• 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.
    • Improved malignant melanoma prognosis at a consultant-delivered multidisciplinary pigmented lesion clinic in Cork.

      Field, S; Deady, S; Fitzgibbon, J; Murphy, M; Comber, H; Dermatology Department, South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork. sineadfield@hotmail.com (2010-02)
      Early detection and excision is the only effective treatment for malignant melanoma. To assess the effect of a consultant-delivered, rapid-access pigmented lesion clinic (PLC) established at the South Infirmary-Victoria University Hospital (SIVUH), we analyzed melanoma tumour-stage prior to (1998-2002) and after (2003-2007) the advent of the PLC. Patients attending SIVUH had a greater proportion of early-stage tumours (65.3%) compared to the rest of Cork (51.2%), County Cork as a whole (56.7%) and all of Ireland (57.4%). The proportion of SIVUH males with early-stage tumours was statistically significantly higher than the rest of County Cork (chi2 = 11.23, P < 0.05). The proportion of patients > 50y with early-stage tumours was also statistically significantly higher than the rest of County Cork (chi2 = 18.88, P < 0.05), the whole of County Cork (chi2 = 7.84, P < 0.05) and all of Ireland (chi2 = 9.67, P < 0.05). We believe that the early detection and improved prognosis of Cork melanoma patients is at least partly due to the PLC.
    • Improved malignant melanoma prognosis at a consultant-delivered multidisciplinary pigmented lesion clinic in Cork.

      Field, S; Deady, S; Fitzgibbon, J; Murphy, M; Comber, H; Dermatology Department, South Infirmary-Victoria University Hospital, Old, Blackrock Road, Cork. sineadfield@hotmail.com (2012-02-01)
      Early detection and excision is the only effective treatment for malignant melanoma. To assess the effect of a consultant-delivered, rapid-access pigmented lesion clinic (PLC) established at the South Infirmary-Victoria University Hospital (SIVUH), we analyzed melanoma tumour-stage prior to (1998-2002) and after (2003-2007) the advent of the PLC. Patients attending SIVUH had a greater proportion of early-stage tumours (65.3%) compared to the rest of Cork (51.2%), County Cork as a whole (56.7%) and all of Ireland (57.4%). The proportion of SIVUH males with early-stage tumours was statistically significantly higher than the rest of County Cork (chi2 = 11.23, P < 0.05). The proportion of patients > 50y with early-stage tumours was also statistically significantly higher than the rest of County Cork (chi2 = 18.88, P < 0.05), the whole of County Cork (chi2 = 7.84, P < 0.05) and all of Ireland (chi2 = 9.67, P < 0.05). We believe that the early detection and improved prognosis of Cork melanoma patients is at least partly due to the PLC.
    • Increased occurrence of cardiovascular events and comorbidities in a general rheumatology cohort.

      Mohammad, A; Hartery, K; Bond, U; Phelan, M; Department of Rheumatology, South Infirmary Victoria University Hospital, Cork,, Ireland. ausafmohammad@gmail.com (2012-02-01)
      BACKGROUND: To identify cardiovascular and other comorbidities in a general rheumatology cohort. METHODS: Interviews/retrospective chart audits were conducted on 1,000 patients attending rheumatology outpatient clinics of a university teaching hospital. Comorbidities were classified using the Charlson comorbidity index (Ambrose et al. in Ir J Med Sci 178(1):53-55, 2009). RESULTS: Mean age 58 +/- 15.3 years, mean BMI 26. Of the patients, 400 (40%) were diagnosed with dyslipidemia and hypertension (p = 0.002), 160 (16%) with obesity and 80 (8%) with hypothyroidism. Overall 160 (16%) patients were diagnosed with coronary heart disease (CHD). Of these, 120 (75%) had RA (p = 0.001), 100 (63%) were male, mean age 60 +/- 15.8 years, 120 (75%) had dyslipidemia and BMI > 30 (p = 0.002), 112 (70%) were smokers (p = 0.002), 40 (25%) were diagnosed with diabetes mellitus and 20 (12%) with hypothyroidism. CONCLUSIONS: The increased prevalence of these comorbidities may serve as a reminder to the rheumatologists that many of their patients will have coexistent disease of which they need to be aware to properly plan their management.
    • Initial results from the newborn hearing screening programme in Ireland.

      O'Connor, A; O'Sullivan, P G; Behan, L; Norman, G; Murphy, B; Department of Otolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland, aoconnor@rcsi.ie. (2013-03-02)
      INTRODUCTION: Hearing screening programmes aim to detect hearing loss in the neonate. The Health Service Executive (HSE) South was the first phase of a national roll-out of a neonatal hearing screening programme in Ireland, going live on 28 April 2011. RESULTS: Over 11,738 babies have been screened for permanent childhood hearing impairment (PCHI) during the first 12 months. The percentage of eligible babies offered hearing screening was 99.2 %. Only 0.2 % (n = 25) of those offered screening declined. 493 (4 %) were referred for immediate diagnostic audiological assessment. The average time between screen and diagnostic audiology appointment was 2 weeks. 15 (1.3/1,000) babies have been identified with a PCHI over the 12-month period. 946 (4 %) babies screened were admitted to the neonatal intensive care unit (NICU) for >48 h. The prevalance of PCHI is 7.3/1,000 in the NICU population compared to 0.6/1000 in the well baby population. 214 (1.8 % of total babies screened) had a clear response in the screening programmes, but were deemed to be at risk of an acquired childhood hearing impairment. These babies will be reassessed with a diagnostic audiology appointment at 8-9 months of age. To date, there is one case of acquired hearing impairment through this targeted follow-up screen. Of the 15 cases of PCHI identified, 8 (53 %) of these had one or more risk factors for hearing loss and 7 (37 %) were admitted to the NICU for >48 h. Four babies were referred for assessment at the National Cochlear Implant Centre.
    • Intravenous cidofovir for resistant cutaneous warts in a patient with psoriasis treated with monoclonal antibodies.

      McAleer, M A; Bourke, J; Department of Dermatology, South Infirmary-Victoria University Hospital, Cork,, Co. Cork, Ireland. (2012-02-01)
      Human papilloma virus is a common and often distressing cutaneous disease. It can be therapeutically challenging, especially in immunocompromised patients. We report a case of recalcitrant cutaneous warts that resolved with intravenous cidofovir treatment. The patient was immunocompromised secondary to monoclonal antibody therapy for psoriasis.
    • Intussusception: a cause of right iliac fossa mass in a young adult.

      Khan, Ata; Rajendran, Simon; Baban, Chwanrow; Murphy, Micheal; O'Hanlon, Deirdre; South Infirmary Victoria University Hospital, Surgery, Cork, Ireland. (2010)
    • Irish patients knowledge and perception of Anaesthesia

      Smith, A; Mannion, S (Irish Medical Journal, 2013-02)
    • Koebner phenomenon of the ear canal skin.

      Young, O; Murphy, M; Fitzgibbon, J; O'Sullivan, P; Department of Otolaryngology, South Infirmary/Victoria Hospital, Old Blackrock, Road, Cork, Ireland. oyoung@rcsi.ie (2012-02-01)
      The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.
    • Local IgE production in nonatopic nasal polyposis.

      Sheahan, Patrick; Ahn, Chadwick N; Harvey, Richard J; Wise, Sarah K; Mulligan, Ryan M; Lathers, Deanne M R; Schlosser, Rodney J; Department of Otolaryngology-Head and Neck Surgery, South Infirmary Victoria, University Hospital, Cork, Ireland. (2012-02-01)
      INTRODUCTION: Chronic rhinosinusitis with nasal polyposis (CRSwNP) represents an eosinophilic T-helper 2 inflammatory response. Local production of IgE within nasal polyps (NPs) has been demonstrated, suggesting a role for local IgE in the pathogenesis of NP in atopic CRS patients. We hypothesized that local IgE specific to inhalant allergens may also play a role in the genesis of NP in nonatopic CRS patients. METHODS: Sinus and inferior turbinate tissue was obtained from nonatopic CRSwNP patients (n = 7), chronic rhinosinusitis without nasal polyps (CRSsNP) patients (n = 15), and healthy controls (n = 9) at the time of surgery. ImmunoCAP analysis (Phadia AB, Portage, MI) for 14 common inhalant antigens was performed on tissue homogenates to determine the antigen-specific response. RESULTS: Total IgE levels did not differ in sinus or turbinate tissue between CRSwNP, CRSsNP, or control patients. CRSwNP sinus tissue had higher levels of specific IgE for cockroach and plantain (p = .03) than other groups and elevated Alternaria IgE levels when compared with CRSsNP sinus tissue (p < .05). No significant differences were found for any of the other antigen-specific IgE levels. Fifty-seven percent of CRSwNP polyps demonstrated a polyclonal IgE response, whereas the other 43% had no demonstrable antigen-specific IgE. In contrast, only 17% of CRSsNP patients demonstrated a polyclonal response within sinus tissue, whereas 67% had no detectable antigen-specific IgE. There was no significant difference in levels of IgE in inferior turbinate tissue between the groups (p > .05). CONCLUSIONS: Localized mucosal IgE specific to common inhalant allergens appears to play a role in a subset of CRSwNP patients without evidence of systemic atopy.
    • Methotrexate information booklet study 2008.

      Mohammad, A; Kilcoyne, A; Bond, U; Regan, M; Phelan, M; Department of Rheumatology, South Infirmary Victoria University Hospital, Cork,, Ireland. ausafmohammad@gmail.com (2012-02-01)
      INTRODUCTION: I n order to assess the value of using the methotrexate information booklet, we conducted a single blind prospective controlled trial of the patients attending two rheumatology services. METHODS: The active-arm (n=40) used the MTX information booklet for the patients' education and the control-arm (n=38) did not. Patients' interviews were conducted over a 6-month period using an MTX-questionnaire. RESULTS: The entire active-arm patients (100%) were taking folic-acid and 32 (80%) knew the reason why they were taking folic-acid vs. [30 (79%) and 10 (26%) in the control-arm]. In the active-arm 35 (88%) knew the reason for their monthly blood tests vs. 18 (47%) in the control-arm. The entire active-arm was aware of the need for contraception use and MTX-side effects vs. 23 (60%) and 15 (40%) in the control-arm respectively. CONCLUSIONS: The use of the MTX information booklet in our cohort improved their understanding of the treatment.
    • Non-Hodgkin lymphoma presenting as bilateral tonsillar hypertrophy: case report.

      Khan, Sardar U; Kenefick, Cyril; O'Leary, Gerard; Lucey, James J; Department of Otorhinolaryngology-Head and Neck Surgery, South Infirmary-Victoria, University Hospital, Cork, Ireland. sardarent@hotmail.com (2012-02-01)
      We describe the case of a 57-year-old man who was referred to us with persistent sore throat, dysphagia, and enlarged tonsils. He had not responded to earlier treatment with antibiotic therapy and other routine measures. In view of the persistent nature of the patient's symptoms and the tonsillar hypertrophy, we decided to perform a tonsillectomy and to send the excised specimens for pathologic analysis. Histologic evaluation identified non-Hodgkin lymphoma in both tonsils. The patient was treated with postoperative chemo- and radiotherapy, and he was free of symptoms during 18 months of follow-up. To the best of our knowledge, only 4 cases of bilateral non-Hodgkin lymphoma of the tonsils have been reported in the English-language literature. We also discuss the importance of histologic analysis of excised tonsil tissue in selected cases.
    • Occupational allergic contact dermatitis to HBTU [(o-benzotriazole-10yl)-N,N,N',N,-tetramethyluronium hexafluorophosphate].

      McAleer, Maeve A; Bourke, Breeda; Bourke, Johnny; Department of Dermatology, South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork, Ireland. (2010-02)
    • Occupational allergic contact dermatitis to HBTU [(o-benzotriazole-10yl)-N,N,N',N,-tetramethyluronium hexafluorophosphate].

      McAleer, Maeve A; Bourke, Breeda; Bourke, Johnny; Department of Dermatology, South Infirmary-Victoria University Hospital, Old, Blackrock Road, Cork, Ireland. (2012-02-01)
    • Occupational allergic contact dermatitis to olanzapine.

      Lowney, Aoife C; McAleer, Maeve A; Bourke, Johnny; Dermatology Department, South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork, Ireland. (2010-02)