’s Disease: A Case Series

Kirthi et al report 7 cases with both hidradenitis suppurativa (HS) and Crohn’s disease.  HS consists of recurrent abscesses and draining sinuses with scarring.

Ivacaftor for cystic fibrosis: An evaluation of real world utilisation and expenditure in the Irish Healthcare Setting

Corcoran et al report that in a 12 month period 140 patients have been treated with Ivacaftor.  The patient age range was 6 to 61 years.  The cost was €29.81m.

Skin cancer awareness amongst Irish golfers

McCarthy et al surveyed 163 golfers about skin cancer.  Sixteen  previously had skin cancer, 8 melanomas and 8 non- melanomas.  85% were compliant with SPF.  59% were aware that melanoma can lead to death if left untreated.

Growing old in the Emergency Department

Liston et al examine the relationship between age and the total time spent in the ED department.  The findings demonstrate that the ED is busy all year round.  Planning is needed for the current and future healthcare of older patients

Case Reports

Idiopathic Atypical Haemolytic Uraemic Syndrome presenting with acute dystonia.

Rizwan, KE Maduemem

Atresia hymenalis with haematometrocolpos: A benefit of teaching a case series and review of the literature

Whitla et al present 4 cases of atresia hymenalis.  Acute urinary retention appears to be the commonest presenting feature.  Back pain is also common.

 Short Report

Antimicrobial-resistant faecal organisms in algae products marketed as health supplements

Ryan et al draw attention to the blue-green algae which are commonly used as dietary supplements.  In a study of 3 products, Chlorella, Spirulina and Super Greens all cultured enteric flora.  Clinicians should be aware of this risk for vulnerable patients.

Letters to the Editor

Cold Case Files: 15 years on, did patient controlled analgesia mask acute compartment syndrome?
S Mannion, P Lee, CTaylor.