• Can Early Changes in Vital signs Predict Duration of Antibiotic Therapy in Suspected Neonatal Sepsis?

      McGovern, M; Morrissey, P; Ryan, E (Irish Medical Journal, 2019-04)
      Suspected sepsis remains a leading causes of Neonatal Intensive Care Unit admission, with infants often receiving 48-72 hours of empirical antibiotic therapy. Early in treatment it is difficult to predict infants who will require prolonged antibiotic therapy. Our aim was to assess if vital sign measurements in the initial period of treatment can predict those neonates requiring prolonged antibiotic therapy in term and late-preterm infants.
    • Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study.

      O'Donnell, Martin; Mente, Andrew; Rangarajan, Sumathy; McQueen, Matthew J; O'Leary, Neil; Yin, Lu; Liu, Xiaoyun; Swaminathan, Sumathi; Khatib, Rasha; Rosengren, Annika; Ferguson, John; Smyth, Andrew; Lopez-Jaramillo, Patricio; Diaz, Rafael; Avezum, Alvaro; Lanas, Fernando; Ismail, Noorhassim; Yusoff, Khalid; Dans, Antonio; Iqbal, Romaina; Szuba, Andrzej; Mohammadifard, Noushin; Oguz, Atyekin; Yusufali, Afzal Hussein; Alhabib, Khalid F; Kruger, Iolanthe M; Yusuf, Rita; Chifamba, Jephat; Yeates, Karen; Dagenais, Gilles; Wielgosz, Andreas; Lear, Scott A; Teo, Koon; Yusuf, Salim (BMJ, 2019-03-13)
      To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.
    • Meconium Ileus in Two Irish Newborns: The Presenting Feature of Cystic Fibrosis

      Smith, A.; Ryan, E; O’Keeffe, D; O’Donovan, D. (Irish Medical Journal, 2019-03)
      Cystic Fibrosis (CF) is the most common genetically inherited disease in Ireland1. Approximately 1/ 2,300 infants per year are born with CF in Ireland2. Newborn bloodspot screening (NBS) screening for CF was introduced to Ireland in 20113. NBS screening for CF is associated with improved lung function, nutritional status and increased survival into early adulthood4. Therefore early recognition and management of this chronic condition is vital to ensuring optimal patient management.
    • Kicking off a Retropharyngeal Abscess

      Rana, A; Heffernen, L; Binchy, J (Irish Medical Journal, 2019-03)
      Retropharyngeal abscesses (RPA) are deep neck space infections that can pose an immediate life-threatening emergency, such as airway obstruction. [1] The potential space can become infected by bacteria spreading from a contiguous area [2] or direct inoculation from penetrating trauma. [3] Infection is often polymicrobial (most commonly group A beta-hemolytic streptococci). [4
    • A Case of Paget-Schroetter Syndrome in a Young Male After Lifting Weights

      Umana, E.; Elsherif, M.; Binchy, J. (Irish Medical Journal, 2019-02)
      Paget-Schroetter Syndrome (PSS) or effort thrombosis of the axillary-subclavian venous axis is a rare disease affecting healthy young adults which requires a high index of suspicion to diagnose. Management often requires not only anticoagulation but also thrombolysis with first rib resection to prevent recurrence and complications. We present a case of a 31-year-old male who presented to our emergency department with pain and swelling of his left upper limb. He was diagnosed with PSS and underwent; anticoagulation, catheter directed thrombolysis and planned for first rib resection.
    • A Survey of Colorectal Cancer Surveillance Practices In Ireland, And Implementation of A Survivorship Care Plan Pilot Programme

      Greally, M.; Keane, F; Power, D.G; Leonard, G.D (Irish Medical Journal, 2019-02)
      The number of colorectal cancer (CRC) survivors in Ireland is rising. We aimed to survey current surveillance practices and pilot the use of survivorship care plans (SCPs) in the clinic.
    • Human Papilloma Virus- Associated Head and Neck Cancer: A 21st Century Pandemic; Assessing Student Awareness and Knowledge

      Kavanagh, F.G; McNamara, A.T; Fopohunda, O; Keogh, I.J (Irish Medical Journal, 2018-11)
      The Human Papillomavirus (HPV) is a causal agent in a subset of Head and Neck Cancers (HNC) being diagnosed in younger patients without significant tobacco and alcohol use. This survey assessed the awareness level of HNC and HPV vaccinations in university students.
    • Attitudes and Knowledge of Healthcare Professionals Regarding Organ Donation. A Survey of the Saolta University Health Care Group.

      Umana, E; Grant, O; Curran, E; May, P; Mohamed, A; O’Donnell, J; University Hospital Galway (Irish Medical Journal, 2018-11)
      Organ donation saves lives and healthcare professionals (HCPs) play a vital role in that process. Therefore, the purpose of this study was to assess the attitudes and level of knowledge of HCPs regarding organ donation. An online anonymous self-administered questionnaire containing 40 questions on organ donation using google forms was created. The survey was distributed to HCPs working in the Saolta University Health Care Group. A hundred and thirty-nine responses were received giving a response rate of 11.8%. HCPs willingness to donate their organs was at 93% compared to 97% willing to receive a transplant. More HCPs understood or had knowledge of the term donation after brain death (64%) than donation after circulatory death (49%). HCPs working in intensive care knew more about the management of brain dead donors than other specialties (p<0.0001). Over 60% of HCPs when asked either disagreed or strongly disagreed with the adequacy of training in organ donation and transplant. Overall, HCPs surveyed had positive attitudes towards organ donation but there was a lack of knowledge particularly among non-intensive care professionals. This study highlights the need to increase awareness along with implementation of educational programmes among HCPs regarding organ donation and transplant.
    • Ultrasound as a Diagnostic Tool in Pediatric Distal Forearm Fractures

      Ahmed, A.S; Abdelhady, A.E; McNicholl, B (Irish Medical Journal, 2018-11)
      To evaluate the accuracy of ultrasound in pediatric distal forearm fractures as well as the effect on the ED waiting time for these patients.
    • Academic Background of Irish Orthopaedic Trainees

      Unknown author (Irish Medical Journal, 2018-11)
      Academic achievement may be used to distinguish between trainees in competition for training or consultant posts. This study aimed to quantify the academic achievement among orthopaedic trainees in Ireland.
    • Management of Paediatric Buckle (Torus) Wrist Fractures in Irish Emergency Departments: A National Survey

      Abdelhady, A; Ahmed, A; Umana, E; O’Donnell, J; University Hospital Galway (Irish Medical Journal, 2018-07)
      Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures. Twenty eight centres that manage paediatric patients with trauma were contacted. This survey demonstrates that over 70% (>20) of centres in Ireland are managing buckle fractures using the traditional approach of backslab cast and follow-up in fracture clinic. Despite relevant research and NICE guideline recommendations, there is a slow adoption of current evidence among Irish hospitals which points to a need for a national consensus on management of buckle fractures.
    • The Perceptions of Patients, their Parents and Healthcare Providers on the Transition of Young Adults with Type 1 Diabetes to Adult Services in the West of Ireland.

      Walsh, Ó; Wynne, M; O Donnell, M; Geoghegan, R; O Hara, Mary Clare; Paediatric Department, University Hospital Galway, School of Medicine, National University of Ireland Galway, Research and Development, HSE Strategic Planning and Transformation (Irish Medical Journal, 2018-07)
      This study aims to describe the perceptions of young adults’, parents of young adults’ and health care professionals’ (HCPs) of the transition process for young adults with Type 1 Diabetes in the West of Ireland.
    • Apixaban-Associated Spontaneous Splenic Rupture - A Case Report

      Abdelhady, A; Ahmed, A; Mohamed, Y; Binchy, J; University Hospital Galway (Irish Medical Journal, 2018-07)
      A 62-year-old lady presented to The Emergency Department (ED) with one-day history of dizziness, vomiting and feeling weak. ECG showed new onset Atrial Fibrillation. Four days ago, she was referred to the Cardiology team where she underwent PCI and was discharged on Apixaban and Plavix. Two days later she represented to the ED pale and hypotensive with BP 70/50. CT-Abdomen showed a large splenic hematoma and thickening of the inferior wall of the stomach.
    • Introduction of an Oral Fluid Challenge Protocol in the Management of Children with Acute Gastroenteritis: A Regional Hospital Experience.

      Umana, E; Rana, A; Maduemem, K; Moylett, E (Irish Medical Journal, 2018-06)
      Oral rehydration therapy (ORT) remains the ideal first line therapy for acute gastroenteritis (AGE). Our aim was to assess the impact of introducing an Oral Fluid Challenge (OFC) protocol on outcomes such as intravenous fluid use and documentation in our institution. A single centre study with data collected retrospectively pre-implementation (April 2015) of the OFC protocol and post implementation (April 2016). Consecutive sampling of the first 55 patients presenting with GE like symptoms and underwent OFC were recruited. One hundred and ten patients were included in this study with 55 patients per cycle. The rates of IVF use decreased from 22% (12) in cycle one to 18% (10) in cycle two. There was an improvement in documentation by 26% (14) for level of dehydration and 52% (31) for OFC volume from cycle one to two. Overall, the addition of the OFC protocol to the management of patients with uncomplicated AGE would help streamline and improve care.
    • Alcohol-related presentations to emergency departments in Ireland: a descriptive prevalence study

      McNicholl, Brian; Goggin, Deirdre; O’Donovan, Diarmuid (BMJ Open, 2018-05-24)
      To determine the prevalence of alcohol-related presentations in all 29 emergency departments (EDs) in Ireland and compare with non-alcohol-related presentations in order to identify opportunities for improvements in the quality of patient care and related data collection.
    • Patients’ Attitude towards Travelling For Breast Services versus Waiting Longer For Local Services

      Abd Elwahab, S; McGough, P; Cooley, G; McLaughlin, R (Irish Medical Journal, 2018-05)
      Geographical access is a cornerstone of health care provision. However, prolonged waiting for breast clinic appointments in local services results in delayed diagnosis and excessive anxiety for patients. In this study, we present a patient satisfaction survey results of an initiative to offer out-patient clinic appointments for non-urgent patients referred to the breast unit in Letterkenny General Hospital (LGH), Ireland, and exceeded the recommended waiting period of 12 weeks. These patients were offered appointment in University Hospital Galway (UCHG), which is an average travel time of about 3.5-4.5 hours away from LGH. 163 patients out of 336 (48.5%) patients actively waiting more than 12 weeks for appointments in LGH accepted alternative appointments in UCHG. Despite the long travel distance for these patients, 100% of them reported high satisfaction and 97.3% said they would accept further UCHG appointments if a similar situation of prolonged waiting in LGH arises. None of these patients were diagnosed with cancer, and only one had a benign lumpectomy. This study showed that if offered alternative appointments, just under half of the patients would accept. The initiative provides a feasible solution for long waiters, and the survey shows that patients’ satisfaction remains high despite long travel.
    • Fracture Patients’ Attitudes towards Online Health Information & a ‘Prescribed’ Fracture Website

      Clesham, JG; Galbraith, SR; Kearns, ME. O’ Sullivan (Irish Medical Journal, 2018-04)
      Following musculoskeletal injury patient education is essential to help patients understand their treatment. Many attend the orthopaedic fracture clinic with multiple questions related to their diagnosis and treatment.
    • Kernicterus with abnormal high-signal changes bilaterally in the globus pallidus: A case report.

      Culleton, S; Kok, HK; Barras, C; Looby, S; Brennan, P; Asadi,H (Irish Medical Journal, 2018-04)
      Kernicterus is a relatively rare consequence of hyperbilirubinemia. There is an important role for MRI imaging for this entity in the appropriate clinical context as there are distinct signal changes in the globus pallidus. A case report and image findings are presented
    • Survey of Smartphone Use among Anaesthetists In Saolta University Health Care Group

      Kinirons, Alhomary, B. (Irish Medical Journal, 2018-03)
      Recent centuries have witnessed a revolution in technology which has made significant contributions to improve the quality of many aspects of our lives, including healthcare systems. Among these rapidly advancing technologies, smartphones stand out as an example of valuable devices that have dramatically changed the healthcare domain and the clinical practice. There is substantial evidence of the role of smartphones and medical applications in the daily practice of healthcare professionals. In one market research, it was estimated that 72% of US physicians use smartphones, and this number was expected to rise to 81% by 20121. This increasing popularity of smartphones can be attributed to the numerous benefits associated with their use. For instance, they can provide immediate access to a wealth of medical and health information via internet, emails and instant messages. Furthermore, they can lead to improved communications between healthcare professionals, and hence improved patient care2. An essential feature of smartphones is the integrated software applications (apps). These apps can either be preinstalled on the device or can be web apps that are accessed and downloaded via the internet. It is estimated that over 300,000 apps were developed between 2007 and 20103, and developers categorise a subset of these applications as medical apps. The utilisation of these medical apps by health care personnel, including anaesthetists has evolved recently.
    • Strength in Numbers: an international consensus conference to develop a novel approach to care delivery for young adults with type 1 diabetes, the D1 Now Study

      O’Hara, Mary Clare; Hynes, L.; O’Donnell, M.; Keighron, C.; Allen, G.; Caulfield, A.; Duffy, C.; Long, M.; Mallon, M.; Mullins, M.; Tonra, G.; Byrne, M.; Dinneen, S. F.; School of Medicine, National University of Ireland, Galway. Health and Wellbeing Division, Health Service Executive, Merlin Park University Hospital, Galway. (BioMed Central, 2017-12-04)
      Abstract: Background A 3-day international consensus meeting was hosted by the D1 Now study team in Galway on June 22–24, 2016 called “Strength In Numbers: Teaming up to improve the health of young adults with type 1 diabetes”. The aim of the meeting was to bring together young adults with type 1 diabetes, healthcare providers, policy makers and researchers to reach a consensus on strategies to improve engagement, selfmanagement and ultimately outcomes for young adults living with type 1 diabetes. Methods This diverse stakeholder group participated in the meeting to reach consensus on (i) a core outcome set (COS) to be used in future intervention studies involving young adults with type 1 diabetes, (ii) new strategies for delivering health services to young adults and (iii) potential digital health solutions that could be incorporated into a future intervention. Results A COS of 8 outcomes and 3 key intervention components that aim to improve engagement between young adults with type 1 diabetes and service providers were identified. A digital health solution that could potentially compliment the intervention components was proposed. Conclusion The outputs from the 3-day consensus conference, that held patient and public involvement at its core, will help the research team further develop and test the D1 Now intervention for young adults with type 1 diabetes in a pilot and feasibility study and ultimately in a definitive trial. The conference represents a good example of knowledge exchange among different stakeholders for health research and service improvement.