Research by staff affiliated to St. Columcille's Hospital

Recent Submissions

  • Practical Approaches to Treating Obesity: Patient and Healthcare Professional Perspectives.

    O'Shea, Donal; Kahan, Scott; Lennon, Lorna; Breen, Cathy (2021-04-30)
    Obesity is a chronic and treatable disease carrying risk for numerous health complications, including cardiovascular disease, respiratory disease, type 2 diabetes mellitus and certain cancers. While there is a great need to address the topic in clinical practice, healthcare professionals (HCPs) often struggle to initiate conversations about weight. In this paper, guidance on how to raise and address the subject of weight with individuals is provided from an HCP and patient perspective using the 5As framework. This model facilitates advising individuals on the benefits of weight loss and supports them to develop achievable and sustainable weight management plans. With obesity rates still rising across the globe, it is imperative that more HCPs become skilled in raising and addressing the issue.
  • Domestic Violence: Guidelines for Hospital Staff

    Murphy, Anne Marie
    Successive studies and reports have indicated the widespread incidence of violence against women and, to a lesser extent, men and its prevalence in all social classes and regions. These guidelines however are based on research into women’s experiences of abuse and as such are intended for application to women. We have been careful not to assume that the experiences of women can be simply applied to that of men. However, men who have experienced abuse need to be treated with the same respect, dignity and sensitivity as women as emphasised in these guidelines. Domestic violence is a crime. It is a crime that is committed every day in Ireland. It is a crime which occurs regardless of class, race, religion, income, education or profession. Violence against women and men has serious implications for both physical and psychological health of individual women/men and children and the provision of health care services. The recommendation of the report of the Task Force on Violence Against Women (1997) advocates the adoption by health service providers of written protocols and procedures in relation to domestic abuse backed up by the appropriate training for health care providers.
  • Documentation of allergies on inpatient medication charts

    Beary, E; Lillis, Y (Irish Medical Journal, 2015-07)
    Medication allergies are common and can result in significant morbidity and mortality, allergic drug reactions have an estimated mortality rate of 0.09 per 1,000 hospital admissions. 1 In Ireland medication allergies accounted for 2% of medication events reported, according to the Irish Medication Safety Network. 2 Therefore documentation of allergies on medication charts is commonplace in order to prevent or minimise potential adverse reactions due to known allergens. Previous research from an Irish hospital had shown that only 70% (211/300) of charts examined had a completed drug allergy box. 3
  • Can lithium unmask the preclinical parkinsonian features?

    Bhattacharjee, S; Yela, R; Chadwick, G (Irish Medical Journal, 2013-09)
    Sir Drug induced Parkinsonism( DIP) is diagnosed when symptoms of parkinsonism start during the use of the offending drug and in the absence of a history of symptoms of parkinsonism before initiation of the drug. 1 We describe a case of Parkinsonism that was clinically diagnosed as DIP but DAT scan pointed towards idiopathic Parkinsonâ s disease( PD).
  • The effect of gastric band slippage on patient body mass index and quality of life.

    Sahebally, Shaheel M; Burke, John P; O'Shea, Donal; Geoghegan, Justin; Department of Surgery, St Columcille's Hospital, Loughlinstown Co, Dublin, Ireland. (Obesity surgery, 2012-05)
    Laparoscopic adjustable gastric banding (LAGB) is a popular surgical procedure for the management of morbid obesity. Gastric band slippage (GBS) is the most common long-term complication. In this study, the effect of GBS on body mass index (BMI) and quality of life (QOL) were assessed.
  • Weight management services for adults highlighting the role of primary care

    Hassan, SJ; O’Shea, D (Irish Medical Journal, 2012-12)
  • Domestic violence: a health issue: guidelines for hospital staff

    Murphy, Anne Marie (St Columcille's Hospital, 2012-11-07)
  • Should we mobilise critically ill patients? A review.

    O'Connor, Enda D; Walsham, James; St Columcille's Hospital, Loughlinstown, County Dublin, Ireland. (2009-12)
    Neuromuscular weakness, a frequent complication of prolonged bed rest and critical illness, is associated with morbidity and mortality. Mobilisation physiotherapy has widespread application in patients hospitalised with non-critical illness.
  • Cigarette smoke alters the invariant natural killer T cell function and may inhibit anti-tumor responses.

    Hogan, Andrew E; Corrigan, Michelle A; O'Reilly, Vincent; Gaoatswe, Gadintshware; O'Connell, Jean; Doherty, Derek G; Lynch, Lydia; O'Shea, Donal; Obesity Immunology Group, Education and Research Centre, St Vincents University Hospital, UCD, Dublin 4, Ireland. (2011-09)
    Invariant natural killer T (iNKT) cells are a minor subset of human T cells which express the invariant T cell receptor Vα24 Jα18 and recognize glycolipids presented on CD1d. Invariant NKT cells are important immune regulators and can initiate anti-tumor responses through early potent cytokine production. Studies show that iNKT cells are defective in certain cancers. Cigarette smoke contains many carcinogens and is implicated directly and indirectly in many cancers. We investigated the effects of cigarette smoke on the circulating iNKT cell number and function. We found that the iNKT cell frequency is significantly reduced in cigarette smoking subjects. Invariant NKT cells exposed to cigarette smoke extract (CSE) showed significant defects in cytokine production and the ability to kill target cells. CSE inhibits the upregulation of CD107 but not CD69 or CD56 on iNKT cells. These findings suggest that CSE has a specific effect on iNKT cell anti-tumor responses, which may contribute to the role of smoking in the development of cancer.
  • Impaired decision making among morbidly obese adults.

    Brogan, Amy; Hevey, David; O'Callaghan, Georgia; Yoder, Ruth; O'Shea, Donal; School of Psychology, Trinity College Dublin, Dublin, Ireland. (2011-02)
    The Iowa Gambling Task (IGT) measures affective decision making and has revealed decision making impairments across a wide range of eating disorders. This study aimed to investigate affective decision making in severely obese individuals.
  • The relationship of omental and subcutaneous adipocyte size to metabolic disease in severe obesity.

    O'Connell, Jean; Lynch, Lydia; Cawood, Tom J; Kwasnik, Anna; Nolan, Niamh; Geoghegan, Justin; McCormick, Aiden; O'Farrelly, Cliona; O'Shea, Donal; Obesity Research Group, Education and Research Centre, St Vincent's University Hospital, Dublin, Ireland. (2010)
    Several studies have reported the existence of a subgroup of obese individuals with normal metabolic profiles. It remains unclear what factors are responsible for this phenomenon. We proposed that adipocyte size might be a key factor in the protection of metabolically healthy obese (MHO) individuals from the adverse effects of obesity.
  • Glucagon-like peptide-1 (GLP-1) and the regulation of human invariant natural killer T cells: lessons from obesity, diabetes and psoriasis.

    Hogan, A E; Tobin, A M; Ahern, T; Corrigan, M A; Gaoatswe, G; Jackson, R; O'Reilly, V; Lynch, L; Doherty, D G; Moynagh, P N; et al. (2011-11)
    The innate immune cells, invariant natural killer T cells (iNKT cells), are implicated in the pathogenesis of psoriasis, an inflammatory condition associated with obesity and other metabolic diseases, such as diabetes and dyslipidaemia. We observed an improvement in psoriasis severity in a patient within days of starting treatment with an incretin-mimetic, glucagon-like peptide-1 (GLP-1) receptor agonist. This was independent of change in glycaemic control. We proposed that this unexpected clinical outcome resulted from a direct effect of GLP-1 on iNKT cells.
  • BMI > or = 50 kg/m2 is associated with a younger age of onset of overweight and a high prevalence of adverse metabolic profiles.

    O'Connell, Jean; Kieran, Phillip; Gorman, Kathleen; Ahern, Tomas; Cawood, Tom J; O'Shea, Donal; Obesity Research Group, St Columcille's Hospital and St Vincent's University Hospital, Elm Park, Dublin 4, Republic of Ireland. (2010-07)
    To study the demographic and clinical parameters of three different categories of obesity, with particular focus on a cohort of individuals with BMI > or = 50 kg/m2, the fastest growing category of obesity.
  • Urinary collagen IV and πGST: potential biomarkers for detecting localized kidney injury in diabetes--a pilot study.

    Cawood, T J; Bashir, M; Brady, J; Murray, B; Murray, P T; O'Shea, D; Department of Diabetes and Endocrinology, Christchurch Hospital, Christchurch, New Zealand. tom.cawood @ (2010)
    Urinary biomarkers can identify damage to specific parts of the nephron. We performed a cross-sectional study to characterise the pattern of diabetic nephropathy using urinary biomarkers of glomerular fibrosis (collagen IV), proximal tubular damage (α-glutathione-S-transferase, GST) and distal tubular damage (πGST).
  • A new approach to incisor retention--the lingual spur retainer.

    McNamara, T G; McNamara, T; Sandy, J R; Orthodontic Department, St Camillus Hospital, Limerick, Eire. (1996-08)
    Late lower incisor crowding and incisor rotations remain a problem in orthodontics. We describe a new fixed retainer which is simple to use, allows physiological tooth movement, but prevents rotational and labio-lingual relapse.
  • Beyond statin therapy: a review of the management of residual risk in diabetes mellitus.

    Judge, Eoin P; Phelan, D; O'Shea, Donal; Department of Endocrinology, St Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland. (2010-09)
    Total cholesterol and low-density lipoprotein (LDL) cholesterol exhibit an independent, strong, continuous correlation with cardiovascular events. The effectiveness of hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in the treatment and prevention of atherosclerosis is well-established. However, despite the lowering of LDL targets and the increased use of statins, patients with type 2 diabetes mellitus (DM) continue to experience a higher proportion of adverse coronary artery disease events. This is as a result of an atherogenic dyslipidaemia, characterized by low levels of high-density lipoprotein and elevated plasma triglyceride concentrations, often with high levels of cholesterol-rich remnant particles. This article will review dyslipidaemia and its role in DM, and will discuss available treatment modalities that address residual cardiovascular risk in this disease.
  • Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis.

    Lahiff, C; Khiaron, O B; Nolan, N; Chadwick, G A; Department of Medicine, St. Columcilles Hospital, Loughlinstown, Co. Dublin, Ireland. (2007-12)
    Pneumocystis carinii pneumonia (PCP) is a rare form of pneumonia associated with immune-suppression. It is common in patients with AIDS and with a CD4 count of less than 200 cells/mm(3). We report a case of PCP secondary to immune-suppression in a 41-year-old man with psoriatic arthritis being treated with the immune-modulatory agent etanercept.
  • Identifying orthodontic problems.

    Scott, Ciara; Hagan, Sheila; Regional Orthodontic Unit, St Columcilles Hospital, Dublin. (2011-07-08)
  • Gender identity disorder.

    De Gascun, C; Kelly, J; Salter, N; Lucey, J; O'Shea, D; Department of Endocrinology, St Columcilles Hospital, Dublin. (2006-05)
    Gender Identity Disorder (GID) is a relatively rare condition of atypical gender development in which there is a psychological perception of self as masculine or feminine which is incongruent with ones phenotype. GID replaced the term Transsexualism in DSM-IV in 1994. The demographics of GID in Ireland have not been established. Since 2000 we have received 52 referrals of individuals with confirmed GID to our endocrine service for consideration for hormonal treatment (HT). Of the 52 patients 45 have male to female (MTF) GID (mean age 38.9 years) and 7 have female to male (FTM) GID (mean age 30.7 years). The age at presentation in this group is approximately 9 years older than in international series for both MTF (39 years v 30yrs) and FTM (31 yrs v 22yrs). The karyotype where analysed has been normal for their phenotypic sex. Twenty-three of the patients had received HT prior to attending our clinic that in only one case had been prescribed by a specialist. A number of patients had obtained HT via the internet or from overseas sources without medical review. Eighteen of the patients have been or are married and 14 of the group have children. The scale of referrals confirms that GID exists in the Irish population to a significant degree. Thus an appropriate care pathway for people with the condition needs to be established. This will facilitate optimum medical management of the patient group and a coherent approach to the many difficult social issues faced individuals with this disorder.
  • Serotonin syndrome:case report and current concepts.

    Fennell, J; Hussain, M; Department of Medicine, St.Columcilles Hospital, Loughlinstown, Co. Dublin. (2005-05)
    Selective serotonin reuptake inhibitors (SSRI's) are increasingly being used as the first line therapeutic agent for the depression. It is therefore not unusual to see a case of overdose with these agents. More commonly an adverse drug reaction may be seen among the older patients who are particularly vulnerable to the serotonin syndrome due to multiple co-morbidity and polypharmacy. The clinical picture of serotonin syndrome (SS) is non-specific and there is no confirmatory test. SS may go unrecognized because it is often mistaken for a viral illness, anxiety, neurological disorder or worsening psychiatric condition.

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