Knowledge of face masks and attitudes to re-sterilisation among healthcare workers.

Introduction: COVID-19 was declared a pandemic in March 2020. With the sudden surge in demand for personal protective equipment (PPE), significant concerns regarding the ongoing availability emerged. One solution proposed is re-sterilisation of respirator masks and this has been commenced in some parts of the world.

Practice review: Evidence-based quality use of corticosteroids in the palliative care of patients with advanced cancer.

Background: It would be unusual for a patient with advanced cancer not to be prescribed corticosteroids at some stage of their disease course for a variety of specific and non-specific indications.

Aim: The aim of this practice review was to provide a pragmatic overview of the evidence supporting current practice and to identify areas in which further research is indicated.

Design: A 'state-of-the-art' review approach was used to examine the evidence supporting the use of corticosteroids for the management of cancer-related complications and in symptom control, in the context of known risks and harms to inform quality use of this medicine.

Predicting bacteraemia in maternity patients using full blood count parameters: A supervised machine learning algorithm approach.

Introduction: Bacteraemia in pregnancy and the post-partum period can lead to maternal and newborn morbidly. The purpose of this study was to use machine learning tools to identify if bacteraemia in pregnant or post-partum women could be predicted by full blood count (FBC) parameters other than the white cell count.

Methods: The study was performed on 129 women with a positive blood culture (BC) for a clinically significant organism, who had a FBC taken at the same time.

Platelet cloaking of circulating tumour cells in patients with metastatic prostate cancer: Results from ExPeCT, a randomised controlled trial.

Background: Circulating tumour cells (CTCs) represent a morphologically distinct subset of cancer cells, which aid the metastatic spread. The ExPeCT trial aimed to examine the effectiveness of a structured exercise programme in modulating levels of CTCs and platelet cloaking in patients with metastatic prostate cancer.

Methods: Participants (n = 61) were randomised into either standard care (control) or exercise arms.

Pathologically oriented descriptive study of male genital circumcisions across medical and surgical specialties.

Background: Circumcision is one of the most frequently performed procedure by clinicians, yet its role and indication in clinical practice lacks consensus and remains unclear. We sought to evaluate a collection of male circumcisions to determine the range of indications, histopathological diagnoses, and type of clinicians associated with circumcision.

Methods: We performed a retrospective descriptive cohort study of male patients who received a circumcision reported by one major dermatopathology laboratory between January 2017 and December 2018.

Associations between informal care costs, care quality, carer rewards, burden and subsequent grief: the international, access, rights and empowerment mortality follow-back study of the last 3 months of life (IARE I study).

Background: At the end of life, formal care costs are high. Informal care (IC) costs, and their effects on outcomes, are not known. This study aimed to determine the IC costs for older adults in the last 3 months of life, and their relationships with outcomes, adjusting for care quality.

A Novel Skin Closure Technique for the Management of Lacerations in Thin-Skinned Individuals.

Suturing thin, fragile skin, particularly in elderly patients, is often problematic and presents a challenge to many clinicians. We describe a novel technique that re-enforces the edges of such thin fragile skin, with the use of topical skin adhesive, 2-octyl cyanoacrylate (Dermabond™; Ethicon, Somerville, NJ). This allows secure suture placement and application of tension to facilitate wound closure.

Diagnostic utility of genetic testing in patients undergoing renal biopsy.

High-throughput DNA testing is becoming established as a standard diagnostic test in the renal clinic. Previously published studies on cohorts of patients with unexplained chronic kidney disease of a suspected genetic aetiology have suggested a diagnostic yield for genomic sequencing of up to 18%. Here we determine the yield of targeted gene panel in a clinically unscreened cohort of patients referred for percutaneous native renal biopsy.

Trouble afoot: A review of common skin conditions of the feet and nails.

Background: Common foot and toenail problems may cause diagnostic and management difficulties and are often complicated by comorbid factors.

Objective: The aim of this article is to discuss common disorders of the skin and nails of the feet, regional physiological factors to consider and appropriate investigations and management.

Discussion: Cutaneous disorders of the feet and nails present significant diagnostic and management challenges given the considerable overlap of common signs and symptoms and regionally difficult management.

Prognostic Importance of Pathological Fractures in Osteosarcomas.

Aims To investigate whether pathological fractures impact on osteosarcoma patient prognosis in Ireland. Methods This was a retrospective study over 22 years in a National Orthopaedic Oncology Centre. There were 117 nonfracture cases and 15 fracture cases.

Transient receptor potential channels TRPC1/TRPC6 regulate lamina cribrosa cell extracellular matrix gene transcription and proliferation.

The lamina cribrosa (LC) in glaucoma is with augmented production of extracellular matrix proteins (ECM) and connective tissue fibrosis. Fundamental pathological mechanisms for this fibrosis comprise fibrotic growth factors and oxidative stress. Transient receptor potential canonical channels (TRPC) channels play a key role in ECM fibrosis.

Drivers of care costs and quality in the last 3 months of life among older people receiving palliative care: A multinational mortality follow-back survey across England, Ireland and the United States.

Background: Care costs rise towards the end of life. International comparison of service use, costs and care experiences can inform quality and improve access.

Aim: The aim of this study was to compare health and social care costs, quality and their drivers in the last 3 months of life for older adults across countries.

A bolt from the blue; A case report of an unusual asthma exacerbation.

Background: We describe this case of a young gentleman presenting with acute dyspnoea on a background history of known, long-standing asthma. His dramatic presentation, notable for profound hypoxia and cyanosis, led to an unexpected additional diagnosis of type one congenital methaemoglobinaemia.

Case Presentation: A 26-year-old Irish gentleman was transferred urgently to the emergency department resuscitation room with marked cyanosis and tachypnoea.

Incorporating Cone-Beam CT Into the Diagnostic Algorithm for Suspected Radiocarpal Fractures: A New Standard of Care?

The purpose of this study was to assess the result of adding cone-beam CT to the standard imaging algorithm for patients with suspected radiographically occult traumatic radiocarpal fractures. A prospective review was performed on all patients who had cone-beam CT investigation of acute wrist pain after normal initial radiographs. Patients with no identified fractures were clinically reassessed and referred for MRI if concern for a fracture persisted.

Establishing how patient size and degree of miscentring affect CTDI, using patient data from a dose tracking system.

Objectives: The work aimed to investigate and model the relationship between CT dose index (CTDI), patient size and miscentring metrics using data extracted from a dose tracking software tool. Further, using the established model we aimed to extract and estimate further AEC metrics and, finally, demonstrate how the CTDI may vary across a range of imaging exams and with variations in patient size, positional metrics and with scan parameters.

Methods: CT scan parameters, patient dose metrics, patient positioning information and patient and water equivalent diameter information was extracted from abdomen, thorax-abdomen-pelvis and thorax imaging exams acquired on a 128-slice Siemens Somatom Definition AS + CT system using dose tracking software over a 1 year period.

The effect of i-gel insertion on the accuracy of cricothyroid membrane identification in adult females: a prospective observational study.

Background: Identification of the cricothyroid membrane is frequently inaccurate in females because of less distinct anatomy compared with males. Supraglottic airway devices cause ventral displacement of the laryngeal structures. We investigated if this would impact on the accuracy of cricothyroid membrane identification using palpation.

The efficacy of twelve early warning systems for potential use in regional medical facilities in Queensland, Australia.

Aim: Early warning system (EWS) validation studies are conducted predominantly in tertiary metropolitan facilities and are not necessarily applicable to regional hospitals. This study evaluates 12 EWSs for use in regional subcritical hospitals.

Method: This is a retrospective case-control study of patients who experienced severe adverse events (SAEs) in two regional private hospitals.

Changes in biochemical tests in pregnancy and their clinical significance.

Interpretation of laboratory investigations relies on reference intervals. Physiological changes in pregnancy may result in significant changes in normal values for many biochemical assays, and as such results may be misinterpreted as abnormal or mask a pathological state. The aims of this review are as follows: 1.

Laryngeal handshake technique in locating the cricothyroid membrane: a non-randomised comparative study.

Background: Evaluation of the anterior neck anatomy is used to identify the cricothyroid membrane (CTM) before front of neck airway access. This has been traditionally performed using palpation which results in misidentification of the CTM in a high proportion of subjects. The 'laryngeal handshake' is currently advocated by the Difficult Airway Society as the method to identify the CTM.

Minimizing Spine Autofusion With the Use of Semiconstrained Growing Rods for Early Onset Scoliosis in Children.

Background: A new growing rod (GR) design, the semiconstrained growing rod (SCGR), with the added advantage of axial rotation freedom within the components, has been introduced at our center which has been shown to be growth friendly. We hypothesize that the SCGR system would reduce autofusion in vivo, thereby maximizing the coronal plane correction, T1-S1 growth, and the final correction achieved at definitive fusion for children with an early onset scoliosis.

Methods: In total, 28 patients had either single or dual 5.