Improved mortality outcomes over time for weekend emergency medical admissions
ConclusionNo increase in 30-day in-hospital mortality for weekend admissions was found in this study. There has been a substantial reduction in mortality for both weekday and weekend admissions over time. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 11, 2017 Category: General Medicine Source Type: research

Research amongst Irish surgical trainees: what ’s the trend?
ConclusionThere has been a significant decrease in publication rates between new and old GS pathways. No significant changes were identified between new and old T&O pathways. There was no difference between H-index and average citations between specialties. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 11, 2017 Category: General Medicine Source Type: research

Risk factors for cardiovascular disease in subclinical hypothyroidism
AbstractSubclinical hypothyroidism (SH), defined as an increased serum thyrotropin (TSH) level and normal plasma-free thyroid hormones ’ concentrations, is common in the general population, in particular, among elderly women. Its prevalence ranges from 4 to 15% and up to 20% among females aged >  60 year. Although SH has been associated with atherosclerotic cardiovascular disease (CVD), it is acknowledged that the high prevalence of dyslipidemia in elderly people is considered a common biochemical condition. Therefore, whether SH is associated with a higher risk for CVD is still controver sial. At t...
Source: Irish Journal of Medical Science - May 10, 2017 Category: General Medicine Source Type: research

Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery
ConclusionThere is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 6, 2017 Category: Journals (General) Source Type: research

Trends in corneal transplant surgery in Ireland: indications and outcomes of corneal transplant surgery and intraocular lens opacification following Descemet ’s stripping automated endothelial keratoplasty
ConclusionsPseudophakic corneal decompensation is the commonest indication for corneal transplant surgery, with lamellar keratoplasty the most frequent approach in our cohort, reflecting developments observed in corneal transplant surgery elsewhere. Prior corneal transplant failure and Fuch ’s dystrophy remain important risk factors for failure. The risk of intraocular lens opacification and its potential effects on vision should be elaborated prior to endothelial keratoplasty. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 6, 2017 Category: Journals (General) Source Type: research

Comparison of nomograms predicting lymph node invasion in patients undergoing radical prostatectomy for prostate cancer
ConclusionNomograms produce useful information regarding risk of disease; however, they often have not been validated on different populations. Risk predictions need to be considered carefully and treatment decisions were made on a patient specific basis. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 6, 2017 Category: Journals (General) Source Type: research

Reply: The significance of regression in thin melanoma of the skin
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 6, 2017 Category: Journals (General) Source Type: research

Margins of viability
AbstractA poem reflecting the compassion, conflicts, dilemmas and outcome in the management of an extremely premature 22+4-week gestation baby girl. Challenges faced by neonatologists in offering optimal care to extremely low birth weight (ELBW) newborn infants and their families is summarised in this poem as an emotional transaction between the clinician and the periviable baby. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 6, 2017 Category: Journals (General) Source Type: research

Is chemotherapy always required for cancer in pregnancy? An observational study
ConclusionsThis study identified a select cohort of patients that did not receive chemotherapy during pregnancy. There were no adverse outcomes to mothers due to delayed treatment. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 5, 2017 Category: Journals (General) Source Type: research

Circulating rotavirus genotypes in the Irish paediatric population prior to the introduction of the vaccination programme
ConclusionThis distribution of genotypes is comparable to those found in other European countries prior to vaccination suggesting that the vaccine should be highly efficacious in the Irish population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 5, 2017 Category: Journals (General) Source Type: research

Assessment of the effectiveness of group education on knowledge for women with newly diagnosed gestational diabetes
AbstractBackgroundGestational diabetes mellitus (GDM) is identified in pregnancy and resolves following delivery. It increases maternal and foetal morbidity and may increase risk of future type 2 diabetes. Women diagnosed with GDM need high-quality multidisciplinary education in order to apply necessary changes to their diet and lifestyle. There is a paucity of information on the effectiveness of group education for women with GDM.AimsThe aim of this study was to assess the effect of a multidisciplinary group intervention delivered by a specialist midwife and dietitian on women ’s knowledge of GDM.MethodsAll women wi...
Source: Irish Journal of Medical Science - May 5, 2017 Category: Journals (General) Source Type: research

Can chronic disease be managed through integrated care cost-effectively? Evidence from a systematic review
ConclusionsThe economic evidence, examined within this review, suggests that integrated care programmes have the potential to be cost-effective, achieving greater health benefits and are less expensive than usual care. Across all the interventions considered, the reduction in inpatient and outpatient admissions was the main contributor to reducing costs. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 5, 2017 Category: Journals (General) Source Type: research

Patients treated with immunosuppressive steroids are less aware of sick day rules Than those on endocrine replacement therapy and may be at greater risk of adrenal crisis
This study sets out to compare patient awareness of steroid sick day rules in endocrine and non-endocrine patients.DesignA short case history is presented to illustrate the clinical impact of adrenal crisis in a patient on immune suppression. Subsequently, we present the results of a 9-point questionnaire, devised to determine knowledge of steroid sick day rules, in two patient cohorts. In group 1, patients on immunosuppressive steroids were recruited from non-endocrine clinics to complete the questionnaire. In group 2, patients on replacement steroids were recruited from endocrine clinics.ResultsEndocrine patients exhibit...
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

The impact of a structured clinical training course on interns ’ self-reported confidence with core clinical urology skills
ConclusionThis study raises concerns about newly qualified doctors ’ practical experience in urology. We suggest that this course improves knowledge and confidence with practical urology skills and should be incorporated into intern induction. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

Pragmatic considerations for medical imaging of the obese patient
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

Association analysis of rs1049255 and rs4673 transitions in p22phox gene with coronary artery disease: A case-control study and a computational analysis
ConclusionOur data demonstrated that rs4673 transition may be involved in susceptibility to CAD and could be applied as a potential biomarker for this disease. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

Tinzaparin thromboprophylaxis prescribing practice after caesarean delivery 2009 –2014
AbstractBackgroundNational guidelines have been developed to ensure correct dosing of tinzaparin for women delivered by caesarean delivery (CD) to reduce the risk of venous thromboembolism.AimsThe aim of this study is to examine the impact of implementation of national guidelines on thromboprophylaxis prescribing practice for women undergoing CD in a university maternity hospital.MethodsDetails of tinzaparin usage were obtained from the Hospital pharmacy for the years 2009 –2014. Information on CD and pulmonary embolism (PE) were obtained from the Hospital’s annual clinical reports.ResultsFollowing guideline re...
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

Prospective evaluation of a virtual urology outpatient clinic
ConclusionsVirtual clinic is a safe and cost-effective alternative to general OPD review in appropriately selected patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2017 Category: Journals (General) Source Type: research

Synchronous diffuse large B cell lymphomas of the endometrium and breast: a staging dilemma
ConclusionsStaging of synchronous extra-nodal lymphomas, particularly when they arise in rare sites such as the endometrium and breast, is difficult and previously unreported. We present our rationale for defining our patient ’s disease as synchronous stage IE DLBCL’s. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

Small interfering RNA targeting receptor for advanced glycation end products protects the rats from multibacterial sepsis
The objective of this study is to investigate the effect of small interfering RNA (siRNA) targeting RAGE on the outcome of multibacterial sepsis induced by cecal ligation and puncture (CLP) in a rat model.MethodsA vector-based RAGE-targeted siRNA expression system (Psilencer-siRNA) was constructed and injected into rats via the jugular vein catheter after CLP injury. The RAGE expression in livers, survival rate, and plasma cytokine levels after CLP were compared between Psilencer-siRNA treated and control rats.ResultsThe expression of RAGE in livers which was upregulated after CLP injury was greatly curtailed by Psilencer-...
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

Oral manifestations of lupus
ConclusionOur findings suggest that oral pathology is common in this cohort of patients. Regular oral examination is warranted to identify oral lupus and provide treatment. Associated diseases such as Sjogren ’s syndrome may also be identified. Patients should be encouraged to see their general dental practitioners on a regular basis for mucosal review. Any persistent ulcer that fails to respond to treatment or hard lump needs urgent histopathological evaluation to exclude malignant transformation to s quamous cell carcinoma. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

Association of NUDT15 c.415C & gt;T allele and thiopurine-induced leukocytopenia in Asians: a systematic review and meta-analysis
ConclusionThe results of this meta-analysis confirm thatNUDT15 c.415C>T may be an important predictor of thiopurine-induced leukocytopenia in Asians. Genotype targeting ofNUDT15 c.415C>T before initiating thiopurine treatment may be useful to limit leukocytopenia. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent ’s University Hospital over a 6-month period
ConclusionBroad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

In recognition of Ireland ’s medical scientists
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

CCK1 receptor is involved in the regulation of protein lysine acetylation in GBC-SD cells and gallbladder carcinoma
ConclusionsCCK might regulate protein lysine acetylation via CCK1 receptor. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2017 Category: Journals (General) Source Type: research

The significance of regression in thin melanoma of the skin
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 28, 2017 Category: Journals (General) Source Type: research

Surgical tuition within Irish hospitals: a national survey
ConclusionIn surgery, the apprenticeship model is still the framework for developing the surgeons of the future. In attempting to produce a highly skilled workforce for the future, we rely on those in senior positions to train those coming through; higher surgical trainees are relied on to teach the core surgical trainees and so on. Our study shows a low level of formalisation of this model. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 28, 2017 Category: Journals (General) Source Type: research

High-mobility group box 1 regulates cytoprotective autophagy in a mouse spermatocyte cell line (GC-2 spd ) exposed to cadmium
ConclusionsOur data suggest that HMGB1-induced autophagy appears to act as a defense/survival mechanism against Cd cytotoxicity in GC-2spd cells. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 7, 2017 Category: Journals (General) Source Type: research

An updated review of cardiac devices in heart failure
ConclusionDue to the clinical and economic arguments, treatment of heart failure is said to be the biggest unmet need in cardiology today. The data reviewed herein support this statement. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 25, 2017 Category: Journals (General) Source Type: research

The analysis of lncRNA HOTAIR rs12826786 C & gt;T polymorphism and gastric cancer susceptibility in a Turkish population: lack of any association in a hospital-based case –control study
ConclusionsOur results demonstrate that theHOTAIR rs12826786 C>T polymorphism has not been in any major role in genetic susceptibility to gastric carcinogenesis, at least in the population studied here. Independent studies are needed to validate our findings in a larger series, as well as in patients of different ethnic origins. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 24, 2017 Category: Journals (General) Source Type: research

Transformed follicular lymphoma (tFL): consolidation therapy may improve survival
ConclusionThis consecutively treated series of 26 patients with tFL have had a better outcome than expected which may be due to the use of rituximab-chemotherapy and a consolidation strategy based on age, PS and availability of a sibling donor. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 21, 2017 Category: Journals (General) Source Type: research

Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA)
ConclusionDespite a substantial reduction in population mean TC from a high of 6.0  mmol/L in the 1980s to 5.1 mmol/L, this study reports a failure to control hypercholesterolaemia to recommended risk-stratified targets in the Irish adult population. Recommendations for policy include continued monitoring of those at highest risk and CVD risk assessment in those perceived to be at low risk in order to inform shared decision making in relation to lifestyle modification and medication management. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 10, 2017 Category: Journals (General) Source Type: research

Proceedings of the RAMI Section of OtoRhinoLaryngology Head and Neck Surgery (ORL HNS) Spring Meeting, Friday 9th December 2016, Education and Research Centre, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2017 Category: Journals (General) Source Type: research

The effect of Rapid Access Prostate Clinics on the outcomes of Gleason 7 prostate cancer: does earlier diagnosis lead to better outcomes?
AbstractIntroductionRapid Access Prostate Clinics (RAPC) were introduced in Ireland by the National Cancer Control Programme bringing about expedited referral pathways and increased detection rates of prostate cancer. Lower Gleason (G) grade at diagnosis due to RAPC has been previously reported but grade at prostatectomy has not been assessed. The aim of this study was to assess the impact of RAPC on the outcomes of patients with G7 disease on radical prostatectomy (RP).MethodsA retrospective analysis was carried out of all RPs performed over a 9-year period (2006 –2014). Outcomes for G7 prostatectomies were compared...
Source: Irish Journal of Medical Science - March 9, 2017 Category: Journals (General) Source Type: research

An international assessment of trainee experience, confidence, and comfort in operative vaginal delivery
AbstractAimThe aim of this study was to assess Irish and Canadian obstetricians in training ( “trainees”) experience, confidence, and comfort in performing operative vaginal delivery (OVD).Study designTrainees in Obstetrics and Gynaecology in the University of Toronto and the Royal College of Physicians of Ireland (RCPI) were invited to participate in an anonymous online survey reviewing experience as primary operator of OVD. Trainee confidence and comfort was self-assessed based upon their last few OVDs.ResultsThe response rate was 55% amongst Canadian trainees (31/56) and 44% amongst Irish trainees (21/48). W...
Source: Irish Journal of Medical Science - March 7, 2017 Category: Journals (General) Source Type: research

Patient response to physician expressions of uncertainty: a systematic review
ConclusionsUncertainty is a ubiquitous feature of medicine and more research should examine how physician ’s expressions of uncertainty affect patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 7, 2017 Category: Journals (General) Source Type: research

General poster session
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 6, 2017 Category: Journals (General) Source Type: research

Effects of different methods of using pneumatic tourniquet in patients undergoing total knee arthroplasty: a randomized control trial
AbstractBackgroundThe goal of this work was to investigate the effects of different methods of using pneumatic tourniquet on reducing blood loss in patients undergoing cemented total knee arthroplasty (TKA).MethodsOne hundred and fifty patients undergoing unilateral cemented TKA were randomly divided into three groups (50 patients per group). The tourniquet was used during the entire operation (Group A), used from the beginning of operation to the completion of joint replacement (Group B), and from the beginning of osteotomy to the completion of arthroplasty (Group C). The following parameters were recorded: intraoperative...
Source: Irish Journal of Medical Science - March 4, 2017 Category: Journals (General) Source Type: research

The cost and mortality of hip fractures in centenarians
ConclusionsThe 1-year mortality rate of any person aged 100  years or older is thought to be 67% for men and 59% for women. This suggests that the 1-year mortality rate of 71% in this current study is only slightly worse than the usual life expectancy of a person older than 100 years of age. Our data suggest that the extreme elderly should be offered opera tive management. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 4, 2017 Category: Journals (General) Source Type: research

Audit of aspects of practice in relation to patients with suspected community-onset blood stream infection
ConclusionsSuspected C-BSI is common.E. coli is the leading pathogen. Urine is a common suspect source. Urinary catheters are present in 4.5%. Median time to first dose of antimicrobial treatment is almost 4  h suggesting scope to expedite patients transition from presentation to intervention. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 2, 2017 Category: Journals (General) Source Type: research

Increased number of community-living older adults attending an emergency department with falls and fractures: North Dublin experience
ConclusionWith the rapidly ageing population in North Dublin, there is an urgent need to prioritise comprehensive assessment and provide a coordinated falls programme when older adults present to ED to reduce the risk of future falls and injuries. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 25, 2017 Category: Journals (General) Source Type: research

Left cardiac sympathetic denervation: case series and technical report
ConclusionIn this case series, we highlight that LCSD provides a critical adjunct to existing medical therapies and should be considered for all patients with life-threatening refractory arrhythmias especially those patients on maximal medical therapy. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 25, 2017 Category: Journals (General) Source Type: research

Evaluating cardioversion outcomes for atrial fibrillation on novel oral anticoagulants versus warfarin: experience at a tertiary referral centre
ConclusionIn elective cardioversions, the group anticoagulated with NOAC was less likely to have subtherapeutic anticoagulation and hence deferred procedures and had reduced health care consumption when compared to the group anticoagulated with warfarin. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 24, 2017 Category: Journals (General) Source Type: research

Definitions and resistance rate difference
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 22, 2017 Category: Journals (General) Source Type: research

Proceedings of the RAMI Section of Healthcare Informatics Students Meeting, Friday 17th June 2016, Setanta House, Dublin
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 21, 2017 Category: Journals (General) Source Type: research

The effect of candesartan on pentraxin-3 plasma levels as marker of endothelial dysfunction in patients with essential arterial hypertension
ConclusionsCandesartan decreases PTX3 and hs-CRP plasma levels more powerful than other classes of antihypertensive drugs (beta blockers, calcium channel blockers, and diuretics), so we may assume that candesartan has a more potent action in reversing endothelial dysfunction and that it offers a higher vascular protection than other classes of antihypertensive drugs. We are suggesting that this new biochemical marker, PTX3, might be better and more specific marker for endothelial dysfunction, than hs-CRP. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 21, 2017 Category: Journals (General) Source Type: research

Dysphagia screening in acute stroke care among non-consultant hospital doctors
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 21, 2017 Category: Journals (General) Source Type: research

25th Sylvester O ’Halloran Perioperative Scientific Symposium, 2017
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 14, 2017 Category: Journals (General) Source Type: research

Impact of Xpert MRSA/SA blood culture PCR assay on management of positive blood cultures in obstetric patients: a retrospective audit
ConclusionThis study has shown a reduction in the median duration of intravenous antimicrobials and admission; however, larger multi-centre studies are needed to evaluate this potential benefit further. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 14, 2017 Category: Journals (General) Source Type: research

Susan Bewley (Ed.): My life as a woman and a doctor —Beulah Bewley
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 14, 2017 Category: Journals (General) Source Type: research