• Acute compartment syndrome and the role of regional anesthesia.

      Mannion, Stephen; Capdevila, Xavier; Department of Anaesthesiology, South Infirmary-Victoria University Hospital,, Cork, Ireland. Mannionstephen@gmail.com (2012-02-01)
    • Acute suppurative neonatal parotitis: Case report.

      Khan, Sardar U; O'Sullivan, Peter G; McKiernan, John; Department of Otorhinolaryngology-Head and Neck Surgery, South Infirmary-Victoria, University Hospital, Cork, Ireland. sardarent@hotmail.com (2012-02-01)
      Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.
    • Antegrade deligation of iatrogenic distal ureteric obstruction utilising a high pressure balloon dilatation technique.

      Rajendran, Simon; Hodgnett, Philip; O'Hanlon, Deirdre; Curtain, Andrew; Murphy, Micheal; Department of Surgery, South Infirmary Victoria University Hospital, Cork,, Ireland. simonrajendran@gmail.com (2012-02-01)
      BACKGROUND: Iatrogenic trauma is the leading cause of ureteric injury with an incidence in abdominal and pelvic surgery varying between 0.4 and 2.5%. CASE: We report a case of ureteric obstruction caused by a haemostatic clip. There was associated rupture of the ureter proximal to the clip with intra-peritoneal leakage of urine. The patient was unfit for surgery and was managed by a novel procedure of endoluminal balloon deligation. CONCLUSION: Ureteric injuries are rare but potentially serious complications. They require prompt diagnosis and management depends on the patients' clinical condition, extent of injury and interval from injury to diagnosis. We have successfully demonstrated a new technique to treat ureteric obstruction caused by a haemostatic clip with associated ureteral rupture in a patient unfit for surgery.
    • Awareness of diabetes complications in an Irish population.

      O'Sullivan, E P; Bhargava, A; O'Callaghan, M; Buckley, U; De Faoite, T; Moynihan, K; Thabit, H; Walsh, C H; Sreenan, S; Department of Diabetes and Endocrinology, South Infirmary Victoria University, Hospital, Cork, Ireland. eoinposullivan@yahoo.i.e (2012-02-01)
      BACKGROUND: Patients' awareness of the increased cardiovascular risk associated with their diabetes is poorly documented. AIM: The aim of this study was to assess the awareness of diabetes complications among patients with diabetes in Ireland. METHODS: Patients attending diabetes outpatient clinics in two teaching hospitals in different regions of the country were invited to complete a questionnaire. RESULTS: A total of 258 (59.3% male) patients completed the questionnaire; mean age 57.8 years. On questioning, 53.5% reported cardiovascular disease as a potential complication of diabetes, with awareness rates of 61.2, 17.1, 16.3 and 12% for retinopathy, stroke, peripheral vascular disease and amputation, respectively. Disappointingly, less than half of respondents felt that improvements in diet and exercise could potentially reduce their cardiovascular risk. CONCLUSIONS: Awareness of cardiovascular risk and knowledge of effective measures to reduce this were low in our study and an alternative means of education may need to be considered.
    • Bare necessities? The utility of full skin examination in the COVID-19 era.

      O'Connor, C; Gallagher, C; O'Connell, M; Bourke, J; Murphy, M; Bennett, M (2021-03-18)
      Full skin examination (FSE) may improve the detection of malignant melanoma (MM). The objective of this study was to assess the safety of targeted lesion examination (TLE) compared with FSE in our Pigmented Lesion Clinic (PLC). Patients attending the PLC were randomized in a 2 : 1 ratio to FSE (intervention) or TLE (standard care). Demographic details and risk factors were documented, and the time taken to perform FSE and TLE was noted. Of 763 participants, 520 were assigned to FSE and 243 were assigned to TLE. On average, FSE took 4.02 min and TLE took 30 s to perform. Of the 520 participants assigned to FSE, 37 (7.1%) had incidental findings, of whom 12 patients (2.3%) had additional lesions biopsied. No additional melanomas were detected that would have been missed by use of the standard protocol. This study suggests that in low-risk patients referred to a PLC with a lesion of concern, the possibility of missing incidental cutaneous malignancies using lesion-directed examination is low.
    • The benefits of hypopharyngeal packing in nasal surgery: a pilot study.

      Fennessy, B G; Mannion, S; Kinsella, J B; O'Sullivan, P; Department of ENT, South Infirmary and Victoria Hospital, Old Blackrock Road,, Cork, Ireland. bfennessy@rcsi.ie (2012-02-01)
      BACKGROUND: Hypopharyngeal packs are used in nasal surgery to reduce the risk of aspiration and postoperative nausea and vomiting. Side effects associated with their use range from throat pain to retained packs postoperatively. AIM: To evaluate, as a pilot study, postoperative nausea/vomiting and throat pain scores for patients undergoing nasal surgery in whom a wet or dry hypopharyngeal pack was placed compared with patients who received no packing. METHODS: A randomized, double-blind prospective trial in a general ENT unit. RESULTS: The study failed to show a statistically significant difference between the three groups in terms of their postoperative nausea/vomiting and throat pain scores at 2 and 6 h postoperatively. This is the first study in which dry packs have been compared with wet and absent packs. CONCLUSION: Based on our findings, the authors recommend against placing hypopharyngeal packs for the purpose of preventing postoperative nausea and vomiting.
    • Cervical surgical emphysema following routine tonsillectomy.

      Al Omari, B; Sadacharam, M; Sheahan, P; South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork, Ireland. basilomari@yahoo.com (2011)
      Complications of tonsillectomy have been well documented. However spontaneous subcutaneous emphysema of the neck following tonsillectomy has rarely been described. We report a case of this complication in a young female patient.
    • Changing paradigms for oropharynx cancer: swinging of pendulum back towards surgery

      Sheahan, P (Irish Medical Journal, 2015-07)
      The oropharynx, extending from the soft palate to the level of the epiglottis, and containing the palatine tonsils and base of tongue (BOT), is a common site for Head and Neck cancer. Squamous cell carcinoma (SCC) comprises the overwhelming majority of cases. Traditional aetiological factors for oropharynx SCC (OPSCC) are smoking and alcohol consumption. In recent years, human papilloma virus (HPV) type 16 has emerged as the major cause of an ever increasing number of cases 1 . Over the last two decades, there has been a dramatic surge in the incidence of OPSCC. Figures obtained by the Irish National Cancer Registry show an increase from 50 cases per year in 1994 to over 100 cases per year in 2012. This recent rise in OPSCC incidence is almost exclusively related to an increase in HPV related cancers. In the United States, between 1988 and 2004, HPV related OPSCC showed a 225% increase, while HPV-negative OP SCC showed a 50% decline, attributed to decreased prevalence of smoking 1 .
    • Comparison of incidence of postoperative seroma between flapless and conventional techniques for thyroidectomy: a case-control study.

      Sheahan, P; O'Connor, A; Murphy, M S; Department of Otolaryngology-Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. sheahan.patrick@sivuh.ie (2012-04)
      The incidence of seroma after thyroidectomy has been reported between 1.3% and 7%. We hypothesised that a flapless thyroidectomy technique would reduce the incidence of seroma.
    • Critical Airway Compromise due to a Massive Vagal Schwannoma

      McDermott, AM; Sadadcharam, M; Manning, BJ; Sheahan, P (Irish Medical Journal, 2016-05)
      We describe the case of a 37-year-old man with a slowly enlarging neck lump and compressive symptoms. He presented to a separate institution 10 years prior where an observational approach was advocated. Following preoperative investigations and embolization, an 11cm vagal schwannoma was excised and vagus nerve was sacrificed. Although conservative management is appropriate for a select patient population, surgical excision is treatment of choice for cervical neurogenic tumours and paraganglionomas and must be considered in young patients or rapidly expanding tumours to avoid compressive symptoms, as in this case.
    • Distance as a Barrier to Melanoma Care

      McCarthy, S; Feeley, K; Murphy, M; Bourke, J F (2019-08-01)
      Our aim was to review cases of melanoma diagnosed histologically in UHK in 2016 and to compare them to cases of melanoma nationally and in Kerry. Methods For each patient we recorded age, Breslow depth, and shortest distance to travel by car and travelling time (without traffic) to the South Infirmary Victoria University Hospital (SIVUH) from their primary residence (calculated using Google maps™ (2018)). Results 20 cases of invasive melanoma were diagnosed in UHK in 2016. Of the 20 cases, 9 (45%) presented at a very advanced stage with a Breslow depth of greater than 4mm. A further 7 (35%) cases had a depth of 1.5-4mm. These patients with invasive melanoma had a mean age of 72.5 (±15). The mean shortest distance to travel from the patient’s primary residence to the SIVUH was 114.8km (±15.5) taking an average of 102 minutes (±14.6) by car. Conclusion Cases of melanoma diagnosed locally in UHK presented at an advanced stage compared to the national average. We suspect that the long distances to travel to the SIVUH pigmented lesion clinic is a barrier for these patients.
    • Double stenting in advanced colorectal cancer.

      Khan, Ata; Baban, C K; Rajendran, S; Murphy, M; O'Hanlon, D M; Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. (2011)
    • Eccrine porocarcinoma arising within an area of Bowen disease.

      Lowney, A C; Mc Aleer, M A; O'Connor, K; Fitzgibbon, J F; Bourke, J F; Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland. aoifelowney@gmail.com (2012-03)
      Summary Very little is known about the aetiology of eccrine porocarcinoma (EP), a rare malignant sweat-gland tumour. Most reported cases have arisen de novo, or from a benign eccrine poroma. We report an unusual case, in which eccrine porocarcinoma arose at the exact site of pre-existing Bowen disease (BD).
    • Establishing a temporal bone laboratory: considerations for ENT specialist training.

      Fennessy, B G; O'Sullivan, P; Department of ENT, South Infirmary and Victoria Hospital, Cork, Ireland., bfennessy@rcsi.ie (2012-02-01)
      Cadaveric temporal bone dissection in a temporal bone laboratory is a vital component in training safe, competent otorhinolaryngologists. Recent controversies pertaining to organ retention have resulted in a more limited supply of temporal bones. Consequently, current trainees are dissecting far fewer bones than their consultants. We discuss the establishment of a temporal bone laboratory in the Department of Anatomy in the University College Cork, from the timely preparation and preservation of the tissue to its disposal. Comparisons are drawn between our experience and that of the United States training schemes. The temporal bone laboratory in Cork is the only one in existence in Ireland. The exposure and experience obtained by registrars rotating through Cork, has resulted in noticeable improvements in their operative abilities. The temporal bone laboratory remains a core component to training. It is hoped that this article may facilitate other units overcoming obstacles to establish a temporal bone laboratory.
    • Guidelines for the management of contact dermatitis: an update.

      Bourke, J; Coulson, I; English, J; Department of Dermatology, South Infirmary, Victoria Hospital, Cork, Ireland. (2009-05)
      These guidelines for management of contact dermatitis have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for investigation and treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, including details of relevant epidemiological aspects, diagnosis and investigation.
    • Guidelines for the management of contact dermatitis: an update.

      Bourke, J; Coulson, I; English, J; Department of Dermatology, South Infirmary, Victoria Hospital, Cork, Ireland. (2012-02-01)
      These guidelines for management of contact dermatitis have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for investigation and treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, including details of relevant epidemiological aspects, diagnosis and investigation.
    • Herpes zoster infection, vaccination and immunocompromised rheumatology patients.

      O'Connor, Mortimer B; Phelan, Mark J; Department of Rheumatology, South Infirmary Victoria University Hospital, Cork, Ireland. mortimeroconnor@gmail.com (2013-01)
      Varicella is a self-limiting and relatively mild disease of childhood, although it is frequently more severe and complicated among the immunocompromised rheumatology patients on immunomodulator therapies. In addition, future reactivation of the dormant virus in dorsal root ganglia may cause herpes zoster infection, which can be very debilitating. In this manuscript, we discuss the nature of this infection along with its potential vaccine especially among rheumatology patients.
    • A history of haemovigilance South Infirmary Victoria University Hospital 2000 - Present

      Roche, Catherine (South Infirmary Victoria University Hospital, 2012)
      The Haemovigilance speciality defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing. The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to patients. Indirect care relates to activities that influence others in their provision of direct care. The Haemovigilance Officer as a clinical professional in the Irish healthcare environment is required to maintain professional competency and this is achieved through continuous ongoing education and training, attending in-service study days, conferences locally and nationally. While attending various conferences numerous posters have been presented which have showcased the hospital’s work. Evidence of continuous professional development is contained in Appendix 1. Mission Statement: In collaboration with nursing staff, medical staff and the Irish Blood Transfusion Service, the Haemovigilance Officer strives to deliver an effective, efficient, cost effective and quality transfusion service for the patients of the SIVUH through ongoing education, surveillance and clinical audit. (Reviewed August 2011). Haemovigilance is internationally recognised as essential to the development of safe clinical transfusion practice. As the time of writing this report, the hospital in the context of the Reconfiguration of Health services for the Cork and Kerry region, is in a transitional phase as the hospital moves from an acute general hospital to an elective and largely surgical hospital. Such changes in the nature and type of clinical service provision will naturally impact on the requirement for blood and blood products.
    • The impact of HSV for inflammatory arthropathy patients.

      O'Connor, Mortimer B; Phelan, Mark J; Department of Rheumatology, South Infirmary Victoria University Hospital, Cork, Ireland. mortimeroconnor@gmail.com (2012-02)
      Herpes simplex virus type 1 (HSV-1), also known as herpes labialis, is the etiologic agent of vesicular lesions of the oral mucosa commonly referred to as "cold sores". HSV-1 can also cause clinical disease in a wide variety of other anatomic locations including the genitalia, liver, lung, eye, and central nervous system. These infections can be severe, particularly in the setting of immunosuppression, such as inflammatory arthropathy patients on Methotrexate ± biological therapies. Here, we highlight the importance of physician awareness of HSV due to its potential impact for rheumatology patients.
    • The impact of total laryngectomy: the patient's perspective.

      Noonan, Brendan J; Hegarty, Josephine; School of Nursing and Midwifery, University College Cork, South, Infirmary-Victoria University Hospital, Cork, Ireland. b.noonan@ucc.ie (2012-02-01)
      PURPOSE/OBJECTIVES: To describe the experiences of patients who had total laryngectomy from their perspective. RESEARCH APPROACH: Descriptive, qualitative study.Setting: Participants' homes or investigator's hospital office. PARTICIPANTS: 10 patients after total laryngectomy. METHODOLOGIC APPROACH: Data were collected by semistructured, open-ended interviews during a period of six months, with an interview topic guide built on the framework of the literature review. Data were analyzed with descriptive content analysis. Trustworthiness of the study was enhanced through the use of verbatim quotations, audible data analysis trail, and a reflexive approach. MAIN RESEARCH VARIABLES: Patients' experiences of undergoing total laryngectomy. FINDINGS: Patients who have undergone a total laryngectomy report difficulties and concerns that are largely functional and psychological. The functional difficulties reported included descriptions of altered swallow, excess phlegm, speech difficulties, weak neck muscles, and altered energy levels. The psychological concerns reported included descriptions of depression, regrets, and personal resolve. CONCLUSIONS: As a group, patients experience a broad range of problems well after completion of treatment, reinforcing the need for rehabilitation management for prolonged periods after surgery. INTERPRETATION: Nurses are suitably positioned to support this group of patients across the disease management trajectory, from the initial preoperative period to the postoperative period and through to the rehabilitative period and beyond.