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Chronic disease management in general practice: results from a national study: Darker et al assess the chronic care model (CCM) in general practice. It is not a departure from the traditional emphasis on person centred care but rather the addition of elements in relation to prevention and management of chronic disease.
Maternal Smoking and alcohol consumption during pregnancy as risk factors for sudden infant death: McDonnell/Naughton et al report on risk factors for SIDS. A total of 287 SIDS cases were compared with 832 infant controls. Mothers who smoked were 3 times more likely to have a SIDS. Alcohol when consumed throughout all 3 trimesters was also a risk factor. 67% of SIDS mothers consumed alcohol compared with 49% of controls.
Progress in reducing road-related deaths and injuries in Irish children: Donnelly et al compare RTA morbidity and mortality in children for 2 time periods 1996-2000 and 2004-2008. Over the 2 time periods the number of car occupant fatalities decreased by 36% and pedestrian deaths fell by 50%. Cyclist fatalities decreased by 76%. Important factors are safety campaigns, garda enforcement and cultural changes.
Choledochal Cysts: our 10 year experience: Cianci et al describe 17 children with choledochal cysts. The average age at diagnosis was 28 months, the common presenting features being jaundice, abdominal pain and vomiting. All cases underwent a Roux-en-Y Hepaticojejunostomy.
Must we review printed lab reports without checking them? A prospective analysis of emergency department practice: McCabe et al examined a total of 519 laboratory reports for significant abnormal results. There were 158 cases with abnormal results. No patient was discharged inappropriately. The authors suggest that routine subsequent checking of printed biochemistry and haematology reports is unnecessary.
What do General Practitioners think of the new professional competence scheme? Daly et al surveyed 48 GPs about the new competence scheme. 75% were concerned about the time required and 67% felt that they needed further information about the scheme. 60% have never had any teaching on clinical audits and only 48% felt that it was practical in their current practice.
Scoliosis secondary to an unusual rib lesion: Burke et al describe a 16 year old boy with a right-sided scoliosis. MRI revealed an extensive soft tissue lesion of the left posterior cheat wall. A CT guided biopsy found a cavernous haemangioma. A rib resection was undertaken with satisfactory results.
Complications of nasogastric tube placement-don’t blow it: Leonard et al report on inadvertent placement of nasogastric tubes. The first instance resulted in a pneumothorax and the second in a lung abscess. Positive auscultation can have a false positive rate of 20%. Misinterpretation of radiography occurs in 27% of cases and therefore should be confirmed by a radiologist.
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