• Barriers to exercise in obese patients with type 2 diabetes.

      Egan, A M; Mahmood, W A W; Fenton, R; Redziniak, N; Kyaw Tun, T; Sreenan, S; McDermott, J H; Department of Endocrinology and Diabetes Mellitus, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. aoife.egan@gmail.com (2013-07)
      Although regular exercise is a critical component of the management of type 2 diabetes, many patients do not meet their exercise targets. Lack of exercise is associated with obesity and adverse cardiovascular outcomes.
    • Basic surgical training in Ireland: the impact of operative experience, training program allocation and mentorship on trainee satisfaction.

      O'Sullivan, K E; Byrne, J S; Walsh, T N; RCSI Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland, kaosulli@tcd.ie. (2013-12)
      Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs.
    • A case of spontaneous hypoglycaemia and impaired glucose tolerance in the same patient.

      Thabit, Hood; Healy, M L; Royston, Derval; Broe, Patrick; Scarramuzzi, N; Walsh, Thomas N; Sreenan, Seamus; Department of Endocrinology, Connolly Hospital, Blanchardstown, Dublin, Ireland. , hoodeenee@gmail.com (2012-01-31)
      We present a rare case of an insulin-like growth factor-2 (IGF-2)-secreting tumour of the thorax. This patient demonstrated the combination of fasting hypoglycaemia and impaired glucose tolerance on oral glucose tolerance testing, which has not been previously described in this condition. A review of the literature of IGF-2-secreting intrathoracic tumours is presented here.
    • Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

      Lobo, Melvin D; Sobotka, Paul A; Stanton, Alice; Cockcroft, John R; Sulke, Neil; Dolan, Eamon; van der Giet, Markus; Hoyer, Joachim; Furniss, Stephen S; Foran, John P; et al. (2015-01-22)
      Hypertension contributes to cardiovascular morbidity and mortality. We assessed the safety and efficacy of a central iliac arteriovenous anastomosis to alter the mechanical arterial properties and reduce blood pressure in patients with uncontrolled hypertension.
    • Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus.

      Bass, G A; Furlong, H; O'Sullivan, K E; Hennessy, T P J; Walsh, T N; Royal College of Surgeons in Ireland, Department of Surgery, Connolly Hospital, Dublin 15, Ireland. Electronic address: garybassmd@gmail.com. (2014-04)
      Oesophageal cancer usually presents with systemic disease, necessitating systemic therapy. Neo-adjuvant chemoradiotherapy improves short-term survival, but its long-term impact is disputed because of limited accrual, treatment-protocol heterogeneity and a short follow-up of randomised trials.
    • Clinical characteristics, management, and control of permanent vs. nonpermanent atrial fibrillation: insights from the RealiseAF survey.

      Murin, Jan; Naditch-Brûlé, Lisa; Brette, Sandrine; Chiang, Chern-En; O'Neill, James; Steg, P Gabriel; 5Connolly/Mater Hospitals/Royal College of Surgeons in Ireland, Dublin, Ireland. (PLoS ONE, 2014)
      Atrial fibrillation can be categorized into nonpermanent and permanent atrial fibrillation. There is less information on permanent than on nonpermanent atrial fibrillation patients. This analysis aimed to describe the characteristics and current management, including the proportion of patients with successful atrial fibrillation control, of these atrial fibrillation subsets in a large, geographically diverse contemporary sample.
    • Collagenous colitis as a possible cause of toxic megacolon.

      Fitzgerald, S C; Conlon, S; Leen, E; Walsh, T N; Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, Ireland. ktsfitz@hotmail.com (2009-03)
      Collagenous colitis is a microscopic colitis characterized by normal appearing colonic mucosa on endoscopy. It is regarded as a clinically benign disease which rarely results in serious complications. We report a case of toxic megacolon occurring in a patient with collagenous colitis. This is the first reported case of toxic megacolon occurring in this subset of patients.
    • Connolly Hospital Blanchardstown: implementation plan

      Connolly Hospital, Blanchardstown (2005)
    • Connolly Hospital Blanchardstown: strategic plan

      Connolly Hospital, Blanchardstown (2005)
    • Consultant and trainee attitudes towards supervision of operative procedures in the UK and Ireland

      O’Neill, BJ; Rankn, KS; Banks, LN; Daruwall, ZJ; Sprowson, AP; Robinson, DP; Reed, MR; Kenny, PJ (Irish Medical Journal, 2014)
      The e-logbook is used to monitor progression through training and to assess training within teaching units. We document consultant and trainee opinions with regards to supervision status, and to inform guidelines for trainees and trainers using the e-logbook. A questionnaire was sent to consultants and trainees in the UK and Ireland. Eight theatre scenarios were described and respondents were asked to state what they felt was the appropriate supervision status for the trainee. Significantly more consultants in the UK use the e-logbook than those based in Ireland (58.5%:14.5%). There were differences in consensus response to the scenarios between consultants and trainees, and between Irish and UK based surgeons. We have documented the opinions of consultants and trainees from across the UK and Ireland with regards to supervision status for trainees under certain theatre situations. This information should support formal guidelines for all users of the logbook.
    • Correlation of intra-articular osseous measurements with posterior cruciate ligament length on MRI scans.

      Orakzai, S H; Egan, C M; Eustace, S; Kenny, P; O'flanagan, S J; Keogh, P; Department of Orthopaedics, Connolly Hospital Blanchardstown, Dublin, Republic of Ireland. sajjadho@yahoo.com (2010-01)
      Six patients with a clinical diagnosis of chronic posterior cruciate ligament (PCL) rupture, based on a positive posterior drawer test, had a normal appearance of the PCL on an MRI scan. It is postulated that the PCL had been ruptured but healed in a lengthened state. 12 volunteers with no history of knee trauma underwent an MRI scan of the knee. In this control group (n = 12), there was a close correlation between the lateral femoral condylar width in the sagittal plane and the PCL length, with a ratio of 2:1 (95% confidence interval (CI) = 1.817-2.095). In the clinically abnormal group (n = 6), the ratio was 1.49:1 (95% CI = 1.206-1.782) (p< 0.0005). In conclusion, the ratio of the lateral femoral condylar width in the sagittal plane to the PCL length is a useful index for diagnosing PCL attenuation and lengthening in the presence of a normal morphological MR appearance.
    • Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension.

      Faul, John; Schoors, Danny; Brouwers, Sofie; Scott, Benjamin; Jerrentrup, Andreas; Galvin, Joseph; Luitjens, Sandra; Dolan, Eamon (2014-01-28)
      Vasodilators are used with caution in patients with chronic obstructive pulmonary disease (COPD). We have developed a device for percutaneous arteriovenous shunt creation in the iliac region to increase cardiac output and oxygen delivery for patients with COPD. Although this device does not cause significant blood pressure changes in normotensive patients with COPD, we hypothesized that arteriovenous shunt creation might cause vasodilator effects in hypertensive patients because of a reduction in vascular resistance.
    • Dietary nitrate supplementation in COPD: An acute, double-blind, randomized, placebo-controlled, crossover trial.

      Kerley, Conor P; Cahill, Kathleen; Bolger, Kenneth; McGowan, Aisling; Burke, Conor; Faul, John; Cormican, Liam (2014-12-19)
      The acute consumption of dietary nitrate has been shown to improve exercise capacity in athletes, healthy adults and subjects with peripheral vascular disease. Many COPD patients have reduced exercise capacity. We hypothesized that acute nitrate consumption might increase incremental shuttle walk test (ISWT) distance in COPD subjects.
    • Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: study protocol of a multinational observational study.

      Hagens, Eliza R C; van Berge Henegouwen, Mark I; van Sandick, Johanna W; Cuesta, Miguel A; van der Peet, Donald L; Heisterkamp, Joos; Nieuwenhuijzen, Grard A P; Rosman, Camiel; Scheepers, Joris J G; Sosef, Meindert N; et al. (2019-07-04)
      Background: An important parameter for survival in patients with esophageal carcinoma is lymph node status. The distribution of lymph node metastases depends on tumor characteristics such as tumor location, histology, invasion depth, and on neoadjuvant treatment. The exact distribution is unknown. Neoadjuvant treatment and surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy has not been reached. The aim of this study is to determine the distribution of lymph node metastases in patients with resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed. This can be the foundation for a uniform worldwide staging system and establishment of the optimal surgical strategy for esophageal cancer patients. Methods: The TIGER study is an international observational cohort study with 50 participating centers. Patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival. Discussion: The TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatment can be developed based on these results, such as the optimal radiation field and extent of lymphadenectomy based on the primary tumor characteristics.
    • Does Impaired Gallbladder Function Contribute to the Development of Barrett's Esophagus and Esophageal Adenocarcinoma?

      Nassr, Ayman O; Gilani, Syeda Nadia Shah; Atie, Mohammed; Abdelhafiz, Tariq; Connolly, Val; Hickey, Neil; Walsh, Thomas Noel; Department of Surgery, Academic Centre, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. (2011-06)
      Esophageal adenocarcinoma is aetiologically associated with gastro-esophageal reflux, but the mechanisms responsible for the metaplasia-dysplasia sequence are unknown. Bile components are implicated. Impaired gallbladder function may contribute to duodenogastric reflux (DGR) and harmful GERD.
    • The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.

      Faul, John L; Wilson, Sandra R; Chu, James W; Canfield, James; Kuschner, Ware G; Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland. (2009-06)
      OBJECTIVE: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. SETTING: A United States Department of Veterans Affairs Health Care System outpatient setting. PARTICIPANTS: Adults with type 2 diabetes and asthma or COPD. METHODS: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 microg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. RESULTS: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and -0.14, respectively). CONCLUSION: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS, especially with higher dosages.
    • The effect of inclement weather on ankle fracture management in an Irish trauma unit.

      O'Neill, B J; Kelly, E G; Breathnach, O C; Keogh, P; Kenny, P J; O'Flanagan, S J; Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Blanchardstown, Dublin 15, Ireland. barryoneill1922@gmail.com (2013-09)
      Ireland is unfamiliar with extreme weather conditions. Such conditions occurred in winter 2009-2010 and 2010-2011, with much of the country being affected by snow and ice. We reviewed the effect that these conditions had on the treatment of ankle fractures in our trauma unit.
    • Elective surgery: a comparison of in-patient versus day surgery practices in Ireland.

      Meshkat, B; Cowman, S; Gethin, G; Higgins, P; Ryan, K; Mulligan, E; Department of Surgery, Connolly Hospital Blanchardstown, Blanchardstown, Dublin 15, Ireland. b_meshkat@hotmail.com (2013-06)
      Currently, there is a paucity of research which has assessed practices at the point of care for day surgery patient.
    • Endoscopic assessment of inflammatory bowel disease: colonoscopy/esophagogastroduodenoscopy.

      Chan, Grace; Fefferman, David S; Farrell, Richard J; Gastroenterology Department, Connolly Hospital Blanchardstown, Dublin, Republic of Ireland. (2012-06)
      Endoscopy plays an important role in the initial diagnosis of IBD, including the evaluation of disease severity, activity, and extent. The implications of complete mucosal healing further confirm the function of endoscopy in the follow-up of IBD patients. The use of therapeutic endoscopy, for example stricture dilatation, can avoid the need for bowel resection. Modalities such as capsule endoscopy, EUS, NBI, CE, and other emerging techniques are likely to have an increasing role in the management of IBD, particularly in the area of dysplasia surveillance and treatment.
    • Endothelial progenitor cells in mothers of low-birthweight infants: a link between defective placental vascularization and increased cardiovascular risk?

      King, Thomas F J; Bergin, David A; Kent, Etaoin M; Manning, Fiona; Reeves, Emer P; Dicker, Patrick; McElvaney, Noel G; Sreenan, Seamus; Malone, Fergal D; McDermott, John H; et al. (2013-01)
      Offspring birthweight is inversely associated with future maternal cardiovascular mortality, a relationship that has yet to be fully elucidated. Endothelial progenitor cells (EPCs) are thought to play a key role in vasculogenesis, and EPC numbers reflect cardiovascular risk.