Visual impairment in Northern Ireland.

Statistics on the registration of blind and partially-sighted patients in Northern Ireland underestimate the true extent of visual impairment within our community. In comparison to other UK regions, where between 0.53% and 0.59% of the population avail of blind or partial sight registration, only 0.35% of residents in Northern Ireland appear on the respective registers. Most patients on the combined registers are in the older age groups and many also suffer from other disabilities. Regional discrepancies may be attributed to a combination of factors including: patient attitudes to the registration process, medical attitudes to registration and local anomalies in the way in which social services departments both record and present annual registration returns. Better liaison is necessary between the community, hospital and voluntary sector providers to improve identification and support services for the visually impaired in the future.     

Prophylactic oophorectomy in Northern Ireland.

A postal questionnaire was sent to all gynaecological consultants and senior registrars (n = 50) in Northern Ireland to establish the prevalence of prophylactic oophorectomy. Forty three (84%) replied. 72% performed prophylactic oophorectomy (28% unilateral), 28% did not. With reference to the world literature, there appears to be no benefit from the unilateral procedure but a consensus that bilateral oophorectomy is an option which should be considered in certain cases where there is a high risk of ovarian cancer.     

Home haemodialysis in Ireland

Background

A home haemodialysis programme (HHD) was established in Ireland in 2009 following studies suggesting better outcomes and a survival advantage when compared to conventional in-centre dialysis.

Aim

The aim of this study was to assess the outcomes in patients commenced on the HHD programme.

Methods

Baseline characteristics, standard dialysis parameters, blood pressure control, antihypertensive usage, vascular access problems, hospitalisation rates and technical issues related to dialysis were analysed.

Results

Seventeen patients were followed over a 2-year period. Time spent travelling for dialysis-related treatments was reduced with time on dialysis per week increased. There was a trend towards lower blood pressure with nine patients, either discontinuing or having a reduction in antihypertensive medications. There were eight episodes of hospitalisation with the majority of complications related to vascular access.

Conclusion

Home haemodialysis is a community-based therapy, offering an alternative to conventional in-centre haemodialysis in a select patient population.     

Experience with schistosomiasis in Northern Ireland.

Five cases of schistosomiasis have been recorded in the Belfast City Hospital Histopathology Laboratory over the last three years. The sites of infection have included the colon, bladder, uterus and seminal vesicles. All the infected individuals had visited Africa. Three of them were health care workers. The clinician must maintain a high index of suspicion when treating those with a history of travel and risk of exposure to this infection. Diagnosis is made even more critical as the condition is treatable, and serological markers can identify those with occult infection.     

Cancer in Northern Ireland by 2002.

An estimate of cancer deaths and incidence for the years 1997 and 2002, taking account of current trends and population projections for Northern Ireland is presented below. These numbers will be of value to those planning services and, in particular, for those implementing the report "Cancer Services - Investing for the Future". Cancer deaths are expected to rise by almost 13% to 4056 by the year 2002. Marked rises are expected in the number of deaths from cancer of the lung, oesophagus, kidney, bladder and prostate with smaller rises in deaths from breast and pancreatic cancer. The fall in stomach cancer is expected to continue as is the trend of lower deaths from cervical cancer. Deaths from cancer of the colon and rectum are expected to remain static. Estimates of cancer incidence currently and for the years 1997 and 2002 are also included. The impact of tobacco use by the population, which poses a current and future serious threat to public health is highlighted.     

Hereditary breast cancer in Northern Ireland.

The aim of this investigation was to document hereditary breast cancer in Northern Ireland. Family history details from over nine hundred women were obtained by postal survey and one hundred and twenty nine home visits were carried out to collect pedigree information. The families documented varied in the number of affected women from three, which was the minimum criteria for inclusion, to a maximum of nine and many families described other features of hereditary disease such as bilateral breast cancer, ovarian and gastrointestinal malignancies.     

Malaria in Northern Ireland

The clinical features, parasitology and prophylactic history of 67 patients who imported malaria to Northern Ireland between 1974 and 1983 are reported. P. falciparum infections were encountered more frequently than anticipated from current United Kingdom experience. The clinical implications of these findings are discussed.     

The visual arts in Northern Ireland hospitals.

Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals.     

The haematuria clinic--referral patterns in Northern Ireland.

One hundred consecutive patients with haematuria were seen over a three month period at the haematuria clinic, Belfast City Hospital. 14% of patients were found to have transitional cell carcinoma of the urinary bladder; all of these presented with frank haematuria and were over 50 years of age. No malignancy was detected in the microscopic haematuria group. 14% of patients with macroscopic haematuria held back for longer than one month before seeking advice from their general practitioner. 23% with macroscopic and 30% with microscopic haematuria had their symptoms noted by the general practitioner for more than a month before they were referred for investigation. The waiting time for initial investigation at the haematuria clinic took longer than six weeks in 52% with macroscopic and 39% with microscopic haematuria. Our study has identified a high-risk group who need immediate referral and investigation. The importance of patient education, rapid referral by general practitioners and also the need to increase the capacity of the haematuria clinic are emphasized.