LENUS Collection:

How many joints does the 5th toe have? A review of 606 patients of 655 foot radiographs.

Sat, 01 Dec 2012 00:00:00 GMT

Title: How many joints does the 5th toe have? A review of 606 patients of 655 foot radiographs. Authors: Moulton, Lawrence Stephen; Prasad, Seema; Lamb, Robert G; Sirikonda, Siva P Abstract: It is a common understanding that the fifth toe has three bones with two interphalangeal joints. However, our experience shows that a significant number have only two phalanges with one interphalangeal joint.

Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.

Sun, 01 Jan 2012 00:00:00 GMT

Title: Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery. Authors: Murphy, Deirdre J; Burke, Gerard; Montgomery, Alan A; Ramphul, Meenakshi Abstract: Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 - 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.

The impact of new national guidelines on screening for gestational Diabetes Mellitus

Fri, 01 Feb 2013 00:00:00 GMT

Title: The impact of new national guidelines on screening for gestational Diabetes Mellitus Authors: Ali, FM; Farah, N; O’Dwyer, V; O’Connor, C; Kennelly, MM; Turner, MJ Abstract: Gestational diabetes mellitus (GDM) has important maternal and fetal implications. In 2010, the Health Service Executive published guidelines on GDM. We examined the impact of the new guidelines in a large maternity unit. In January 2011, the hospital replaced the 100g Oral Glucose Tolerance Test (OGTT) with the new 75g OGTT. We compared the first 6 months of 2011 with the first 6 months of 2010. The new guidelines were associated with a 22% increase in women screened from 1375 in 2010 to 1679 in 2011 (p<0.001). Of the women screened, the number diagnosed with GDM increased from 10.1% (n=139) to 13.2% (n=221) (p<0.001).The combination of increased screening and a more sensitive OGTT resulted in the number of women diagnosed with GDM increasing 59% from 139 to 221 (p=0.02).This large increase has important resource implications but, if clinical outcomes are improved, there should be a decrease in long-term costs.

The efficacy of fibrinogen concentrate compared with cryoprecipitate in major obstetric haemorrhage - an observational study.

Mon, 01 Oct 2012 00:00:00 GMT

Title: The efficacy of fibrinogen concentrate compared with cryoprecipitate in major obstetric haemorrhage - an observational study. Authors: Ahmed, S; Harrity, C; Johnson, S; Varadkar, S; McMorrow, S; Fanning, R; Flynn, C M; O' Riordan, J M; Byrne, B M Abstract: Fibrinogen replacement is critical in major obstetric haemorrhage (MOH). Purified, pasteurised fibrinogen concentrate appears to have benefit over cryoprecipitate in ease of administration and safety but is unlicensed in pregnancy. In July 2009, the Irish Blood Transfusion Service replaced cryoprecipitate with fibrinogen.