• 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)
    • 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. (2012-02-01)
    • Osteonecrosis following alcohol, cocaine, and steroid use.

      Ziraldo, Laura; O'Connor, Mortimer B; Blake, Simon P; Phelan, Mark J; Department of Medicine, South Infirmary-Victoria University Hospital, Cork,, Ireland. (2012-02-01)
      Alcohol, steroids and cocaine have all been shown to be independent risk factors for osteonecrosis when taken in excess. Here we present a case of a young girl who developed debilitating osteonecrosis secondary to low doses of alcohol, steroids and cocaine. We feel it is important to highlight to those caring for such patients of the potential devastating complication of these three agents.
    • Peristomal allergic contact dermatitis to stoma-adhesive paste containing monobutyl ester/maleic acid of polymethylvinylether (Gantrez 425) but not to Isopropyl ester/maleic anhydride of polymethylvinylether (Gantrez 335).

      Field, Sinead; O'Sullivan, Carmel; Murphy, Michelle; Bourke, John F; Dermatology Department, South Infirmary-Victoria University Hospital, Cork, Ireland. sineadfield@hotmail.com (2010-02)
    • Peristomal allergic contact dermatitis to stoma-adhesive paste containing monobutyl ester/maleic acid of polymethylvinylether (Gantrez 425) but not to Isopropyl ester/maleic anhydride of polymethylvinylether (Gantrez 335).

      Field, Sinead; O'Sullivan, Carmel; Murphy, Michelle; Bourke, John F; Dermatology Department, South Infirmary-Victoria University Hospital, Cork,, Ireland. sineadfield@hotmail.com (2012-02-01)
    • The preferences for outpatient clinic appointment reminders among rheumatology patients.

      O'Connor, Mortimer B; Bond, Ursula; Saunders, Jean A; Casey, Pamela; Mohammad, Ausaf; O'Dwyer, Marie; Daly, Nicola; Regan, Michael J; Phelan, Mark J; Department of Medicine, South Infirmary-Victoria University Hospital, Cork,, Ireland. mortimeroconnor@gmail.com (2012-02-01)
    • Preoperative information needs of children undergoing tonsillectomy.

      Buckley, Aoife; Savage, Eileen; General Operating Theatres, South Infirmary Victoria University Hospital, Cork,, Ireland. buckley_aoife@hotmail.com (2012-02-01)
      AIMS AND OBJECTIVES: To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. BACKGROUND: Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. DESIGN: A qualitative descriptive study. METHOD: Data were collected from nine children (aged 6-9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. RESULTS: Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing 'soreness' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. CONCLUSION: Preoperative educational interventions need to take account of children's information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. RELEVANCE TO CLINICAL PRACTICE: Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children.
    • The prevalence and genotype of human papillomavirus on cervical samples from an Irish female population with external genital warts.

      Cremin, Suzanne M; Menton, John F; Canier, Lydie; Horgan, Mary; Fanning, Liam J; STI Clinic, Infirmary, South Victoria University Hospital, Cork, Ireland. suzannem.cremin@hse.ie (2012-07)
      The aim of this study was to determine the cervical genotype profile of females who presented to an STI Clinic with external genital warts (EGW); and to determine the potential vaccine coverage prior to the uptake of the HPV vaccines. Sixty-one cervical scrapings were taken from females aged 18-35 y who had external genital warts or a history of external genital warts. The resulting 50 samples that were positive for HPV-DNA were subjected to genotype identification. Forty-six of these samples had detectable genotypes by LIPA analysis and most (78%, 36/46) had multiple low risk (LR) and high risk (HR) genotypes on the cervix. Twenty-five of these samples (54%) had more than 1 HR genotype. Of the 36 patients who had any HR genotypes, 18 (50%) were identified to have the most oncogenic HPV genotypes, namely 16 and 18. Three of these samples had both 16 and 18 on the cervix. The presence of multiple HR genotypes on the majority of cervical samples from a self-referred population of females with EGW is presented. This study is of importance since persistent HR-HPV is the necessary risk factor in the development of precancerous and cancerous lesions of the cervix. Gardisil, the quadrivalent HPV vaccine would have been useful in the prevention of 28% (13/46) of these infections.
    • The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

      Haroon, Muhammad; Bond, Ursula; Quillinan, Niamh; Phelan, Mark J; Regan, Michael J; Arthritis and Osteoporosis Centre, Department of Rheumatology, South, Infirmary-Victoria University Hospital, Cork, Ireland. mharoon301@hotmail.com (2012-02-01)
      The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as /=65 and 78% of patients aged
    • Risk factors for recurrent laryngeal nerve neuropraxia postthyroidectomy.

      Sheahan, Patrick; O'Connor, Ann; Murphy, Matthew S; Department of Otolaryngology-Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. sheahan.patrick@sivuh.ie (2012-06)
      Despite preservation of the recurrent laryngeal nerve (RLN), transient vocal cord paralysis (VCP) occurs after 1.2% to 10.9% of thyroidectomies. The objective of this study was to study risk factors for transient VCP after thyroidectomy.
    • Safety of body piercings for rheumatology patients on immunosuppressive medications.

      O'Connor, M B; Phelan, M J (Irish Medical Journal (IMJ), 2012-05)
    • Second toe swelling: Nora's lesion or glomus tumour, case report and literature review.

      Mohammad, A; Kilcoyne, A; Blake, S; Phelan, M; Department of Rheumatology and Radiology, South Infirmary Victoria University Hospital, Cork, Ireland. ausafmohammad@gmail.com (2012-09)
      We report a rare case of bizarre parosteal osteochondromatous proliferation (BPOP, Nora's lesion) of the right second toe in a 60-year-old man who presented with painful, bluish and bulbous swelling of the right second toe without any break in the skin.
    • Skin Cancer Awareness Amongst Irish Golfers

      McCarthy, Siobhan; Paul, Lyndsey; O’Connell, Michael (Irish Medical Journal, 2017-09)
      The aim of this study was to assess skin cancer awareness and identify the UV protective measures used by golfers within the Munster region of Ireland.
    • Spontaneous cholecystocutaneous fistula.

      Khan, Ata; Rajendran, Simon; Baban, Chwanrow; Murphy, Micheal; O'Hanlon, Deirdre; Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. (2011)
    • A study of needle stick injuries among non-consultant hospital doctors in Ireland.

      O'Connor, M B; Hannon, M J; Cagney, D; Harrington, U; O'Brien, F; Hardiman, N; O'Connor, R; Courtney, K; O'Connor, C; Department of Medicine, South Infirmary, Victoria University Hospital, Old, Blackrock Road, Cork, Ireland. mortimeroconnor@gmail.com (2012-02-01)
      INTRODUCTION: NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries. METHODS: A cross-sectional self-administered anonymous questionnaire survey was conducted on 185 NCHDs working in a clinical setting among seven teaching hospitals in Ireland. Implied consent was obtained. The data was analysed using Excel spreadsheets. Ethical approval was received. RESULTS: A response rate of 85.4% (158/185) was achieved. Findings of the study are shown in the manuscript table. CONCLUSIONS: A needle stick injury (NI) history is greater among surgical NCHDs than medical NCHDs. The level of disposable glove usage is worryingly poor. Training in sharps handling and dealing with a NI needs to be addressed. HIV is the blood-borne infection most fear of being contracting as a consequence of a NI.