• Validation of continuous glucose monitoring in children and adolescents with cystic fibrosis: a prospective cohort study.

      O'Riordan, Stephen M P; Hindmarsh, Peter; Hill, Nathan R; Matthews, David R; George, Sherly; Greally, Peter; Canny, Gerard; Slattery, Dubhfeasa; Murphy, Nuala; Roche, Edna; et al. (Diabetes care, 2009-06)
      To validate continuous glucose monitoring (CGM) in children and adolescents with cystic fibrosis.
    • Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard.

      Bruyn, G A W; Pineda, C; Hernandez-Diaz, C; Ventura-Rios, L; Moya, C; Garrido, J; Groen, H; Pena, A; Espinosa, R; Möller, I; et al. (Arthritis care & research, 2010-08)
      To assess the intra- and interobserver reproducibility of musculoskeletal ultrasonography (US) in detecting inflammatory shoulder changes in patients with rheumatoid arthritis, and to determine the agreement between US and the Shoulder Pain and Disability Index (SPADI) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, using magnetic resonance imaging (MRI) as a gold standard.
    • Value and limitations of existing scores for the assessment of cardiovascular risk: a review for clinicians.

      Cooney, Marie Therese; Dudina, Alexandra L; Graham, Ian M; Cardiology Department, Adelaide Meath Hospital, Tallaght, Dublin, Ireland. (Journal of the American College of Cardiology, 2009-09-29)
      Atherosclerotic cardiovascular diseases (CVDs) are the biggest causes of death worldwide. In most people, CVD is the product of a number of causal risk factors. Several seemingly modest risk factors may, in combination, result in a much higher risk than an impressively raised single factor. For this reason, risk estimation systems have been developed to assist clinicians to assess the effects of risk factor combinations in planning management strategies. In this article, the performances of the major risk estimation systems are reviewed. Most perform usably well in populations that are similar to the one used to derive the system, and in other populations if calibrated to allow for different CVD mortality rates and different risk factor distributions. The effect of adding "new" risk factors to age, sex, smoking, lipid status, and blood pressure is usually small, but may help to appropriately reclassify some of those patients who are close to a treatment threshold to a more correct "treat/do not treat" category. Risk estimation in the young and old needs more research. Quantification of the hoped-for benefits of the multiple risk estimation approach in terms of improved outcomes is still needed. But, it is likely that the widespread use of such an approach will help to address the issues of both undertreatment and overtreatment.
    • The value of the combined assessment of COPD in accurate characterization of stable COPD

      Sahadevan, A; Cusack, R; O’Kelly, B; Amoran, O; Lane, SJ (Irish Medical Journal, 2016-01)
      There is evidence showing a tendency to upgrade COPD severity previously staged with spirometric-based GOLD (GOLD 1234) when using the new GOLD combined disease assessment (GOLD ABCD). 1,2 The aim of our study was to compare the GOLD 1234 classification in a population of stable COPD patients with the GOLD ABCD classification to determine whether stable COPD was upgraded when using this new classification. After an observational study of a stable COPD cohort (n=112), 61 patients (54.5%) had an increase in their COPD severity when moving from the old GOLD 1234 classification to the current GOLD ABCD assessment (p<0.01). 42 patients (37.5%) had no change in severity of COPD. 9 patients COPD were assessed to be better on using GOLD ABCD. This study highlights previously missed high-risk patients when reviewing stable COPD. Continued incorporation of GOLD ABCD will translate into better evidence-based management.
    • Variants in linkage disequilibrium with the late cornified envelope gene cluster deletion are associated with susceptibility to psoriatic arthritis.

      Bowes, John; Flynn, Edward; Ho, Pauline; Aly, Batool; Morgan, Ann W; Marzo-Ortega, Helena; Coates, Laura; McManus, Ross; Ryan, Anthony W; Kane, David; et al. (Annals of the rheumatic diseases, 2010-12)
      A common deletion mapping to the psoriasis susceptibility locus 4 on chromosome 1q21, encompassing two genes of the late cornified envelope (LCE) gene cluster, has been associated with an increased risk of psoriasis vulgaris (PsV). One previous report found no association of the deletion with psoriatic arthritis (PsA), suggesting it may be a specific risk factor for PsV. Given the genetic overlap between PsA and PsV, a study was undertaken to investigate whether single nucleotide polymorphisms (SNPs) mapping to this locus are risk factors for PsA in a UK and Irish population.
    • Variation in the vitamin D receptor gene is not associated with risk of colorectal cancer in the Czech Republic.

      Hughes, David J; Hlavata, Ivona; Soucek, Pavel; Pardini, Barbara; Naccarati, Alessio; Vodickova, Ludmila; Jenab, Mazda; Vodicka, Pavel; Department of Clinical Medicine, Trinity College Centre for Health Sciences,, Adelaide and Meath Hospital, Dublin 24, Ireland. hughesd4@tcd.ie (2012-02-01)
      PURPOSE: Increased levels of vitamin D may protect against colorectal cancer (CRC) development and recurrence. Accumulating epidemiologic evidence suggests these effects may be partly mediated by genetic variants of the vitamin D receptor (VDR) proposed to be associated with altered risk of CRC. We wished to determine if common VDR polymorphisms affected CRC risk in the Czech Republic, a homogenous European population with a high CRC incidence rate. METHODS: Frequencies of the common VDR gene polymorphisms rs2238136, rs1544410 (BsmI), rs7975232 (ApaI), and rs731236 (TaqI) were determined using allele-specific PCR in a case control analysis of a series of 754 CRC patients and 627 patients without malignant disease recruited from centers throughout the Czech Republic. Unconditional logistic regression was used to calculate odds ratios and 95% confidence intervals for the association between these variants and risk of CRC. RESULTS: None of the four polymorphisms tested had any significant effect on CRC risk. No significant differences were observed in susceptibility when the population was stratified by anatomical sub-site, sex, BMI, smoking, alcohol, or presence of polyps. CONCLUSIONS: We conclude that common variation in the VDR gene had little effect on its own on predisposition to sporadic CRC in the Czech population.
    • Vascular endothelial growth factor and not cyclooxygenase 2 promotes endothelial cell viability in the pancreatic tumor microenvironment.

      Toomey, Desmond P; Manahan, Ellen; McKeown, Ciara; Rogers, Annamarie; McMillan, Helen; Geary, Michael; Conlon, Kevin C; Murphy, Joseph F; Professorial Surgical Unit, University of Dublin, Trinity College, Dublin, Ireland. (Pancreas, 2010-07)
      Cyclooxygenase 2 (COX-2) and vascular endothelial growth factor (VEGF), often coexpressed in cancer, are associated with poor prognosis. However, results from pancreatic cancer trials of their inhibitors were disappointing. This study delineated the role of COX-2 and nonsteroidal anti-inflammatory drugs in angiogenesis and VEGF regulation.
    • Vascular Specialist Outreach Community Clinic (VSOCC) is an efficient way of providing specialist opinion

      Devaney, A; Shaikh, F M; Egan, B; Tierney, S; Neil, C; Feeley, M (Irish Journal of Medical Science, 2012)
    • Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii(®) Fit Plus.

      Meldrum, Dara; Glennon, Aine; Herdman, Susan; Murray, Deirdre; McConn-Walsh, Rory; Royal College of Surgeons in Ireland, School of Physiotherapy, Dublin, Ireland. dmeldrum@rcsi.ie (Disability and rehabilitation. Assistive technology, 2012-05)
      The aim of this study was to investigate the usability of the Nintendo Wii Fit Plus(®) (NWFP) in the treatment of balance impairment in vestibular and other neurological disease.
    • Vitamin D deficiency in Crohn's disease: prevalence, risk factors and supplement use in an outpatient setting.

      Suibhne, Treasa Nic; Cox, Gerry; Healy, Martin; O'Morain, Colm; O'Sullivan, Maria; Department of Clinical Medicine, Trinity College Dublin, Adelaide & Meath Hospital, Dublin, Ireland. (2012-03)
      Vitamin D deficiency impacts on bone health and has potential new roles in inflammation. We aimed to determine the prevalence of and risk factors for vitamin D deficiency and to explore vitamin D supplement usage in patients with Crohn's disease (CD) in an outpatient setting, compared with controls.
    • Vitamin D: new roles and therapeutic potential in inflammatory bowel disease.

      Raftery, Tara; O'Morain, Colm A; O'Sullivan, Maria; Department of Clinical Medicine, Trinity College Dublin Centre for Health Sciences, Adelaide & Meath Hospital, Dublin 24, Ireland. (2012-11)
      Inflammatory bowel disease (IBD) encompasses 2 independent but related entities: ulcerative colitis (UC) and Crohn's disease. Crohn's disease is characterised by transmural patchy inflammation which can involve any portion of the gastrointestinal tract. UC is characterised by superficial inflammation that begins in the rectum and extends proximally along the colon. In Europe, approximately 2.2 million people have a diagnosis of IBD. The aetiology of IBD is unknown, however, immune, environmental and genetic factors are thought to be involved. Individuals with IBD are at risk of developing osteoporosis. In line with this, there are clear guidelines that recommend vitamin D supplementation for IBD patients to prevent bone disease, especially when undergoing steroid treatment. Despite an established role for vitamin D in IBD, deficiency is common. More novel effects of vitamin D beyond bone are emerging. It is now well established that vitamin D is an important regulator of the immune system which may have implications for the development, severity and management of immune related disorders such as IBD. The efficacy of vitamin D as an immune modulator in IBD remains to be proven. This review aims to evaluate the evidence implicating vitamin D deficiency in IBD pathogenesis, to examine vitamin D's anti-inflammatory mechanisms and to explore its therapeutic potential, optimal serum levels and dietary intakes which may support immune function in this disease.
    • Voriconazole in the treatment of allergic bronchopulmonary aspergillosis in cystic fibrosis.

      Glackin, L; Leen, G; Elnazir, B; Greally, P; Department of Respiratory Medicine, National Children's Hospital, Tallaght, Dublin 24. Peter.Greally@amnch.ie (2009-01)
      Allergic bronchopulmonary aspergillosis (ABPA) can cause a significant clinical deterioration in patients with cystic fibrosis. There is very little research in the current literature with regard to alternatives for treatment, apart from long courses of steroids. We conducted a retrospective review of all our patients with ABPA treated with the antifungal voriconazole and found there was a significant drop in IgE levels post treatment as well as a decrease in steroid dosing. The improvement in FEV was not statistically significant; however there was a very wide variation in pre-treatment levels.
    • The way forward for the refractory asthmatic

      Kooblall, M; Moloney, E; Lane, SJ (Irish Medical Journal, 2015-07)
      Ireland has the fourth highest prevalence of asthma in the world. 7.1% of 18+ population and 18.9% of 13-15 year olds have asthma. 38.5% of 13-15 year olds reported wheezing. More than 1 person a week dies from asthma and 29% of asthma patients miss school or work. 1 Despite very safe and effective treatment 5-10% of patients with bronchial asthma do not respond well to their treatment. This group of patients are labelled as refractory asthmatics. Besides compliance, presence of psychogenic and trigger factors and comorbid illness, steroid insensitiveness or resistance may play a significant role in the poorly controlled/responding asthmatics. Type I Steroid resistance is due to lack of binding affinity of steroids to glucocorticoid receptors and may respond to higher doses of steroids while type II steroid resistance is because of reduced number of cells with glucocorticoid receptors, which is very rare and do not respond to even higher doses of systemic steroids and these cases require alternative/novel therapies. 2
    • What is my risk of developing cardiovascular disease?

      Graham, Ian M; Cooney, Marie-Therese; Dudina, Alexandra; Squarta, Sophie; Trinity College and Department of Cardiology, The Adelaide and Meath Hospital, Incorporating National Childrens' Hospital Tallaght, Dublin, Ireland., ian.graham@amnch.ie (2012-02-01)
    • What is the place of new risk markers in the prediction of cardiovascular disease

      DeBacker, G; Cooney, MT; Graham, IM (European Journal Cardiovascular Prevention Rehabilitation, 2011)
    • Where does Pelvic and Acetabular Fracture Treatment fit into the Newly Proposed Major Trauma Model in Ireland?

      Fenelon, C; Murphy, E.P; O’Daly, B.J; Leonard, M (Irish Medical Journal, 2019-04)
      Major trauma continues to be the biggest cause of death in people aged between 5 and 45 years of age. Suboptimal trauma management results in greater ongoing costs to patients, hospitals and society. Trauma networks in the United States, Australia and more recently the United Kingdom have proven successful in significantly reducing morbidity and mortality. In the UK, analysis by the Trauma Audit Research Network (TARN) has shown that a major trauma patient has a 19% increase in the odds of survival following major trauma since its introduction in 2012. No integrated trauma network yet exists in Ireland but a recent report “A Trauma System for Ireland” published in January of 2018 outlined plans of how such a trauma network would be introduced. The report called for the introduction of two regional trauma networks, a central and south network, with one major trauma centre for each. However, the report made no mention of where the treatment of pelvic and acetabular fractures fell within it.
    • Whole-Body MRI versus PET in assessment of multiple myeloma disease activity.

      Shortt, Conor P; Gleeson, Tadhg G; Breen, Karen A; McHugh, John; O'Connell, Martin J; O'Gorman, Peter J; Eustace, Stephen J; Department of Radiology and Diagnostic Imaging, Mater Misericordiae University Hospital, Dublin, Ireland. (AJR. American journal of roentgenology, 2009-04)
      The purpose of this study was to compare FDG PET; whole-body MRI; and the reference standard, bone marrow aspiration and biopsy, to determine the best imaging technique for assessment of disease activity in multiple myeloma.