This Month’s IMJ


Technical knockout: When is traumatic brain injury ‘just’ a concussion? 

O’Halloran and Johnson in a comprehensive editorial review the latest understanding on concussion in team sports.



Car safety seat usage and selection among families attending University Hospital Limerick

Scully et al report that 89.9% of children were restrained in a car seat during travel.  96.2% of the safety seats were newly purchased.



Attitudes toward palliative care and end of life issues: A prospective survey in patients with metastatic cancer

Docherty et al report that palliative care (PC) resources are under-utilised.  In a survey of patients with metastatic cancer, 60% believed that PC can make people feel better.  63.4% believe that PC is offered when nothing more can be done.  80% said that symptom control is more important than prolonging life.



The efficacy of bronchial thermoplasty for severe persistent asthma- the first national experience

Watchorn et al state that thermoplasty is a bronchoscopic procedure which uses radiofrequency to reduce airway smooth muscle mass.  In a series of 7 patients, the procedure resulted in significant improvement in mean asthma control scores.



A prospective analysis of the relationship between chronic diseases and adiposity in older adults: findings from the lifeways cross-generation cohort study of a thousand families 2001-2014

 O’Reilly et al in the lifeways study report that 42.4% are overweight and 32.1% are obese.  The BMI showed a linear association with both diabetes and cardiovascular disease.



Critical airway compromise due to a massive vagal schwannoma

McDermott et al a 37 year old male who presented with an enlarging neck mass and compression symptoms.  A vagal schwannoma was subsequently removed.

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Culture negative infective endocarditis: a changing paradigm

Daly et al on the application of molecular diagnostic techniques in a case of culture negative infective endocarditis (CNIE).  PCR testing was positive for Tropheryma Whipplei.  The authors state that with the advent of molecular testing, CNIE will become less common.



Palliative subcutaneous terbutaline infusion in severe asthma

 Sahadevan and Lane describe the use of continuous subcutaneous infusion of terbutaline (CSIT).  Brittle asthmatics tend to benefit most with an improvement in diurnal variability.



Band heterotopia: an unusual cause of seizures

Keraliya et al describe a 12 year old girl who presented with complex seizures.  Brain MRI revealed bilateral band heterotopia.  This category of heterotopia needs to be distinguished from periventricular and subcortical heterotopia.

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Medical student and general practitioner perceptions of challenges in general practice in Ireland

Gouda et al surveyed 96 medical students and 35 GPs.  The perceived challenges to general practice were remuneration, stress, access to imaging, respect from fellow medical practitioners, treating the ageing patient, and the complexity of patients.  18% of medical students stated that general practice was their career choice.



Beware of non-traumatic Chylothorax

Kooblall et al describe a 34 year old woman who presented with dyspnea secondary to a Chylothorax.  Imaging demonstrated a prominent mediastinal, which on sampling was a lymphoma.



Clinical decision rules for CT in minor head injury

Healy et al reviewed 168 patients presenting with a minor head injury.  79 patients underwent a CT scan.  8 patients had an ICH and 1 patient died.  The authors found the Canadian guidelines on minor head injuries to be the most accurate.



Hand in hand- The activity of a soft tissue trauma clinic in a tertiary referral centre and its association with economic prosperity

 McQuade et al reviewed the functions of a soft tissue trauma clinic over 3 time periods.