LENUS Collection:

A 'one in a million' case of pulsating thoracoabdominal mass.

Thu, 01 Nov 2012 00:00:00 GMT

Title: A 'one in a million' case of pulsating thoracoabdominal mass. Authors: Tan, Lay Ong; Lim, Soo Yen; Sharif, Farhana Abstract: Ectopia cordis is a rare congenital malformation in which the heart is located partially or totally outside the thoracic cavity. It comprises 0.1% of congenital heart diseases. The authors present a case of a male baby born at term by emergency caesarean section due to prolonged fetal bradycardia, who was noted to have a large pulsating mass in the thoracoabdominal area. In view of lower thoracolumbar abdominal defect, ectopic placement of the umbilicus, deficiency of the diaphragmatic pericardium, deficiency of anterior diaphragm and intracardiac abnormalities, a diagnosis of ectopia cordis-Pentalogy of Cantrell was made. He was transferred to a tertiary centre and required oxygen supplement initially. He was sent home after 1 week, on propanolol, with weekly oxygen saturation checks. He is awaiting further surgical intervention pending the required weight gain.

Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session.

Thu, 01 Nov 2012 00:00:00 GMT

Title: Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session. Authors: O'Callaghan, Geraldine; Murphy, Sean; Loane, Dorothy; Farrelly, Evelyn; Horgan, Frances Abstract: Poor knowledge of stroke risk factors and failure to recognize and act on acute symptoms hinders efforts to prevent stroke and improve clinical outcomes. Levels of stroke knowledge are poorly established within Ireland. This study was conducted to establish levels of knowledge among men and women aged >40 years in an Irish community, and also to determine the impact of a single education session on stroke knowledge. Subjects from 2 separate geographical locations were allocated to an intervention group (n = 200), who received stroke information over a 90-minute session, or a control group (n = 200). Both groups completed a stroke knowledge questionnaire at baseline and at 4 weeks after the educational session. Overall, the initial response rate was 70% (280/400); 52% of the respondents knew that the brain is affected by stroke, 58% could list 2 or more risk factors but only 27% could list 2 or more warning signs, 50% would call 999 (emergency number in Ireland) in response to stroke, 17% had heard of thrombolytic therapy, but only 1% knew the time frame for receiving thrombolytics. The response rate to the resurvey following the educational session was 57%, with 47 of 117 subjects in the intervention group (40%) attending the session. Stroke knowledge scores improved by 50% in the intervention group (P < .001). Overall, the knowledge of stroke risk factors, warning signs, and thrombolytic therapy was poor in this Irish community-dwelling cohort. Our study demonstrates that a single educational session can improve short-term knowledge of stroke symptoms and thrombolytic therapy.

Linking audit and clinical effectiveness in the lung tumour service

Thu, 01 Jan 2009 00:00:00 GMT

Title: Linking audit and clinical effectiveness in the lung tumour service Authors: Gorman, S; Doyle, C; O’Brien, A Abstract: The aim of the audit is to capture the lung cancer patient’s care pathway, to improve clinical effectiveness, advance service quality and improve standards of care by reducing diagnosis and treatment time delays.

A disjointed effort: paediatric musculoskeletal examination.

Sun, 01 Jul 2012 00:00:00 GMT

Title: A disjointed effort: paediatric musculoskeletal examination. Authors: Gill, Irwin; Sharif, Farhana Abstract: Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.