• Waking up to darkness.

      Lowney, Aoife C; Ryan, Stephen A; Ryan, Andrea; Harney, Sinead; Department of Rheumatology, Cork University Hospital, Wilton, Cork, Ireland. aoifelowney@gmail.com (2011-08)
    • Wegener's granulomatosis of the main pulmonary arteries: imaging findings.

      Doyle, D J; Fanning, N F; Silke, C S; Salah, S; Burke, L; Molloy, M; Spence, L; Radiology Department, Cork University Hospital, Wilton, Cork, Ireland., doyledj@hotmail.com (2012-02-03)
    • Weight gain is associated with improved glycaemic control but with adverse changes in plasma lipids and blood pressure isn Type 1 diabetes.

      Ferriss, J B; Webb, D; Chaturvedi, N; Fuller, J H; Idzior-Walus, B; Department of Medicine, Cork University Hospital, Wilton, Cork, Ireland., b.ferriss@ucc.ie (2012-02-03)
      AIMS: To assess the effects of weight gain on metabolic control, plasma lipids and blood pressure in patients with Type 1 diabetes. METHODS: Patients in the EURODIAB Prospective Complications Study (n = 3250) were examined at baseline and 1800 (55%) were re-examined a mean of 7.3 years later. Patients had Type 1 diabetes, defined as a diagnosis made before age 36 years and with a need for continuous insulin therapy within a year of diagnosis. Patients were aged 15-60 years at baseline and were stratified for age, sex and duration of diabetes. RESULTS: The change in HbA(1c) from baseline to follow-up examination was significantly more favourable in those who gained 5 kg or more during follow-up ('marked weight gain') than in patients who gained less or no weight or lost weight ('less or no weight gain'). In those with marked weight gain, there was a significantly greater rise in plasma triglycerides and total cholesterol and significantly less favourable changes in low-density lipoprotein and high-density lipoprotein cholesterol compared with those with less or no weight gain, with or without adjustment for HbA(1c). Systolic and diastolic blood pressure also rose significantly more in the group with marked weight gain. CONCLUSION: Weight gain in patients with Type 1 diabetes has adverse effects on plasma lipids and blood pressure, despite a small improvement in glycaemic control.
    • What a signature adds to the consent process.

      Neary, Peter; Cahill, Ronan A; Kirwan, W O; Kiely, E; Redmond, H P; Department of Surgery, Cork University Hospital, Cork, Ireland. (2012-02-03)
      BACKGROUND: "Consent is a process by which a patient is informed and becomes a participant in decisions regarding their medical management." It is argued, however, that providing a signature to a form adds little to the quality of this process. METHODS: Views regarding the consent ritual of nonselected patients undergoing endoscopy (cystoscopy or sigmoidoscopy) were prospectively studied together with those of the attending staff. Patient volunteers were randomly assigned to one of two groups and given verbal explanation before the procedure, either alone (group A) or with a request to sign a form in addition (group B). A standardized questionnaire regarding preferences then was applied. RESULTS: A total of 37 patients (22 men) were studied along with seven staff members. Most surveyed felt that signing a consent form helped to empower the patient (group A, 84%; group B, 83%; staff, 100%). Although the patients mainly believed that it functioned primarily to protect the hospital and doctor (group A, 89%; group B, 67%), only one patient (3% of total) felt that such a formality undermined the patient-doctor relationship. Most staff members favored signing a form (86%). The majority of patients either favored it (group A, 47%; group B, 78%) or expressed no strong preference (group A, 32%; group B, 11%). Interestingly, more women than men preferred signing (73 vs. 55%; p = 0.25), perhaps because more women believed that it functioned to preserve autonomy (93 vs. 77% of men). Age was no particular determinant of perspective. CONCLUSION: Although it may be viewed as primarily serving to protect the doctor and hospital, the formal process of signing written consent forms appeals to patients and staff.
    • What is the evidence for the use of probiotics in functional disorders?

      Quigley, Eamonn M M; Department of Medicine, Clinical Sciences Building, Cork University Hospital,, Cork, Ireland. e.quigley@ucc.ie (2012-02-03)
      A rationale for the use of probiotics for a number of functional gastrointestinal symptoms and syndromes can be developed, and an experimental basis for their use continues to emerge, but data from well-conducted clinical trials of probiotics in this area remain scarce. Irritable bowel syndrome (IBS) has attracted the most attention; recent revelations regarding the potential pathogenic roles of the enteric flora and immune activation have led to reawakened interest in bacterio-therapy for this common and challenging disorder. Some recent randomized, controlled studies attest to the efficacy of some probiotics in alleviating individual IBS symptoms, and selected strains have a more global impact. Evidence for long-term efficacy is also beginning to emerge, though more studies are needed in this regard. In other functional syndromes, data are far from adequate to make recommendations, but there is evidence for efficacy of probiotics in treating individual symptoms such as diarrhea, constipation, and bloating. The interpretation of much of the literature in this area is complicated by lack of quality control, use of many different species and strains, and, above all, significant deficiencies in trial methodology.
    • "What we learn in time of pestilence...".

      Gaensbauer, J T; Ni Chroinin, M; Cork University Hospital, Division of Paediatrics, Wilton Road, Wilton, Cork,, Ireland. jgaens@u.washington.edu (2012-02-03)
    • "What we learn in time of pestilence...".

      Gaensbauer, J T; Ní Chróinín, M; Cork University Hospital, Division of Paediatrics, Wilton Road, Wilton, Cork, Ireland. jgaens@u.washington.edu (2009-08)
    • When do we think it is Safe to Drive after Hand Surgery? – Current Practice and Legal Perspective

      Murphy, SF; Martin-Smith, JD; Martin-Smith, W; O’Broin, E; Clover, APJ (Irish Medical Journal, 2016-11)
      Patients recovering from hand surgery frequently ask when it is safe to drive and it is unclear where the responsibility lies; the surgeon, the patient or the insurance company. An eight-question survey looking at various aspects of clinical practice was circulated to consultant and trainee plastic and orthopaedic surgeons in Ireland and the UK. Of the 89 surgeons who replied, (53%) felt the decision when to drive was the patient’s compared with the insurance company (40%) and the surgeon (7%). 80% advised patients to contact their insurance company. 87% were unaware of current regulations or guidelines. National guidelines were vague and left the decision with the treating doctor. Similarly, major insurers advise patients to contact their doctor for advice. From a legal standpoint, the patient has a duty of care to other road users to be in full control of his vehicle prior to driving, regardless of any advice received.
    • When pain after surgery doesn't go away...

      Burke, Siún; Shorten, George D; Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton, Cork, Ireland. (2009-02)
      Chronic post-surgical pain is a common, under-recognized and important clinical problem which affects millions of patients worldwide. It results from a series of neuroplastic changes associated most commonly with peripheral nerve injury at the time of surgery. Predisposing factors include the type of surgery, pre-operative and acute post-operative pain intensity, and probably psychological (e.g. pain-catastrophizing) and genetic factors [e.g. GCH1 (GTP cyclohydrolase 1) haplotype]. Preventive measures which are currently available include selection of a minimally invasive surgical technique and an aggressive multimodal perioperative analgesic regimen. Very promising therapeutic agents which target the sensitization process are currently in development.
    • Which patients will benefit from percutaneous radiofrequency ablation of colorectal liver metastases? Critically appraised topic.

      McGrane, Siobhan; McSweeney, Sean E; Maher, Michael M; Department of Radiology, Cork University Hospital, University College Cork, Cork,, Ireland. (2012-02-03)
      In clinical radiology, there are numerous examples of new techniques that were initially enthusiastically promoted and then subsequently abandoned when early promise was not realized in routine patient care. Appropriateness of new or established interventional radiology techniques to specific clinical conditions must be determined from clinical experience, from communication with experts in the field and/or careful review of available medical literature, and on an individual patient basis by means of review of clinical notes and diagnostic imaging studies. For patients with liver neoplasms, regional techniques such as radiofrequency ablation (RFA) have been developed and are now the subject of ongoing research. This article describes the utilization of Evidence-Based Practice (EBP) techniques as a means of deciding the appropriateness of percutaneous RFA in treating colorectal liver metastases (CLM).
    • Who's talking about breast cancer? Analysis of daily breast cancer posts on the internet.

      Quinn, Edel M; Corrigan, Mark A; McHugh, Seamus M; Murphy, David; O'Mullane, John; Hill, Arnold D; Redmond, Henry Paul; Department of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland. edelquinn@rcsi.ie (2013-02)
      Breast cancer is the cancer most commonly searched for on the internet. Our aim was to assess daily new breast cancer related posting on the internet.
    • Why blind nasotracheal intubation?

      Ajmal, Muhammad (2011-09)