• H1N1 influenza in an Irish population: patterns of chest radiograph abnormality in patients testing positive.

      O'Sullivan, K; Halpenny, D; McNeill, G; Torreggiani, W; Department of Radiology, AMNCH, Tallaght, Dublin 24 (2012-02-29)
      The winter of 2010/2011 saw a second peak in the number of H1N1 cases detected in Ireland. The purpose of this study was to investigate the radiological characteristics of patients diagnosed during this period. A retrospective analysis of these cases was performed. Chest radiographs were classified as normal or abnormal. A total of 37 patients were included. Of these, 22 (59%) of chest radiographs were abnormal and 15 (41%) were normal. In the 7 paediatric patients, 4 (57%) had a perihilar distribution of disease, 2 (28%) had peripherally based disease with 1 (14%) having a mixed distribution. A series of radiographs was available for 9 patients, 6 of these showed a radiographic deterioration from the initial study. The majority of chest radiographs of patients with confirmed H1N1 infection will be abnormal. In children, disease is more likely to be perihilar in distribution. Chest radiography is an important initial investigation in patients with H1N1 infection and is useful to track progression of disease in the subset of patients requiring hospitalization for severe disease.
    • Haematological abnormalities in Adults with Down’s Syndrome

      McClean, S; McHale, C; Enright, H (Irish Journal Medical Science, 2009)
    • Hand weakness in Charcot-Marie-Tooth disease 1X.

      Arthur-Farraj, P J; Murphy, S M; Laura, M; Lunn, M P; Manji, H; Blake, J; Ramdharry, G; Fox, Z; Reilly, M M; MRC Centre for Neuromuscular Diseases, Department of Molecular Neuroscience, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. p.arthurfarraj@gmail.com (Neuromuscular disorders : NMD, 2012-07)
      There have been suggestions from previous studies that patients with Charcot-Marie-Tooth disease (CMT) have weaker dominant hand muscles. Since all studies to date have included a heterogeneous group of CMT patients we decided to analyse hand strength in 43 patients with CMT1X. We recorded handedness and the MRC scores for the first dorsal interosseous and abductor pollicis brevis muscles, median and ulnar nerve compound motor action potentials and conduction velocities in dominant and non-dominant hands. Twenty-two CMT1X patients (51%) had a weaker dominant hand; none had a stronger dominant hand. Mean MRC scores were significantly higher for first dorsal interosseous and abductor pollicis brevis in non-dominant hands compared to dominant hands. Median nerve compound motor action potentials were significantly reduced in dominant compared to non-dominant hands. We conclude that the dominant hand is weaker than the non-dominant hand in patients with CMT1X.
    • Hand-assisted laparoscopic sigmoid colectomy skills acquisition: augmented reality simulator versus human cadaver training models.

      Leblanc, Fabien; Senagore, Anthony J; Ellis, Clyde N; Champagne, Bradley J; Augestad, Knut M; Neary, Paul C; Delaney, Conor P; Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio 44106-5047, USA. (Journal of surgical education, 2010)
      The aim of this study was to compare a simulator with the human cadaver model for hand-assisted laparoscopic colorectal skills acquisition training.
    • Hand-assisted versus straight laparoscopic sigmoid colectomy on a training simulator: what is the difference? A stepwise comparison of hand-assisted versus straight laparoscopic sigmoid colectomy performance on an augmented reality simulator.

      Leblanc, Fabien; Delaney, Conor P; Ellis, Clyde N; Neary, Paul C; Champagne, Bradley J; Senagore, Anthony J; Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA. (World journal of surgery, 2010-12)
      We hypothesized that simulator-generated metrics and intraoperative errors may be able to differentiate the technical differences between hand-assisted laparoscopic (HAL) and straight laparoscopic (SL) approaches.
    • HDL cholesterol protects against cardiovascular disease in both genders, at all ages and at all levels of risk.

      Cooney, M T; Dudina, A; De Bacquer, D; Wilhelmsen, L; Sans, S; Menotti, A; De Backer, G; Jousilahti, P; Keil, U; Thomsen, T; et al. (Atherosclerosis, 2009-10)
      We aimed to clarify some previous inconsistencies regarding the role of high density lipoprotein cholesterol (HDL-C) as a CVD protective factor.
    • A health and safety survey of Irish funeral industry workers.

      Kelly, N; Reid, A; Occupational Health Unit, The Adelaide and Meath Hospital, incorporating the, National Children's Hospital, Dublin 24, Ireland. nualakelly@physicians.ie (2012-02-01)
      BACKGROUND: Those handling deceased individuals, including the funeral industry, face a variety of health and safety hazards including occupationally acquired infectious disease. AIMS: To identify the knowledge, attitudes and beliefs of Irish funeral industry workers towards occupational hazards and infectious disease in 2009. METHODS: The sample analysed consisted of all listed member premises of the Irish Association of Funeral Directors as at 1 July 2009. A postal survey was sent to each premises in July 2009, with two rounds of follow-up reviews sent to non-responders. Four main areas were covered--occupational hazards, embalming, industry expertise and demographics. The quantitative and qualitative results were analysed to assess knowledge, attitudes and beliefs. Data collection was completed on 31 December 2009. RESULTS: Two hundred and thirty listed member premises were contacted. Twenty-two were unsuitable for the survey. One hundred and thirty-eight valid replies were received from 130 premises, representing a premises response rate of 63% (130/208). Seventy-three premises (56%) identified themselves as embalmers. Embalmers had variable vaccine uptake and variable knowledge, attitude and beliefs towards embalming those with blood-borne viruses. Fifteen per cent of respondents reported a work-related injury, back injury being the most common. Splash and sharps injuries were reported as a work-related injury, and infections believed to be work related were also reported. CONCLUSIONS: This study demonstrates widespread occupational health concerns among this professional group. It confirms the need for occupational health advice and services. There is also a strong desire for regulation of this profession in Ireland.
    • The Health Professions Admission Test (HPAT) score and leaving certificate results can independently predict academic performance in medical school: do we need both tests?

      Halpenny, D; Cadoo, K; Halpenny, M; Burke, J; Torreggiani, W C; Department of Radiology, AMNCH, Tallaght, Dublin 24. (2010-11)
      A recent study raised concerns regarding the ability of the health professions admission test (HPAT) Ireland to improve the selection process in Irish medical schools. We aimed to establish whether performance in a mock HPAT correlated with academic success in medicine. A modified HPAT examination and a questionnaire were administered to a group of doctors and medical students. There was a significant correlation between HPAT score and college results (r2: 0.314, P = 0.018, Spearman Rank) and between leaving cert score and college results (r2: 0.306, P = 0.049, Spearman Rank). There was no correlation between leaving cert points score and HPAT score. There was no difference in HPAT score across a number of other variables including gender, age and medical speciality. Our results suggest that both the HPAT Ireland and the leaving certificate examination could act as independent predictors of academic achievement in medicine.
    • HeartScore predicts surrogate markers of cardiovascular disease in individuals aged below 40 years.

      Cooney, Marie Therese; Dudina, Alexandra; Graham, Ian (European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 2009-08)
    • Height in Turner syndrome: Does growth hormone therapy have impact?

      Nadeem, M; Roche, EF (Irish Medical Journal (IMJ), 2014-02)
    • Helicobacter pylori and nonmalignant diseases.

      Alakkari, Alaa; Zullo, Angelo; O'Connor, Humphrey J; Department of Gastroenterology, Adelaide and Meath Hospital, Faculty of Health, Sciences of Trinity College, Dublin, Ireland. (2012-02-01)
      Research published over the past year has documented the continued decline of Helicobacter pylori-related peptic ulcer disease and increased recognition of non-H. pylori, non-steroidal anti-inflammatory drugs ulcer disease--idiopathic ulcers. Despite reduced prevalence of uncomplicated PUD, rates of ulcer complications and associated mortality remain stubbornly high. The role of H. pylori in functional dyspepsia is unclear, with some authors considering H. pylori-associated nonulcer dyspepsia a distinct organic entity. There is increasing acceptance of an inverse relationship between H. pylori and gastroesophageal reflux disease (GERD), but little understanding of how GERD might be more common/severe in H. pylori-negative subjects. Research has focused on factors such as different H. pylori phenotypes, weight gain after H. pylori eradication, and effects on hormones such as ghrelin that control appetite.
    • Helicobacter pylori resistance rates for levofloxacin, tetracycline and rifabutin among Irish isolates at a reference centre.

      O'Connor, A; Taneike, I; Nami, A; Fitzgerald, N; Ryan, B; Breslin, N; O'Connor, H; McNamara, D; Murphy, P; O'Morain, C; et al. (2013-04-27)
      INTRODUCTION: Helicobacter pylori eradication rates using conventional triple therapies are falling, making viable second-line and rescue regimens necessary. Levofloxacin, tetracycline and rifabutin are three efficacious antibiotics for rescue therapy. AIM: We aimed to assess the resistance rates for H. pylori against these antibiotics in an Irish cohort. METHODS: Gastric biopsies were collected from 85 patients infected with H. pylori (mean age 46 years) in the Adelaide and Meath Hospital, Dublin in 2008 and 2009. Susceptibility to antibiotics was tested using the Etest. Clinical information was obtained from endoscopy reports and chart review. RESULTS: 50.6 % of patients were females. Mean age was 47 years. Ten had prior attempts at eradication therapy with amoxicillin-clarithromycin-PPI, two had levofloxacin-based second-line therapy. 11.7 % [95 % CI (6.5-20.3 %)] (N = 10) had strains resistant to levofloxacin. There were no strains resistant to rifabutin or tetracycline. Levofloxacin resistance in the under 45 age group was 2.6 % (1/38) compared to 19.1 % (9/47) of above 45 age group (p = 0.02). DISCUSSION: The levofloxacin rates illustrated in this study are relatively low by European standards and in line with other studies from the United Kingdom and Germany, with younger patients having very low levels of resistance. Levofloxacin, tetracycline and rifabutin are all valid options for H. pylori eradication in Irish patients but the importance of compliance cannot be underestimated.
    • Helicobacter pylori resistance to metronidazole and clarithromycin in Ireland.

      O'connor, Anthony; Taneike, Ikue; Nami, Abdurrazag; Fitzgerald, Niamh; Murphy, Philip; Ryan, Barbara; O'connor, Humphrey; Qasim, Asghar; Breslin, Niall; O'morain, Colm; et al. (2012-02-01)
      INTRODUCTION: Helicobacter pylori eradication rates have fallen considerably in recent years. Antibiotic resistance is thought to be rising. OBJECTIVES: To examine the levels of resistance to metronidazole (MTZ) and clarithromycin (CLA) in H. pylori, isolates were taken in a reference centre in Ireland from 2007 to 2008 and were compared to a similar cohort from a study in 1997. METHOD: Antimicrobial susceptibilities were tested by E-test. Frequencies of spontaneous metronidazole and clarithromycin resistance were measured on an agar plate containing the antibiotics at concentrations of 2x and 4x minimum inhibition concentration values. Clinical data were obtained from charts, laboratory and endoscopy reports. RESULTS: Two hundred and twenty-two patients were analyzed, 98 were females. Colonies amenable to culture were grown in 219 patients. Thirty-seven had prior attempts at eradication therapy (all with amoxicillin-CLA-proton pump inhibitor. A total of 31.5% of the patients had strains resistant to MTZ and 13.2% of the patients were noted to have strains resistant to CLA. About 8.6% of the patients had strains resistant to both the agents. CLA resistance was 9.3% in those who had no prior eradication therapy compared with 32.4% of those who had. CLA resistance increased from 3.9%, among treatment-naive patients in 1997, to 9.3% in our study. MTZ resistance was 29.1% in the treatment-naive population. In 1997, MTZ resistance in the treatment-naive cohort was 27.1%. MTZ resistance was more likely to occur in females (35.4 vs. 28.5%) than in males. CONCLUSION: This study shows that resistance to CLA among Irish patients infected with H. pylori has increased since 1997. The future of treatment may well lie in the widespread use of sensitivity testing before the treatment. This would promote an accurate treatment.
    • Helping to alleviate pain for children having venepuncture.

      Gilboy, Siobhan; Hollywood, Eleanor; The National's Children Hospital, County Dublin, Ireland. (2009-10)
      This article reviews the literature on venepuncture and children. The evidence on the use of topical agents namely tetracaine (amethocaine) gel and lidocaine/prilocaine cream is discussed, along with the use and benefits of distraction techniques and parental presence to make this an easier procedure for the child, their families and the nurse.
    • Hematological abnormalities in adult patients with Down's syndrome.

      McLean, S; McHale, C; Enright, H; Department of Haematology, Adelaide and Meath Hospital, Dublin, Incorporating the, National Children's Hospital, Tallaght, D24, Dublin, Ireland. Smclean81@yahoo.com (2012-02-01)
      BACKGROUND: There is a paucity of data regarding hematological abnormalities in adults with Down's syndrome (DS). AIMS: We aimed to characterize hematological abnormalities in adult patients with DS and determine their long-term significance. METHODS: We retrospectively studied a cohort of nine DS patients referred to the adult hematology service in our institution between May 2001 and April 2008. Data collected were: full blood count (FBC), comorbidities, investigations performed, duration of follow-up and outcome to most recent follow-up. RESULTS: Median follow-up was 26 months (9-71). Of the nine patients, two had myelodysplastic syndrome (MDS) at presentation. Of these, one progressed, with increasing marrow failure, and requiring support with transfusions and gCSF. The remaining eight patients, with a variety of hematological abnormalities including leukopenia, macrocytosis, and thrombocytopenia, had persistently abnormal FBCs. However there was no evidence of progression, and no patient has evolved to acute myeloid leukemia (AML). CONCLUSIONS: MDS is a complication of DS and may require supportive therapy. However, minor hematological abnormalities are common in adult DS patients, and may not signify underlying marrow disease.
    • Hemobilia as a potential complication in patients treated with photodynamic therapy for unresectable cholangiocarcinoma.

      Killeen, Ronan P; Torreggiani, William C; Malone, Dermot E; Brophy, David P; Adelaide and Meath Hospital, Dublin, Ireland. (Gastrointestinal cancer research : GCR, 2009-03)
    • Hepatic lymphangioma: a rare cause of abdominal pain in a 30-year-old female.

      Stunell, H; Ridgway, P F; Torreggiani, W C; Crotty, P; Conlon, K C; Department of Surgery, Adelaide and Meath Incorporating National Children's Hospital, Tallaght, Dublin 24, Ireland. helenstunell@eircom.net (Irish journal of medical science, 2009-03)
      Lymphangiomas are rare tumours usually found in the paediatric population in extra abdominal sites.
    • Hepatorenal correction in murine glycogen storage disease type I with a double-stranded adeno-associated virus vector.

      Luo, Xiaoyan; Hall, Gentzon; Li, Songtao; Bird, Andrew; Lavin, Peter J; Winn, Michelle P; Kemper, Alex R; Brown, Talmage T; Koeberl, Dwight D; Department of Pediatrics, Division of Medical Genetics, Duke University Medical Center, Durham, North Carolina 27710, USA. (2011-11)
      Glycogen storage disease type Ia (GSD-Ia) is caused by the deficiency of glucose-6-phosphatase (G6Pase). Long-term complications of GSD-Ia include life-threatening hypoglycemia and proteinuria progressing to renal failure. A double-stranded (ds) adeno-associated virus serotype 2 (AAV2) vector encoding human G6Pase was pseudotyped with four serotypes, AAV2, AAV7, AAV8, and AAV9, and we evaluated efficacy in 12-day-old G6pase (-/-) mice. Hypoglycemia during fasting (plasma glucose <100 mg/dl) was prevented for >6 months by the dsAAV2/7, dsAAV2/8, and dsAAV2/9 vectors. Prolonged fasting for 8 hours revealed normalization of blood glucose following dsAAV2/9 vector administration at the higher dose. The glycogen content of kidney was reduced by >65% with both the dsAAV2/7 and dsAAV2/9 vectors, and renal glycogen content was stably reduced between 7 and 12 months of age for the dsAAV2/9 vector-treated mice. Every vector-treated group had significantly reduced glycogen content in the liver, in comparison with untreated G6pase (-/-) mice. G6Pase was expressed in many renal epithelial cells of with the dsAAV2/9 vector for up to 12 months. Albuminuria and renal fibrosis were reduced by the dsAAV2/9 vector. Hepatorenal correction in G6pase (-/-) mice demonstrates the potential of AAV vectors for the correction of inherited diseases of metabolism.
    • Hereditary amyloid neuropathy.

      Murphy, Sinead M; Reilly, Mary M (2012)
    • Hereditary sensory and autonomic neuropathy type 1 (HSANI) caused by a novel mutation in SPTLC2

      Murphy, S. M.; Ernst, D.; Wei, Y.; Laura, M.; Liu, Y.-T.; Polke, J.; Blake, J.; Winer, J.; Houlden, H.; Hornemann, T.; et al. (2013-05-29)