This Month’s IMJ
June 2018 Vol 111, Number 6
IMJ Commentary
Medical Negligence Costs are Unsustainable
JFA Murphy
Editor
IMJ
Editorial
Medical Professionalism: Promoting Patient and Physician Safety
D Slattery
Original Papers
Quality Improvement of Clinical Handover in a Liaison Psychiatry Department: A Three-Phase Audit
L Alexander, N Bechan, S Brady, L Douglas, S Moore, R Shelley
Alexander et al describe an intervention that improved clinical handover. It consisted of an 11 item handover checklist.
A Review of the Parenteral Nutrition Supply Service in an Irish Neonatal Unit
Smith A, Glynn AC , Shankar A , McDermott C, McCallion N
Smith et al report on the impact of a 5 day rather than a 7 day patient specific parenteral nutrition (PSPN). Education, training and improvements in stock bags help in part to overcome the disadvantages.
The Doctor Can See You Now: A Key Stakeholder Study Into The Acceptability Of Ambulance Based Telemedicine.
P Gilligan, A Bennett, A Houlihan, A Padki, N Owens, D Morris, I Chochliouros, A Mohammed, A Mutawa, M A Eswararaj, S Gannon, A Alrmawi, J Zuhair Gasem, P P Natalie Sheung, Claire Tynan, Ruth Little, Willie Merriman, Ahjoku Amadi-Obi, L Kenna, D A Alim, C O’Donnel
Gilligan et al explore the feasibility of a telelink between a patient, a paramedic and an ED doctor. 98.5% of patients, 89% of doctors, 76% of nurses and 91% of ambulance personnel saw the potential in an audio-visual link.
Subtrochanteric Femur Fractures in an Irish Trauma Centre over 9 years: How the Impact of Hospital Coding on Diagnosis of Subtrochanteric Femur Fractures Leads to Inaccurate Occurrence Rates
EI Coveney, Harriz E, Gibney B, JF Quinlan
Coveney et al report that 1701 patients were admitted with hip fractures. Using ICD-10 coding 48 cases were coded with a subtrochanteric fracture. However when the AO/OTA classification is applied the revised number was 8 cases.
Screening For Gestational Diabetes Mellitus Selectively in a University Maternity Hospital
O’Malley EG, O’Duill M, McArdle C, Kennedy RAK, Reynolds CM, Turner MJ
O’Malley et al audited selective screening with an oral glucose tolerance test (OGTT). Based on national recommendations 46.5% had maternal risk factors, and 6.5% had fetal risk factors. 9 women with risk facts did not have an OGTT.
Case Reports
Extramammary Paget ’s disease Of Glans Penis, A Rare Case Report
Inder M S, O’Kelly F, Sheikh M, O’Hare K, Barbara M L, Thornhill J A
Inder et al report a case of extramammary Padget’s disease of the penis. The presentation was distal penile pain and blood per urethra.
Scombrotoxic Fish Poisoning Secondary to Tuna Ingestion
Ferris HA, Ryan FM, Byrne K, Fleming E, O’ Sullivan H, Hamilton D
Ferris et al report a case of scombrotoxic fish poisoning following ingestion of tuna. 21 individuals ate tuna and 12 of them promptly became unwell within 2.5 hours of ingestion. Fish species such as tuna contains histidine which converts to histamine when inadequately chilled. One of affected patients required antihistamine medication
A Combination Of Surgery And Methotrexate For Successful Treatment Of A Caesarean Scar Ectopic Pregnancy.
WG Tadesse, G Von Bunau
Tadesse and Bunau describe the management of a caesarean scar ectopic pregnancy (CSEP). At diagnostic laparoscopy the gestational sac was aspirated and then injected with methotrexate.
Short Reports
Introduction of an Oral Fluid Challenge Protocol in the Management of Children with Acute Gastroenteritis: A Regional Hospital Experience.
E Umana, A Rana, K Maduemem , E Moylett
Umana et al report on the efficacy of an oral fluid challenge protocol (OFC). The rates of intravenous fluid use decreased from 22% in cycle 1 to 18% in cycle 2.
Case Series
The Triangular Sign, a Useful Diagnostic Marker for Biliary Atresia: A Case Series of Three Irish Infants
Smith A, Shankar A, Collins A, Tarrant A, Boyle MA
Smith et al describe the triangular cord (TC) sign in cases of biliary atresia. It is a triangular shaped echogenic density at the portal vein bifurcation.
Occasional Piece
Food Insecurity and Tuberculosis: Policy Urgently Needs To Play Catch-Up
D A. Cassidy, L C. Ivers
Obituary
Beulah Bewley DBE, FRCPCH, FFPHM , FRCP (Sept 2nd 1929 – Jan 20th 2018)
Letters to the Editor
The Light at the End of the Tunnel: A Case of Dysautonomia Associated With Melkersson-Rosenthal Syndrome
EA Donlon, K O’Connell, R Varini, MG Khan, J Lynch
Peripheral White Blood Cell Differential Counts In Children With UTI, Is There A Link?
Rutledge E, Whitla L, Coghlan D, Nadeem M
Influenza Vaccine Attitudes in Amateur GAA Club Footballers.
Mortimer B. O’Connor
The Opportunities for Medical Education Internationalisation in the Republic of Ireland
Y Finn