Research by staff affiliated to Cork University Hospital

Recent Submissions

  • ERS International Congress, Madrid, 2019: highlights from the Allied Respiratory Professionals' Assembly.

    Oliveira, Ana; Rutter, Matthew; Quijano-Campos, Juan Carlos; Herrero-Cortina, Beatriz; Clari, Marco; O'Rourke, Aoife; McGowan, Aisling; Burtin, Chris; Sajnic, Andreja; De Brandt, Jana (2020-04-06)
    This article provides an overview of outstanding sessions that were (co)organised by the Allied Respiratory Professionals' Assembly during the European Respiratory Society International Congress 2019 in Madrid, Spain. Session content was mainly targeted at allied respiratory professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses, and is summarised in this document. Short take-home messages related to pulmonary function testing highlight the importance of quality control. Furthermore, novel findings regarding the assessment of functional status call attention to bodily factors that can affect functional status. Regarding pulmonary rehabilitation, data were presented about the use of equipment and type of exercise training in COPD and lung cancer. Recent developments in physical activity-related research give insight in enablers of physical activity after hospital admission. The importance of integrated respiratory care was also highlighted, with the occupational therapist, nurse, and nutritional and psychological counsellor playing a pivotal role, which relates directly to research in the field of respiratory nursing that formulates the need for more nursing led-interventions in the future. To conclude, this review provides readers with valuable insight into some of the emerging and future areas affecting clinical practice of allied healthcare professionals.
  • Two cases of deliberate implant mismatch in knee arthroplasty.

    Marie-Hardy, Laura; O'Loughlin, Padhraig; Bonnin, Michel; Ait Si Selmi, Tarik (2020-06-17)
    Cases: Knee arthroplasty is increasingly common with good clinical results. However, there is a cohort of patients whose native knee anatomy may not marry well with standard implants. The current authors describe two cases (one unicompartmental knee arthroplasty (UKA), one total knee arthroplasty (TKA)), during which deliberately implanting an implant designed for the contra-lateral distal femur (TKA) or contralateral femoral condyle (UKA) respectively, led to a better fit than correct-sided implants. Conclusion: The authors share their experience to raise awareness of a potential solution to such an intra-operative challenge and suggest that implant customisation may ultimately address challenges with grossly abnormal native anatomy.
  • Cardiovascular Clinical Trials in a Pandemic: Immediate Implications of Coronavirus Disease 2019.

    Spitzer, Ernest; Ren, Ben; Brugts, Jasper J; Daemen, Joost; McFadden, Eugene; Tijssen, Jan Gp; Van Mieghem, Nicolas M (2020-05-01)
    The coronavirus disease 2019 (COVID-19) pandemic started in Wuhan, Hubei Province, China, in December 2019, and by 24 April 2020, it had affected >2.73 million people in 185 countries and caused >192,000 deaths. Despite diverse societal measures to reduce transmission of the severe acute respiratory syndrome coronavirus 2, such as implementing social distancing, quarantine, curfews and total lockdowns, its control remains challenging. Healthcare practitioners are at the frontline of defence against the virus, with increasing institutional and governmental supports. Nevertheless, new or ongoing clinical trials, not related to the disease itself, remain important for the development of new therapies, and require interactions among patients, clinicians and research personnel, which is challenging, given isolation measures. In this article, the authors summarise the acute effects and consequences of the COVID-19 pandemic on current cardiovascular trials.
  • Case report of spuriously low sodium and calcium in a 36-year-old male in primary care.

    Costelloe, Seán J; McCarthy, Kelly; O'Connell, Marguerite; Butler, Mark (2020-04-15)
    An unseparated serum specimen for a 36-year-old male was received from primary care. The specimen arrived in the laboratory at Cork University Hospital one day after collection, as documented on the paper request card, and was promptly centrifuged. Analysis was delayed for three days due to operational constraints and serum indices were run at the same time as the biochemical analyses. Results showed a moderately haemolysed specimen with remarkably low concentrations of both sodium (119 mmol/L) and total calcium (1.15 mmol/L), with all other parameters within their appropriate reference intervals (RIs). The complete report was released electronically and both sodium and calcium results were phoned to, and acknowledged by, the requesting general practitioner (GP). Discussion between the medical scientists and clinical biochemist on duty raised the possibility that the specimen was significantly older than initially thought. Further discussion of results with the GP clarified that the documented time of collection corresponded with specimen receipt by the courier, rather than the time of phlebotomy. Thus, the specimen was 7 days old when received in the laboratory and 10 days old when analysed. This case illustrates the dangers of multiple convergent preanalytical errors. Laboratories should be mindful of the stability of analytes in unseparated blood and unusual patterns of results which might suggest a specimen is "old", and that this may coexist with erroneous request information. Any potential adverse effects on patient care were prevented in this case by laboratory vigilance.
  • Histologic Case Definition of an Atypical Glomerular Immune-Complex Deposition Following Kidney Transplantation.

    Chin, Kuo-Kai; Charu, Vivek; O'Shaughnessy, Michelle M; Troxell, Megan L; Cheng, Xingxing S (2020-02-05)
    Introduction: Immune-complex deposition in the transplanted kidney can present as well-phenotyped recurrent or de novo glomerular disease. However, a subset, herein termed immune-complex glomerulopathy not otherwise specified (ICG-NOS), defies classification. We quantified, categorized, and characterized cases of transplant ICG-NOS occurring at a single US academic medical center. Methods: We retrospectively reviewed our single-institution pathology database (July 2007-July 2018) to identify and categorize all cases of immune-complex deposition in kidney allografts (based on immunofluorescence microscopy). We extracted clinicopathologic and outcome data for ICG-NOS (i.e., immune complex deposition not conforming to any well-characterized glomerular disease entity). Results: Of 104 patients with significant immune deposits, 28 (27%) were classified as ICG-NOS. We created 5 mutually exclusive ICG-NOS categories: Full-house, Quasi-full-house, IgA-rich, C1q-rich, and C1q-poor. Overall, 16 (57%) patients met criteria for definite or possible allograft rejection, including 9 (32%) with antibody-mediated rejection (ABMR), 3 (11%) suspicious for ABMR, 1 (4%) with T-cell-mediated rejection (TCMR), and 9 (32%) with borderline TCMR. After a median follow-up of 2.3 (range, 0.1-14.0) years after biopsy, 7 (25%) allografts had failed and an additional 8 (29%) had persistent renal dysfunction (hematuria, 14%; proteinuria, 21%; and estimated glomerular filtration rate <60 ml/min per 1.73 m2, 11%). Conclusion: In contrast to prior studies, our findings suggest that ICG-NOS is not necessarily a benign glomerular process and that there may be an association between ICG-NOS and alloimmunity. Our immunofluorescence-based classification provides a framework for future studies aiming to further elucidate ICG-NOS pathogenesis and prognosis.
  • International Perspective on the Pursuit of Quality in Cancer Care: Global Application of QOPI and QOPI Certification.

    Blayney, Douglas W; Albdelhafeez, Nafisa; Jazieh, Abdul Rahman; Pinto, Carlos Frederico; Udrea, Adrian; Roach, Alex; Das, Devika; Grubbs, Stephen; Hamm, John; Jahanzeb, Mohammad; et al.
  • 'I've always done what I was told by the medical people': a qualitative study of the reasons why older adults attend multifactorial falls risk assessments mapped to the Theoretical Domains Framework.

    Racine, Emmy; Soye, Anna; Barry, Patrick; Cronin, Finola; Hosford, Orla; Moriarty, Eileen; O'Connor, Kieran A; Turvey, Spencer; Timmons, Suzanne; Kearney, Patricia M; et al. (2020-02-18)
    Sixteen interviews were conducted. Three main themes explained participants' reasons for attending the multifactorial risk assessment; being that 'type of person', being 'linked in' with health and community services and having 'strong social support'. Six other themes were identified, but these themes were not as prominent during interviews. These were knowing what to expect, being physically able, having confidence in and being positive towards health services, imagining the benefits given previous positive experiences, determination to maintain or regain independence, and being 'crippled' by the fear of falling. These themes mapped on to nine TDF domains: 'knowledge', 'skills', 'social role and identity', 'optimism', 'beliefs about consequences', 'goals', 'environmental context and resources', 'social influences' and 'emotion'. There were five TDF domains that were not relevant to the reasons for attending.
  • Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study.

    Kiely, L F; Moloney, E; O'Sullivan, G; Eustace, J A; Gallagher, J; Bourke, J F (2020-09-05)
    COVID-19 healthcare workers (HCWs) require frequent handwashing and use of personal protective equipment (PPE) to prevent infection. However, evidence is emerging that these practices are causing adverse effects on their skin integrity. A single-centre, cross-sectional study of HCWs from an Irish hospital was undertaken to evaluate the degree of COVID-19-related irritant contact dermatitis (ICD) between April and May 2020. Of 270 participants surveyed, 223 (82.6%) reported symptoms of ICD. The hands were the most commonly affected site (76.47%) and the most frequently reported symptom was dry skin (75.37%). Nearly all (268; 99.26%) HCWs had increased hand-washing frequency, but 122 (45.35%) did not use emollients. In the ICD group, 24.7% cited a history of dermatitis compared with 4.3% of unaffected staff (P < 0.001). The ICD group recorded PPE usage for an average of 3.15 h compared with the non-ICD group at 1.97 h (P = 0.21). Promoting awareness of COVID-19-related ICD is vital to highlight prevention and treatment for frontline staff.
  • Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial.

    Cronin, Owen; Barton, Wiley; Moran, Carthage; Sheehan, Donal; Whiston, Ronan; Nugent, Helena; McCarthy, Yvonne; Molloy, Catherine B; O'Sullivan, Orla; Cotter, Paul D; et al. (2019-02-12)
    Improved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident.
  • Development of an Insulin-Prescribing Chart for Paediatric Diabetes

    Finn, B.P; O’Neill, T.; Bradfield, A.; O’Sullivan, T.; Beattie, S.; O’Connell, S.M. (Irish Medical Journal, 2019-10)
    Our aim was to design a new insulin prescribing tool in compliance with the Irish Medicines Safety Network recommendations.
  • High-flow Nasal Cannulae, Bronchopulmonary Dysplasia and Retinopathy of Prematurity

    Healy, L.I; Corcoran, P.; Murphy, B.P (Irish Medical Journal, 2019-09)
    To determine if HFNC use was associated with changes in incidence of BPD and ROP.
  • Telephone Follow-Up of Mild Traumatic Brain Injury; A Feasibility Study

    Underwood, S.; Campbell, S.; Deasy, C. (Irish Medical Journal, 2019-09)
    This study investigates the prevalence of Post-Concussion Syndrome (PCS) one-year post-injury in patients that were treated for Mild Traumatic Brain Injury (mTBI) in the Clinical Decision Unit (CDU) of Cork University Hospital’s (CUH) Emergency Department.
  • Listeria Meningitis in an Immunocompetent Child: Case Report and Literature Review

    McCarthy, K.N; Leahy, T.R; Murray, D.M (Irish Medical Journal, 2019-05)
    Listeria monocytogenes is a facultatively anaerobic Gram-positive bacillus that is an unusual cause of illness among immunocompetent individuals1. Infection with listeria is most commonly encountered in pregnancy, the neonatal period, and in immunocompromised patients2. Risk factors include food-borne exposures, particularly to soft cheeses and delicatessen meats, and life stock exposure3. Meningitis is the most frequently encountered clinical syndrome. L. monocytogenes accounts for 20% of cases of meningitis in neonates and in those >60 years and is the most common cause of meningitis among immunocompromised individuals1. Listeriosis is a rare disease in Ireland with a crude incidence rate of 0.41 per 100,000 which is lower than the EU average of 0.48 per 100,000 4.
  • High Rates of Diabetic Ketoacidosis in Patients with New and Known Type 1 Diabetes over a Six-Year Period

    Finn, B.P.; Trayer, J.; Cronin, C.; O’Connell, S.M (Irish Medical Journal, 2019-03)
    Ireland is a high incidence country for type 1 diabetes (T1DM) with 28.8 newly diagnosed cases/100,000/year1. Patients with new onset T1DM frequently (15-70%) present with diabetic ketoacidosis (DKA)2,3,4,5. Lansdown et al found that 25% of children with new onset T1DM under 19 years of age presented in DKA in Wales between 1991 and 20096. The rates of DKA in known T1DM on an international stage remains significant- Austria and Germany (5%), Wales and England (6.4%) and the United States (7.1%)7. The aim of our study was to analyse all admissions with diabetic ketoacidosis to the regional paediatric diabetes centre at Cork University Hospital, over the past six years. Our objectives include assessing the proportion of patients with new and known T1DM, treatment modalities (e.g. pump/multiple daily injections), patient demographics, severity, length of stay and outcomes.
  • Diagnostic Yield of Routine EEG in Adults with Active Epilepsy

    McGinty, R.N.; Costello, D.J.; Kinirons, P; McNamara, B (Irish Medical Journal, 2019-01)
    Routine electroencephalogram (rEEG) is an important investigation in suspected seizures but can be normal in people with epilepsy. The diagnostic yield of rEEG varies considerably according to the patient group studied. We aimed to estimate the diagnostic yield of rEEG in a real-world cohort of adults with active epilepsy—a population not previously reported. This single centre study evaluated neurophysiology findings for adults with prolonged inpatient video EEG (vEEG)-confirmed active epilepsy, who had at least one prior rEEG. Sixty-eight patients had a total of 171 rEEGs, of which 93 (54.4%) were normal, 42 (24.6%) found non-specific abnormalities and 36 (21.1%) captured interictal epileptiform abnormalities (IIEAs). Serial rEEGs revealed a 22.1% yield of IIEAs on the first test, with the cumulative yield peaking at 33.8% on the fourth rEEG. This study adds to existing evidence regarding the limited diagnostic usefulness of serial rEEG in patients with active epilepsy.
  • IgG4 Related Disease, A Case of Large Vessel Vasculitis

    O’Sullivan, A; Ghazi Al Qatari, S; Murphy, G; Cork University Hospital (Irish Medical Journal, 2018-10)
    This report describes a case of large vessel vasculitis highlighting diagnostic and therapeutic challenges. It describes the use of the B cell depleting agent Rituximab in this setting. This is the case of a 50 year old lady with bipolar disorder presenting with lower limb pain.
  • Gene-trait matching across the Bifidobacterium longum pan-genome reveals considerable diversity in carbohydrate catabolism among human infant strains.

    Arboleya, S; Bottacini, F; O'Connell-Motherway, M; Ryan, CA; Ross, RP; van Sinderen, D; Stanton, C; University College Cork (Irish Medical Journal, 2018-07)
    Bifidobacterium longum is a common member of the human gut microbiota and is frequently present at high numbers in the gut microbiota of humans throughout life, thus indicative of a close symbiotic host-microbe relationship. Different mechanisms may be responsible for the high competitiveness of this taxon in its human host to allow stable establishment in the complex and dynamic intestinal microbiota environment. The objective of this study was to assess the genetic and metabolic diversity in a set of 20 B. longum strains, most of which had previously been isolated from infants, by performing whole genome sequencing and comparative analysis, and to analyse their carbohydrate utilization abilities using a gene-trait matching approach.
  • 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; et al. (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.
  • 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.
  • 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.

View more