• UK experience of azacitidine therapy in patients with myelodysplastic syndromes

      Killick, S; Enright, H; Vyas, P; Das-Gupta, E; Dennis, M; Culligan, D; Milic, M; Chacko, J (Leukemia Research, 2011)
    • Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

      Henari, Shwan; Banks, Louisa N; Radovanovic, Ingrid; Queally, Joseph; Morris, Seamus; Department of Trauma and Orthopedics, Adelaide and Meath Hospital, Dublin, Ireland. shwanhenari@hotmail.com (Orthopedics, 2011-10)
      The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.
    • Ultrasound appearances of Implanon implanted contraceptive devices.

      McNeill, G; Ward, E; Halpenny, D; Snow, A; Torreggiani, W; Department of Radiology, AMNCH Tallaght, Dublin 24, Ireland. (JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 2009-09)
      Subdermal contraceptive devices represent a popular choice of contraception. Whilst often removed without the use of imaging, circumstances exist where imaging is required. Ultrasound is the modality of choice. The optimal technique and typical sonographic appearances are detailed in this article.
    • Ultrasound in Rheumatology

      Kane, David ((Hochberg), 2013)
    • Ultrasound in the evaluation of enthesitis: status and perspectives.

      Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick; Wakefield, Richard J; Naredo, Esperanza; D'Agostino, Maria Antonietta; Rheumatology Department, Université Paris 6-Pierre et Marie Curie, Hôpital La Pitié Salpetrière, APHP, 83 Boulevard de l’hôpital 75013 Paris, France. (Arthritis research & therapy, 2011)
      An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter.
    • Ultrasound-guided removal of Implanon devices.

      Persaud, T; Walling, M; Geoghegan, T; Buckley, O; Stunell, H; Torreggiani, W C; Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. (European radiology, 2008-11)
      Our study has shown that ultrasound-guided localisation and removal of Implanon rods is safe, practical and highly successful. Over a 4-year period, 119 patients had successful, uncomplicated removal of their subdermal devices.The technique is particularly useful for removal of the device when it is not palpable or when an attempt at removal of a palpable device has not been successful.
    • Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report.

      Good, Daniel W; Royds, Jonathan E; Smith, Myles J; Neary, Paul C; Eguare, Emmanuel; Minimally Invasive Surgical Unit, Division of Colorectal Surgery, AMNCH, Tallaght, Dublin 24, Ireland. goodd@tcd.ie. (Journal of medical case reports, 2011)
      The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.
    • Understanding type 2 diabetes: including the family member's perspective.

      White, Patricia; Smith, Susan M; Hevey, David; O'Dowd, Thomas; Department of Public Health and Primary Care, Trinity College Centre for Health, Sciences, Adelaide and Meath Hospital incorporating the National Children's, Hospital, Tallaght, Dublin 24, Ireland. pwhite@tcd.ie (2012-02-01)
      PURPOSE: The purpose of this study was to examine the relationship between psychological and social factors and diabetes outcomes in people with type 2 diabetes and their family members. METHODS: A total of 153 patients with type 2 diabetes were assessed at a diabetes outpatient clinic and postal questionnaires were sent to nominated family members. The measures examined were diabetes knowledge, social support, well-being, and illness perceptions. RESULTS: When compared with those with diabetes, family members reported lower positive well-being and lower levels of satisfaction with support. They also perceived diabetes as a more cyclical illness, which was controlled more by treatment than by the individual. Family members also reported that the person with diabetes was more emotionally distressed and knew more about diabetes than the patient had actually reported himself or herself. There were no differences between the family members of those in good or poor glycaemic control. CONCLUSIONS: This study reinforces the importance of understanding social context and illness beliefs in diabetes management. It also highlights the potential for including family members in discussions and education about diabetes management.
    • Undiagnosed sarcoidosis manifesting as persistent FDG-PET positivity after treatment of lymphoma

      Burke, A; Dyszkiewicz-Korpanty, A; Wilson, L; Johnston, C; McHugh, J; Enright, H (2011)
    • Undiagnosed sarcoidosis manifesting as persistent FDG-PET positivity aftertreatment of lymphoma

      Burke, A; Dyszkiewicz-Korpanty A,; Wilson, L; Johnson, C; McHugh, J; Enright, H (2011)
    • An Unusual Case Of Urinary Bladder Arteriovenous Malformation

      Gnanappiragasam, D; Gnanappiragasam, S; Mcdermott, T.E.D (Irish Medical Journal, 2016-07)
      A 45-year-old male presented with haematuria and urinary frequency. Computed Tomography (CT) urogram revealed gross thickening of the left bladder wall. Histology showed large vessels cuffed by eosinophonilic material suggestive of urinary bladder arteriovenous malformation (AVM). No further intervention was carried out as symptoms resolve after the resection. Follow up rigid cystoscopy and CT at 3 months showed resolution of all visible pathology and no evidence of recurrence.
    • An unusual cause of cavernous sinus syndrome

      Smyth, A.; Murphy, S. M; Counihan, T. J (Case Reports, 2009)
    • An unusual cause of pelvic pain: struma ovarii.

      Halpenny, D F; O'Brien, J; Ibrahim, M M; Crotty, R; Torreggiani, W C; Department of Radiology, Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland. (JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 2009-09)
      A 22 year old female patient presented with a three month history of pelvic discomfort and dysmenorrhoea. A pelvic MRI demonstrated a large mass measuring 10 x 6 cm in size. On T1 and T2 weighted images the mass was noted to be predominantly cystic. The mass also contained peripheral solid components as well as a large fat fluid level. Following excision, histological examination revealed a lesion with mature teratomatous elements but with a significant component (> 50%) being composed of mature thyroid tissue. A 2cm area within the lesion had the morphological pattern of a classical papillary thyroid carcinoma. A diagnosis of struma ovarii was made. Struma ovarii is a rare ovarian neoplasm generally arising in a teratoma and accounts for less than 1% all ovarian neoplasms. Here we present the above case of struma ovarii in a young patient and discuss the radiological characteristics of the disease.
    • An unusual cause of pleuritic chest pain on a CT pulmonary angiogram.

      O'Brien, J; Barrett, S; Torreggiani, W; Department of Radiology, Adelaide and Meath Incorporating the National Children's Hospital,Tallaght, Dublin, Ireland. (JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 2010-04)
    • Unusual long-term complications of a splenic cyst.

      Ward, E V M; O'brien, J; Conlon, K; Torreggiani, W C; Department of Radiology, The Adelaide and Meath Hospital, Dublin, Ireland. (2012-02-01)
      Splenic cysts are relatively uncommon, and are usually asymptomatic. They are benign, typically treated conservatively and followed up with ultrasound examination, with few reported complications. We report a case of a simple splenic cyst that was followed up on imaging over a seven-year period. During that time, the cyst gradually enlarged from 5 cm to 12 cm in diameter, however the patient remained asymptomatic. After seven years, the patient was admitted with abdominal pain and a pelvic mass. The spleen was located within the pelvis, which was felt to be due to the weight of the cyst which caused the spleen to migrate out of its normal position. This case illustrates an extremely unusual complication, and suggests that while most splenic cysts may be managed conservatively, enlarging cysts may be prone to gravitational effects and prophylactic treatment should be considered.
    • Unusual long-term complications of a splenic cyst.

      Ward, E V M; O'brien, J; Conlon, K; Torreggiani, W C; Department of Radiology, The Adelaide and Meath Hospital, Dublin, Ireland. (JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 2010)
      Splenic cysts are relatively uncommon, and are usually asymptomatic. They are benign, typically treated conservatively and followed up with ultrasound examination, with few reported complications. We report a case of a simple splenic cyst that was followed up on imaging over a seven-year period. During that time, the cyst gradually enlarged from 5 cm to 12 cm in diameter, however the patient remained asymptomatic. After seven years, the patient was admitted with abdominal pain and a pelvic mass. The spleen was located within the pelvis, which was felt to be due to the weight of the cyst which caused the spleen to migrate out of its normal position. This case illustrates an extremely unusual complication, and suggests that while most splenic cysts may be managed conservatively, enlarging cysts may be prone to gravitational effects and prophylactic treatment should be considered.
    • An unusual mode of failure of a tripolar constrained acetabular liner: a case report.

      Banks, Louisa N; McElwain, John P; Adelaide and Meath Hospital, Incorporating the National Children's Hospital,, Tallaght, Dublin, Ireland. Louisabanks@hotmail.com (2012-02-01)
      Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient's weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.
    • Unusual presentation of renal calculous disease.

      Campbell, Naomi; Barrett, Sarah; Stunell, Helen; Torreggiani, William C; Department of Radiology, Adelaide and Meath Hospitals incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. (British journal of hospital medicine (London, England : 2005), 2009-12)
    • Updates in growth hormone treatment and mortality.

      Sherlock, Mark; Stewart, Paul M; aCentre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK bDepartment of Endocrinology and Diabetes, Adelaide and Meath Hospitals, Incorporating the National Children's Hospital, Dublin, Ireland and Trinity College, Dublin. (2013-08)
      To review the literature with regard to mortality in patients with hypopituitarism with a focus on the role of growth hormone (GH) deficiency and therapy.
    • The use of computerised tomography guided percutaneous fine needle aspiration in the evaluation of solitary pulmonary nodules.

      Khan, K A; Zaidi, S; Swan, N; Browne, R; Torreggiani, W; Lane, S; Moloney, E; Department of Respiratory Medicine, AMNCH, Tallaght, Dublin 24. drkhan95@hotmail.com (2012-02)
      The evaluation of a solitary pulmonary nodule (SPN) has changed over the years with increased access to percutaneous computerised tomography (CT) guided fine needle aspiration (FNA), where bronchoscopy is unhelpful. The aim of our study was to evaluate the sample adequacy, diagnostic and complication rate of CT-FNA of a SPN at our academic teaching hospital over an 18 month period. CT-FNA was performed by a radiologist, with a cytopathologist in attendance to confirm the adequacy of the sample obtained. The size of the nodule, sample material and adequacy, diagnosis and complications were recorded. A total of 101 patients were included, 54 male and the mean age was 68 +/- 11 years. The mean size of the SPN was 2.3 cm (range 1-11 cm). 56 (56%) patients had a right SPN, 45 (45%) had a left SPN. CT-FNA was diagnostic in 80 (80%) patients and non-diagnostic in 21 (20%) patients. The sample was insufficient for immunocytochemistry, although the morphological appearance was diagnostic in 20 (25%) of the 80 patients. Pneumothorax occurred in 26/101 (26%) patients post CT-FNA, of these 7 (27%) required chest drain insertion, while 19 (73%) were managed conservatively. CT FNA is a useful tool for the diagnosis of a SPN, with our diagnostic accuracy comparable to that reported in the literature. However, CT-FNA may not provide adequate sample volume to perform ancillary testing and has a moderate complication rate.