Our Lady's Hospital Navanhttp://hdl.handle.net/10147/2643332024-03-29T11:58:01Z2024-03-29T11:58:01ZPatellar Dislocation: Not the Bees KneesDuignan, MartinMcGibney, Maryhttp://hdl.handle.net/10147/6209192019-08-30T12:27:52Z2016-09-01T00:00:00ZPatellar Dislocation: Not the Bees Knees
Duignan, Martin; McGibney, Mary
Patellar dislocations are common, particularly in the adolescent polulation. Registered Advanced Nurse Practitioners are healthcare professionals who can appropriately manage these injuries to minimise the risk of chronicity.
2016-09-01T00:00:00ZDelayed recovery of consciousness after elbow arthroscopyRaval, PradyumnaMalkan, Dilip Jhttp://hdl.handle.net/10147/3468262019-08-30T12:46:38Z2015-03-01T00:00:00ZDelayed recovery of consciousness after elbow arthroscopy
Raval, Pradyumna; Malkan, Dilip J
Letter to the Editor
2015-03-01T00:00:00ZAdvances in the diagnosis and management of asthma in older adults.Al-Alawi, MazenHassan, TidiChotirmall, Sanjay Hhttp://hdl.handle.net/10147/3111282019-08-30T12:09:35Z2013-12-28T00:00:00ZAdvances in the diagnosis and management of asthma in older adults.
Al-Alawi, Mazen; Hassan, Tidi; Chotirmall, Sanjay H
Global estimates on ageing predict an increased burden of asthma in the older population. Consequently, its recognition, diagnosis and management in clinical practice require optimization. This review aims to provide an update for clinicians highlighting advances in the understanding of the ageing process and immunosenescence together with their applicability to asthma from a diagnostic and therapeutic perspective. Ageing impacts airway responses, immune function and influences efficacy of emerging phenotype-specific therapies when applied to the elderly patient. Differentiating eosinophilic and neutrophilic disease accounts for atopic illness and distinguishes long-standing from late-onset asthma. Therapeutic challenges in drug delivery, treatment adherence and side effect profiles persist in the older patient while novel recording devices developed to aid detection of an adequate inhalation evaluates treatment effectiveness and compliance more accurately than previously attainable. Anti-cytokine therapies improve control of brittle asthma while bronchial thermoplasty is an option in refractory cases. Multi-dimensional intervention strategies prove best in the management of asthma in the older adult which remains a condition that is not rare but rarely diagnosed in this patient population.
2013-12-28T00:00:00ZCongruence of pain assessment between nurses and emergency department patients: a replication.Duignan, MartinDunn, Virginiahttp://hdl.handle.net/10147/3027272019-08-30T12:57:29Z2008-01-01T00:00:00ZCongruence of pain assessment between nurses and emergency department patients: a replication.
Duignan, Martin; Dunn, Virginia
To ascertain congruence between patients' self-report of pain intensity and nurses' assessment of their pain intensity.; This study adopted a replication methodology which aimed to ascertain congruence between patients' self-report of pain intensity and nurses' assessment of their pain intensity. Raw statistical data was analysed using SPSS for windows.; This study supports the findings of the original US study that emergency nurses frequently underestimate patients' pain intensity. However, this study also found incidents where nurses accurately assessed their patients' pain intensity, and incidences of overestimation.; This study illustrates underestimation of patients' pain intensity by emergency nurses which is both clinically and statistically significant.; Implications for nursing practice include a need for assessment of patients' pain intensity, the development of pain management protocols, and increased emphasis on education in both undergraduate and postgraduate nursing curricula. Also there needs to be continued clinical audit of pain management standards.
AIM: To ascertain congruence between patients' self-report of pain intensity and nurses' assessment of their pain intensity.
METHODS: This study adopted a replication methodology which aimed to ascertain congruence between patients' self-report of pain intensity and nurses' assessment of their pain intensity. Raw statistical data was analysed using SPSS for windows.
RESULTS: This study supports the findings of the original US study that emergency nurses frequently underestimate patients' pain intensity. However, this study also found incidents where nurses accurately assessed their patients' pain intensity, and incidences of overestimation.
CONCLUSIONS: This study illustrates underestimation of patients' pain intensity by emergency nurses which is both clinically and statistically significant.
RELEVANCE TO CLINICAL PRACTICE: Implications for nursing practice include a need for assessment of patients' pain intensity, the development of pain management protocols, and increased emphasis on education in both undergraduate and postgraduate nursing curricula. Also there needs to be continued clinical audit of pain management standards.
2008-01-01T00:00:00ZDiagnosing Achilles tendon injuries in the emergency department.Gibbons, Lyndahttp://hdl.handle.net/10147/3019892019-08-30T12:42:43Z2013-09-01T00:00:00ZDiagnosing Achilles tendon injuries in the emergency department.
Gibbons, Lynda
Achilles tendon (AT) injury is an overuse injury often seen in professional and recreational athletes. It tends to affect men, particularly those in their thirties and forties, more than women, and is typically seen in people who are intermittently active. To ensure AT ruptures are identified and treated effectively, early intervention in emergency departments (EDs) is crucial. This article discusses how advanced nurse practitioners can use their comprehensive problem-solving, clinical decision-making and clinical judgement skills to manage patients who present with suspected AT injury. It also describes the anatomy of tendon rupture, the aetiology and mechanism of injuries, and the importance of assessment and diagnostic tools, therapeutic techniques and management strategies. Finally, it considers the psychological effect this injury can have on patients, while in the ED and after discharge. A case study is included as an example of ED management.
2013-09-01T00:00:00ZFunctional exercise after total hip replacement (FEATHER): a randomised control trial.Monaghan, BrendaGrant, TimHing, WayneCusack, Tarahttp://hdl.handle.net/10147/3014702019-08-30T12:36:28Z2012-11-01T00:00:00ZFunctional exercise after total hip replacement (FEATHER): a randomised control trial.
Monaghan, Brenda; Grant, Tim; Hing, Wayne; Cusack, Tara
Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.; This will be a single blind multi centre randomized control trial with two arms. Seventy subjects post primary total hip arthroplasty will be randomized into either an experimental group (n=35), or to a control group (n=35). The experimental group will attend a functional exercise class twice weekly for a six week period from week 12 to week 18 post surgery. The functional exercise group will follow a circuit based functional exercise class supervised by a chartered Physiotherapist. The control group will receive usual care. The principal investigator (BM) will perform blinded outcome assessments on all patients using validated measures for pain, stiffness, and function using the Western Ontario and Mc Master Universities Osteoarthritis index (WOMAC). This is the primary outcome measurement tool. Secondary outcome measurements include Quality of life (SF-36), 6 min walk test, Visual Analogue Scale, and the Berg Balance score. The WOMAC score will be collated on day five post surgery and repeated at week twelve and week eighteen. All other measurements will be taken at week 12 and repeated at week eighteen. In addition a blinded radiologist will measure gluteus medius cross sectional area using real time ultrasound for all subjects at week 12 and at week 18 to determine if the functional exercise programme has any effect on muscle size.; This randomised controlled trial will add to the body of evidence on the relationship between muscle size, functional ability, balance, quality of life and time post surgery in patients following total hip arthroplasty. The CONSORT guidelines will be followed to throughout. Ethical approval has been gained from the Ethics committee Health Services Executive Dublin North East.
2012-11-01T00:00:00ZA Novel Study of Comorbidity between Schizoaffective Disorder and Geschwind Syndrome.O'Connell, KaraKeaveney, JoannePaul, Raymondhttp://hdl.handle.net/10147/2968022019-08-30T11:58:43Z2013-01-01T00:00:00ZA Novel Study of Comorbidity between Schizoaffective Disorder and Geschwind Syndrome.
O'Connell, Kara; Keaveney, Joanne; Paul, Raymond
Geschwind syndrome has been described in patients with temporal lobe epilepsy and is characterized by sexual behavioural disorders, hyperreligiosity, hypergraphia, and viscosity. Presented here is a case of a 53-year-old man with clinical findings consistent with Geschwind syndrome in the setting of a known diagnosis of schizoaffective disorder, with no identifiable comorbid illness of temporal lobe epilepsy or frontotemporal dementia. Brain MRI showed bilateral temporal lobe atrophy greater than would be expected for age and more prominent on the left side than the right. It is likely that these structural abnormalities may be related to this patient's clinical presentation of Geschwind syndrome. To our knowledge, this is the first reporting of a case of Geschwind syndrome in the setting of schizoaffective disorder. These symptoms of Geschwind syndrome were present irrespective of mental state status. The report highlights the importance in correct identification of underlying cause and differentiation between Geschwind syndrome and schizoaffective disorder in order to avoid mistreatment and consequent iatrogenic adverse events.
2013-01-01T00:00:00Z