Irish Journal of Medical Science最新文献

Backround: While low-carbohydrate/high-protein diets are common for rapid weight loss, their controversial side effects warrant investigation.

Aims: This study aimed to examine age- and duration-dependent effects of high-protein diets on the liver and kidneys of adult (6 months) and elderly (18 months) rats.

Methods: Thirty-two male Wistar albino rats were divided into four groups: Adult Standard, Adult High-Protein, Elderly Standard, and Elderly High-Protein. After one month, we collected kidney and liver samples for histological analysis and biochemical assessment of MDA and GSH levels.  RESULTS: High-protein diets severely affected the kidneys of both adult and elderly rats. The livers also exhibited moderate degenerative changes. We found a significant increase in MDA levels, indicating lipid peroxidation. Additionally, hepatic and renal GSH levels significantly increased in elderly rats on a high-protein diet, suggesting a metabolic response to oxidative stress.  CONCLUSION: Our findings suggest that high-protein diets should be applied very cautiously, especially in elderly individuals and those with existing kidney disorders.

Background: Ochronosis is a rare metabolic disorder characterized by the deposition of homogentisic acid in connective tissues, leading to fragility and degeneration. Total knee arthroplasty (TKA) in ochronotic arthropathy is challenging due to compromised bone and soft tissue quality. Patellar tendon rupture during TKA in this context is an uncommon but serious complication.

Case presentation: A 64-year-old male with severe degenerative knee arthropathy underwent left TKA. Intraoperatively, blackish discoloration of cartilage and tendons consistent with ochronosis was noted. During patellar eversion, a partial-thickness rupture of the friable patellar tendon occurred. The rupture was repaired. Postoperative recovery included early mobilization with a range-of-motion brace. At six months, the patient regained a knee range of motion from 0 to 120 degrees. Histopathology and biochemical testing confirmed ochronotic arthropathy.

Conclusion: This case highlights the risk of patellar tendon rupture during TKA in ochronotic patients due to altered tendon integrity. Preoperative recognition and cautious handling of tendons are crucial. Early repair and rehabilitation can lead to favorable functional outcomes. Preoperative tendon evaluation by ultrasonography may help anticipate such complications.

Background: Turning is an essential and challenging activity in daily life but is not specifically assessed for people with Alzheimer's disease (PwAD). The timed 360º turn test (360TT) is a specific tool assessing turning ability; however, its reliability and validity have not been established in Alzheimer's disease (AD).

Aims: To investigate: (1) the test-retest reliability of the 360TT in PwAD; (2) the standard error of measurement (SEM) and minimum detectable change (MDC) in the 360TT times; (3) the concurrent and known-groups validity of the 360TT times.

Methods: This cross-sectional study included 33 PwAD and 32 healthy people. The 360TT was administered along with the Berg Balance Scale, Timed Up and Go Test, and Mini-Mental State Examination. The test-retest reliability of the 360TT was examined by performing it twice at a 7-10 day interval for PwAD.

Results: Test-retest reliability of the 360TT was excellent for the dominant and non-dominant sides (ICC = 0.957 and ICC = 0.916, respectively). The SEM₉₅ and MDC₉₅ values were 0.33 s and 0.91 s for the dominant side, while these values were 0.31 s and 0.85 s for the non-dominant side. The 360TT was correlated with the BBS, TUG, and MMSE in both sides (p < 0.05). PwAD took longer to complete the 360TT on both sides compared to healthy people (p < 0.001).

Conclusions: The 360TT is a reliable and valid method in the evaluation of turning ability for PwAD. Clinicians and researchers can also use the 360TT to quantify changes in turning ability in AD.

The Objective Structured Clinical Examination (OSCE) first appeared as a title and as an acronym in 1979. It has now become a worldwide phenomenon with almost 3,200 related publications reported in PubMed to date. Prior to its introduction, there were very real concerns regarding Objectivity, Validity and Reliability of prior clinical assessment methods and the overall fairness to students on their assessment of clinical competence. Variations and applications in other allied clinical sub-specialties and non-allied, have now emerged on the method. In addition, numerous psychometric papers have resulted. However, very little in reference to its precise origin has been accurately reported. What has been reported thus far, in some otherwise excellent publications, has been significantly incorrect. A combination of the Steeplechase Examination method, a joint paper from the University of Dundee and the University of Glasgow, and a dissertation for a Diploma in Educational Technology by the author, has resulted in what has now become the globally recognised term: OSCE. The detailed evidence-based narrative of its true origins and its Irish connections to The Royal College of Surgeons in Ireland (RCSI) in this paper summarises the preceding two years of academic endeavour in Dundee prior to its publication debut in January 1979.

Background: Non-pharmacological distraction methods are alternatives that can help relieve pain and anxiety during blood collection in pediatric patients.

Aims: This study aimed to evaluate the effects of distraction methods used during blood collection on pain and anxiety in children aged 9-13. Wong-Baker FACES Pain Rating Scale (WB-FACES) and Visual Analog Scale (VAS) were used to assess pain and anxiety levels.

Methods: A randomized controlled experimental study involving 450 pediatric patients aged 9-13 who applied to the pediatric endocrinology unit of a university hospital. During the blood collection procedure, children were randomly divided into 3 groups: watching cartoons, cold application (Buzzy), and control. Age-appropriate pain scales were used to assess pain.

Results: The study included 450 children, 57.6% (n = 259) male and 42.4% (n = 191) female, with a mean age of 11.02 ± 1.45. One-third (n = 150) of the participants were shown cartoons, and one-third (n = 150) were given the cold application method. The remaining 1/3 (n = 150) were not given any distraction intervention during blood collection. Significantly lower pain scores were recorded in both intervention groups compared to the control group (P < 0.001 and P < 0.001).

Conclusion: Less pain was noted in the Buzzy and cartoon groups compared to the control group. This suggests that these methods are effective non-pharmacological methods that can be used to reduce pain. The results show that these methods can be safely used for venipuncture pain in children aged 9-13 years.

Introduction: Cerebral venous thrombosis as the first manifestation of Behçet's Syndrome (BS) is very rare. We describe a case of BS in which all four major cerebral venous sinuses, including the bilateral sigmoid sinuses, transverse sinuses, and superior sagittal sinuses, exhibited severe cerebral venous thrombosis.

Case report: An 18-year-old man was brought to our hospital with a three-month-old, wide, throbbing headache in both hemispheres and double, blurred vision while looking to the right for the last week. Magnetic Resonance Imaging (MRI) showed extensive thrombosis involving the bilateral sigmoid sinuses, transverse sinuses, and superior sagittal sinus. Collagen tissue diseases and systemic thrombophilia were ruled out. The patient, who had a history of erythema nodosum and genital and oral aphthae, was evaluated as 3/6 (+) positive by the pathergy test, leading to the diagnosis of BS. Prednisolone 48 mg/day and azathioprine 2 × 50 mg/day were started, and the prednisolone dosage was lowered to be stopped in three to four months. For nine months, anticoagulant medicine was administered. Partial recanalization was seen on control MRI venography.

Conclusions: It may be life-saving to consider Behçet syndrome as a differential diagnosis in patients with multiple cerebral venous thrombosis.