• 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.
    • Cardiovascular risk age: concepts and practicalities.

      Cooney, Marie Therese; Vartiainen, Erkki; Laatikainen, Tiina; De Bacquer, Dirk; McGorrian, Catherine; Dudina, Alexandra; Graham, Ian; Department of Cardiology, Adelaide Meath Hospital, Dublin, Ireland. (2012-06)
      A young person with many risk factors may have the same level of risk as an older person with no risk factors. Thus a high-risk 40-year-old may have a risk age of 60 years or more. The aim of the study was to derive a generic equation for risk age, construct risk age charts, and explore the hypothesis that risk age is similar regardless of the cardiovascular disease (CVD) end point used.
    • Cardiovascular risk estimation in older people: SCORE O.P.

      Cooney, MT; Lindman, A; Selmer, R; Tverdal, A; De Bacquer, D; Be Backer, G; Menotti, A (European heart journal, 2012)
    • Cardiovascular risk-estimation systems in primary prevention: do they differ? Do they make a difference? Can we see the future?

      Cooney, Marie Therese; Dudina, Alexandra; D'Agostino, Ralph; Graham, Ian M; Department of Cardiology, Adelaide Meath Hospital incorporating the National Children's Hospital Tallaght, Dublin, Ireland. (Circulation, 2010-07-20)
    • ‘The Care and Connect Project : An Example of Practice Based Research

      Donnelly, S (2010-05)
      Presentation to TCD Practitioner Research Group, 28th May Trinity College Dublin
    • Care of the stroke patient-communication between the community pharmacist and prescribers in the Republic of Ireland.

      Grimes, Tamasine; Duggan, Catherine; Gallagher, Paul; Strawbridge, Judith; Adelaide and Meath Hospital, incorporating the National Children's Hospital,, Dublin 24, Ireland. tgrimes@rcsi.ie (2012-02-01)
      OBJECTIVE: This study sought to examine the perceptions that community pharmacists have of communication with prescribers in both primary and secondary care in Ireland, with respect to care of stroke patients. SETTING: Community pharmacies across Ireland, stratified into the four representative administrative regions. METHOD: Survey using a structured postal questionnaire. MAIN OUTCOME MEASURE: Perceptions of communication with prescribers based in primary and secondary care; pharmacy and pharmacy premises demographics. RESULTS: A response rate of 52% (n = 314) was achieved. Community pharmacists' perceptions of information provision from secondary care were low, the majority (83%) never received any information from the hospital, although they would welcome it. Communication with hospital based prescribers was considered by most (93%) to be poor. The majority (greater than 75%) of respondents expressed a desire for greater information provision concerning a stroke patient's medication and diagnostic information. Pharmacists' perceptions of interaction with general practitioners were generally regarded as good (63%) although information provision in both directions between pharmacist and general practitioner could be improved. CONCLUSION: The findings of this study indicated that community pharmacists perceive that there is room for improvement in the communication between themselves and prescribers in the primary and secondary care settings, concerning the care of the stroke patient. This highlights the need for the development of formal communication channels between community pharmacists and other members of the healthcare team involved in the care of the stroke patient. However, the challenges of communicating patient information across healthcare sectors are recognized.
    • Care planning meetings: best practice guidelines for healthcare professionals: an individualised approach to patient participation

      Donnelly, Sarah; Tallaght Hospital; Trinity College Dublin (Trinity College Dublin. School of Social Work and Social Policy, 2013-08)
    • Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

      Ederle, Jörg; Dobson, Joanna; Featherstone, Roland L; Bonati, Leo H; van der Worp, H Bart; de Borst, Gert J; Lo, T Hauw; Gaines, Peter; Dorman, Paul J; Macdonald, Sumaira; et al. (Lancet, 2010-03-20)
      Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy.
    • A case of polyarteritis nodosa limited to the right calf muscles, fascia, and skin: a case report.

      Ahmed, Saad; Kitchen, Joanne; Hamilton, Samuel; Brett, Francesca; Kane, David; Department of Rheumatology, The Adelaide and the Meath Hospital incorporating the National Children's Hospital, Dublin, Ireland. saadkorak@yahoo.com. (2011)
    • Case report - An acute presentation of lymphangiomatosis.

      Nason, G J; Barry, B D; Shatwan, R; Neary, P; Division of Colorectal Surgery, Adelaide and Meath (incorporating the National Children's) Hospital, Tallaght, Dublin 24, Ireland. (International journal of surgery case reports, 2012)
      Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease.
    • Case report of a symptomatic giant renal oncocytoma.

      Ahmad, Sarfraz; Manecksha, Rustom; Hayes, Brian D; Grainger, Ronald; Department of Urology, The Adelaide and Meath Hospital Incorporating, the National Children Hospital Tallaght, Dublin 24, Ireland. (International journal of surgery case reports, 2011)
      Renal oncocytomas are benign tumours, often asymptomatic, and picked incidentally on radiological imaging. We present a case report of a symptomatic giant renal oncocytoma in a 61-year old man having lower back/right flank pain. A large right renal mass was identified on abdominal CT scan. Radiological features were not sufficient to differentiate this lesion from renal cancer. Right radical nephrectomy was performed. Typical features of oncocytoma, without evidence of malignancy, were seen on histological examination of the specimen. In this report, we discuss literature review of radiological, genetic, and pathological characteristics of renal oncocytoma.
    • Central Venous Catheter Integrity during Mechanical Power Injection of Iodinated Contrast Medium

      Halpenny, D; Burke, J; McNeill, G; Snow, A; Torreggiani, W (Radiology, 2010-05)
    • Cerebrovascular Disease

      Murphy, Sinead M; Counihan, Timothy J (Saunders Elsevier, 2010)
    • Challenges of drug resistance in the management of pancreatic cancer.

      Sheikh, Rizwan; Walsh, Naomi; Clynes, Martin; O'Connor, Robert; McDermott, Ray; Adelaide and Meath Hospital incorporating The National Children's Hospital,, Tallaght, Dublin 24, Ireland. sheikh.rizwan68@gmail.com (2012-02-01)
      The current treatment of choice for metastatic pancreatic cancer involves single-agent gemcitabine or a combination of gemcitabine with capecitabine or erlotinib (a tyrosine kinase inhibitor). Only 25–30% of patients respond to this treatment and patients who do respond initially ultimately exhibit disease progression. Median survival for pancreatic cancer patients has reached a plateau due to inherent and acquired resistance to these agents. Key molecular factors implicated in this resistance include: deficiencies in drug uptake, alteration of drug targets, activation of DNA repair pathways, resistance to apoptosis and the contribution of the tumor microenvironment. Moreover, for newer agents including tyrosine kinase inhibitors, overexpression of signaling proteins, mutations in kinase domains, activation of alternative pathways, mutations of genes downstream of the target and/or amplification of the target represent key challenges for treatment efficacy. Here we will review the contribution of known mechanisms and markers of resistance to key pancreatic cancer drug treatments.
    • Challenges with current inhaled treatments for chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis.

      Greally, Peter; Whitaker, Paul; Peckham, Daniel; National Children's Hospital, Tallaght, Dublin, Ireland. Peter.Greally@amnch.ie (Current medical research and opinion, 2012-06)
      Pseudomonas aeruginosa (Pa) is the predominant pathogen infecting the airways of patients with cystic fibrosis (CF). Initial colonization is usually transient and associated with non-mucoid strains, which can be eradicated if identified early. This strategy can prevent, or at least delay, chronic Pa infection, which eventually develops in the majority of patients by their late teens or early adulthood. This article discusses the management and latest treatment developments of Pa lung infection in patients with CF, with a focus on nebulized antibiotic therapy.
    • The changing epidemiology of the Bronchiolitis epidemic in Tallaght Hospital

      O’Connor, G; Tariq, M; Greally, P; Elnazir, B (Irish Medical Journal (IMJ), 2013)
      Bronchiolitis affects one third of babies in their first year of life. We investigated all bronchiolitis admissions to Tallaght Hospital in the last five years, with the hope of providing an insight into the epidemic in an Irish population. We analysed these 1,202 admissions on the basis of time of year (busiest being December at 24.2%), length of stay (mean 2.92 days), gender (62% male) and age (mean 30.29 weeks). There was a 102% increase in the average incidence of bronchiolitis in the first six months of 2011 and 2012 (186) compared to the previous four years (92.25). P value was statistically significant at 0.0469. Our findings were backed up by comparable data from OLCH, Crumlin (149.5 for 2011-2012 vs 36.25 for 2007-2010). There has been in a significant shift in the timing and incidence of bronchiolitis in Tallaght Hospital in the last two years. We explored the possible reasons for this, with special attention to RSV incidence, climate causes and vaccine programs.
    • The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009.

      Cullen, Ivor M; Manecksha, Rustom P; McCullagh, Eddie; Ahmad, Sarfraz; O'Kelly, Fardod; Flynn, Robert J; McDermott, Ted; Murphy, Philip; Grainger, Ronald; Fennell, Jerome P; et al. (BJU international, 2012-04)
      To investigate the changing pattern of antimicrobial resistance in Escherichia coli urinary tract infection over an eleven year period, and to determine whether E. coli antibiotic resistance rates vary depending on whether the UTI represents a nosocomial, community acquired or urology patient specific infection.
    • A changing trend in the management of patients with newly diagnosed Crohn's disease.

      Qasim, A; Ullah, N; Crotty, P; Swan, N; Breslin, N; Ryan, B; Torreggiani, W; Eguare, E; Neary, P; O'Connor, H; et al. (2012-02-01)
      BACKGROUND: Epidemiologic shift with rising incidence of Crohn's disease (CD) has been reported in recent studies. AIMS: To determine disease behaviour and therapeutic interventions undertaken in newly diagnosed patients with CD. METHODS: Patients diagnosed with CD between January 2006 and June 2008 were included. Disease type, location, degree of involvement and type of therapeutic interventions were recorded. RESULTS: A total of 78 patients were included. Colonic, ileo-colonic, terminal ileal and isolated small bowel disease were present in 37, 27, 9 and 5 patients, respectively. Disease phenotype was inflammatory, stenosing and fistulising in 42, 30 and 6 patients, respectively. Surgery was required in 22 patients, including right hemicolectomy (n = 8), subtotal colectomy (n = 4), segmental colonic resection (n = 2), segmental small bowel resection (n = 2), appendectomy (n = 2) and perianal surgery (n = 4). Fourteen patients underwent surgery at the time of diagnosis. Laparoscopic surgery was performed in 14 patients. CONCLUSIONS: A significant proportion of newly diagnosed patients with CD underwent surgical intervention on their first admission to hospital. This may signify a changing trend in the management approach.
    • Characteristics and outcomes of older patients attending an acute medical assessment unit

      Fallon, A; Armstrong, J; Coughlan, T; Collins, DR; O Neill, D; Kennelly, SP (Irish Medical Journal, 2015-07)
      The care of older persons accounts for an increasing proportion of the unscheduled care workload for acute hospitals. The recent development of acute medical assessment units (AMAU) has provided an alternative model for acute unscheduled care for all medical patients. Screening instruments have been developed to capture the higher levels of clinical complexity and medical comorbidities that older patients present with. The aim of this study was to report on the characteristics and outcomes for older patients reviewed in the AMAU of a tertiary referral university teaching hospital. Data on 3071 patients attending the unit over one year was prospectively collected and information on characteristics and outcomes for older patients retrieved. Older patients represented over one third (1066/3071, 35%) of those attending AMAU, and had an admission rate of nearly twice that of younger patients (60.5% vs 32%), highlighting the increased complexity of this group. Gerontologically attuned AMAUs have great potential to enhance care for frail older patients from the time of their acute presentation to hospital.