This Month’s IMJ

July/August 2018 Vol 111, Number 7 


IMJ Commentary

The Williams Review on Gross Negligence Manslaughter

JFA Murphy



Advances in Management of Neonatal Abstinence Syndrome: What’s the score?

Katie M Shanahan,1 Michael J O’Grady1,2


Original Papers

Staff Attitudes towards Patient Safety Culture and Working Conditions in an Irish Tertiary Neonatal Unit

Dwyer L, Smith A, McDermott R, Breatnach C, El-Khuffash A, Corcoran JD

Dwyer et al have analysed their neonatal staff’s attitude to safety and working conditions.  Stress recognition scored highest followed by job satisfaction.  The lowest score was for perceptions of management.

The Perceptions of Patients, their Parents and Healthcare Providers on the Transition of Young Adults with Type 1 Diabetes to Adult Services in the West of Ireland

Órla Walsh1, Miriam Wynne2, Máire O’ Donnell3, Mary Clare O’Hara4, Rosemary Geoghegan3

Walsh et al addressed the important issue of the transfer of adolescent diabetics to the adult services.  The adolescents were mostly unaffected by the physical move but their parents were more anxious.  Key issues were resource limitations and an inability of the young adult to self-manage.  Preparation is important.

Emergency Department Overcrowding And The Full Capacity Protocol Cross Over Study: What Patients Who Have Experienced Both Think About Being An Extra Patient In The Emergency Department Or On A Ward

Hugh McGowan, Krystal Gopeesingh1, Patrick O’Kelly2, Peadar Gilligan3

McGowan et al sought the views of 99 patients.  The majority (83.83%) preferred being an additional patient on a ward, 12.12% had no preference, and 4.04% preferred being in the ED.  The authors conclude that patients requiring emergency admission should be placed in extra beds on wards rather than being kept in the ED.

Sweat Testing in Ireland

Blake1, V. Tsang2, R. Ghori2, S. Whelan2, G. Boran3, B. Linnane2,4,5

Blake et al report that there were 2555 sweat tests undertaken across 15 centres in a 1-year period (2011).  35 (1.4%) cases were positive.  10.3% of samples were insufficient.  The authors state that the newborn screening for CF was introduced in 2011 and that it will greatly reduce the need for sweat tests into the future.

Figure 1. Frequency of sweat tests plotted against measured chloride value.

The Predictive Ability of Pre-Operative Magnetic Resonance Imaging to Detect Pathological Outcomes in Prostate Cancer

Nason GJ1, Selvarajah  L2, O’Connor EM1, O’Kelly J1, Considine SW1, Moss B1, MacMahon D3, Heneghan J4, Meyer N5, Buckley J2, O’Regan K2, O’Brien MF1,3

Nelson et al in a study of prostate cancer report a relatively good specificity and poor sensitivity of MRI for predicting pathological outcomes at radical prostatectomy (RP).  They point out that the presence of T3 disease (extension outside the capsule (ECE) and/or seminal vesicle invasion) is a key issue in reaching a decision with the patient.  Hence, the importance of MRI accuracy.  In this study the sensitivity and specificity of MRI for detecting ECE was 27.3% and 87.6% respectively.

Case Reports

Giant Cell Arteritis Presenting as an Ischaemic Upper Limb

Gerald Fitzgerald, Mortimer B. O’Connor, Mark J. Phelan

Gerald Fitzgerald et al report on a 64 year old lady presenting with right upper limb pain for 5 days. Data was collected from the patient’s chart and from radiology and laboratory systems. A CT angiogram of the aortic arch and right upper limb was subsequently arranged and showed an occlusion of the right axillary artery with good collateralisation (Fig 1). 


Apixaban-Associated Spontaneous Splenic Rupture – A Case Report

A. Abdelhady, A. Ahmed, Y. Mohamed, J. Binchy

A. Abdelhady et al report on the importance of prompt recognition of a spontaneous splenic rupture in a patient on Direct Oral Anticoagulants (DOAC).


Short Reports

Management of Paediatric Buckle (Torus) Wrist Fractures in Irish Emergency Departments: A National Survey

A. Abdelhady, A. Ahmed, E. Umana, J. O’Donnell

A. Abdelhady et al present a survey demonstrating that over 70% of centres in Ireland are managing buckle fractures using the traditional approach of back slab cast and follow up in fracture clinic.


Letters to the Editor

The Handback Rule – “Lost in Translation”

Emergency Admissions of Children and Young People with Mental Health Needs to the Paediatric Ward

An Assessment of the Paediatric Internship at University Hospital Limerick over a 30 Month Period

Continual Professional Development

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