• Magnetic resonance imaging features of asymptomatic bipartite patella.

      O'Brien, J; Murphy, C; Halpenny, D; McNeill, G; Torreggiani, W C; Department of Radiology, Adelaide and Meath Incorporating National Children's Hospital, Tallaght, Dublin 24, Ireland. juliemobrien@gmail.com (European journal of radiology, 2011-06)
      The purpose of our study was to describe the magnetic resonance imaging (MRI) features of bipartite patella in asymptomatic patients.
    • Malignant peripheral nerve sheath tumour of the bladder associated with neurofibromatosis I.

      O'Brien, Julie; Aherne, Susan; Buckley, Orla; Daly, Padraig; Torreggiani, William C; Departments of Radiology. (Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2008-12)
      Neurofibromatosis is a hamartomatous disorder of autonomic peripheral nerve sheaths associated with peripheral nerve sheath tumours. Most tumours are neurofibromas; however, the genitourinary system is rarely involved. We present a rare case of a nerve sheath tumour of the bladder in a young patient, which was discovered to be malignant.
    • Malignant priapism: a case report.

      Ellanti, P; Connolly, S S; McDermott, R; Crotty, P L; Grainger, R; c/o Marjorie White-Flynn, Department of Urology, Adelaide and Meath Incorporating National Children's Hospital, Tallaght, Dublin 24, Ireland. prasad.ellanti@gmail.com (Irish journal of medical science, 2011-12)
      Metastatic involvement of the penis is most commonly from a primary malignant genitourinary tumour. It is a rare phenomenon usually reflecting disseminated malignancy associated with a poor prognosis. Metastasis to the penis mimicking priapism is extremely rare, particularly in the absence of disseminated disease.
    • Mallet Injury Management in Ireland

      Minchin, P (British Journal of Hand Therapy, 2012-12-10)
    • Mast Cell Tryptase Reduces Junctional Adhesion Molecule-A (JAM-A) Expression in Intestinal Epithelial Cells: Implications for the Mechanisms of Barrier Dysfunction in Irritable Bowel Syndrome.

      Wilcz-Villega, Ewa M; McClean, Siobhán; O'Sullivan, Maria A; Department of Clinical Medicine, Trinity Centre for Health Sciences, Adelaide and Meath Hospital, Dublin, Ireland. (2013-07)
      The objective of this study was to investigate how mast cell tryptase may influence intestinal permeability and tight junction (TJ) proteins in vitro and explore translation to irritable bowel syndrome (IBS).
    • Measurement of damage in systemic vasculitis: a comparison of the Vasculitis Damage Index with the Combined Damage Assessment Index

      Suppiah, R.; Flossman, O.; Mukhtyar, C.; Alberici, F.; Baslund, B.; Brown, D.; Hasan, N.; Holle, J.; Hruskova, Z.; Jayne, D.; et al. (Annals of the Rheumatic Diseases, 2011-01)
    • Meath Hospital Accident and Emergency study 1992

      1992
      A prospective study of all Accident & Emergency attenders at the Meath Hospital was undertaken during 20th - 27th June, 1992. The results were compared with a similar survey conducted between 11th - 18th December, 1989. The main aim of this study was to provide a profile of Accident & Emergency attenders, to examine the proportion of self-referred patients and to determine the reasons a patient had for not attending the general practitioner. Comparisons between the 1992 and 1989 survey show that: the most common age group of attendance is 25 - 44 approximately 25% are seen at weekends the proportion seen between 12 midnight and 8 a.m. has increased· the majority attend within 24 hours of the onset of the condition regarding GP. services: almost 80% had a G.P, yet the number of self-referred patients is increasing, 75% compared to 63.7% in the 1989 survey injury treatment continues to be the most common reason for attending A.& E the·number of investigations performed in A & E has decreased since 1989. Xray continues to be the most common investigation (over 50% having one) the issuing of a prescription was the most common treatment. This, together with some minor treatments could have been provided by G.P.s. appropriateness of attendance has increased (79% compared to 68.8%) On examining 1992 data in more detail, it emerged that self referrals were more likely to present on a Sunday and after 6 p.m. Older patients were less likely to be self-referred. Over 80% of self-referrals had a G.P. but only 5.3% of them attempted to contact the G.P. They stated that "needed immediate attention" was the most common reason for attending A. & E. Yet 50% waited up to 2 hours to be seen.
    • Medical humanities - serious academic pursuit or doorway to dilettantism?

      Moss, H; O'Neill, D (Irish Medical Journal, 2012-09)
    • Medical therapy in acromegaly.

      Sherlock, Mark; Woods, Conor; Sheppard, Michael C; Centre for Endocrinology Diabetes and Metabolism, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. (Nature reviews. Endocrinology, 2011-05)
      Acromegaly is a rare disease characterized by excess secretion of growth hormone (GH) and increased circulating insulin-like growth factor 1 (IGF-1) concentrations. The disease is associated with increased morbidity and premature mortality, but these effects can be reduced if GH levels are decreased to <2.5 μg/l and IGF-1 levels are normalized. Therapy for acromegaly is targeted at decreasing GH and IGF-1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, radiotherapy and medical therapies, such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant. Medical therapy is currently most widely used as secondary treatment for persistent or recurrent acromegaly following noncurative surgery, although it is increasingly used as primary therapy. This Review provides an overview of current and future pharmacological therapies for patients with acromegaly.
    • Medical therapy in patients with acromegaly: predictors of response and comparison of efficacy of dopamine agonists and somatostatin analogues.

      Sherlock, M; Fernandez-Rodriguez, E; Alonso, A Aragon; Reulen, R C; Ayuk, J; Clayton, R N; Holder, G; Sheppard, M C; Bates, A; Stewart, P M; et al. (The Journal of clinical endocrinology and metabolism, 2009-04)
      Acromegaly is associated with increased morbidity and mortality. Treatment options include surgery, radiotherapy, and medical therapy.
    • Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

      Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul; Pharmacy Department, Adelaide and Meath Hospital, incorporating the National, Children's Hospital (AMNCH), Tallaght, Dublin 24 School of Pharmacy , Trinity, College, Dublin 2, Ireland. tagrimes@tcd.ie (2012-02-01)
      AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.
    • Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

      Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul; Pharmacy Department, Adelaide and Meath Hospital, incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin 24 School of Pharmacy , Trinity College, Dublin 2, Ireland. tagrimes@tcd.ie (2011-03)
      Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.
    • Medication use process survey in Irish hospitals: implications for patient safety and continuity of care

      Grimes, T.C.; Duggan, C.A.; Delaney, T.; Graham, I.M.; Bates, I.P.; Conlon, K.C.; Kelly, J.G. (The International Society for Quality in Health Care, 2009)
      To identify baseline data that describes medication use in secondary care in Ireland and the gaps in the process where patient safety can be enhanced.
    • Memory Th1 Cells Are Protective in Invasive Staphylococcus aureus Infection.

      Brown, Aisling F; Murphy, Alison G; Lalor, Stephen J; Leech, John M; O'Keeffe, Kate M; Mac Aogáin, Micheál; O'Halloran, Dara P; Lacey, Keenan A; Tavakol, Mehri; Hearnden, Claire H; et al. (2015)
      Mechanisms of protective immunity to Staphylococcus aureus infection in humans remain elusive. While the importance of cellular immunity has been shown in mice, T cell responses in humans have not been characterised. Using a murine model of recurrent S. aureus peritonitis, we demonstrated that prior exposure to S. aureus enhanced IFNγ responses upon subsequent infection, while adoptive transfer of S. aureus antigen-specific Th1 cells was protective in naïve mice. Translating these findings, we found that S. aureus antigen-specific Th1 cells were also significantly expanded during human S. aureus bloodstream infection (BSI). These Th1 cells were CD45RO+, indicative of a memory phenotype. Thus, exposure to S. aureus induces memory Th1 cells in mice and humans, identifying Th1 cells as potential S. aureus vaccine targets. Consequently, we developed a model vaccine comprising staphylococcal clumping factor A, which we demonstrate to be an effective human T cell antigen, combined with the Th1-driving adjuvant CpG. This novel Th1-inducing vaccine conferred significant protection during S. aureus infection in mice. This study notably advances our understanding of S. aureus cellular immunity, and demonstrates for the first time that a correlate of S. aureus protective immunity identified in mice may be relevant in humans.
    • Metabolic and hormonal aspects of polycystic ovary syndrome: the impact of diet.

      O'Connor, Annalouise; Gibney, James; Roche, Helen M; Nutrigenomics Research Group, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. (The Proceedings of the Nutrition Society, 2010-11)
      Polycystic ovary syndrome (PCOS) is a common, chronic endocrine condition affecting young women of reproductive age. It is characterised by hyperandrogenaemia, and profound menstrual and ovulatory dysfunction with consequent sub-fertility. A clustering of metabolic aberrations is commonly associated with this condition and these include insulin resistance, disordered lipid metabolism and chronic low-grade inflammation. Overweight and obesity, as well as a degree of adipose tissue dysfunction, are present in a large proportion of women with PCOS, and where present, magnify the inherent hyperandrogenaemia characteristic of the condition, in addition to worsening the metabolic profile. Diet and lifestyle interventions are among the first-line treatments for PCOS, and weight reduction through energy restriction has been shown to exert positive influences on both metabolic and hormonal aspects of this condition. Alterations in carbohydrate amount and type have also been investigated, and more recently, dietary fatty acids, with a particular emphasis on PUFA, have been shown to have a positive impact within this population group. Although it is likely that diet is not the root cause of PCOS, it represents a modifiable variable with the potential to improve the health of women with this condition. Work to date has provided insights into the role of diet in PCOS; however, further work is required to determine the role of nutrients specifically within the context of PCOS, in order to develop more effective, evidence-based dietary guidelines for this condition.
    • Metastatic transitional cell carcinoma of the tibia radiologically mimicking osteosarcoma.

      Cunningham, Laurence Patrick; O'Neill, Barry James; Quinlan, John Francis; The Adelaide & Meath Hospital Incorporating The National Children's Hospital, Tallaght, Dublin, Ireland. (2013)
      We report a case of a 73-year-old lady with transitional cell carcinoma and no evidence of metastatic disease presenting with gradual weight loss, pretibial swelling and painful weightbearing. Investigations revealed a lesion of the right tibial diaphysis. The radiological and clinical appearance was that of primary osteosarcoma. Biopsy results revealed metastatic transitional cell carcinoma of the tibia. Intramedullary nailing was performed which relieved pain on weightbearing. The patient declined radiotherapy and was started on a palliative care regimen. This case illustrates the importance of histological diagnosis in the treatment of diaphyseal lesions.
    • Methadone-maintained patients in primary care have higher rates of chronic disease and multimorbidity, and use health services more intensively than matched controls

      O’Toole, John; Hambly, Róisín; Cox, Anne-Marie; O’Shea, Brendan; Darker, Catherine (European Journal of General Practice, 2014-05)
      Background: Methadone maintenance treatment in primary care is cost-effective and improves outcomes for opiate-dependent patients. A more developed understanding of the evolving needs of this important cohort will facilitate further improvements in their integrated care within the community. Objectives: The aim of this study was to compare the burden of chronic disease, multi-morbidity and intensity of health-service use between methadone-maintained patients (MMPs) and matched controls in primary care. Method: This is a retrospective matched case-control design. Data on chronic disease and health service use was collected in 13 computerized GP surgeries on 414 patients (207 MMPs and 207 controls). Twelve months of records were examined. MMPs were compared with controls matched by gender, age, socio-economic status (SES) and GP surgery. Read More: http://informahealthcare.com/doi/abs/10.3109/13814788.2014.905912
    • Mindfulness based Cognitive Therapy for Patients with Depression and Heart Disease

      O’Doherty, V; Carr, A; Kehoe, A; Graham, I. (2009)
      23rd Annual Conference of the European Health Psychology Society, Pisa, Italy.
    • Minimally invasive percutaneous plate fixation of distal tibia fractures.

      Bahari, Syah; Lenehan, Brian; Khan, Hamad; McElwain, John P; Department of Orthopaedics, Adelaide and Meath Hospital incorporating National Children Hospital, Tallaght, Dublin, Ireland. syahbahari@gmail.com (Acta orthopaedica Belgica, 2007-10)
      We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.
    • Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

      Magill, Paul; McGarry, James; Queally, Joseph M; Morris, Seamus F; McElwain, John P; Centre for Pelvic and Acetabular Surgery, Adelaide Meath and National Children's Hospital, Dublin, Ireland. pmagill8@gmail.com (2012-04)
      Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.