• Taxing your memory.

      Martin, Ruth; O'Neill, Desmond; Centre for Ageing, Neuroscience and the Humanities, Adelaide and Meath Hospital, , Dublin 24, Ireland. (2012-02-01)
    • Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.

      Wong, C F; Little, M A; Vinjamuri, S; Hammad, A; Harper, J M; Department of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, United Kingdom. chriswong@doctors.org.uk (Transplantation proceedings, 2008-06)
      Because death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.
    • Technical skill set training in natural orifice transluminal endoscopic surgery: how should we approach it?

      Nugent, Emmeline; Traynor, Oscar; Neary, Paul; National Surgical Training Centre, Royal College of Surgeons in Ireland, Dublin, Ireland. emelinenugent@rcsi.ie (Journal of laparoendoscopic & advanced surgical techniques. Part A, 2011-03)
      The boundaries in minimally invasive techniques are continually being pushed further. Recent years have brought new and exciting changes with the advent of natural orifice transluminal endoscopic surgery. With the evolution of this field of surgery come challenges in the development of new instruments and the actual steps of the procedure. Included in these challenges is the idea of developing a proficiency-based curriculum for training.
    • Terminology and details of the diagnostic process for testis cancer.

      Connolly, Stephen S; Daly, Padraig J A; Floyd, Michael St J; Collins, Ian M; Grainger, Ronald; Thornhill, John A; Department of Urology, Trinity College Dublin, Adelaide and Meath incorporating National Children's Hospital, Dublin, Ireland. (The Journal of urology, 2011-03)
      We examined the process and causes of diagnostic delay, defined as the interval from symptom onset to diagnosis, for testis (germ cell) cancer and the change with time. Diagnostic delay influences disease burden and may be subdivided into symptomatic interval, defined as symptom onset to first presentation, and diagnostic interval, defined as first presentation to diagnosis.
    • Texture Modified Diets

      Regan, J.; Ickenstein, G (UNI-MED VERLAG Publishing, 2011)
    • Texture Neuromuscular Conditions

      Regan, J. (Plural Publishing, 2012)
    • Thyroid disorders in girls with Turner syndrome and the influence of the underlying karyotype.

      Nadeem, M; Roche, E F (Irish Medical Journal, 2015-03)
      The risk of developing thyroid dysfunction is higher in Turner syndrome (TS) than the general population 1,2 . In previous studies, the influence of karyotype 3 and thyroid autoantibodies 4 on thyroid disorder in patients with TS has been investigated. We therefore set out to determine the prevalence of thyroid dysfunction in Irish girls with TS. The impact of underlying karyotype and thyroid autoantibodies has also been examined. The presence of thyroid dysfunction was assessed by measuring serum thyroid-stimulating hormone (TSH), thyroxin (T4) and anti-thyroid peroxidase antibodies (TPO-Ab) values. The association between TPO-Ab values and thyroid dysfunction (hypothyroidism and hyperthyroidism) was also assessed.
    • Thyroid dysfunction in Down's syndrome and screening for hypothyroidism in children and adolescents using capillary TSH measurement.

      Murphy, J; Philip, M; Macken, S; Meehan, J; Roche, E; Mayne, P D; O'Regan, M; Hoey, H M C V; Department of Paediatrics, University of Dublin, Trinity College, Tallaght, Dublin, Ireland. murphyj6@tcd.ie (Journal of pediatric endocrinology & metabolism : JPEM, 2008-02)
      Thyroid dysfunction is more common in individuals with Down's syndrome (DS) than in the general population, whose clinical features can mask the presenting signs and symptoms of hypothyroidism. Biochemical screening is necessary; however, venepuncture may be difficult.
    • Timing and modality of neuroimaging in acute stroke: an Irish perspective.

      McEvoy, S; Trainor, S; Caffrey, N; Torreggiani, W C; Collins, D R (Irish medical journal, 2009-04)
      Letter
    • The tip of the iceberg: never ignore a chronic cough

      Kooblall, M; Lane, SJ; Moloney, E (Irish Medical Journal, 2016-01)
      A chronic cough is defined as a cough lasting longer than 8 weeks. Around 10% of referrals to respiratory outpatient have a chronic cough as the presenting complaint. Coughing is classically described as a protective reflex response to mechanical and chemical airway stimulation and therefore a chronic cough must be adequately investigated. The following case illustrates this.
    • To Anthrometrically compare a sample of patients form a single Haemodialysis Inut in Ireland to those patients studied in the HEMO study

      O’Neill, J (2012-05)
      The National Kidney Foundation Clinical meeting in Washington, USA, May 2012
    • Total and phosphorylated tau protein as biological markers of Alzheimer's disease.

      Hampel, Harald; Blennow, Kaj; Shaw, Leslie M; Hoessler, Yvonne C; Zetterberg, Henrik; Trojanowski, John Q; 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. harald.hampel@med.uni-muenchen.de (2012-02-01)
      Advances in our understanding of tau-mediated neurodegeneration in Alzheimer's disease (AD) are moving this disease pathway to center stage for the development of biomarkers and disease modifying drug discovery efforts. Immunoassays were developed detecting total (t-tau) and tau phosphorylated at specific epitopes (p-tauX) in cerebrospinal fluid (CSF), methods to analyse tau in blood are at the experimental beginning. Clinical research consistently demonstrated CSF t- and p-tau increased in AD compared to controls. Measuring these tau species proved informative for classifying AD from relevant differential diagnoses. Tau phosphorylated at threonine 231 (p-tau231) differentiated between AD and frontotemporal dementia, tau phosphorylated at serine 181 (p-tau181) enhanced classification between AD and dementia with Lewy bodies. T- and p-tau are considered "core" AD biomarkers that have been successfully validated by controlled large-scale multi-center studies. Tau biomarkers are implemented in clinical trials to reflect biological activity, mechanisms of action of compounds, support enrichment of target populations, provide endpoints for proof-of-concept and confirmatory trials on disease modification. World-wide quality control initiatives are underway to set required methodological and protocol standards. Discussions with regulatory authorities gain momentum defining the role of tau biomarkers for trial designs and how they may be further qualified for surrogate marker status.
    • Total cardiovascular disease risk assessment: a review.

      Cooney, Marie Therese; Cooney, Helen C; Dudina, Alexandra; Graham, Ian M; Department of Cardiology, Adelaide Meath Hospital, Tallaght, Dublin 24, Ireland. therese.cooney@yahoo.com (Current opinion in cardiology, 2011-09)
      The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual's total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.
    • Total hip arthroplasty in a patient with arthrogryphosis and an ipsilateral above knee amputation.

      Leonard, Michael; Nicholson, Paul; Department of Orthopaedic Surgery, Adeladie and Meath Incorporating the National Childrens Hospital, Tallaght, Dublin, Ireland. mikeleonard77@gmail.com (Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2010-10)
      The authors present the case of a young man with arthrogryphosis multiplex congenita and an above knee amputation who underwent an ipsilateral total hip replacement. The unique aspects of the case and technical difficulties are highlighted. Follow-up at five years revealed an excellent clinical and radiological outcome.
    • Towards realistic and flexible advance care planning

      O'Neill, D (Irish Medical Journal (IMJ), 2013)
      The suffering of the many Irish people who bought houses at the height of the economic boom with variable mortgages is a topical and telling demonstration of the difficulties of planning for the future. What seemed like a good idea in 2006 has become a millstone around many necks, putting huge strains on marriages and family life, and is deservedly a topic of national debate. Signing into a binding written commitment for their financial future has been a bitter experience for this large group of people: how much more painful might it be if they had signed into unhappy binding agreements about their future healthcare? The illusion that the future healthcare can be tightly defined is typified by the case for advance directives, an idea for which enthusiasm has unhappily out-stripped an increasingly critical biomedical literature1. This ranges from their description by the majority of ICU staff in one US study as â uselessâ 2 to clear problems which arise when advance directives are patently in conflict with the patient's best interests3.
    • A transatlantic survey of nutrition practice in acute pancreatitis.

      Duggan, SN; Smyth, N D; O'Sullivan, M; Feehan, S; Ridgway, P F; Conlon, K C; Department of Surgery, Trinity College Dublin, Dublin, Ireland. siduggan@tcd.ie (Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 2012-08)
      Many guidelines exist for the nutritional management of acute pancreatitis; however, little is known regarding current practice. We aimed to investigate feeding practices, including the use of parenteral/enteral nutrition.
    • Transesophageal Echocardiographically-Confirmed Pulmonary Vein Thrombosis in Association with Posterior Circulation Infarction.

      Kinsella, Justin A; Maccarthy, Allan J; Kiernan, Thomas J; Moore, David P; McDermott, Raymond S; McCabe, Dominick J H; Department of Neurology, The Adelaide and Meath Hospital, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland. (Case reports in neurology, 2010)
      Pulmonary venous thromboembolism has only been identified as a cause of stroke with pulmonary arteriovenous malformations/fistulae, pulmonary neoplasia, transplantation or lobectomy, and following percutaneous radiofrequency ablation of pulmonary vein ostia in patients with atrial fibrillation. A 59-year-old man presented with a posterior circulation ischemic stroke. 'Unheralded' pulmonary vein thrombosis was identified on transesophageal echocardiography as the likely etiology. He had no further cerebrovascular events after intensifying antithrombotic therapy. Twenty-eight months after initial presentation, he was diagnosed with metastatic pancreatic adenocarcinoma and died 3 months later. This report illustrates the importance of doing transesophageal echocardiography in presumed 'cardioembolic' stroke, and that potential 'pulmonary venous thromboembolic' stroke may occur in patients without traditional risk factors for venous thromboembolism. Consideration should be given to screening such patients for occult malignancy.
    • Transitional cell carcinoma

      Browne, RFJ; Torreggiani, William C (Springer-Verlag, 2012-11-20)
    • Transurethral Resection of the Prostate Now and Then

      C Dowling, C; Moran, D; Walsh, A; Alsinnawi, M; Flynn, R; McDermott, TED; Grainger, R; Thornhill, JA (Irish Medical Journal, 2015-05)
      The number of transurethral resections of the prostate (TURP) performed each year is decreasing. The aim of this study was to assess a cohort of patients undergoing TURP and compare this to one twenty years earlier in terms of procedure, complications and outcomes. A retrospective comparative analysis of one hundred consecutive TURPs performed in 2010 was compared to one hundred cases performed in 1990. Fifty-five (55%) had a urinary catheter (UC) in situ pre-operatively in 2010 compared to 22 (22%) in 1990. The length of catheterisation time was significantly longer in 2010 compared with 1990 (average 65 days vs 20 days). Infective complications occurred in six (6%) patients in 2010 and three (3%) in the 1990 cohort. Patients who had UCs in situ pre-operatively for longer periods had a higher rate of infective complications and more serious complications. This highlights the importance of early specialist referral for patients diagnosed with urinary retention