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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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