Festschrift for Patrick Ronan (PR) O ’Connell (also known as ROCON): reconciling surgery and science
AbstractRonan O Connell ’s clinical activities were fundamentally based on accurate data. His scientific outputs were based on similarly high quality data. Anybody who trained with him and in particular those who trained with him on more than occasion base their clinical and scientific activities on a similar approach. H is many clinical, scientific and political achievements and accolades will be detailed in the articles in this Festschrift. There is an advancement that is important to me personally and that I would like to attribute to his influence. Exceptional and highly reproducible technique underpinned his su ...
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

Caffeine, CYP1A2 genotype, and sports performance: is timing important?
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

Have bailouts shifted the burden of paying for healthcare from the state onto individuals?
AbstractBackground/aimsThe financial crisis that enveloped Europe in 2009 created financial pressure for governments and required a number of countries to obtain a financial bailout from the IMF. The purpose of this paper is to examine the effect of the financial crisis on public health expenditure in bailout countries and if bailouts shift the burden of paying for healthcare from the state onto individuals.MethodsQuantitative health expenditure data were collected from the WHO and OECD for the period 2004 –2015 and evaluated using a comparison of means Welch’st test.ResultsThe majority of bailout countries rec...
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

An animal model of faecal incontinence and sacral neuromodulation
AbstractThe pudendal nerves can be injured during traumatic vaginal childbirth and result in faecal incontinence. Some of these incontinent patients benefit from chronic sacral neuromodulation and the mechanism of action of this therapy has been a focus of many studies. In 2008, a rodent model of neuropathic faecal incontinence was introduced and subsequently validated through a series of investigations. This review summarizes the decade-long contribution of Professor Ronan O ’Connell to the inception and application of this rodent model of faecal incontinence and sacral neuromodulation. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 8, 2018 Category: General Medicine Source Type: research

Clinical presentation of cashew nut allergy in a paediatric cohort attending an allergy clinic in the West of Ireland
ConclusionChildren are ingesting CN at a young age with more than half of allergic reactions reportedly severe in nature. The specific CN IgE value was not helpful in predicting severity of reactions. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 5, 2018 Category: General Medicine Source Type: research

Glucose sensing technology —current practice?
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 4, 2018 Category: General Medicine Source Type: research

Difference in intraocular pressure measurements between non-contact tonometry and Goldmann applanation tonometry and the role of central corneal thickness in affecting glaucoma referrals
AbstractBackgroundPatients at glaucoma risk are commonly identified by optometrists and subsequently referred to glaucoma specialists. Optometrists mainly use non-contact tonometry (NCT) for intraocular pressure (IOP) measurement.AimsTo investigate the role of differences in IOP measurement between NCT and Goldmann applanation tonometry (GAT) and the effect of central corneal thickness (CCT) on these differences in optometrist referralsMethodsDetails of the initial clinical visit of patients referred with IOP>  21 mmHg in either eye as measured by NCT to a consultant glaucoma specialist were retrospectively ...
Source: Irish Journal of Medical Science - April 4, 2018 Category: General Medicine Source Type: research

Child Art Psychotherapy in CAMHS in Ireland —a parent satisfaction study
ConclusionParents are satisfied with the Vasarhelyi method of Child Art Psychotherapy. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 29, 2018 Category: General Medicine Source Type: research

Quality of information on the Internet —has a decade made a difference?
ConclusionsDue to the reduced completeness of information available to patients online, it is important that health professionals direct patients to appropriate websites if they wish to do their own research. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 28, 2018 Category: General Medicine Source Type: research

Cardiovascular disease risk factor profile of male Gaelic Athletic Association sports referees
ConclusionsThe findings from this study demonstrate the presence of hypertension and negative lifestyle behaviours within this male population. This justifies the need to implement a policy on the pre-participation screening and risk reduction of CVD for male G.A.A. referees in Ireland. This health promotion intervention would assist in reducing the CVD epidemic within this specific population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Future career intentions of higher specialist trainees in general Paediatrics
ConclusionThere appears to be a mismatch between the career goals of the future paediatric consultant workforce and the requirements for staffing paediatric units nationally. This has the potential to complicate the proposed expansion of general paediatricians in regional centres and result in a significant proportion of current trainees failing to secure a post in their desired location. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Acute hospital reconfiguration and self-harm presentations: a before-and-after study
ConclusionsThere is evidence to suggest that acute hospital reconfiguration of hospital services impacts on patterns of patient flow. Findings have implications for those implementing reconfiguration of acute services. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Breast screening in symptomatic women over 35  years of age: improvements in service efficiency
ConclusionImage first patients, who represent a cohort of “symptomatic” non-urgent women, have a greater rate of breast cancer detection than an asymptomatic screening population. This may have an impact on the appropriate triaging of symptomatic women in a national cancer center. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 26, 2018 Category: General Medicine Source Type: research

Evaluation of regulatory T lymphocytes and IL2Ra and FOXP3 gene expression in peripheral mononuclear cells from patients with amyotrophic lateral sclerosis
AbstractBackgroundLoss of neuroprotective role of CD4+ helper T cells, regulatory T cells, and M2 microglia constitutively results in the rapid neural death in the “rapidly progressive phase” of amyotrophic lateral sclerosis (ALS).AimWe aimed to investigate relative count of CD4+ and regulatory T lymphocytes and expression level of IL2Ra and FOXP3 genes in peripheral blood mononuclear cells (PBMCs) from patients with ALS.MethodWe performed a flow cytometric analysis on PBMC from 38 patients with ALS and 32 controls to determine the count of CD4+ and CD4+CD25+ cells. Quantitative real-time PCR analyses were impl...
Source: Irish Journal of Medical Science - March 25, 2018 Category: General Medicine Source Type: research

A meta-analysis of consanguinity and breast cancer
ConclusionThough there is limited literature published on the effects of parental consanguinity, the available data does not demonstrate that it is a risk factor for breast cancer. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 24, 2018 Category: General Medicine Source Type: research

Coloproctology procedure clinic: a novel service developed to reduce suffering of patients with bleeding per rectum
AbstractAimsEvaluation of the role and impact of introducing a dedicated coloproctology procedure clinic in tertiary referral colorectal unit.MethodsA retrospective analysis of 126 consecutive patients managed in the coloproctology clinic between March2015 and September 2016 was carried out. All patients were preselected for attendance based on symptom-based protocol.ResultsBased on the information available in GP referrals, 126 patients with bleeding per rectum with low risk of cancer were re-triaged from the general outpatient to dedicated coloproctology procedure clinic. Those patients accounted for 14% of waiting list....
Source: Irish Journal of Medical Science - March 22, 2018 Category: General Medicine Source Type: research

Evaluation of the effect of the accordion suturing technique on wound lengths in breast cancer surgery: a randomised clinical trial
ConclusionThe accordion suturing technique was associated with a significant reduction in surgical wound lengths in breast conserving surgery at 6  weeks without compromising the cosmetic result. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 21, 2018 Category: General Medicine Source Type: research

The College of Anaesthetists of Ireland Simulation Training programme: a descriptive report and analysis of course participants ’ feedback
AbstractBackgroundSimulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date.AimsDescribe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants ’ feedback.MethodsA retrospective r...
Source: Irish Journal of Medical Science - March 20, 2018 Category: General Medicine Source Type: research

Fifteen-year outcomes of an acute medical admission unit
We report on the 15-year outcomes of an AMAU in our institution.MethodsAll emergency medical admissions between 2002 and 2016 were examined and 30-day in-hospital mortality, admission rates, readmission rates and length of stay (LOS) assessed. We used logistic and Poisson regression and margin statistics to evaluate outcomes.ResultsThere were 96,305 admissions in 50,612 patients. By admission, the 30-day in-hospital mortality averaged 5.6% (95% CI 5.4 to 5.7%); there was a relative risk reduction (RRR) of 33.9% between 2002 and 2016, from 7.0 to 4.6% (p = 0.001), number need to treat (NNT) 41.9. By unique pat...
Source: Irish Journal of Medical Science - March 17, 2018 Category: General Medicine Source Type: research

A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis
AbstractBackgroundCore needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM).AimsIt is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method.MethodsArticles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were ...
Source: Irish Journal of Medical Science - March 16, 2018 Category: General Medicine Source Type: research

Clinical characteristics of Black patients with hypertensive urgency
ConclusionThe large proportion of newly diagnosed hypertensive patients presenting with end organ signs of prolonged uncontrolled hypertension suggests that there are significant numbers of undiagnosed Black patients in the community, suggesting that we should more actively conduct test for hypertension and its complications when we encounter these patients, who constitute a growing part of the populations in Europe. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 14, 2018 Category: General Medicine Source Type: research

Dedicated general practitioner education sessions can improve diagnostic capabilities and may have a positive effect on referral patterns for common skin lesions
ConclusionDedicated education sessions on skin lesions can improve the diagnostic accuracy of GP trainees, and we suggest that they are incorporated into the GP training curriculum. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 14, 2018 Category: General Medicine Source Type: research

Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review
ConclusionThere is an emerging consensus in the literature regarding strategies proven to reduce antibiotic consumption for acute respiratory tract infections. The widespread adoption of these strategies in primary care is imperative. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 12, 2018 Category: General Medicine Source Type: research

The effect of CYP1A2 genotype on the ergogenic properties of caffeine during resistance exercise: a randomized, double-blind, placebo-controlled, crossover study
ConclusionIn conclusion, acute ingestion of CAF significantly enhanced RE performance in resistance-trained men who were homozygous for the A allele, but not for C allele carriers. Further studies are needed to replicate the potential role of theCYP1A2 -163C>A polymorphism on the ergogenic effects of CAF in other modes of exercise and in other populations. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 12, 2018 Category: General Medicine Source Type: research

Festschrift for Ronan O ’Connell: pouchitis, ulcerative colitis and the microbiome
This article, part of a festschrift, summarises the contributions of the O ’Connell lab to the field of host-microbial interactions in inflammatory bowel disease. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research

‘All by myself’: interns’ reports of their experiences taking consent in Irish hospitals
ConclusionThe majority of interns reported that they had taken consent for a procedure without full knowledge of the procedure and its complications. Supervision or instruction from a senior colleague was reported by a minority. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research

The benefits of a Neurogenetics clinic in an adult Academic Teaching Hospital
AbstractGenetics is the backbone of Neurology, where a number of disorders have a genetic aetiology and are complex, requiring a dedicated Neurogenetics clinic. Genetics in the Republic of Ireland is under-resourced, with the lowest number of consultants per million of population in Europe. In November 2014, we established the monthly adult Neurogenetics clinic in Ireland, staffed by 2 consultants and 2 registrars from each speciality. We see patients with complex rare neurological conditions that may potentially have an underlying genetic basis, in the presence or absence of a family history. We performed a retrospective ...
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research

Neurological autoantibodies in drug-resistant epilepsy of unknown cause
ConclusionAutoimmune factors may be aetiologically relevant in patients with drug-resistant epilepsy of unknown cause, especially if focal seizures are present together with focal EEG abnormality and frequent seizures. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research

Frequency of Beh çet’s disease among a group of visually impaired adults
ConclusionBD is still one of the causes of acquired visual impairment in Turkey. In this study, BD prevalence among a visually impaired adult group was 2.04%. BD accounted for 5.5% among adults who had acquired visual impairment. In a study of 1965, BD prevalence among people with acquired blindness was 12%. However, this study was conducted at pre-immunosuppressive period. Our prevalence is obviously lower than those studies. Extended population-based studies are needed for population estimations. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research

Lumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis affecting the lower extremities —a single-centre experience
ConclusionLumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis. Non-PAD patients have the greatest benefit. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 7, 2018 Category: General Medicine Source Type: research

Single-institution experience with selective internal radiation therapy (SIRT) for the treatment of unresectable colorectal liver metastases
ConclusionsSIRT is a safe and effective therapy for certain patients with unresectable colorectal liver metastases. This case series supports our opinion that selected patients should be offered SIRT in concert with their medical oncologist, concomitant with their chemotherapy. Larger multi-center studies are required to more clearly define the patient groups that will derive most benefit from SIRT. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 6, 2018 Category: General Medicine Source Type: research

Shock wave lithotripsy or retrograde intrarenal surgery: which one is more effective for 10 –20-mm renal stones in children
ConclusionsIn this present study, we have shown that shock wave lithotripsy is cheaper, has short hospitalization time and long fluoroscopy time and similar stone-free rate, and has the same efficiency compared to flexible ureteroscopy regarding pediatric renal stones with the diameter between 10 and 20  mm. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 3, 2018 Category: General Medicine Source Type: research

A positive conversion in hormone receptor and HER2 status might have an impact on survival after liver resection for breast cancer metastases
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 3, 2018 Category: General Medicine Source Type: research

Reproductive ageing —turning back the clock?
ConclusionIf the current reproductive trends continue, many women will find themselves in the harrowing position of being unintentionally childless. In addition, many will inevitably turn to assisted reproductive technologies in an effort to protect and preserve their reproductive autonomy. However, it is not always possible to reverse the effects of reproductive ageing. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 2, 2018 Category: General Medicine Source Type: research

Plasma concentration of urokinase plasminogen activator receptor is a marker of kidney allograft function
ConclusionsThe results of our study indicate that uPAR plasma concentrations in kidney allograft recipients are significantly negatively correlated with graft function and may be elevated in patients with tubular atrophy. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 1, 2018 Category: General Medicine Source Type: research

Prediction efficiency of serum cystatin C for clinical outcome in patients with cardiac resynchronization therapy
AbstractBackgroundSince only 60 –70% of select patients with chronic heart failure (CHF) are responders in cardiac resynchronization therapy (CRT), this study aimed to investigate whether serum cystatin C (Cys C) can be used to evaluate the effectiveness of CRT in patients with CHF.MethodsSeventy-six patients implanted with CRT were retrospectively enrolled. The concentration of serum Cys C was detected and echocardiography was performed before and after 15  days, 1 month, and 6 months of CRT.ResultsThere were 52 patients (68.4%) who responded to CRT during the follow-up. In the responding group, compa...
Source: Irish Journal of Medical Science - February 24, 2018 Category: General Medicine Source Type: research

The case for medicinal cannabis
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 24, 2018 Category: General Medicine Source Type: research

Angiotensin II receptor blockers for the treatment of portal hypertension in patients with liver cirrhosis: a systematic review and meta-analysis of randomized controlled trials
ConclusionsARBs did not reduce portal pressure in patients with cirrhosis; moreover, the risk of symptomatic hypotension may increase. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 22, 2018 Category: General Medicine Source Type: research

A letter of reply to: Can the gastrointestinal microbiota be modulated by dietary fibre to treat obesity? Davis, H.C. Ir J Med Sci (2017). https://doi.org/10.1007/s11845-017-1686-9
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 21, 2018 Category: General Medicine Source Type: research

The importance of standardisation of measurement and reference intervals for detection of phaeochromocytoma and paraganglioma (PPGL)
AbstractA 51-year-old male presented 25  years ago with excessive sweating and haematuria. Blood pressure was labile. CT abdomen showed a large right-sided adrenal mass. Two 24-h urine collections showed elevated urinary catecholamines. Right adrenal resection was performed; a phaeochromocytoma (PC) was confirmed histologically. Two deca des later, the patient represented with excessive sweating and measured variable blood pressure readings. Measurement of plasma metanephrines (PMets) showed elevated normetanephrine (NMN) [50,250 (R.I. 0-1180) pmol/L] and metanephrine (MN) [1030 (R.I. 0-510) pmol/L] values. CT abdomen...
Source: Irish Journal of Medical Science - February 19, 2018 Category: General Medicine Source Type: research

Emphasis of FAS/FASL gene polymorphism in patients with non-muscle invasive bladder cancer
AbstractBackgroundBladder cancer (BCa) is the seventh most common cancer among males worldwide. Some reliable markers in blood, urine, and tumor tissue, including clinicopathologic variables, molecular and inflammatory markers, gene polymorphisms, and tumor gene expression profiles are identified for predicting response to BCG immunotherapy in high-risk BCa patients.AimsWe aimed to determine ifFAS andFASL polymorphisms are associated with lack of response to BCG in patients with BCa.MethodsThe study included patients with primary non-muscle invasive BCa that had undergone transurethral resection (TUR). Patient demographics...
Source: Irish Journal of Medical Science - February 16, 2018 Category: General Medicine Source Type: research

Financial impact of inaccurate Adverse Event recording post Hip Fracture surgery: Addendum to 'Adverse event recording post hip fracture surgery'
AbstractIntroductionA study in 2011 by (Doody et al. Ir Med J 106(10):300 –302,2013) looked at comparing inpatient adverse events recorded prospectively at the point of care, with adverse events recorded by the national Hospital In-Patient Enquiry (HIPE) System.MethodsIn the study, a single-centre University Hospital in Ireland treating acute hip fractures in an orthopaedic unit recorded 39 patients over a 2-month (August –September 2011) period, with 55 adverse events recorded prospectively in contrast to the HIPE record of 13 (23.6%) adverse events. With the recent change in the Irish hospital funding model f...
Source: Irish Journal of Medical Science - February 15, 2018 Category: General Medicine Source Type: research

Mortality rates of patients undergoing emergency laparotomy in an Irish university teaching hospital
AbstractIntroductionEmergency laparotomy (EL) is a commonly performed operation with increased morbidity and mortality. Currently, there is a lack of published outcomes following emergency laparotomy within an Irish population. The aim of this study was to assess our outcomes and compare these to predefined outcomes from NELA.MethodsA review of a prospectively maintained database of all patients who underwent an emergency laparotomy between January 1st 2015 and October 31st 2016 was performed. Patient demographics, operative indication and procedures, preoperative lactate, time of surgery, admission to high dependency unit...
Source: Irish Journal of Medical Science - February 15, 2018 Category: General Medicine Source Type: research

An assessment of deep venous thrombosis in Irish older adults in an acute medical assessment unit
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 13, 2018 Category: General Medicine Source Type: research

Can the synthetic C view images be used in isolation for diagnosing breast malignancy without reviewing the entire digital breast tomosynthesis data set?
ConclusionWhile the synthetic C view gives additional information when compared to a screening 2D mammogram, the full DBT tomosynthesis data set needs to be reviewed to diagnose a breast malignancy. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 9, 2018 Category: General Medicine Source Type: research

Proceedings of the RAMI Section of OtoRhinoLaryngology Head and Neck Surgery (ORL HNS) Winter Meeting, Friday 8 th December 2017, 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 - February 9, 2018 Category: General Medicine Source Type: research

The emerging role of stereotactic radiotherapy in gastrointestinal malignancies: a review of the literature and analysis from the Irish perspective
This article reviews the current indications for SBRT in these settings, comparing it with other treatments including surgery, chemotherapy, radiofrequency ablation, and trans-arterial chemoembolisation. We also review the current use of abdominal SBRT and future projections in the Irish healthcare setting. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 8, 2018 Category: General Medicine Source Type: research

Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study
ConclusionStaff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 8, 2018 Category: General Medicine Source Type: research

Non-operative treatment of appendicitis: public perception and decision-making
ConclusionsParticipant knowledge levels were variable with many concerned that non-operated appendicitis would always perforate. Perceptions of treatment were variable with some believing surgery was an absolute requirement and others preferring antibiotics due to the belief that NOTA is complication-free. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 8, 2018 Category: General Medicine Source Type: research

Attitudes of Irish patients with chronic pain towards medicinal cannabis
ConclusionsThe study highlights the attitudes of chronic pain patients in Ireland towards medicinal cannabis. It shows their desire to have medical cannabis legalised for chronic pain and that they view it as a reasonable pain management option. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - February 8, 2018 Category: General Medicine Source Type: research