• Barriers to dental attendance in older patients

      Shanahan, D; O’Neill, D (Irish Medical Journal, 2017-04)
      Health professionals in Ireland are increasingly concerned about the quality of oral health in older patients. The aim of this study is to identify the obstacles that face this age-group when accessing dental care, so that we are in a better position to address them. A questionnaire was completed by 105 patients attending a geriatric outpatient clinic. Over 50 percent of respondents had not attended a dentist in over 36 months, for the reasons that 'I have no problem or need for treatment’ (62%) and ‘I have no teeth, and therefore I have no need to go’ (54%). While it is common to assume that no teeth means no need to see a dentist, research shows that regular dental visits are vital for ensuring the early screening of oral cancer and other mucosal pathologies, and the optimisation of existing rosthesis/restorations. The chief recommendation of this paper is thus to provide better education and access to older people on the importance of visiting the dentist.
    • The Belfast musculoskeletal ultrasound course.

      Taggart, Allister J; Wright, Stephen A; Ball, Elisabeth; Kane, David; Wright, Gary; Regional Rheumatology Unit, Musgrave Park Hospital, Belfast, Northern Ireland, UK. allister.taggart@ntlworld.com (Rheumatology (Oxford, England), 2009-09)
      To conduct a training course in musculoskeletal ultrasound (MSUS) for rheumatologists in Northern Ireland with the aim of equipping the participants with a basic knowledge of the theoretical and practical aspects of MSUS as they are applied to rheumatology.
    • The benefit of an enhanced recovery programme following elective laparoscopic sigmoid colectomy.

      Al Chalabi, Hasan; Kavanagh, Dara O; Hassan, Lana; Donnell, Kate O; Nugent, Emmeline; Andrews, Emmet; Keane, Frank B V; O'Riordain, Diarmuid S; Miller, Andrew; Neary, Paul; et al. (2012-02-01)
      BACKGROUND: Enhanced recovery programmes (ERPs) have demonstrated reduced morbidity and length of hospital stay in patients undergoing open elective colorectal resections. The application of laparoscopic techniques to colorectal surgery is associated with shorter length of stay and morbidity compared to open resections. In the setting of laparoscopic surgery, it is unclear whether there is an additive effect on length of stay and morbidity by combining these. The current study addresses the benefit of an ERP (RAPID protocol) in a cohort of matched patients undergoing laparoscopic sigmoid colon resection MATERIALS AND METHODS: Consecutive patients over a 40-month period who underwent laparoscopic sigmoid colon resection were assigned either to the RAPID protocol (group 1) or traditional post operative care (group 2) in a non-randomised manner. Analysis was on an "intention to treat" basis. Primary and secondary endpoints were identified; primary endpoints included length of hospital stay and readmission rate. Secondary endpoints included morbidity and mortality rate. RESULTS: Seventy-three consecutive patients were included. Group 1 included 37 patients. Group 2 included 36 patients. Median length of hospital stay in groups 1 and 2 was 5 and 8 days, respectively (p = 0.01). Readmission rate in groups 1 and 2 was 8.1% and 8.3%, respectively (p = 0.98). Morbidity rate in groups 1 and 2 was 30% and 22%, respectively (p = 0.61); there was one mortality in each group. CONCLUSION: The application of the ERP (RAPID) to patients undergoing laparoscopic sigmoid colon resection results in a significant improvement in length of hospital stay, with comparable morbidity and readmission rates.
    • Beware of the devastating pulmonary aspergillosis syndromes In certain environments

      Kooblall, M; Moloney, E; Lane, SJ (Irish Medical Journal, 2016-02)
      Nowadays with more stem cell transplants and immunosuppressive therapies there has been a rise in pulmonary aspergillosis syndromes. The following illustrates such a case. A 49 year old man had a past history of ankylosing spondylitis with a bilateral hip replacement. He was also on surveillance for a superficial bladder tumour since 2007. His chest x-ray in 2008 was normal. In 2010 his CXR showed patchy opacification in the right apex. CT thorax confirm fibrotic changes.
    • Beyond consent--improving understanding in surgical patients.

      Mulsow, Jürgen J W; Feeley, T Martin; Tierney, Sean; Department of Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. (American journal of surgery, 2012-01)
      Little is known of the actual understanding that underlies patient choices with regard to their surgical treatment. This review explores current knowledge of patient understanding and techniques that may be used to improve this understanding.
    • Beyond the maths of biology: long-term spontaneous Tumoral Regression After Sunitinib Withdrawal.

      Teo, Minyuen; Downey, Fiona P; McDermott, Ray S; Department of Medical Oncology, Adelaide and Meath Hospital incorporating National Children's Hospital, Tallaght, Dublin, Ireland. Electronic address: neuy924@gmail.com. (2012-12-28)
    • Bilateral posterior cerebral artery infarction

      Ryan, D.; Murphy, S. M.; Hennessey, M. J. (Case Reports, 2012-12-05)
    • Bilateral synchronous rupture of the quadriceps tendon.

      Ellanti, P; Davarinos, N; Morris, S; Rice, J; Department of Trauma Orthopaedics, Adelaide and Meath and National Children's Hospital, Tallaght, Dublin 24, Ireland. prasad.ellanti@gmail.com (Irish journal of medical science, 2012-09)
      Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.
    • Bilateral uncemented ceramic-on-ceramic total hip arthroplasty in a 26-year-old man with Morquio syndrome.

      Leonard, Michael; Nicholson, Paul; Department of Orthopaedic Surgery, Adeladie and Meath Incorporating the National Childrens Hospital, Tallaght, Dublin, Ireland. mikeleonard77@gmail.com (American journal of orthopedics, 2011-11)
    • Biological markers of amyloid beta-related mechanisms in Alzheimer's disease.

      Hampel, Harald; Shen, Yong; Walsh, Dominic M; Aisen, Paul; Shaw, Les M; Zetterberg, Henrik; Trojanowski, John Q; Blennow, Kaj; Discipline of Psychiatry, School of Medicine and Trinity College Institute of, Neuroscience (TCIN), Laboratory of Neuroimaging and Biomarker Research, Trinity, College Dublin, Trinity Centre for Health Sciences, The Adelaide and Meath, Hospital Incorporating The National Children's Hospital (AMiNCH), Dublin,, Ireland; Department of Psychiatry, Alzheimer Memorial Center, Ludwig Maximilian, University, Munich, Germany. (2012-02-01)
      Recent research progress has given detailed knowledge on the molecular pathogenesis of Alzheimer's disease (AD), which has been translated into an intense, ongoing development of disease-modifying treatments. Most new drug candidates are targeted on inhibiting amyloid beta (Abeta) production and aggregation. In drug development, it is important to co-develop biomarkers for Abeta-related mechanisms to enable early diagnosis and patient stratification in clinical trials, and to serve as tools to identify and monitor the biochemical effect of the drug directly in patients. Biomarkers are also requested by regulatory authorities to serve as safety measurements. Molecular aberrations in the AD brain are reflected in the cerebrospinal fluid (CSF). Core CSF biomarkers include Abeta isoforms (Abeta40/Abeta42), soluble APP isoforms, Abeta oligomers and beta-site APP-cleaving enzyme 1 (BACE1). This article reviews recent research advances on core candidate CSF and plasma Abeta-related biomarkers, and gives a conceptual review on how to implement biomarkers in clinical trials in AD.
    • Blind bedside insertion of small bowel feeding tubes.

      Duggan, SN; Egan, S M; Smyth, N D; Feehan, S M; Breslin, N; Conlon, K C; Department of Nutrition and Dietetics & Centre for Pancreatico-Biliary Diseases, Adelaide & Meath Hospitals, Incorporating the National Children’s Hospital, Dublin, Ireland. sinead.duggan@amnch.ie (Irish journal of medical science, 2009-12)
      The use of Naso-Jejunal (NJ) feeding is limited by difficulty in feeding tube placement. Patients have traditionally required transfer to Endoscopy or Radiology for insertion of small bowel feeding tubes, with clear resource implications. We hypothesised that the adoption of a simple bedside procedure would be effective and reduce cost. Clinical nutrition and nurse specialist personnel were trained in the 10/10/10 method of blind bedside NJ insertion.
    • Blood-based biomarkers of microvascular pathology in Alzheimer's disease.

      Ewers, Michael; Mielke, Michelle M; Hampel, Harald; Discipline of Psychiatry, School of Medicine & Trinity College Institute of, Neuroscience, Laboratory of Neuroimaging & Biomarker Research, Trinity College,, University of Dublin, The Adelaide and Meath Hospital Incorporating The National , Children's Hospital, Tallaght, Dublin, Ireland. ewersm@tcd.ie (2012-02-01)
      Sporadic Alzheimer's disease (AD) is a genetically complex and chronically progressive neurodegenerative disorder with molecular mechanisms and neuropathologies centering around the amyloidogenic pathway, hyperphosphorylation and aggregation of tau protein, and neurofibrillary degeneration. While cerebrovascular changes have not been traditionally considered to be a central part of AD pathology, a growing body of evidence demonstrates that they may, in fact, be a characteristic feature of the AD brain as well. In particular, microvascular abnormalities within the brain have been associated with pathological AD hallmarks and may precede neurodegeneration. In vivo assessment of microvascular pathology provides a promising approach to develop useful biological markers for early detection and pathological characterization of AD. This review focuses on established blood-based biological marker candidates of microvascular pathology in AD. These candidates include plasma concentration of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) that are increased in AD. Measures of endothelial vasodilatory function including endothelin (ET-1), adrenomedullin (ADM), and atrial natriuretic peptide (ANP), as well as sphingolipids are significantly altered in mild AD or during the predementia stage of mild cognitive impairment (MCI), suggesting sensitivity of these biomarkers for early detection and diagnosis. In conclusion, the emerging clinical diagnostic evidence for the value of blood-based microvascular biomarkers in AD is promising, however, still requires validation in phase II and III diagnostic trials. Moreover, it is still unclear whether the described protein dysbalances are early or downstream pathological events and how the detected systemic microvascular alterations relate to cerebrovascular and neuronal pathologies in the AD brain.
    • Blowout fracture of the orbital floor secondary to vigorous nose blowing

      Halpenny, D; Corbally, C; Torreggiani, W (Irish Medical Journal (IMJ), 2012-07)
    • Body fat distribution in Turner syndrome and the influence of puberty

      Nadeem, N; Roche, EF (Irish Medical Journal, 2014-09)
      Girls with Turner syndrome (TS) may encounter a wide range of problems. We aim to describe the body composition and its relation to the pubertal development, in affected girls. Precocious pubarche has been found to be associated with excess total body and central fat mass throughout all pubertal stages 1 . Early menarche has impact on body fatness 2 . In girls with TS, growth hormone (GH) was associated with favourable changes in body composition 3 . The consensus, with respect to the association between body composition and pubertal development, has still not been reached in those with TS. We therefore set out to determine the body fat distribution in Irish girls with TS who have attained with breast Tanner stage 2 or more with or without menarche. The influence of pubertal development on fat distribution was also examined. The fat mass of the total body, trunk, arms, and legs was estimated by dual-energy X-ray absorptiometry. Fisherâ s Exact test or Mann-Whitney U test was used to compare groups and correlation was assessed using the Pearsonâ s or Spearman method, where appropriate.
    • Bone Health in Cystic Fibrosis

      Roddy, M (2011)
      2011 INDI Annual Study Conference
    • Bone Health in Cystic Fibrosis

      Roddy, M (2011)
      2011 INDI Annual Study Conference
    • Brain activation predicts treatment improvement in patients with major depressive disorder.

      Samson, Andrea C; Meisenzahl, Eva; Scheuerecker, Johanna; Rose, Emma; Schoepf, Veronika; Wiesmann, Martin; Frodl, Thomas; Department of Psychiatry, School of Medicine & Trinity College Institute of, Neuroscience, Integrated Neuroimaging, The Adelaide and Meath Hospital, incorporating the National Children's Hospital (AMNCH), & St. James's Hospital,, Trinity College, Dublin, Ireland. andrea.samson@stanford.edu (2012-02-01)
      Major depressive disorder (MDD) is associated with alterations in brain function that might be useful for therapy evaluation. The current study aimed to identify predictors for therapy improvement and to track functional brain changes during therapy. Twenty-one drug-free patients with MDD underwent functional MRI twice during performance of an emotional perception task: once before and once after 4 weeks of antidepressant treatment (mirtazapine or venlafaxine). Twelve healthy controls were investigated once with the same methods. A significant difference between groups was a relative greater activation of the right dorsolateral prefrontal cortex (dlPFC) in the patients vs. controls. Before treatment, patients responding better to pharmacological treatment showed greater activation in the dorsomedial PFC (dmPFC), posterior cingulate cortex (pCC) and superior frontal gyrus (SFG) when viewing of negative emotional pictures was compared with the resting condition. Activations in the caudate nucleus and insula contrasted for emotional compared to neutral stimuli were also associated with successful treatment. Responders had also significantly higher levels of activation, compared to non-responders, in a range of other brain regions. Brain activation related to treatment success might be related to altered self-referential processes and a differential response to external emotional stimuli, suggesting differences in the processing of emotionally salient stimuli between those who are likely to respond to pharmacological treatment and those who will not. The present investigation suggests the pCC, dmPFC, SFG, caudate nucleus and insula may have a key role as a biological marker for treatment response and predictor for therapeutic success.
    • Bridging science and health policy in cardiovascular disease: focus on lipid management: A Report from a Session held during the 7th International Symposium on Multiple Risk Factors in Cardiovascular Diseases: Prevention and Intervention--Health Policy, in Venice, Italy, on 25 October, 2008.

      Atella, V; Brady, A; Catapano, A L; Critchley, J; Graham, I M; Hobbs, F D R; Leal, J; Lindgren, P; Vanuzzo, D; Volpe, M; et al. (Atherosclerosis. Supplements, 2009-06-10)
      In Europe, cardiovascular disease (CVD) represents the main cause of morbidity and mortality, costing countries euro 190 billion yearly (2006). CVD prevention remains unsatisfactory across Europe largely due to poor control of CVD risk factors (RFs), growing incidence of obesity and diabetes, and sedentary lifestyle/poor dietary habits. Hypercholesterolaemia is a proven CVD RF, and LDL-C lowering slows atherosclerotic progression and reduces major coronary events. Lipid-lowering therapy is cost-effective, and intensive treatment of high-risk patients further improves cost effectiveness. In Italy, models indicate that improved cholesterol management translates into potential yearly savings of euro 2.9-4 billion. Identifying and eliminating legislative and administrative barriers is essential to providing optimal lipid care to high-risk patients. Public health and government policy can influence clinical practice rapidly, and guideline endorsement via national health policy may reduce the CVD burden and change physician and patient behaviour. Action to reduce CVD burden should ideally include the integration of strategies to lower the incidence of major CV events, improvement in total CV risk estimation, database monitoring of CVD trends, and development of population educational initiatives on CVD prevention. Failure to bridge the gap between science and health policy, particularly in relation to lipid management, could result in missed opportunities to reverse the burgeoning epidemic of CVD in Europe.
    • Calcineurin inhibitor sparing with mycophenolate in kidney transplantation: a systematic review and meta-analysis.

      Moore, Jason; Middleton, Lee; Cockwell, Paul; Adu, Dwomoa; Ball, Simon; Little, Mark A; Ready, Andrew; Wheatley, Keith; Borrows, Richard; Department of Nephrology and Kidney Transplantation, Renal Institute of Birmingham, University Hospital Birmingham, Edgbaston, Birmingham, United Kingdom. j.moore.3@bham.ac.uk (Transplantation, 2009-02-27)
      Limiting the exposure of kidney transplant recipients to calcineurin inhibitors (CNIs) has potential merit, but there is no clear consensus on the utility of current strategies. In an attempt to aid clarification, we conducted a systematic review and meta-analysis of randomized trials that assessed CNI sparing (minimization or elimination) with mycophenolate as sole adjunctive immunosuppression.
    • Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries.

      Kotseva, Kornelia; Wood, David; De Backer, Guy; De Bacquer, Dirk; Pyörälä, Kalevi; Keil, Ulrich; Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. (Lancet, 2009-03-14)
      The first and second EUROASPIRE surveys showed high rates of modifiable cardiovascular risk factors in patients with coronary heart disease. The third EUROASPIRE survey was done in 2006-07 in 22 countries to see whether preventive cardiology had improved and if the Joint European Societies' recommendations on cardiovascular disease prevention are being followed in clinical practice.