Abstract:
BACKGROUND:During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey. Such programmes have aimed to maximise efficiency, whilst maintaining patient satisfaction and achieving exceptional functional outcomes. OBJECTIVE:We have undertaken a thorough review the literature in relation to enhanced recovery programmes (ERPs) and the research that has underpinned individual elements of enhanced recovery. A literature search of enhanced recovery protocols was carried out using PubMed, Cochrane, Embase and OVID. No language restrictions were imposed on the search. REVIEW:ERPs represent a multifactorial framework which may be subdivided into several phases. Pre-operative education programmes, outpatient consultation, pre-anaesthetic assessment, pre-procedural physiotherapy, day-of-surgery admission, pre-operative medications, type of anaesthesia, blood loss reduction protocols, multimodal analgesia delivery, day-of-surgery mobilisation, thromboembolic prophylaxis and ongoing rehabilitation are essential in enhanced recovery. CONCLUSION:These successful strategies have streamlined the patient pathway of arthroplasty surgery in a cost-effective manner, whilst reducing length of hospital stay and maintaining patient outcomes. Further studies are required to appropriately quantify the impact of individual variables and development of an internationally agreed ERP.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Galbraith AS,McGloughlin E,Cashman Jdoi
10.1007/s11845-017-1641-9subject
Has Abstractpub_date
2018-02-01 00:00:00pages
97-109issue
1eissn
0021-1265issn
1863-4362pii
10.1007/s11845-017-1641-9journal_volume
187pub_type
杂志文章,评审abstract:INTRODUCTION:Optimisation of patient comfort during flexible bronchoscopy is achieved with the use of intravenous sedation and vocal anaesthesia. METHODS:The effect of transcricoid lignocaine injection was investigated with regards to ease of procedure and frequency of cough. A single-blinded study was carried out and...
journal_title:Irish journal of medical science
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11845-014-1099-y
更新日期:2015-06-01 00:00:00
abstract::A bioassay method for measuring parathyroid hormone (PTH) and other substances that influence bone metabolism is described. Monolayers of bone cells are culturedin vitro, then treated with the test material. Biological activity is determined by measuring the resulting rise in bone-cell adenosine 3',5'-monophosphate (c...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02938966
更新日期:1976-12-01 00:00:00
abstract::We report a case of primary aldosteronism in pregnancy that was treated surgically by removal of the adenoma in the 2nd trimester. Only a few cases have been reported in the English literature due to the rarity of the condition. Primary aldosteronism follows a variable course in pregnancy. In the majority of cases the...
journal_title:Irish journal of medical science
pub_type: 杂志文章,评审
doi:10.1007/BF02967204
更新日期:1995-10-01 00:00:00
abstract::We report experiences in 3 patients with acromegaly while using the somatostatin analogue octreotide. In case 1, a 44 year old male developed pneumococcal meningitis 3 months after having transphenoidal surgery for a pituitary tumour. This occurred with the re-emergence of communication between the surgical tract and ...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02942899
更新日期:1993-02-01 00:00:00
abstract::Post-traumatic hypopituitarism (PTHP) is an important and relatively common complication of TBI (traumatic brain injury). A number of studies have shown that this clinical phenomenon can occur soon after TBI (acute) or later in the chronic phase. Patients with moderate to severe TBI are at a particular risk of develop...
journal_title:Irish journal of medical science
pub_type: 杂志文章,评审
doi:10.1007/s11845-019-02007-6
更新日期:2019-11-01 00:00:00
abstract:AIM:Scarcity of paediatric cholelithiasis limits the obtainable experience in paediatric laparoscopic cholecystectomy (LPC). We report minilaparotomy cholecystectomy (MLC) in children which may be a useful alternative to LPC avoiding the added cost of disposable laparoscopic equipment. METHODS:Nineteen cases underwent...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-007-0044-8
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Diabetic foot ulcers (DFU) are associated with an increased risk of lower limb amputation and death. Reported mortality rates for patients with DFU are as high as 50% after 5 years. AIMS:The aim of this retrospective study was to examine the 5-year clinical outcomes of patients with high-risk diabetic foot ...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-019-02108-2
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Rubella is caused by the rubella virus, a single-stranded RNA virus of the Togaviridae family. The most severe complications of rubella in adult women occur during pregnancy when infection can lead to miscarriage, stillbirth or congenital rubella syndrome. Antenatal rubella susceptibility screening is no lon...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-017-1722-9
更新日期:2018-08-01 00:00:00
abstract::Serum antibodies to Epstein-Barr virus (EBV) were measured in members of twenty-nine families in which two or more first degree relatives had rheumatoid arthritis (RA). These patients were assessed clinically for activity of disease and their treatment recorded. A higher proportion of seropositive individuals was foun...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02943612
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVES AND BACKGROUND:Glasgow coma scale (GCS) is considered an important parameter to predict the clinical outcome in head injury; however, in some cases such as the use of sedative drugs the estimate of GCS would not be precise. Bispectral index (BIS) is an electrophysiological parameter to determine the clinical...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-011-0768-3
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:A congenital diaphragmatic hernia (Bochdalek's hernia) rarely presents in adulthood. CASE PRESENTATION:We present the case of a 21-year-old woman with thrombocytopenia secondary to hypersplenism due to left-sided (sinistral) portal hypertension. This portal hypertension was caused by strangulation of the sp...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-008-0140-4
更新日期:2009-03-01 00:00:00
abstract::Two term infants suffering severe asphyxial events were found to have diffusely high attenuation of the cortical gyri on CT scanning within 12 days. The findings are consistent with haemorrhagic necrosis or microcalcification. This feature has rarely been described in the literature. The evolution of the CT appearance...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02937934
更新日期:1998-07-01 00:00:00
abstract::Height, body weight, the thickness of triceps, biceps, subscapular and supra-iliac skinfolds and the six-minute run-walk test of aerobic endurance were measured on 1163 National school children between the ages of 7 and 13, who were attending rural or urban schools in counties Cork, Galway, Limerick, Mayo, Waterford a...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02942167
更新日期:1993-09-01 00:00:00
abstract:INTRODUCTION:This is a retrospective review of the Rotunda Hospital Emergency Room (ER) documentation with respect to attendances for a 4-month period (August-November) in both 2009 and 2012. The aim was to quantify the workload and assess the quality of care offered to patients attending the ER over the two time perio...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-014-1185-1
更新日期:2014-12-01 00:00:00
abstract:AIM:The aim of this study was to investigate the microbiology of secondary bacterial peritonitis due to appendicitis and the appropriateness of current antimicrobial practice in one institution. METHODS:A 14-year retrospective single-centre study of 69 consecutive paediatric patients (age 1-14 years) with appendicitis...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-013-1055-2
更新日期:2014-12-01 00:00:00
abstract::Advocates of transhiatal oesophagectomy warn of the danger of tracheal injury resulting from the blind dissection of tumours of the upper and middle thirds of the oesophagus when the tumour has invaded the membranous part of the trachea. We report an unusual cause of tracheal injury at transhiatal oesophagectomy due t...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF02947266
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Anaesthetists are at high risk from blood-borne pathogens. Universal Precautions (UP) include the routine use of appropriate barrier precautions and techniques to reduce the likelihood of exposure to blood, body fluids and tissues that may contain pathogens. The compliance of Irish anaesthetists with these p...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF03167699
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Vitamin D deficiency in pregnancy has important maternal and fetal implications, with increased risk of developing gestational diabetes, preeclampsia, preterm birth and small for gestational age birthweight. It is recommended that every pregnant woman should take 5 μg (200 IU) of vitamin D per day during pre...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-017-1707-8
更新日期:2018-08-01 00:00:00
abstract::This article was published online with an error. In Table 3, the name of the variable in the last row is missing. It just says 'mmHg'. The name to be written is 'MAP (mmHg)'. ...
journal_title:Irish journal of medical science
pub_type: 已发布勘误
doi:10.1007/s11845-020-02363-8
更新日期:2020-09-09 00:00:00
abstract:BACKGROUND:A review of theatre activity in all Health Service Executive (HSE) hospitals in Cork and Kerry in 2008 required a manual extraction of theatre activity data from largely paper-based log books. A key data management recommendation suggested that "a standardised computerised theatre log book system be develope...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-013-1030-y
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Postoperative sore throat (POST) is a common complication following tracheal intubation. The effectiveness of prophylactic dexamethasone on POST needs further elucidation. AIMS:To evaluate the effectiveness and safety of intravenous dexamethasone for the prevention of POST in patients undergoing endotrachea...
journal_title:Irish journal of medical science
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11845-013-1057-0
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Obtaining patient consent is a fundamental process in surgical practice and is integral in respecting and safeguarding patient autonomy. It has been reported that the task of consenting patients frequently lies with junior doctors, who have the least experience of the procedure. AIM:To examine the role of i...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-018-1782-5
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Non-attendance at outpatient clinics is common and costly. AIMS:This study aimed to determine if sending SMS ('short message service' or text message) reminders to patients before appointments reduced non-attendance. METHODS:We collected outpatient data at Ballyfermot and Lucan Community Adult Mental Healt...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-017-1710-0
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Surgery for perforated peptic ulcer disease is one of the most common emergency procedures carried out in the western world. The role of postoperative empiric Helicobacter Pylori eradication therapy is controversial. METHODS:The clinical, operative and postoperative surveillance details of 84 consecutive pa...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF03167950
更新日期:2006-04-01 00:00:00
abstract:INTRODUCTION:We conducted a study at two main centres for paediatric surgery in the Republic of Ireland, Temple Street Children's University Hospital (TSCUH) and Our Lady's Children's Hospital Crumlin (OLCHC). AIM:The aim of the study was to assess doctors' opinions, frequency and methods of smartphone use in clinical...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-017-1713-x
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Clarithromycin is a commonly used macrolide antibiotic. It is known to cause QT prolongation. Medication induced QT prolongation is a major risk factor for the development of torsade de pointes. METHODS:A 79-year-old lady presented with frequent episodes of torsade de pointes following commencement of clari...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-007-0057-3
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The apolipoprotein (Apo) E gene, and thus its gene product, plays a central and pervasive role in lipid metabolism by serving as a ligand for lipoprotein receptors. Polymorphisms of this gene have been associated with variation in lipid phenotypes in some Caucasian and Asian populations, but not in others. N...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/BF03170486
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:In patients presenting with rapidly progressive dementia, prion disease may enter the differential diagnosis. The commonest malignancies masquerading as prion disease are primary CNS lymphoma and intravascular large B-cell lymphoma, both rare and difficult to diagnose without brain biopsy. CASE PRESENTATION...
journal_title:Irish journal of medical science
pub_type: 杂志文章,评审
doi:10.1007/s11845-017-1653-5
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:Prostate cancer is the most common solid cancer affecting men in Ireland. Transrectal ultrasound (TRUS) biopsies of the prostate are routinely performed to diagnose prostate cancer. They are, in general, a safe procedure but are associated with a significant risk of infective complications ranging from fev...
journal_title:Irish journal of medical science
pub_type: 杂志文章
doi:10.1007/s11845-011-0774-5
更新日期:2012-03-01 00:00:00
abstract::It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. Much of the metabolic monitoring is carried out by psychiatrist...
journal_title:Irish journal of medical science
pub_type: 杂志文章,评审
doi:10.1007/s11845-014-1205-1
更新日期:2015-03-01 00:00:00