In This Month’s IMJ

June 2017 Vol 110 Number 6

IMJ Commentary

Decision Making and the New Technologies in Clinical Practice

JFA Murphy



Trends in surgical mortality following colorectal resection between 2002 and 2012: A single-centre retrospective analysis

I Stephens, C Stuart, R Stephens, P McCormick, J Larkin, B Mehigan

Stephens et al report on the surgical outcome for 959 patients with colorectal cancer during an 11 year period.  Over time the mortality rate has decreased from 7.8% (2002) to 0% (2012).  During the study period there were 28 surgical deaths.

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Original Papers

Association between psychological distress and cancer type in patients referred to a psycho-oncology service

CLavelle, MF Ismail, K Doherty, A Bowler, MM Mohamad, EM Cassidy

Lavelle et al report that the cancer type is not associated with the level of cancer distress.  The 3 commonest cancers encountered were breast, haematological, and lung.

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A national audit of smoking cessation services in Irish maternity hospitals

Reynolds  CME., Egan B., Cawley  S., Kennedy , R.,  Sheehan S.R., Turner M.J.

Reynolds et al found that all Units gave verbal cessation advice to smokers.  12 Units in addition gave written advice.  5 Units revisited smoking status in later pregnancy.  The authors recommend that smoking cessation services should be implemented in a more standardized way across all Units.

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A survey of clinical uncertainty from the paediatric basic trainee perspective

MB O’Neill,ZA Sarani, AJ Nicholson,M Elbadry ,AM Deasy

O’Neill et al explored the decision-making strategies of trainees.  Important factors were clinical knowledge and senior colleague’s opinion.  60% experienced anxiety post-call due to uncertainty.  The authors urge that these issues be addressed during training.

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Long-term follow-up of patients with spontaneous clearance of hepatitis C: does viral clearance mean cure? 

M Iqbal, P A McCormick, M Cannon, N Murphy, P Flanagan, J E Hegarty, L Thornton

Iqbal et al report on the long-term follow-up of patients who were hepatitis C antibody positive but HCV RNA negative.  Among 321 patients the follow-up tests remained negative.  The median time interval was 13 years.

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Fancy a cup of scald? The role of hot beverage burns in paediatric burns admissions in Ireland

F McGuire, M Hegarty, P Jennings, P Marsden, L Smith

 McGuire et al report on 233 burn injuries in children.  74% of the burns were due to scalds.  77% were partial thickness and 73 affected the upper body.  Hot beverages accounted for 33% cases.

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Consent for routine neonatal procedures: A study of practices in Irish neonatal units: How do we compare with the gold standard BAPM guidelines? 

M A Ryan, C A Ryan, E Dempsey, R O’Connell

Ryan et al found lack of consistency in relation to the modes of consent obtained for a bundle of procedures.  There was agreement for 3 items, BCG, 6-in-1 and donor breast milk.

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Older motorcyclists in Ireland  

D Fitzpatrick, D O’Neill

Fitzpatrick and O’Neill motorcycle injuries among older riders is increasing.  Injuries have increased from 17 (2005) to 31 (2012).  They have longer stays in hospital but are less likely to be fatally injured.

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Case Reports

Stevens-Johnson Syndrome induced by combination of Lamotrigine and Valproic Acid in a 9 year boy

K Maduemem, A Vatca, T O’Neill, D Buckley

Maduemem et al report a case of Stevens-Johnson Syndrome (SJS) in a child.  The causative agents were Lamotrigine and Valproic Acid.  The authors explain that Valproic Acid decreases Lamotrigine clearance by 60%.  It is postulated a rapid rise in Lamotrigine levels increases the occurrence of skin lesions and rash

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A cluster of Hepatitis A viral infection in HSE South

HA Ferris, A Dillon, MB O’ Sullivan

Ferris et al report on 5 cases of Hepatitis A.  The spread appears to have been related to a swimming pool with suboptimal chlorine levels.  The authors emphasise the importance of prompt notification of cases.

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An unusual case of multiple self-inflicted punctures to the precordium

F Borhan, N Borhan , B O’Riordan.

Borhan et al report a 32 female patient who inserted at least 19 sewing needles into her chest, abdomen, and soft tissues.  She required both a thoracotomy and a laparotomy.  One needle had penetrated her right ventricle.

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Short Report

The selfie wrist- selfie induced trauma

RF Lyons, JC Kelly, CG Murphy.

Lyons report 4 cases of fracture to the distal upper limb extremity in patients who fell while taking a selfie.  All fractured occurred in the limb not holding the phone.  Selfie sticks were not involved.  The explanation is poor spatial awareness while taking the photograph.

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Letters to the Editor

Ectopic Duodenal Varices: A rare cause of upper GI bleeding 
K M Nawawi

Can psychiatry lead the way in legislating for health and wellbeing? 
R.M. Duffy, B.D. Kelly

Splenic infarction in a young man with sickle cell trait following air travel at high altitude 
O’Shea J, Burke J, Murphy P, Quinn J

The Mobile Phone: Friend or Foe for the NCHD? 
Looney AT, Brady CM, Kiely EA, O’Brien MF