• Utilisation of clinical networks to facilitate elective surgical workload; a preliminary analysis

      Burke, T; Waters, P; Waldron, RM; Joyce, K; Khan, I; Khan, W; Kerin, M; Barry, K; Mayo General Hospital and Galway University Hospital (Irish Medical Journal, 2015-12)
      Clinical networks have potential to increase elective surgical workload for benign conditions in non-cancer centres. The aims of this study were to determine outcomes for elective laparoscopic cholecystectomy in our unit and to evaluate early experience in managing benign surgical workload referred from the tertiary centre within our clinical network. An analysis of cholecystectomies performed at Mayo General Hospital was conducted (2003-2013). A review of elective procedures more recently referred from Galway University Hospital (GUH) waiting lists was also conducted. 1937 consecutive cholecystectomies were performed with an overall laparoscopic conversion rate of 1.7% (33/1875). The total major complication rate was 0.93% (18/1937). 151 selected procedures originating from GUH have been performed since December 2013 without adverse events. Laparoscopic cholecystectomy can be performed in significant volume in the general hospital environment. This and other appropriate benign surgical procedures may be performed outside of tertiary units according to network agreements.
    • Variations in the presentation of aphasia in patients with closed head injuries.

      Kavanagh, Dara Oliver; Lynam, Conor; Duerk, Thorsten; Casey, Mary; Eustace, Paul W; Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo, Ireland. (2012-01-31)
      Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.
    • Withholding truth from patients.

      O'Sullivan, Elizabeth; Mayo General Hospital, Castlebar, Co Mayo. lizosul@eircom.net (2012-01-31)
      The issue of whether patients should always be told the truth regarding their diagnosis and prognosis has afforded much debate in healthcare literature. This article examines telling the truth from an ethical perspective. It puts forward arguments for and against being honest with patients, using a clinical example to illustrate each point.