The development of percutaneous devices capable of closing atrial septal defects has led to renewed debate about optimal management of patients with patent foramen ovale (PFO). Echocardiography has made diagnosing PFO routine , but in most patients appropriate management, including the role of device closure, remains a matter of speculation. Anatomy and prevalence During infancy, fibrous adhesi...

Background Following centralisation of breast cancer services in Ireland, the number of patients attending symptomatic breast units (SBU) has increased significantly. A considerable proportion of patients referred to SBU present with non-suspicious symptoms and fall into a “low-risk” category for breast cancer. It has been proposed that consideration be given to a GP-delivered service for these...

In patients with cardiovascular disease, partial correction of anaemia with epoetin improves quality of life and exercise capacity, and reduces left ventricular hypertrophy. The currently recommended haemoglobin in these patients is 11-12 g/dl. The optimal haemoglobin in patients with diabetes mellitus does not differ from that in non-diabetic patients; however, haemoglobin should be increased ...

INTRODUCTION To assess differences in associations of ocular perfusion pressure (OPP) as well as retinal and retrobulbar blood flow between men and women with primary open angle glaucoma (OAG). METHODS A total of 116 patients with OAG (age 66.9 ± 10.9 years, 70 females) participating in the Indianapolis Glaucoma Progression Study were assessed for OPP, retinal microcirculation, and retrobulba...

It is now recognised that Helicobacter pylori, like most enteric infections, is mainly acquired in childhood. Adults rarely become infected, with seroconversion rates varying between 0.33and 0.5% per person year. The age at which children are most likely to become infected is still unclear, but findings in a number of cross-sectional studies suggest that infection is acquired before the age of ...

Dyspepsia, according to the internationally accepted Rome criteria, refers to pain or discomfort centred in the upper abdomen; patients with predominant heartburn are excluded from this group, although minor or infrequent heartburn is commonly associated with dyspepsia. It is an important condition not only because it is common and costly, but because it may indicate the presence of serious dis...

Chronic hepatitis C virus (HCV) infection may cause slowly progressive chronic hepatitis, cirrhosis, advanced liver failure, and hepatocellular carcinoma. These varying outcomes of type C hepatitis pose a challenge and responsibility which requires firstly, that antiviral treatment is targeted as precisely as possible to those who have progressive disease, and secondly, that patients with advan...

Biological invasions and natural disasters are similar phenomena: Their causes are well understood, but their occurrences are generally unpredictable and uncontrollable. Both invasions and natural disasters can generate enormous environmental damage, and the frequency of damaging events is inversely proportional to their magnitude. Many nations invest in personnel training, disaster preparednes...