Lenus: Research Repository

Recent Submissions

  • PublicationMetadata only
    National Open Disclosure Steering Committee Terms of Reference 2022
    (2022-03-01) HSE, National Open Disclosure Steering Committee
  • PublicationOpen Access
    Computed tomographic angiography in planning thoraco-dorsal artery perforator flap in breast and soft tissue reconstruction: a systematic review.
    (2025-01-01) Soliman, Mahmoud; Metwally, Islam H; Denewer, Adel; Abdallah, Ahmed; Denewar, Fatmaelzahraa Abdelfattah; Healy, Nuala Ann; Romics, Laszlo; Agrawal, Amit
    OBJECTIVES: Thoraco-dorsal artery perforator (TDAP) flaps have been increasingly used in breast and soft tissue reconstruction. Perforator localization is often done using a hand-held doppler, however, false results are not uncommon. This study aimed to systematically review the literature on the value of preoperative computed tomographic angiography (CTA) in TDAP flaps examining scanning protocol, mapping technique, concordance with operative findings, and disadvantages. METHODS: A PRISMA-compliant comprehensive search of Medline, Embase, Cochrane Library, and CINAHL databases was conducted in November 2023. We included studies evaluating CTA mapping of free and pedicled TDAPs for breast or soft tissue reconstruction using The Joanna Briggs Institute (JBI) Critical Appraisal Tools. RESULTS: Five studies were included and considered at high risk of bias. The studies included 72 patients with a mean age of 43.8 years. Concordance between CT findings and Doppler mapping or operative visualization was reported in two studies. In three studies, CTA was combined with Doppler flowmetry, whilst dynamic infrared thermography was used in one study. Standardized scanning protocol and patient positioning were lacking in all reports. CONCLUSIONS: This study highlights the paucity of evidence on the value of CTA in TDA perforator mapping with inconsistent outcomes and non-standardized scanning protocols. Despite difficult imaging acquisition and interpretation, 3D reconstructed images and detailed vascular anatomy may facilitate planning. ADVANCES IN KNOWLEDGE: Further research is required to explore the practical value of CTA in TDAP planning and standardizing protocols.
  • PublicationOpen Access
    Review of Clinically Assessed Molecular Fluorophores for Intraoperative Image Guided Surgery.
    (2024-12-18) Ge, Yuan; O'Shea, Donal F
    The term "fluorescence" was first proposed nearly two centuries ago, yet its application in clinical medicine has a relatively brief history coming to the fore in the past decade. Nowadays, as fluorescence is gradually expanding into more medical applications, fluorescence image-guided surgery has become the new arena for this technology. It allows surgical teams to real-time visualize target tissues or anatomies intraoperatively to increase the precision of resection or preserve vital structures during open or laparoscopic surgeries. In this review, we introduce the concept of near-infrared fluorescence guided surgery, discuss the recent and ongoing clinical trials of molecular fluorophores (indocyanine green, 5-aminolevulinic acid, methylene blue, IR-dye 800CW, pafolacianine) and their surgical goals, highlight key chemical and medical factors for imaging agent optimization, deliberate challenges and potential advantages, and propose a framework for integrating this technology into routine surgical care in the near future. The notable clinical achievements of these fluorophores over the past decade strongly indicates that the future of fluorescence in surgery is bright with many more patient benefits to come.
  • PublicationOpen Access
    Synergistic Effects of the Combination of Alpelisib (PI3K Inhibitor) and Ribociclib (CDK4/6 Inhibitor) in Preclinical Colorectal Cancer Models.
    (2024-12-10) Aslam, Razia; Richards, Cathy E; Fay, Joanna; Hudson, Lance; Workman, Julie; Lee, Cha Len; Murphy, Adrian; O'Neill, Brian; Toomey, Sinead; Hennessy, Bryan T
    The CDK4/6 inhibitor Ribociclib has shown limited efficacy as a monotherapy in colorectal cancer (CRC). However, combining Ribociclib with targeted therapies could present a viable strategy for treating CRC. This study evaluated the combination of Ribociclib and the PI3K inhibitor Alpelisib across four distinct cell lines representing different mutational statuses ( wild-type, -mutated, -mutated, and -mutated). We analyzed the drugs' impact on key proteins involved in the PI3K pathway, cell cycle regulation, and apoptosis. The combination of Alpelisib and Ribociclib demonstrated a synergistic anti-proliferative effect across all cell lines, leading to a simultaneous decrease in pRB, pAKT, and p-S6 levels, and a more comprehensive suppression of the PI3K/AKT/mTOR pathway. Additionally, there was an upregulation of the apoptotic marker, p-BCL2, in cells treated with the combination compared to controls. In vivo studies using Caco-2, LS1034, and SNUC4 xenografts revealed a significant reduction in tumour growth with the combination therapy compared to single-agent treatments. These findings suggest that combining Alpelisib and Ribociclib could be a promising therapeutic approach for CRC, warranting further clinical exploration.
  • PublicationOpen Access
    HSE Corporate Procurement Plan 2025 2027
    (Health Service Executive (HSE), 2025-12) Health Service Executive (HSE)

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