• Factors predicting suicidal ideation in the preceding 12 months among patients attending a community psychiatric outpatient clinic.

      Anyansi, Tochukwu E; Agyapong, Vincent I O; Department of Psychiatry, Connolly Hospital, Dublin, Ireland. (2013-06)
      Predictive factors are used to alert the clinician to the necessity of carrying out a suicide risk assessment in those patients whose demographic and clinical characteristics suggest the possibility of suicide.
    • Future bed needs of James Connolly Memorial Hospital: Report of the Hospital Review Group.

      James Connolly Memorial Hospital Review Group. (James Connolly Memorial Hospital, 2000-08)
      In April 1999, a hospital group at James Connolly Memorial Hospital (JCMH) was convened to discuss and study the future bed needs at the hospital. The reasons for this review were due to concerns of a) high occupancy, b) increasing emergency admissions and the knock-on effect on elective work, c) catchment area growth without matching resources and d) the possible change in referral patterns of GPs in favour of JCMH after the new hospital is opened in 2003 and the need for appropriate apportionment of resources. The overall remit of the hospital study group was: 1. To understand the current concerns and future predictions in regard to bed needs at JCMH. 2. To conduct this work in phases with full ownership of relevant groups in the hospital. 3. To produce a report. 4. To discuss findings and recommendations/options with Senior Managers in the Eastern Regional Health Authority and the Dept of Health and Children.
    • Global DNA methylation is altered by neoadjuvant chemoradiotherapy in rectal cancer and may predict response to treatment - A pilot study.

      Tsang, J S; Vencken, S; Sharaf, O; Leen, E; Kay, E W; McNamara, D A; Deasy, J; Mulligan, E D; Department of Surgical Research, Connolly Hospital & RCSI, Blanchardstown, Dublin, Ireland. Electronic address: julianst@yahoo.com. (2014-07-28)
      In rectal cancer, not all tumours display a response to neoadjuvant treatment. An accurate predictor of response does not exist to guide patient-specific treatment. DNA methylation is a distinctive molecular pathway in colorectal carcinogenesis. Whether DNA methylation is altered by neoadjuvant treatment and a potential response predictor is unknown. We aimed to determine whether DNA methylation is altered by neoadjuvant chemoradiotherapy (CRT) and to determine its role in predicting response to treatment.
    • Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

      Moran, D; Buckley, A; Daly, K; Meaney, B; Curtin, R; O'Neill, J O; Colwella, N; Mahon, N; Murphy, N; O'Hanlon, R; et al. (2014-08-23)
      We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.
    • Hip and low back pain in the presence of femoral anteversion. A case report.

      Tansey, Paula; Physiotherapy Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. Electronic address: paula.tansey@hse.ie. (2014-04-16)
      A change in hip morphology, such as femoral anteversion may be a factor in patients with lower quadrant pain. This case study highlights the importance of angle of torsion assessment and consideration of a patient's individual angle in designing rehabilitation programs. A patient who had a four year history of hip pain and a one year history of low back pain, in the presence of femoral anteversion is presented. She was successfully treated by altering her lower limb position as well as performing exercises in this alignment.
    • Identifying factors that influence the ‘6-hour target’ in the Emergency Department by applying Regression Analysis.

      Borhan, F; Borhan, N; Ahmed, S; Varghese, L; O’Conor, E (Irish Medical Journal, 2018-02)
      To determine factors within the Emergency Department (ED) that have maximum influence on the ‘6-hour target’.
    • Imaging of gunshot injuries in a West Dublin teaching hospital: a ten year review

      Murphy, I; Lavelle, L; Ni Mhurchu, E; McCarthy, R; Heffernan, E; Connolly Hospital (Irish Medical Journal, 2014-09)
      There has been an increase in gun-related crime in Ireland over the last decade to gangland violence, especially in west Dublin. This places a burden on hospital services not previously encountered. The aim of this study was to examine the demographics of gunshot injuries presenting to a Dublin teaching hospital, and the impact on radiology over a ten year period. A total of 65 gunshot injuries were seen. Mortality for high velocity wounds was much higher (10/23, 43%) than for low-velocity shotgun injuries (2/34, 6%).
    • Imitation, the greatest form of flattery?

      Murphy, A; Parihar, V; Shahin, A; Farrell, R (Irish Medical Journal, 2016-01)
      A recent interesting case at our institution reminded us to remain cognisant of the oldest known venereal disease; known as the great imitator , syphilis is a sexually transmitted infection caused by the spirochete Treponema pallidum
    • Impact of antihypertensive combination and monotreatments on blood pressure variability: assessment by old and new indices. Data from a large ambulatory blood pressure monitoring database.

      Parati, Gianfranco; Dolan, Eamon; Ley, Ludwin; Schumacher, Helmut (2014-06)
      High 24-h ambulatory blood pressure (ABP) variability is associated with poor cardiovascular outcomes. We analysed a large ABP monitoring database containing data from hypertensive patients treated with telmisartan/amlodipine combination or various monotherapies with the aim of quantifying the 24-h distribution of blood pressure (BP) reduction by treatment through the smoothness index and of developing and testing a new treatment-on-variability index (TOVI) to quantify the effects of treatment on both mean BP and BP variability.
    • Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

      O'Neill, Barry James; O'hEireamhoin, Sven; Morrissey, David I; Keogh, Peter; Department of Trauma & Orthopaedics, Connolly Hospital, Dublin, Ireland. (2014-04-03)
      Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.
    • Increased risk of severe hypoglycemic events with increasing frequency of non-severe hypoglycemic events in patients with Type 1 and Type 2 diabetes.

      Sreenan, Seamus; Andersen, Marc; Thorsted, Brian Larsen; Wolden, Michael L; Evans, Marc; Department of Endocrinology, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. (2014-07-15)
      Severe hypoglycemic events (SHEs) are associated with significant morbidity, mortality and costs. However, the more common non-severe hypoglycemic events (NSHEs) are less well explored. We investigated the association between reported frequency of NSHEs and SHEs among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in the PREDICTIVE study.
    • Interns as teachers of medical students: a pilot programme.

      Dunne, B; Smyth, P; Furlong, H; Rakovac-Tisdall, A; Murphy, D; Sreenan, S; Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, 15, Ireland. bdunne14784@gmail.com (2011-03)
      In recent years, rising numbers of medical students and an increasingly demanding clinical workload has put pressures on the educational systems for medical students in the hospital. Bedside teaching remains central to education, but tutorial delivery by registrars, tutors and consultants has proven to be increasingly difficult with the greater numbers of students now in the undergraduate system.
    • Interns as teachers of medical students: a pilot programme.

      Dunne, B; Smyth, P; Furlong, H; Rakovac-Tisdall, A; Murphy, D; Sreenan, S; Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin,, 15, Ireland. bdunne14784@gmail.com (2012-01-31)
      BACKGROUND: In recent years, rising numbers of medical students and an increasingly demanding clinical workload has put pressures on the educational systems for medical students in the hospital. Bedside teaching remains central to education, but tutorial delivery by registrars, tutors and consultants has proven to be increasingly difficult with the greater numbers of students now in the undergraduate system. AIMS: We have performed a pilot study to determine the feasibility of developing a Junior Tutor Programme, to assist in the delivery of tutorials to undergraduate medical students. METHODS: This was designed and delivered by interns under the supervision of the academic staff in the Departments of Medicine and Surgery in Connolly Hospital. The programme was evaluated by a questionnaire filled in by the students anonymously. RESULTS: A supervised programme of tutorials delivered by interns is a potentially useful way to ensure delivery of clinical teaching to undergraduate medical students.
    • Intravesical foreign body: clinical features and diagnostic clues.

      Thatte, Amit; Rajendran, Simon; Murphy, Laura; Allen, Michael; Department of Surgery, Royal College of Surgeons, Dublin, Ireland. (2014-05-22)
    • The Irish National Joint Registry: where are we now?

      O'Neill, B J; Nugent, M; Cashman, J P; O'Flanagan, S J; Keogh, P; Kenny, P J; Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Blanchardstown, Dublin, 15, Ireland, barryoneill1922@gmail.com. (2014-03)
      Ireland is currently in the process of establishing a National Joint Registry.
    • James Connolly Memorial Hospital annual report 1993

      James Connolly Memorial Hospital (Eastern Health Board (EHB), 1993)
      1993 was a very busy year for James Connolly Memorial Hospital with activity in all hospital services continuing at a high level. The bed occupancy in the medical area was over 94% with the occupancy in the surgical area in excess of 96%. Emergency admissions accounted for over 75% of all admissions. The average length of stay for medical patients is over eight days. This high average is partly attributable to a number of patients who were inappropriately kept in acute medical beds while appropriate long term care was being sought for them. The average length of stay for surgical patients is less than six days.
    • James Connolly Memorial Hospital annual report 1994

      James Connolly Memorial Hospital (Eastern Health Board (EHB), 1994)
      Hospital Activity 1994 was again a very busy year for the hospital with service activity increasing in many areas. Demands for in-patient services were particularly high throughout the year which resulted in our bed occupancy reaching 100%. This occupancy was achieved through the use of additional beds in the wards. This practice places great strain and demands on patients and staff alike. Staff are to be complimented for their dedication and commitment while working under extremely difficult conditions. The Hospital Management recognises that the primary function of the hospital is the provision of an Accident & Emergency Service and in meeting this commitment the hospital found it necessary on an on-going basis to cancel elective/planned admissions.
    • Low uptake of continuous subcutaneous insulin infusion therapy in people with type 1 diabetes in Ireland: a retrospective cross-sectional study.

      Gajewska, Katarzyna Anna; Bennett, Kathleen; Biesma, Regien; Sreenan, Seamus; Division of Population Health Scineces, RCSI: University of Medicine and Health Sciences, Dublin, Ireland. katarzynagajewska@rcsi.ie. 2Division of Population Health Scineces, RCSI: University of Medicine and Health Sciences, Dublin, Ireland. 3Department of Health Sciences, Global Health, Univeristy Medical Centre Groningen, Groningen, the Netherlands. 43U Diabetes, RCSI: University of Medicine and Health Scineces, Dublin, Ireland. 5Diabetes and Endocrinology. RCSI: University of Medicine and Health Sciences, Connolly Hospital, Dublin, Ireland. (PMC, 2020-06-23)
      Background: The uptake of continuous subcutaneous insulin infusion (CSII) therapy in those with type 1 diabetes varies internationally and is mainly determined by the national healthcare reimbursement systems. The aim of this study is to estimate national and regional uptake of CSII therapy in children, adolescents and adults with type 1 diabetes in Ireland. Methods: A retrospective cross-sectional study was conducted utilizing the national pharmacy claims database in 2016. Individuals using CSII were identified by dispensing of infusion sets. The uptake of CSII was calculated as the percentage of people with type 1 diabetes claiming CSII sets in 2016, both in children and adolescent (age < 18 years) and adult populations (≥ 18 years). Descriptive statistics including percentages with 95% confidence intervals (CIs) are presented, stratified by age-groups and geographical regions, and chi-square tests used for comparisons. Results: Of 20,081 people with type 1 diabetes, 2111 (10.5, 95% CI: 10.1-10.9%) were using CSII in 2016. Uptake was five-fold higher in children and adolescents at 34.7% (95% CI: 32.9-36.5%) than in adults at 6.8% (95% CI: 6.4-7.2%). Significant geographical heterogeneity in CSII uptake was found, from 12.6 to 53.7% in children and adolescents (p < 0.001), and 2 to 9.6% in adults (p < 0.001). Conclusions: Uptake of CSII in people with type 1 diabetes is low in Ireland, particularly in those ≥18 years. Identification of barriers to uptake, particularly in this group, is required.
    • Magnetic Stent Removal in a Nurse-Led Clinic; a Nine-Month Experience.

      O’Connell, L; Broe, MP; Rooney, D; Elhag, S; Cheema, I; McGuire, BB (Irish Medical Journal, 2018-02)
      Ureteric stents are frequently inserted post endourological procedures. However, subsequent endoscopic stent removal requires a second procedure for the patient and the availability of necessary resources. Longer duration of indwelling stents can lead to increased risk of symptoms and complications. The use of magnetic stents removed with a magnetic retrieval device (BlackStar©), offers an alternative which obviates the need for cystoscopy. We assessed the outcomes for this novel method of stent removal in our institution. A retrospective analysis was performed of all patients undergoing magnetic stent insertion and subsequent removal in a nurse-led clinic over a nine-month period. Patients were followed up with a prospective validated Ureteral Stent Symptoms Questionnaire (USSQ)3. A cost analysis was also performed. In total, 59 patients were treated using magnetic stents. The complication rate was low (6.7%). The median duration of indwelling stent was 5.8 days (range 1-11 days). Patients reported haematuria and lower urinary tract symptoms but >90% experienced no functional impairment with minimal days of employment lost (mean 0.75 days). All patients reported satisfaction with nurse-led stent removal and 97% were happy to have stents removed via this method in the future. The total financial savings were estimated at €47,790 over this period. Nurse-led removal of magnetic stents is safe and well tolerated by patients and enables expedient stent removal. It also provides a significant cost benefit and frees up valuable endoscopic resources.
    • Major cost savings associated with biologic dose reduction in patients with inflammatory arthritis.

      Murphy, C L; Awan, S; Sullivan, M O; Chavrimootoo, S; Bannon, C; Martin, L; Duffy, T; Murphy, E; Barry, M (Irish Medical Journal, 2015-01)
      The purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS)) would remain in remission following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction. This prospective non-blinded non-randomised study commenced in 2010. Patients with Inflammatory Arthritis being treated with a biologic agent were screened for disease activity. A cohort of those in remission according to standardized disease activity indices (DAS28 < 2.6, BASDAI < 4) was offered a reduction in dosing frequency of two commonly used biologic therapies (etanercept 50 mg once per fortnight instead of weekly, adalimumab 40 mg once per month instead of fortnightly). Patients were assessed for disease activity at 3, 6, 12, 18 and 24 months following reduction in dosing frequency. Cost saving was calculated. 79 patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n = 45), 13% psoriatic arthritis (n = 10) and 30% ankylosing spondylitis (n = 24). 57% (n = 45) were taking etanercept and 43% (n = 34) adalimumab. The percentage of patients in remission at 24 months was 56% (n = 44). This resulted in an actual saving to the state of approximately 600,000 euro over two years. This study demonstrates the reduction in biologic dosing frequency is feasible in Inflammatory Arthritis. There was a considerable cost saving at two years. The potential for major cost savings in biologic usage should be pursued further.