This Month’s IMJ
January 2018 Vol 111 Number 1
Negligence Claims Costs are Rising Rapidly in the UK
Lithium Use in Pregnancy
Doyle S 1, Green AJ1,2
Oral Cancer Awareness of Non-Consultant Hospital Doctors in Irish Hospitals
D Shanahan1 CM Healy2
Shanahan and Healy address the issue of oral cancer awareness. They surveyed 221 NCHDs. 60% were uncertain, and 21% very unsure of oral cancer diagnosis. 80% do not routinely examine the oral mucosa. More education is required at both undergraduate and postgraduate levels.
Cross-sectional Analysis of the Standards of Consent Applied to Anaesthesia in Ireland: Are Anaesthetists Aware of their Legal and Ethical Obligations?
Cafferkey A, Lyons B
Cafferkey and Lyons report on the responses of 160 anaesthetists. 63.8% do not usually document consent. 21.8% rarely and 27.8% never explain the risks to patients. The findings suggest wide variation in the practice of obtaining consent for anaesthesia.
Overnight emergency CT imaging: a 10-year experience at an Irish tertiary referral hospital.
Hynes J1, Redmond CE1, Healy GM1, Cronin, J2, Heffernan, EJ1.
Hynes et al report that over a 10-year period, overnight CT scan imaging increased. The increase was from 0.4 to 1.2 studies per night. 64% of the scans were normal.
Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.
C O’Brien, J Mc Marrow, E O’Dwyer, P Govender, WC Torreggiani
O’Brien et al describe 2404 referrals for PICC line insertion 2009-15. During the study period the annual number of PICC insertions increased from 255 to 508 annually.
A Review Of Referral Patterns For Sagittal Synostosis In Ireland: 2008-2013
M J Berney, A McGillivary, J Caird, D J Murray
Berney et al describe 81 children with sagittal synostosis. 74% were referred before 6 months, and 26% were late referrals. Late referral led to a more complex referral pathway.
Is Increasing Life Expectancy Leading To More Complexity?
H Johnson, A O’Farrell, D McKeow, G Sayers, C Hayes, D Beaton
Johnson et al examined the relationship between age over 65 years and indicators of clinical complexity in acute hospitals. Over the period 2005-2014 the number and rate of hospital admissions increased especially for those over 85 years.
A Descriptive Study Of The Burden Of Animal-Related Trauma At Cork University Hospital.
M Sheehan, C Deasy
Sheehan and Deasy report that 54 patients were admitted to CUH with major farm animal related trauma over a 5 year period. Most were orthopaedic injuries, fractures of the tibia and fibula being the commonest. 59% of cases required surgery, and 16.7% were admitted to the intensive care unit.
Management of Bone Fragility in Primary Care in Ireland
R O’Connor, A O’Regan , J O ‘Doherty
O’Connor et al studied 243 patients at risk of bone fragility. Using DEXA scan examinations, 17% had osteoporosis, 11 had osteopaenia. 63% were currently being prescribed bisphosphonates. 21% did not have a baseline scan before commencing bisphosphonate therapy.
A Unique Case of Concurrent Long Bone Osteomyelitis and Empyema Caused by Fusobacterium nucleatum.
S Waqas, C Bannan, A Fe Talento, D Byrne, S O’Connell, S Clarke, C Merry
Waqas et al describe a 51 year old man who presented with right thigh swelling, left sided empyema, and poor dentition. Following investigations the unifying diagnosis was dental disease complicated by Fusobacterium Nucleatum. The patient made a complete recovery following an 8- week course of antibiotics.
Laryngeal Chondrosarcoma: A rare cause of critical upper airway obstruction.
K Tuite, J.C Oosthuizen, T Subramaniam, J.B Kinsella
Tuite et al describe the case of an 82 year old male with dyspnea and dysphonia. Endoscopy revealed a large submucosal mass at the laryngeal inlet. A subsequent CT scan and histology confirmed a chondrosarcoma. A total laryngectomy was performed.
Primary Renal Carcinoid – A Case Report
M O’Sullivan, ML Gargan, R Flynn, SCrowther, WTorreggiani
O’Sullivan et al describe a 37 year old female with gastrointestinal symptoms. Abdominal CT scan showed a lesion in the lower pole of the left kidney. The biopsy confirmed a well differentiated neuroendocrine tumour. A nephrectomy was performed.
Iron Refractory Iron Deficiency Anaemia: A Rare Cause of Iron Deficiency Anaemia
T McGrath, M Cotter
McGrath and Cotter describe a 17 months old boy with a hypochromic, microcytic anaemia which was refractory to iron therapy. The cause was 2 mutations in the TMPRSS6 gene. He was successfully treated with intravenous iron sucrose 200mgs
Paediatric Type 2 Diabetes Still Rare in an Irish Tertiary Referral Unit
R Kernan, A Carroll, N Mc Grath, CM Mc Donnell, NP Murphy
Kernan et al report that in their patient cohort of 320 children with diabetes only 2% (7/320) had type 2 diabetes. The 7 children with type 2 diabetes were overweight, hypertensive, and mainly non-caucasian. The affected children required insulin therapy.
Menafrivac, Its Success Against Group A Meningococcus In Sub-Saharan Africa And The Challenges Which Lie Ahead.
L FW Leader
C Fitzpatrick, R M Berlin
Letters to the Editor
True Resistance to Local Anaesthetics: An Unusual Cause of Failure
A Sleiwah, M McBride, S Dustagheer.
Uterine Sacculation in Pregnancy
Langhe, W. M. Blake, M. Gannon