Accuracy and confidence of Irish general practitioners in diagnosing skin disease in patients with darkly pigmented skin.

Managing skin conditions in patients with darkly pigmented skin (DPS) can be challenging due to inadequate exposure to dermatology in DPS in clinical training. In this study, Irish GPs were less likely to correctly diagnose common skin conditions in patients with DPS ( < 0.001) and had lower confidence levels in diagnosis in DPS ( < 0.

Transition to clinical practice during the COVID-19 pandemic: a qualitative study of young doctors' experiences in Brazil and Ireland.

Objectives: To explore and compare the perspectives of junior doctors in Brazil and Ireland regarding transition and professional socialisation during the COVID-19 pandemic, with the purpose of identifying better ways to support doctors as they assume their new professional role.

Design: 27 semistructured interviews. Transcripts were analysed using qualitative thematic analysis.

Does cannabis use predict psychometric schizotypy via aberrant salience?

Cannabis can induce acute psychotic symptoms in healthy individuals and exacerbate pre-existing psychotic symptoms in patients with schizophrenia. Inappropriate salience allocation is hypothesised to be central to the association between dopamine dysregulation and psychotic symptoms. This study examined whether cannabis use is associated with self-reported salience dysfunction and schizotypal symptoms in a non-clinical population.

Respiratory disorders in patients with omphalocele.

The respiratory difficulties experienced by infants with omphalocele are being appreciated with greater frequency. These problems represent self-limited difficulties related to omphalocele closure or are the result of severe pulmonary disease including pulmonary hypoplasia and pulmonary hypertension. Infants with giant omphalocele represent a unique group that may experience increased respiratory morbidity which may lead to chronic respiratory problems extending into childhood and adolescence.

Medical students' empathy and attitudes towards professionalism: Relationship with personality, specialty preference and medical programme.

Background: Existing research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students' attitudes towards professionalism in medicine.

Methods: A cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school.

Characterization of long-term outcomes for pediatric patients with epithelioid hemangioma.

Epithelioid hemangioma (EH) is a rare benign vascular tumor that occurs in soft tissues and bone and presents between the third and sixth decades of life. Little is known about the clinical course and outcomes of pediatric EH. We report 11 patients diagnosed with EH at a median age of 14.

Reality check: What happens when patients with anorectal malformations grow up? A pilot study of medical care transition from the adult patient perspective.

Background: There has been an increased focus on transition of pediatric and adolescent patients to adult centered care. For patients with rare and complex conditions, such as anorectal malformations (ARM), difficulties are compounded by the absence of structured transition protocols and lack of adult provider expertise. We sought to explore the actual experiences of adult patients with ARM and distinguish if there are factors that influence the ability to achieve satisfactory transition to adult centered medical care.

Improvements in Antimicrobial Prescribing and Outcomes in Pediatric Complicated Appendicitis.

Background: Complicated appendicitis, characterized by perforation and/or peritonitis, is common in children, and late infectious complications are frequent. The best antibiotic treatment approach is unknown, resulting in substantial variation in care. We evaluated the effects of 2 successive interventions, an antimicrobial stewardship program (ASP) and a condition-specific clinical practice guideline (CPG), on antimicrobial utilization and patient outcomes in these patients.

A systematic review and individual patient data meta-analysis of published randomized clinical trials comparing early versus interval appendectomy for children with perforated appendicitis.

Purpose: Our objective was to perform a meta-analysis on RCTs that compared outcomes in children with perforated appendicitis (PA) who underwent either early appendectomy (EA) or interval appendectomy (IA). We also sought to determine if the presence of an intra-abdominal abscess (IAA) at admission impacted treatment strategy and outcomes.

Methods: We identified two RCTs comparing EA versus IA in children with PA.

Does the American College of Surgeons National Surgical Quality Improvement Program pediatric provide actionable quality improvement data for surgical neonates?

Background/purpose: The purpose of this project was to examine the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACSNSQIP-P) Participant Use File (PUF) to compare risk-adjusted outcomes of neonates versus other pediatric surgical patients.

Methods: In the ACS-NSQIP-P 2012-2013 PUF, patients were classified as preterm neonate, term neonate, or nonneonate at the time of surgery. The primary outcomes were 30-day mortality and composite morbidity.

Effect of a Clinical Practice Guideline for Pediatric Complicated Appendicitis.

Importance: Complicated appendicitis is a common condition in children that causes substantial morbidity. Significant variation in practice exists within and between centers. We observed highly variable practices within our hospital and hypothesized that a clinical practice guideline (CPG) would standardize care and be associated with improved patient outcomes.

Inguinal hernia repair in premature infants: more questions than answers.

This review shows that there are many single institution studies reviewing outcomes of premature infants with IH. However, the numbers of patients in these studies are often small and most studies were retrospective, therefore, these studies were subject to the limitations inherent to observational studies for identifying best treatment methods. Nevertheless, the studies show that risks are high in this population and that outcomes may vary with the timing of repair.

Does timing of neonatal inguinal hernia repair affect outcomes?

Purpose: The purpose of this study was to examine practice variability and compare outcomes between early and delayed neonatal inguinal hernia repair (IHR).

Methods: Patients admitted to neonatal intensive care units with a diagnosis of IH who underwent IHR by age 1 year in the Pediatric Health Information System from 1999 to 2011 were included. IHR after the index hospitalization was considered delayed.

Early versus delayed surgical correction of malrotation in children with critical congenital heart disease.

Purpose: The purpose of this study was to compare outcomes between early and delayed surgical correction of malrotation in children with critical congenital heart disease (CHD).

Methods: Patients with CHD who underwent cardiac surgery by 1 year of age and had malrotation diagnosed during their initial admission at 34 hospitals contributing to the Pediatric Health Information System in 2004-2009 were included. Ladd's procedures performed during the first admission were considered early correction, and those at a subsequent admission were considered delayed.

Neonatal carotid repair at ECMO decannulation: patency rates and early neurologic outcomes.

Purpose: Neonates placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) undergo either carotid repair or ligation at decannulation. Study aims were to evaluate carotid patency rates after repair and to compare early neurologic outcomes between repaired and ligated patients.

Methods: A retrospective study of all neonates without congenital heart disease (CHD) who had VA-ECMO between 1989 and 2012 was completed using our institutional ECMO Registry.

Surgical wound misclassification: a multicenter evaluation.

Background: Surgical wound classification (SWC) is used by hospitals, quality collaboratives, and Centers for Medicare and Medicaid to stratify patients for their risk for surgical site infection. Although these data can be used to compare centers, the validity and reliability of SWC as currently practiced has not been well studied. Our objective was to assess the reliability of SWC in a multicenter fashion.

Improving gastroschisis outcomes: does birth place matter?

Purpose: Babies born in the hospital where they obtain definitive surgical care do not require transportation between institutions and may have shorter time to surgical intervention. Whether these differences result in meaningful improvement in outcomes has been debated. A multi-institutional retrospective study was performed comparing outcomes based on birthplace.

Is NSQIP Pediatric review representative of total institutional experience for children undergoing appendectomy?

Background/purpose: NSQIP Pediatric (NSQIP-P) is a robust quality improvement effort. A limitation of the NSQIP process lies in capturing a small proportion of the total case volume. This study examines whether appendectomies captured by NSQIP-P are concordant with all appendectomies, the most commonly captured procedure in 2011.

Selection of student-selected component [SSCs] modules across the medical undergraduate curriculum: relationship with motivational factors.

Student-selected components (SSCs) encourage the following within the undergraduate medical curriculum: greater exploration of core curriculum topics; exploration of non-core subjects/experiences; research and self-directed learning; and personal and professional development opportunities. This study examined the motivational factors which influence SSC choice to assess (a) SSC selection patterns across each year of the curriculum (direct and graduate entry) and (b) motivation underlying SSC selection across the curriculum. During SSC registration at University College Cork, all medical undergraduates (years 1-3, graduate-entry medicine) were required to select an SSC and provide a written justification for their selection.

The 2002-2007 trends of prevalence of asthma, allergic rhinitis and eczema in Irish schoolchildren.

Background: Irish adolescents have the third highest asthma prevalence in the world. Few data examine trends of prevalence of asthma and allergic disorders in younger Irish children. We compared the prevalence of asthma, allergic rhinitis and eczema in school children, aged 6-9 in 2002 and 2007.

Epidemiology of allergic reactions to hymenoptera stings in Irish school children.

The aim of this was to study generate the first epidemiological data regarding the prevalence of hymenoptera allergy among school children in Ireland. Questionnaires, including six sting-specific questions (1), were distributed to the parents of primary school children aged 6-8 and 11-13, divided equally between rural and urban backgrounds. From 110 schools, 4112 questionnaires were returned.

Composite tissue allotransplantation: a review of relevant immunological issues for plastic surgeons.

Background: Composite tissue allotransplantation of hand, facial and other tissues is now a clinical reality. The terminology, treatment principles, drug combinations, dosage schedules and mechanisms of the immunosuppression medications on which contemporary transplant surgery is based are unfamiliar to plastic surgeons and most healthcare providers outside the field of transplantation medicine. With this in mind, the purpose of this manuscript is to provide plastic surgeons with a comprehensive and understandable review of key immunological principles relevant to composite tissue allotransplantation.