• Ulnar nerve entrapment by anconeus epitrochlearis ligament.

      Tiong, William H C; Kelly, Jason; Department of Plastic and Reconstructive Surgery, Cork University Hospital, Wilton, Cork, Ireland, UK. willhct@yahoo.com (2012)
      Ulnar nerve entrapment at the elbow is the second most common upper limb entrapment neuropathy other than carpal tunnel syndrome. There have been many causes identified ranging from chronic aging joint changes to inflammatory conditions or systemic disorders. Among them, uncommon anatomical variants accounts for a small number of cases. Here, we report our experience in managing ulnar nerve entrapment caused by a rare vestigial structure, anconeus epitrochlearis ligament, and provide a brief review of the literature of its management.
    • Ultrasound guided supraclavicular block.

      Hanumanthaiah, Deepak; Garstka, Maria; Vaidiyanathan, Sabanayagam; Szucs, Szilard; Iohom, Gabriella; Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital and University College Cork, Ireland; Email: gabriella.iohom@hse.ie. (Medical ultrasonography, 2013-09)
      Ultrasound guided regional anaesthesia is becoming increasingly popular. The supraclavicular block has been transformed by ultrasound guidance into a potentially safe superficial block. We reviewed the techniques of performing supraclavicular block with special focus on ultrasound guidance.
    • Ultrasound-guided axillary brachial plexus block with 20 milliliters local anesthetic mixture versus general anesthesia for upper limb trauma surgery: an observer-blinded, prospective, randomized, controlled trial.

      O'Donnell, Brian D; Ryan, Helen; O'Sullivan, Owen; Iohom, Gabrielle; Department of Anesthesia, Cork University Hospital, Wilton Rd., Cork, Ireland. briodnl@gmail.com (2009-07)
      We performed a randomized, controlled trial comparing low-dose ultrasound-guided axillary block with general anesthesia evaluating anesthetic and perioperative analgesic outcomes.
    • Universal precautions--do Irish anaesthetists comply?

      O'Rourke, N; Bennett, M; Porter, J; Gallagher, D J; Shorten, G; Department of Anaesthesia and Intensive Care Medicine, Medicine, Cork University , Hospital, Cork. (2012-02-03)
      BACKGROUND: Anaesthetists are at high risk from blood-borne pathogens. Universal Precautions (UP) include the routine use of appropriate barrier precautions and techniques to reduce the likelihood of exposure to blood, body fluids and tissues that may contain pathogens. The compliance of Irish anaesthetists with these precautions has not been studied. AIM: To study the attitudes of Irish anaesthetists to Universal Precautions. METHOD: A postal questionnaire was sent to 210 anaesthetists currently practising in Ireland. The questionnaire was based on a model used in Australia and New Zealand. RESULTS: There was a 50% response rate to the survey. Only 15% of respondents had taken a risk history from a patient in the preceding four weeks. Resheathing of needles was commonplace. The effectiveness of hepatitis B immunisation was rarely checked and only 66% of respondents believe implementation of Universal Precautions to be practical. CONCLUSION: Irish anaesthetists comply poorly with Universal Precautions.
    • Unsticking eosinophils.

      Costello, R W; Murphy, D M (2009-12)
    • Unusual aspects of melanoma. Case 3. Melanoma-associated retinopathy presenting with night blindness.

      Myers, Doreen A; Bird, Brian R; Ryan, Susan M; Tormey, Peter; McKenna, Paul; OReilly, Seamus; Breathnach, Oscar S; Department of Medical Oncology, Cork University Hospital, Wilton, Ireland. (2012-02-03)
    • An unusual case of Legionellosis

      Prior, AR; Bredin, CP; Seigne, P (Irish Medical Journal, 2011-03)
    • An unusual case of Legionellosis.

      Prior, A R; Bredin, C P; Seigne, P; Corcoran, D; Prentice, M; Department of Microbiology, Cork University Hospital, Wilton, Co Cork. annarosep@yahoo.com (2011-03)
      Legionella species is a common cause of community-acquired pneumonia. However disease due to L. pneumophila serogroup 13 is rare and has not previously been reported in Ireland. It may not be detected by routine Legionella antigen and antibody kits. Due to these limitations, early culture should be considered when legionellosis is suspected. The potential therapeutic benefit of quinolones in the management of this disease is also illustrated.
    • An unusual cause of respiratory symptoms in a toddler.

      Casey, M C; Rafferty, D; O'Neill, M; Department of Radiology, Cork University Hospital, Cork, Ireland. (2012-02-03)
    • Unusual paraneoplastic syndromes of breast carcinoma: a combination of cerebellar degeneration and Lambert-Eaton Myasthenic Syndrome.

      Romics, L; McNamara, B; Cronin, P A; O'Brien, M E; Relihan, N; Redmond, H P; Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland. Laszlo.Romics@umassmed.edu (2011-06)
      Paraneoplastic neurological disorders are rare complications of breast carcinoma. Lambert-Eaton Myasthenic Syndrome (LEMS) is most commonly associated with small cell lung cancer. However, a combination of LEMS and subacute cerebellar degeneration as paraneoplastic syndromes is extremely rare, and has never been described in association with breast cancer.
    • An unusual phenotype in Muckle-Wells syndrome associated with NLRP3 E311K.

      Murphy, Grainne; Daly, Mary; O'Sullivan, Miriam; Stack, John; Rowczenio, Dorota; Lachmann, Helen; Shanahan, Fergus; Harney, Sinead; Hawkins, Philip; Molloy, Michael (2011-02)
    • An unusual presentation of a glomus tumour.

      Nugent, N; Henry, F; O'Shaughnessy, M; Department of Plastic Surgery, Cork University Hospital, Wilton, Cork. noranugent@gmail.com (2011-02)
      Glomus tumours are benign, soft tissue tumours, usually of fingertips. Classically they present with severe pain, temperature sensitivity and localised tenderness. The diagnosis is often delayed due to sometimes non-specific symptoms and rarity of the disorder. While usually a clinical diagnosis, imaging may be necessary for diagnosis and localisation. We present a case of glomus tumour of the fingertip with an unusual history.
    • An unusual presentation of Fournier's gangrene.

      Kearney, D E; Harney, S; O'Broin, E; McCourt, M; Department of Academic Surgery, Cork University Hospital, Cork, Ireland. dkearnage@gmail.com (2011-06)
      INTRODUCTION: Fournier's gangrene is a rare severe necrotising fasciitis of the genitalia. CASE: A case of Fournier's gangrene caused by perforated sigmoid diverticulitis in a patient with systemic lupus erythematosus is presented along with a review of the relevant literature.
    • An update on radioactive release and exposures after the Fukushima Dai-ichi nuclear disaster.

      McLaughlin, P D; Jones, B; Maher, M M; Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland. mclaughlin.paddy@gmail.com (2012-09)
      On 11 March 2011, the Richter scale 0.9-magnitude Tokohu earthquake and tsunami struck the northeast coast of Japan, resulting in widespread injury and loss of life. Compounding this tragic loss of life, a series of equipment and structural failures at the Fukushima Dai-ichi nuclear power plant (FDNP) resulted in the release of many volatile radioisotopes into the atmosphere. In this update, we detail currently available evidence about the nature of immediate radioactive exposure to FDNP workers and the general population. We contrast the nature of the radioactive exposure at FDNP with that which occurred at the Chernobyl power plant 25 years previously. Prediction of the exact health effects related to the FDNP release is difficult at present and this disaster provides the scientific community with a challenge to help those involved and to continue research that will improve our understanding of the potential complications of radionuclide fallout.
    • Upregulation of Fas-Fas-L (CD95/CD95L)-mediated epithelial apoptosis--a putative role in pouchitis?

      Coffey, J C; Bennett, M W; Wang, J H; O'Connell, J; Neary, P; Shanahan, F; Redmond, H P; Kirwan, W O; Department of Academic Surgery, Cork University Hospital, Cork, Ireland. (2012-02-03)
      INTRODUCTION: Ileal pouch-anal anastomosis (IPAA) remains the gold standard for patients with refractory ulcerative colitis. Pouchitis causes considerable morbidity in 40% of patients with IPAA. This study examined the role of increased epithelial apoptosis in the etiology of pouchitis. METHODS: Following ethical approval pouch biopsies taken from patients with a history of pouchitis were compared with age-matched controls from patients who were pouchitis free. Apoptosis was detected immunohistochemically using a monoclonal antibody (M30) and terminal deoxyribonucleotidyl transferase (TDT)-mediated dUTP-digoxigenin end labeling (TUNEL). Villous atrophy was assessed histologically and correlated with levels of apoptosis. Epithelial Fas-ligand (L) was also assessed immunohistochemically. RESULTS: A significant increase in TUNEL staining was seen at the epithelial but not at the lamina propria level for known pouchitis patients versus controls (0.091 vs 0.035; P < 0.01). Similarly, epithelial M30 immunoreactivity (0.225 vs 0.082; P < 0.05) and villous atrophy (0.035 vs 0.10; P < 0.05) were significantly increased in pouches with previous pouchitis when compared with normal pouches. Upregulation of Fas-L expression was characteristic of this epithelium. Mononuclear cells were strongly positive for Fas-L. Increased epithelial levels of apoptosis correlated with increased levels of villous atrophy. CONCLUSIONS: Our data suggest a role for elevated Fas-Fas-L (CD95-CD95L)-mediated epithelial apoptosis in the etiology of pouchitis. Increased levels of villous atrophy may result from increased apoptosis and thereby predispose to infection by otherwise apathogenic organisms.
    • Upregulation of neurokinin-1 receptor expression in the lungs of patients with sarcoidosis.

      O'Connor, Terence M; O'Connell, Joseph; O'Brien, Darren I; Bennett, Michael W; Goode, Triona; Burke, Louise; Bredin, Charles P; Shanahan, Fergus; Department of Medicine, Cork University Hospital, Cork, Ireland., oconnotm@mcmaster.ca (2012-02-03)
      Substance P (SP) is a proinflammatory neuropeptide that is secreted by sensory nerves and inflammatory cells. Increased levels of SP are found in sarcoid bronchoalveolar lavage fluid. SP acts by binding to the neurokinin-1 receptor and increases secretion of tumor necrosis factor-alpha in many cell types. We sought to determine neurokinin-1 receptor expression in patients with sarcoidosis compared with normal controls. Neurokinin-1 receptor messenger RNA and protein expression were below the limits of detection by reverse transcriptase-polymerase chain reaction and immunohistochemistry in peripheral blood mononuclear cells of healthy volunteers (n = 9) or patients with stage 1 or 2 pulmonary sarcoidosis (n = 10), but were detected in 1/9 bronchoalveolar lavage cells of controls compared with 8/10 patients with sarcoidosis (p = 0.012) and 2/9 biopsies of controls compared with 9/10 patients with sarcoidosis (p = 0.013). Immunohistochemistry localized upregulated neurokinin-1 receptor expression to bronchial and alveolar epithelial cells, macrophages, lymphocytes, and sarcoid granulomas. The patient in whom neurokinin-1 receptor was not detected was taking corticosteroids. Incubation of the type II alveolar and bronchial epithelial cell lines A549 and SK-LU 1 with dexamethasone downregulated neurokinin-1 receptor expression. Upregulated neurokinin-1 receptor expression in patients with sarcoidosis may potentiate substance P-induced proinflammatory cytokine production in patients with sarcoidosis.
    • The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics.

      Haroon, Muhammad; Adeeb, Fahd; Eltahir, Ahmed; Harney, Sinead; Department of Rheumatology, Cork University Hospital, Cork, Ireland. mharoon301@hotmail.com (Elsevier, 2011-07)
      PURPOSE AND OBJECTIVES: The patients using immunosuppressive agents are considered at high risk for acquiring different infections. Accordingly, international guidelines recommend vaccinating such patients against influenza and pneumococcal organisms. The aims of this study were two-fold: (1) to assess the influenza and pneumococcal vaccination uptake among our rheumatology outpatients who are immunosuppressed; (2) to identify the factors influencing immunisation uptake among our sample of patients.
    • Ureteric obstruction with mucocoele of the appendix due to endometriosis.

      O'Sullivan, M J; Kumar, U; Kiely, E A; Academic Department of Surgery, Cork University Hospital, Ireland. (2012-02-03)
    • Usage of emergency contraception between medical related and non-medical related students.

      Khalid, A K; Abd Halim, H; Kenny, L; Cork University Hospital, Wilton, Cork. cubchee@yahoo.co.uk (2009-04)
      Teenagers and young adultshave the most risk of unplanned pregnancy, due to lack of awareness to see a family planning provider after unprotected sexual intercourse. In addition, nearly one in five physicians is reluctant to provide information regarding Emergency Contraception (EC) to women and this may contribute to their lack of awareness. This study was conducted to assess the knowledge, attitudes and practices regarding the use of EC between medical related students compared to non-medical related students. Data collection was done using questionnaires distributed among students in University College Cork (UCC). 93% of medically related students were aware of EC compared to only 73.5% of non-medically related students. Medical related students also were more aware about the mechanism of action and detailed knowledge of EC compared to the non-medical students. This study has proven that medically related students have more detailed knowledge regarding EC compared to non-medical related students. However, there was no significant difference noted regarding the attitude and practice between the two groups.