A review of a GP registrar-run mobile health clinic for homeless people
ConclusionA GP Registrar-run Mobile Health Clinic achieved its aims of improving access to primary care for rough sleepers and sex workers, and challenging stereotypes of GP Registrars. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 24, 2016 Category: Journals (General) Source Type: research

University Hospital Waterford: 5-year experience of cutaneous melanoma
ConclusionThere has been a steady increase in the number of cutaneous melanoma presentations over the past 5-years to the South East Cancer Centre. Patients are managed best by prompt surgical excision and multidisciplinary management. Our results are in keeping with international standards and work continues in determining overall 5-year survival and recurrence rates. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 21, 2016 Category: Journals (General) Source Type: research

The cost of inpatient management of heart failure patients: a microcosting study in the Irish healthcare setting
ConclusionsThis study confirms that heart failure is a costly condition and that inpatient stay is the major cost driver. HF was significantly more expensive to manage in patients ≤65 years compared to those aged over 65 years. DRG costing frequently over or underestimated the admission cost. Patient-level costs and microcosting are more accurate methods of costing inpatient HF admissions. To our knowledge, this is the first study of the cost of the inpatient treatment of HF within the context of the Irish healthcare setting. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 19, 2016 Category: Journals (General) Source Type: research

Radiation safety awareness among medical interns: are EU guidelines being implemented?
ConclusionCurrently, there is little formal radiation safety training in Irish medical schools. Knowledge of radiation dose and the laws governing prescribing is limited among qualifying interns. Implementation of a formal radiation safety curriculum in Irish Medical Schools would adhere to EU guidelines and improve prescriber knowledge, patient, and personal radiation safety. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 14, 2016 Category: Journals (General) Source Type: research

Proceedings of the Winter Scientific Meeting of the Faculty of Public Health Medicine 2015
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 9, 2016 Category: Journals (General) Source Type: research

Proceedings of the Summer Scientific Meeting of the Faculty of Public Health Medicine 2015
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 9, 2016 Category: Journals (General) Source Type: research

Venous thromboembolism prophylaxis risk assessment in a general surgery cohort: a closed-loop audit
AbstractBackground and aimsVenous thromboembolism (VTE) is a potential source of morbidity and mortality in surgical in-patients. A number of guidelines exist that advise on prophylactic measures. We aimed to assess VTE prophylaxis prescribing practices and compliance with a kardex-based risk assessment tool in a general surgery population.MethodsData on general surgery in-patients were collected on two separate wards on two separate days. Drug kardexes were assessed for VTE prophylaxis measures and use of the risk assessment tool. NICE and SIGN guidelines were adopted as a gold standard. The audit results and information ...
Source: Irish Journal of Medical Science - November 9, 2016 Category: Journals (General) Source Type: research

The duration of gonadotropin stimulation does not alter the clinical pregnancy rate in IVF or ICSI cycles
ConclusionThe duration of stimulation does not alter the CP rate in ICSI or IVF cycles using the long, antagonist or flare stimulation protocol. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 7, 2016 Category: Journals (General) Source Type: research

Multiple intra-hospital transports during relocation to a new critical care unit
ConclusionAlthough IHT is associated with morbidity and mortality, careful logistical planning allows for efficient transfer with low complication rates. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 7, 2016 Category: Journals (General) Source Type: research

Obesity is not a descriptive factor for oxidative stress and viscosity in follicular fluid of in vitro fertilization patients
In this study, our aim was to evaluate the levels of oxidative stress markers and the FF viscosity in obese and non-obese patients.MethodsEighty norm-responder patients undergoing IVF were prospectively grouped according to their body mass indexes (BMI). Group 1 (n = 40) and group 2 (n = 40) had BMI values of ≤24.9 and ≥25.0, respectively. Total sulfhydryl (RSH) levels (nmol/m) and the formation of thiobarbituric acid-reactive substances (malondialdehyde, or MDA) (µmol/ml) in FFs were quantified. For the first time in our study, FF viscosity with changing BMI values was al so determined.Resu...
Source: Irish Journal of Medical Science - November 5, 2016 Category: Journals (General) Source Type: research

Clinical and economic benefit of general practitioner integration to a symptomatic breast service
ConclusionThis study demonstrates that GPs can play a substantial role in the provision of a symptomatic breast service. In addition, the incorporation of GPs in this setting can prove cost-effective. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

70,489 primary care encounters: retrospective analysis of morbidity at a primary care centre in Ireland
ConclusionsPractice databases can generate intelligence on morbidity and health service utilisation in the community. Future research to optimise diagnostic coding at a practice level and to promote this activity in a more representative sample of practices is a priority. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Effectiveness of retrograde intrarenal stone surgery in obese patients
AbstractBackgroundA number of comorbid health problems can be found in obese patients. These problems increase the surgical risk in obese patients.AimsTo determine the effectiveness of retrograde intrarenal surgery for renal stone treatment in obese patients.MethodsWe retrospectively reviewed the data of 106 patients who had retrograde intrarenal surgery with the diagnosis of renal stone in our clinic. The patients were divided into three groups regarding their body mass indexes: ≥30 kg/m2 being obese (group 1), 25 –29.9 kg/m2 being overweight (group 2), and
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Edaravone offers neuroprotection for acute diabetic stroke patients
ConclusionEdaravone represents a promising neuroprotectant against cerebral ischemic injury in diabetic patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Emergency peripartum hysterectomy: our experience
AbstractPurposeTo investigate the incidence of and reasons for emergency peripartum hysterectomy (EPH) between 2009 and 2013 in our hospital, one of the three hospitals with the highest rates of delivery in Turkey.MethodsA retrospective study. Seventy-six peripartum hysterectomies were evaluated. We compared the modes of delivery and examined whether bilateral internal iliac artery ligation was performed.ResultsThe incidence of EPH was 0.77 in 1000. The majority of cases involved multiparity, uterine rupture, placenta praevia, or placental invasion abnormalities. The most frequent reason for EPH was uterine atony (64.5 &nb...
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Nutrition education in the medical school curriculum: a review of the course content at the Royal College of Surgeons in Ireland-Bahrain
ConclusionsThe 15  h spent educating RCSI-B medical students on nutrition is inadequate according to international recommendations. However, RCSI-B is one of many medical schools that do not reach the minimum required hours (25–44) as set by the National Academy of Sciences and the American Society for Nutrition. We recommend that more teaching hours on nutrition be introduced into the curriculum. These extra teaching hours may greatly benefit RCSI-B students, patients and public health in Bahrain. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

De-normalising smoking: tackling supply via major grocery retailers
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Assessment of the 2D:4D ratio in aggression-related injuries in children attending a paediatric emergency department
AbstractBackgroundThe 2D:4D ratio is a sexually dimorphic trait. A lower ratio is correlated with sporting prowess, successful financial trading, risk taking behaviour, aggression, and aggression-related injuries, such as the fifth metacarpal fractures.AimsWe aimed to assess if the ratio correlates to skeletally immature patient aggression.MethodsRadiology reports were searched for the terms “5th metacarpal” or “boxer”. Of 537 X-rays, 142 had fractures. The mechanism of injury was recorded in 102 patients, differentiating aggressive and non-aggressive injury groups. Bone age and chronological age we...
Source: Irish Journal of Medical Science - November 1, 2016 Category: Journals (General) Source Type: research

Effects of remote ischemic preconditioning on acute myocardial injury in patients undergoing valve replacement
ConclusionsThe present study demonstrated that remote ischemic preconditioning might reduce release of CK-MB and cTnI in patients undergoing valve replacement. However, RIPC does not improve the clinical outcome of these patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 31, 2016 Category: Journals (General) Source Type: research

Lymphocyte integrin expression differences between SIRS and sepsis patients
ConclusionDistinct differences in T-cell integrin expression exists between patients in SIRS versus sepsis, as well as relative to the source of sepsis. Further work is needed to understand cause and effect relative to the progression from SIRS into sepsis. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 31, 2016 Category: Journals (General) Source Type: research

Patient reported functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomies (ORP)
ConclusionEquivalent good early functional outcomes are being achieved in patients undergoing RP irrespective of surgical approach. Longer follow-up in a prospective randomized fashion is required to fully assess the most appropriate surgical technique. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 28, 2016 Category: Journals (General) Source Type: research

ITS Annual Scientific Meeting 2016
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 25, 2016 Category: Journals (General) Source Type: research

The benefits of utilising geo-mapping for visualising the vitamin D status of Dublin city and the surrounding urban districts
AbstractContextThere have been few published reports of visualising vitamin D status at a micro level, i.e., within large individual urban centres of countries.ObjectiveTo produce a visual map of the vitamin D status [25-hydroxy vitamin D —25(OH)D] of a large urban centre (n >  350,000) incorporating the regions of Dublin city that constitute the general practitioner catchment area of a large academic teaching adult hospital.Design, setting and participantsAn observational investigation of 5287 free living Irish adults (>18  years).ResultsApproximately, 15.2  % of those sampled in the winter...
Source: Irish Journal of Medical Science - October 21, 2016 Category: Journals (General) Source Type: research

The new system of health accounts in Ireland: what does it all mean?
ConclusionSuggestions that Ireland is over-spending on health need to be tempered by cognisance that the Irish health system is under-resourced in a number of areas (particularly the number of doctors and the number of hospital beds) and has not fully recovered from cutbacks in the late 1980s and early 1990s. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 18, 2016 Category: Journals (General) Source Type: research

Colorectal cancer incidence and survival by sub-site and stage of diagnosis: a population-based study at the advent of national screening
ConclusionsThere was a distal-to-proximal shift and a trend towards diagnosis at the late stage during 1994 –2012. Some reversal of this trend is expected following the implementation of a national screening programme. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 18, 2016 Category: Journals (General) Source Type: research

A decade of domiciliary non-invasive ventilation in the west of Ireland
ConclusionsDomiciliary NIV use increased significantly in the West of Ireland from 2000 to 2012. There has been a shift in prescribing toward COPD. Survival rates for COPD on NIV are relatively short in contrast to patients with OHS and chest wall disease. Improved understanding of the benefits of NIV will allow physicians to better determine appropriate and cost-effective use in the future. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 15, 2016 Category: Journals (General) Source Type: research

Proton therapy in paediatric oncology: an Irish perspective
ConclusionDespite the fact that>100,000 patients worldwide have been treated with PT, the level of published evidence to support superiority over conventional treatment remains low. It is debated that randomised control trials in this area would be  inconsistent with the principle of clinical equipoise. In contrast, there is a call for level 1 evidence to justify drastic changes in patient care, particularly in light of recent reports of unexpected toxicities. In time, careful evaluation, follow-up and clinical trials will likely support the preferential use of PT in children. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 15, 2016 Category: Journals (General) Source Type: research

Measure what is measurable: IJMS comes of age as the baton changes hands
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 13, 2016 Category: Journals (General) Source Type: research

The influence of breast cancer subtype on bone metastases development and survival in women with metastatic breast cancer
AbstractBackgroundTumour metastatic disease reflects a complex interplay between tumour characteristics and local host factors. This complex relationship may have an influence on the development of metastatic disease and patient survival. Multiple factors of the primary tumour influence the development of metastases and survival in patients. Breast cancer subtype has been shown to influence patient prognosis and response to therapy.AimThe aim of our study was to correlate breast cancer subtype with bony metastatic disease and patient survival.MethodsAll women undergoing breast cancer surgery in a single institution in Irel...
Source: Irish Journal of Medical Science - October 12, 2016 Category: Journals (General) Source Type: research

Characterization of patients with diabetic foot disease presenting to an Irish Podiatry Centre: profiling suitability for entry to a clinical trial of advanced wound therapeutics
ConclusionsThis research found an eligibility criterion of wound area 2 –10 cm2 for enrolment in a clinical trial of mesenchymal stromal cell therapy too restrictive. Extension of wound area to 1 –10 cm2 and the inclusion of neuro-ischaemic ulcers increased eligibility for enrolment from 1.4 to 20  %. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 11, 2016 Category: Journals (General) Source Type: research

Pregnancy-associated plasma protein-A (PAPP-A) as a possible biomarker in patients with coronary artery disease
AbstractBackgroundCardiovascular disease is the leading cause of death in the Western world, and a major cause of this disease is atherosclerosis. Research has demonstrated that pregnancy-associated plasma protein A (PAPP-A) plays a role in cardiovascular disease, as evidenced by the association between PAPP-A and severity of heart damage.AimThe aim of this work was to investigate the correlation between PAPP-A concentrations in coronary and peripheral blood and certain clinicopathological factors and antioxidant enzyme activities in patients diagnosed with coronary artery disease.MethodsFor 65 patients, arterial blood was...
Source: Irish Journal of Medical Science - October 11, 2016 Category: Journals (General) Source Type: research

Diabetic charcot neuroarthropathy: prevalence, demographics and outcome in a regional referral centre
ConclusionsThis is the first prevalence estimate of DCN in Ireland. These data suggest diagnosis of DCN is missed in the acute phase. There exists a significant risk of diabetic foot ulceration and amputation with DCN. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 6, 2016 Category: Journals (General) Source Type: research

Frequency and analysis of non-clinical errors made in radiology reports using the National Integrated Medical Imaging System voice recognition dictation software
ConclusionThese findings highlight the limitations of VR dictation software. While most error was deemed insignificant, there were occurrences of error with potential to alter report interpretation and patient management. Longer reports and reports on more complex imaging had higher error rates and this should be taken into account by the reporting radiologist. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 1, 2016 Category: Journals (General) Source Type: research

Targeted de-escalation rounds may effectively and safely reduce meropenem use
ConclusionThis pilot study suggests that targeted carbapenem de-escalation stewardship activity based on pre-determined criteria, while labour intensive, can effectively and safely reduce meropenem use in the acute hospital setting. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 29, 2016 Category: Journals (General) Source Type: research

Day case transobturator tapes: a cut and dried solution
ConclusionsWe conclude that the transobturator tape procedure is suitable as a day case in a select group of patients in the Irish healthcare setting. There was no increased rate of morbidity demonstrated in the group and readmission rates were low. It has reduced waiting times by increasing throughput of cases and ultimately will lead to reduced costs for hospitals. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 28, 2016 Category: Journals (General) Source Type: research

Colonisation with extended-spectrum beta-lactamase (ESBL) not detected in a prevalence study
ConclusionsThis community point prevalence study did not identify ESBL colonisation despite high numbers of patients with invasive ESBL bloodstream infections presenting for admission in our institution. We believe this may be because of our small sample size. Data regarding antimicrobial exposure and other risk factors for ESBL colonisation were also not available. We remain vigilant for ESBL-producing organisms. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 24, 2016 Category: Journals (General) Source Type: research

Wolff: straight not curved
AbstractIt was 140  years ago that George von Meyer presented his anatomical diagrams of human bones to a meeting in Zurich. There he was told by Prof. Karl Culmann that the trabecular lines shown within the diagram of the upper femur closely resembled those lines of force which Culmann had determined with Graphic St atics to be passing through a curved, loaded Fairbairn crane. This drew the attention of Julius Wolff, who used this as the basis for his ‘Trajectorial theory’ which was widely accepted and, to date, has been the underlying basis for all biomechanical investigations of this region. Following W...
Source: Irish Journal of Medical Science - September 24, 2016 Category: Journals (General) Source Type: research

Proceedings of the RAMI Section of OtoRhinoLaryngology Head and Neck Surgery (ORL HNS) Winter Meeting, Friday 11th December 2015, 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 - September 23, 2016 Category: Journals (General) Source Type: research

Proceedings of the RAMI Section of OtoRhinoLaryngology Head and Neck Surgery (ORL HNS) Spring Meeting, Saturday 23rd April 2016, Sheraton Hotel, Athlone, Co. Westmeath
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 23, 2016 Category: Journals (General) Source Type: research

Endoscopic tattooing to aid tumour localisation in colon cancer: the need for standardisation
ConclusionBased on the available studies we have recommended a standardised approach to endoscopic tattooing of colorectal tumours prior to laparoscopic resection. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 19, 2016 Category: Journals (General) Source Type: research

The JAK2 V617F mutation in patients with anaemia
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 10, 2016 Category: Journals (General) Source Type: research

Magnitude of non-operative surgical emergency admissions; service implications for surgical and radiological practice
ConclusionAlmost 80  % of all surgical emergency admissions were discharged without undergoing a formal operative procedure while generating a significant workload for the radiology department. Changes in working practices and hospital network structures will be required to reduce the burden of non-operative emergency admissions. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 8, 2016 Category: Journals (General) Source Type: research

Physiology in fine fettle in the fair city
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 8, 2016 Category: Journals (General) Source Type: research

2nd Annual Multidisciplinary Galway University Hospitals Research Symposium
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 6, 2016 Category: Journals (General) Source Type: research

Surgical learning activities for house officers: do they improve the surgical experience?
AbstractObjectiveTo ascertain whether house officers (HOs) attain a more satisfactory surgical rotation experience when they perform basic surgical learning activities. We also sought to establish how many and which learning activities HOs achieve and the effect on their surgical experience.MethodologyA questionnaire listing 20 learning activities and questions regarding satisfaction with an overall experience was disseminated to HOs in the UK and Ireland who had completed ≥3 months of surgical rotations. Satisfaction with surgical experience was dichotomised in order to perform logistic regression using R Studio s...
Source: Irish Journal of Medical Science - September 1, 2016 Category: Journals (General) Source Type: research

Is the fourth port routinely required for laparoscopic cholecystectomy? Our three-port laparoscopic cholecystectomy experience
ConclusionWe concluded that in experienced hand, LC with three ports is safe and feasible technique if it is not endanger the course of the surgery. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 31, 2016 Category: Journals (General) Source Type: research

Irish Endocrine Society 40th Annual Meeting 14th and 15th October 2016, Stormont Hotel Belfast
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 29, 2016 Category: Journals (General) Source Type: research

Who accompanies patients to the chronic pain clinic?
ConclusionsPatients are accompanied to the pain clinic with a typically positive influence on doctor patient relationship and communication. Awareness of these issues is important in good communication in the pain clinic. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 26, 2016 Category: Journals (General) Source Type: research

The association between MMP2 −1306 C  & gt;  T (rs243865) polymorphism and risk of prostate cancer
ConclusionMMP2 −1306 C >  T (rs243865) polymorphism was not significantly related with prostate cancer susceptibility in Iranian men. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 19, 2016 Category: Journals (General) Source Type: research

A retrospective cohort analysis of hypoglycaemic and cardiovascular agent use in young adults in the Irish primary care setting
ConclusionsTreatment patterns were found to be associated with high levels of non-persistence, substantial use of insulin, and a low use of cardiovascular agents. This may pose problems for the management of the long-term complications associated with type 2 diabetes. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 17, 2016 Category: Journals (General) Source Type: research