LENUS Collection:

Acute Cerebellitis associated with Dual Influenza A (H1N1) and B infection

Fri, 01 Mar 2013 00:00:00 GMT

Title: Acute Cerebellitis associated with Dual Influenza A (H1N1) and B infection Authors: I Hackett, I; O’Sullivan, R; Zaid, AA; Rea, D; Walsh, S Abstract: We describe the case of a 6-year old girl who presented to our Emergency Department (ED) with acute onset of ataxia and speech disturbance. Investigative workup included a nasopharyngeal aspirate (NPA) which was influenza A (H1N1) and B positive during the 2010/2011 influenza season. Magnetic resonance imaging (MRI) of the brain confirmed findings consistent with cerebellitis.

Early experience in laparoscopic colectomy for refractory colitis in children

Tue, 01 Jan 2013 00:00:00 GMT

Title: Early experience in laparoscopic colectomy for refractory colitis in children Authors: Stephens, L; Gillick, J Abstract: There is limited literature endorsing the laparoscopic approach for the treatment of refractory colitis in children. We report our experiences of paediatric laparoscopic colectomies performed for ulcerative colitis. A retrospective review over a three year period was undertaken. Operative time, length of stay, post-operative analgesia, time to commencement of diet, and complications were recorded. Nine laparoscopic colectomies were performed. Median operative time was 320 minutes (range â 240-475). Mean time to commencement of full diet was 3.9 days (range 2-8). Median length of stay was 6 days (range - 5-16). In our experience, laparoscopic colectomy in children is a feasible and superior method to open colectomy and in our opinion, facilitates further restorative procedures and will become the default method of treatment in the near future.

Medical manslaughter

Tue, 01 Jan 2013 00:00:00 GMT

Title: Medical manslaughter Authors: Lyons, B Abstract: On November 29, 2011 Dr Conrad Murray was sentenced to four years in prison after being convicted of the involuntary manslaughter of Michael Jackson. Expert witness statements indicated that Murray' s actions were an extreme departure from the standard of care , particularly with regard to (1) inappropriately treating insomnia with a surgical anaesthetic (propofol); (2) failing to acquire sufficiently informed consent; (3) administering propofol without the necessary monitoring equipment; (4) delaying contacting the emergency services; and (5) making ineffective resuscitation efforts. Further medical evidence argued that Murray' s care of Jackson contained "17 egregious violations", defined as acts that posed a foreseeable danger to the patient’s life. These deficiencies, it was stated, constituted gross negligence.

Analysis of postoperative clinical and nutritional outcomes in a cohort of adolescents following major spinal corrective surgery

Fri, 01 Apr 2011 00:00:00 GMT

Title: Analysis of postoperative clinical and nutritional outcomes in a cohort of adolescents following major spinal corrective surgery Authors: Tarrant, R C; Harrington, M; Kiely, P J Abstract: INTRODUCTION This retrospective audit aimed to investigate postoperative complications and nutritional outcomes in a cohort of adolescent idiopathic scoliosis (AIS) and Scheuermann’s Kyphosis (SK) cases following major spinal corrective surgery. METHODS Demographic, biochemical, surgical and nutritional data were retrospectively collected on all the postoperative spinal corrrective AIS and SK cases performed in Our Lady’s Children’s Hospital (OLCHC) and the Blackrock Clinic during 2010. SPSS® was used to analyse the data. RESULTS In total, 40 spinal corrective procedures were performed in OLCHC (n=14) and the Blackrock Clinic (n=26) from Jan-Nov 2010 (mean age: 14.9 yrs; 95% AIS). The majority of subjects experienced minor postoperative complications (constipation, 92.5%; vomiting, 65%); 45% (n=18) were anaemic. Major postoperative complications included: illeus (n=5, 12.5%), pneumonia (n=4, 10%), pleural effusion (n=2, 5%) and Type I respiratory failure (n=1, 2.5%). From admission to discharge (median 10 days), the proportion of subjects having a body mass index <25th centile increased from 20% to 67.6%, respectively (P < 0.001). Postoperatively, less than one quarter of subjects (23.7%) met > 50% of their daily energy requirements; one patient was given supplementary nutrition support (parenteral). The mean % weight loss during the hospital stay was 8.2% (± SD 3.9). All cases with an available albumin level at discharge (n=24/40) were below normal (<35g/L). There was one hospital re-admission due to wound infection and weight loss. CONCLUSION Major spinal corrective surgery in the AIS/SK population is associated with an increased malnutrition risk which is a well recognised marker of poor outcomes and increased hospital costs. To minimise postoperative weight loss and identify high risk malnutriton cases, nutritionally screening these patients on admission ± dietetic referral, and early initiation of supplementary nutrition postoperatively as appropriate, should be considered in this patient group.