Recent Submissions

  • Sweat Testing in Ireland

    Blake; Tsang, V; Ghori, R; Whelan, S; Boran, G; Linnane, B; University Hospital Limerick (Irish Medical Journal, 2018-07)
    Quick, painless, cheap and reliable, the sweat test remains the gold standard diagnostic test for cystic fibrosis. We aimed to describe the pattern of testing in Ireland over a calendar year.
  • The Predictive Ability of Pre-Operative Magnetic Resonance Imaging to Detect Pathological Outcomes in Prostate Cancer

    Nason, GJ; Selvarajah, L; O’Connor, EM; O’Kelly, J; Considine, SW; Moss, B; MacMahon, D; Heneghan, J; Meyer, N; Buckley, J; O’Regan, K; O’Brien, MF; Cork university Hospital (Irish Medical Journal, 2018-07)
    Accurate preoperative knowledge of tumour stage is important in preoperative planning at radical prostatectomy (RP). The aim of this study was to assess the predictive ability of multiparametric MRI for detecting pathological outcomes.
  • A cross sectional study of the relationship between self-reported levels of loneliness and the experience of Pastoral Care in an Older Adult Day-care Service

    Kiely, Elizabeth; Irish College of Humanities and Applied Sciences (2018-08-04)
    Thesis submitted for the Masters in Counselling and Pastoral Care At the Irish College of Humanities and Applied Sciences. The thesis seeks to establish if a correlation exists between self-reported levels of loneliness and the experience of pastoral care in Older Adult Daycare Services (OADS).
  • Revascularisation of left main stem disease: a prospective analysis of modern practice and outcomes in a non-surgical centre.

    Coughlan, J J; Blake, Nial; Chongprasertpon, Napohn; Ibrahim, Munir; Arnous, Samer; Kiernan, Thomas John; Department of Cardiology, University Hospital Limerick (2018-07)
    In this study, we sought to prospectively analyse the management and long term outcomes associated with revascularisation of left main stem disease via percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in our centre.
  • Enhancing acute stroke services: a quality improvement project.

    McGrath, Keith; Cunningham, Nora; Moloney, Elizabeth; O'Connor, Margaret; McManus, John; Peters, Catherine; Lyons, Declan; University Hospital Limerick (BMJ open quality, 2018-07)
    In a busy stroke centre in Ireland, care for acute stroke was provided by a mixture of general physicians. In acute ischaemic stroke, speed is essential for good outcomes.
  • The Utility of Dopamine Transporter Scans for Diagnosing Parkinsonian Disorders.

    Crotty, GF; O’Corragain, QA; Bogue, C; Crotty, J; O’Sullivan, S S (Irish Medical Journal, 2018-05)
    Dopamine transporter scans are increasingly being used in the diagnosis of clinically undefined Parkinsonism.
  • A core outcome set for studies evaluating the effectiveness of prepregnancy care for women with pregestational diabetes.

    Egan, Aoife M; Galjaard, Sander; Maresh, Michael J A; Loeken, Mary R; Napoli, Angela; Anastasiou, Eleni; Noctor, Eoin; de Valk, Harold W; van Poppel, Mireille; Todd, Marie; Smith, Valerie; Devane, Declan; Dunne, Fidelma P (Diabetologia, 2017-04)
    The aim of this study was to develop a core outcome set (COS) for trials and other studies evaluating the effectiveness of prepregnancy care for women with pregestational (pre-existing) diabetes mellitus.
  • Correction to: Dialectical behaviour therapy for treating adults and adolescents with emotional and behavioural dysregulation: study protocol of a coordinated implementation in a publicly funded health service.

    Flynn, Daniel; Kells, Mary; Joyce, Mary; Suarez, Catalina; Gillespie, Conall (BMC Psychiatry, 2018-05-07)
    Upon publication of the original article (1) it was highlighted by the authors that there was just one error in the manuscript in the 'Sample size' subsection of the Methods/Design.
  • Saving Blood and Reducing Costs: Updating Blood Transfusion Practice in Lower Limb Arthroplasty

    Fenelon, C; Galbraith, JG; Kearsley, R; Motherway, C; Condon, F; Lenehan, B (Irish Medical Journal, 2018-04)
    Our aim was to quantify blood transfusion rates in lower limb arthroplasty following the introduction of a multimodal enhanced recovery programme (ERP). We then sought to update the maximum surgical blood ordering schedule (MSBOS) and calculate cost savings achieved.
  • Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

    Maduemem, KE; Adedokun, C; Umana, E (Irish Medical Journal, 2018-04)
    Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.
  • Parental And Clinician Views Of Consent In Neonatal Research

    O’Shea, N; Doran, K; Ryan, C A; Dempsey, E (Irish Medical Journal, 2018-03)
    Informed consent is an obligatory requirement for research participation1. The process of informed consent states that certain measures must be followed to ensure a research participant has made an informed decision about their participation in a research study2,3. Consent for research should be voluntary, informed, and understood by the consenting individual who must also be competent to do so. In the case of neonatal research informed consent is acquired from parent(s)/guardian(s) of a patient.
  • Clozapine Patients at the Interface between Primary and Secondary Care.

    Barrett, Marita; Keating, Anna; Lynch, Deirdre; Scanlon, Geraldine; Kigathi, Mary; Corcoran, Fidelma; Sahm, Laura J (Pharmacy, 2018-02-26)
    Patients receiving clozapine must undergo routine blood monitoring to screen for neutropenia, and to monitor for potential agranulocytosis. In Cork University Hospital, Cork, Ireland, clozapine is dispensed in the hospital pharmacy and the pharmacists are not aware of co-prescribed medicines, potentially impacting upon patient safety. The aim of this study was to examine the continuity of care of patients prescribed clozapine. A retrospective audit was conducted on patients attending the clozapine clinic at Cork University Hospital and assessed patients' (i) independent living, (ii) co-prescribed medicines and (iii) knowledge of their community pharmacists regarding co-prescribed clozapine. A list of prescribed medicines for each patient was obtained, and potential drug-drug interactions between these medicines and clozapine were examined using Lexicomp®and Stockley's Interaction checker. Secondary outcomes included patients' physical health characteristics, and a review of co-morbidities. Data were collected between the 29 May 2017 and 20 June 2017. Local ethics committee approval was granted. Patients were eligible for inclusion if they were receiving clozapine treatment as part of a registered programme, were aged 18 years or more, and had the capacity to provide written informed consent. Microsoft Excel was used for data analysis. Of 112 patients, (33% female; mean age (SD) 43.9 (11.3) years; 87.5% living independently/in the family home) 86.6% patients reported that they were taking other prescribed medicines from community pharmacies. The mean (SD) number of co-prescribed medicines in addition to clozapine was 4.8 (4) per patient. Two thirds of community pharmacists were unaware of co-prescribed clozapine. Interactions with clozapine were present in all but 3 patients on co-prescribed medicines (n= 97). Lexicomp®reported 2.9 drug-drug interactions/patient and Stockley's Interaction Checker reported 2.5 drug-drug interactions/patient. Secondary outcomes for patients included BMI, total cholesterol, and HbA1clevels, which were elevated in 75%, 54% and 17% respectively. Patients prescribed clozapine did not receive a seamless service, between primary and secondary care settings. Community pharmacists were not informed of clozapine, prescribed for their patients, in two thirds of cases. Patients in this study were exposed to clozapine-related drug-drug interactions and hence potential adverse effects. This study supports reports in the literature of substandard management of the physical health of this patient group. This study shows that there is an opportunity for pharmacists to develop active roles in the management of all clozapine-related effects, in addition to their traditional obligatory role in haematological monitoring. This study supports the need for a clinical pharmacist to review inpatients commencing on clozapine, monitor for drug-drug interactions and provide counselling.
  • A Comparison of Perceived and Measured Paternal Weight and BMI, and Relationship to Weight and BMI of his Children

    Power, RF; Power, B; O’Gorman, CS (Irish Medical Journal, 2018-02)
    Nineteen percent of 9 years old Irish children are overweight; seven percent are obese. Our aims were: to examine whether differences exist between paternal self-reported and measured height, weight and BMI in a population representative sample; and to explore paternal perceptions of their own weight status. Measures of height and weight for fathers and for their children from the National Longitudinal Study of Children Growing Up in Ireland were obtained using validated methods. Three quarters of fathers (6,263 of 8,568 study children) with a mean age of 42 years (SD 5.04) responded. The mean difference between self-reported and measured weight was -1.03kg (SD=4.52), indicating that weight was underestimated. Obese fathers were more likely to have an obese son (9.4% compared to 5.3% for the full cohort) and an obese daughter (12.4% compared to 7.7%). These data suggest that there is a strong relationship between fathers' weights and his childrens’ weights. A leading factor in the development of childhood obesity is parental obesity. Targeting overweight and obesity in the child should occur simultaneously with tackling overweight and obesity in the parents; in this study, the fathers
  • Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits.

    Brennan, Ann-Marie; Kiely, Mairead E; Fenton, Sarah; Murphy, Brendan P (Nutrients, 2018-02-02)
    The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.
  • Hemorrhagic lesion on the chest wall after trauma.

    Roche, Lisa; Wall, Dmitri; Hackett, Catriona (JAAD case reports, 2018-01)
    A 59-year-old woman presented with a burning, rapidly progressive mass on the midchest, occurring after a fall, 4 months prior. Examination found a large well-circumscribed mass over the lower xiphisternum (Figs 1 and 2). Results of baseline investigations were normal apart from mildly elevated liver function values. A computerized tomography scan confirmed a 6.4- x 4.9-cm lobulated soft tissue heterogeneous-density mass located in the subcutaneous fat with ill-defined borders and no obvious infiltration of the chest wall. A single focal abnormality was noted in the liver. Several incision/drainage procedures were complicated by difficulty achieving hemostasis. Ellipse incisional biopsy was performed (Figs 3 and 4).
  • A Descriptive Study Of The Burden Of Animal-Related Trauma At Cork University Hospital.

    Sheehan, M; Deasy, C (Irish Medical Journal, 2018-01)
    Farming is the most dangerous occupation in Ireland1 and the incidence of farm accidents is rising. This study examines major farm animal-related trauma treated at Cork University Hospital over a 5 year period. There were 54 patients admitted to Cork University Hospital (C.U.H.) with major farm animal-related trauma. The median age was 56 years, 85% were male and the median hospital length of stay was four days. Older patients had longer lengths of stay; 5.5 vs 4 days (p=0.026). Tibia/fibula fractures were the most common injuries (N=13, 24%); head injury occurred in six patients (11%). There were 32 (59%) patients who required surgery, the majority for orthopaedic injuries. There were nine patients (16.7%) admitted to the intensive care unit; their median ICU stay was four days. Injury prevention and treatment strategies require that the age profile, mechanism of injury and injury patterns of farmers sustaining animal-related trauma is recognised.
  • The impact of stillbirth on bereaved parents: A qualitative study.

    Nuzum, Daniel; Meaney, Sarah; O'Donoghue, Keelin (PloS one, 2018-01-24)
    To explore the lived experiences and personal impact of stillbirth on bereaved parents.
  • The Expression of Inflammatory Mediators in Bladder Pain Syndrome.

    Offiah, Ifeoma; Didangelos, Athanasios; Dawes, John; Cartwright, Rufus; Khullar, Vik; Bradbury, Elizabeth J; O'Sullivan, Suzanne; Williams, Dic; Chessell, Iain P; Pallas, Kenny; Graham, Gerry; O'Reilly, Barry A; McMahon, Stephen B (European urology, 2016-08)
    Bladder pain syndrome (BPS) pathology is poorly understood. Treatment strategies are empirical, with limited efficacy, and affected patients have diminished quality of life.
  • Intrapartum fetal deaths and unexpected neonatal deaths in the Republic of Ireland: 2011 – 2014; a descriptive study

    McNamara, K.; O’Donoghue, K.; Greene, R. A. (BMC Pregnancy and Childbirth, 2018-01-04)
    : Intrapartum fetal death, the death of a fetus during labour, is a tragic outcome of pregnancy. The intrapartum death rate of a country is reflective of the care received by mothers and babies in labour and it is through analysing these cases that good aspects of care, as well as areas for improvement can be identified. Investigating unexpected neonatal deaths that may be associated with an intrapartum event is also helpful to fully appraise intrapartum care. This is a descriptive study of intrapartum fetal deaths and unexpected neonatal deaths in Ireland from 2011 to 2014
  • Women's experience of maternal morbidity: a qualitative analysis.

    Meaney, S; Lutomski, J E; O' Connor, L; O' Donoghue, K; Greene, R A (BMC Pregnancy and Childbirth, 2016-07)
    Maternal morbidity refers to pregnancy-related complications, ranging in severity from acute to chronic. In Ireland one in 210 maternities will experience a severe morbidity. Yet, how women internalize their experience of morbidity has gone largely unexplored. This study aimed to explore women's experiences of maternal morbidity.

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