• A Web-Based Electronic Neurology Referral System: A Solution for anOverburdened Healthcare System

      Williams, L; O’Riordan, S; McGuigan, C; Hutchinson, M; Tubridy, N (Irish Medical Journal (IMJ), 2012-10)
    • What are the spondyloarthropathies?

      FitzGerald, Oliver; Maksymowych, Walter P; Dept of Rheumatology, St. Vincents University Hospital, Elm Park, Dublin, 4, Ireland. oliver.fitzgerald@ucd.ie (2010-10)
    • Whipple's procedure for an oligometastasis to the pancreas from a leiomyosarcoma of the thigh.

      Burke, J P; Maguire, D; Dillon, J; Moriarty, M; O'Toole, G C; Department of Orthopaedic Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. john.burke@ucd.ie (2012-09)
      Pancreatic tumours are most frequently primary, with lesions secondary to metastasis uncommon.
    • Whole body imaging in the abdominal cancer patient: pitfalls of PET-CT.

      McDermott, Shaunagh; Skehan, Stephen J; Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin, 4, , Ireland. mcdermottshaunagh@gmail.com (2012-02-01)
      Proper interpretation of PET-CT images requires knowledge of the normal physiological distribution of the tracer, frequently encountered physiological variants, and benign pathological causes of FDG uptake that can be confused with a malignant neoplasm. In addition, not all malignant processes are associated with avid tracer uptake. A basic knowledge of the technique of image acquisition is also required to avoid pitfalls such as misregistration of anatomical and scintigraphic data. This article reviews these potential pitfalls as they apply to the abdomen and pelvis of patients with cancer.
    • Withdrawal of corticosteroids in inflammatory bowel disease patients after dependency periods ranging from 2 to 45 years: a proposed method.

      Murphy, S J; Wang, L; Anderson, L A; Steinlauf, A; Present, D H; Mechanick, J I; Centre for Colorectal disease, St. Vincent's University Hospital, Dublin,, Ireland. s.murphy@qub.ac.uk (2012-02-01)
      BACKGROUND: Even in the biologic era, corticosteroid dependency in IBD patients is common and causes a lot of morbidity, but methods of withdrawal are not well described. AIM: To assess the effectiveness of a corticosteroid withdrawal method. METHODS: Twelve patients (10 men, 2 women; 6 ulcerative colitis, 6 Crohn's disease), median age 53.5 years (range 29-75) were included. IBD patients with quiescent disease refractory to conventional weaning were transitioned to oral dexamethasone, educated about symptoms of the corticosteroid withdrawal syndrome (CWS) and weaned under the supervision of an endocrinologist. When patients failed to wean despite a slow weaning pace and their IBD remaining quiescent, low dose synthetic ACTH stimulation testing was performed to assess for adrenal insufficiency. Multivariate analysis was performed to assess predictors of a slow wean. RESULTS: Median durations for disease and corticosteroid dependency were 21 (range 3-45) and 14 (range 2-45) years respectively. Ten patients (83%) were successfully weaned after a median follow-up from final wean of 38 months (range 5-73). Disease flares occurred in two patients, CWS in five and ACTH testing was performed in 10. Multivariate analysis showed that longer duration of corticosteroid use appeared to be associated with a slower wean (P = 0.056). CONCLUSIONS: Corticosteroid withdrawal using this protocol had a high success rate and durable effect and was effective in patients with long-standing (up to 45 years) dependency. As symptoms of CWS mimic symptoms of IBD disease flares, gastroenterologists may have difficulty distinguishing them, which may be a contributory factor to the frequency of corticosteroid dependency in IBD patients.
    • Working Backs Project--implementing low back pain guidelines

      Cunningham, C. G.; Flynn, T. A.; Toole, C. M.; Ryan, R. G.; Gueret, P. W. J.; Bulfin, S.; Seale, O.; Blake, C. (2012-04-30)
    • Wunderlich syndrome as the first manifestation of renal cell carcinoma.

      Oon, Sheng F; Murphy, Michael; Connolly, Stephen S; Department of Urology, St. Vincent'sUniversity Hospital, Elm Park, Dublin, Ireland. shengfeioon@rcsi.ie (2010)