• 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).
    • 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)
    • 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.
    • 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; Kirby, B; O'Connell, J; O'Shea, D; Department of Endocrinology, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland. (2011-11)
      The clinical effect observed and the direct interaction between GLP-1 and the immune system raise the possibility of therapeutic applications for GLP-1 in inflammatory conditions such as psoriasis.
    • 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. Andrew.Hogan.3@ucd.ie (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.
    • Identifying orthodontic problems.

      Scott, Ciara; Hagan, Sheila; Regional Orthodontic Unit, St Columcilles Hospital, Dublin. (2011-07-08)
    • 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. broganam@tcd.ie (2011-02)
      Obese participants were significantly impaired on the IGT. The pattern of performance suggested a potential inability to maximise an immediate reward or program a delayed reward. The findings support the view that common decision making impairments exist across disordered eating populations. Future research is required to specify the source and mechanisms of these decision making deficits. The logical progression of this research is the development of interventions which improve decision making capacity and measure subsequent impact on psychological and physical outcomes.
    • 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.
    • 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. jeanoco@gmail.com (2010-07)
      The current study suggests that the increasing prevalence of childhood obesity worldwide will lead to many more individuals achieving a higher BMI at a younger age. Furthermore, an earlier onset of overweight does not appear to prevent the adverse metabolic health outcomes associated with extreme 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 @ cdhb.govt.nz (2010)
      In patients with diabetes, these urinary biomarkers appear to identify renal damage that is related to, but distinct from, urine albumin/creatinine ratios. The markers of glomerular fibrosis and distal tubular damage related most closely to the degree of albuminuria. Longitudinal studies are now required to assess whether these biomarkers can detect early renal disease with greater specificity and sensitivity than the albumin/creatinine ratio.
    • Natural killer cells in obesity: impaired function and increased susceptibility to the effects of cigarette smoke.

      O'Shea, Donal; Cawood, Tom J; O'Farrelly, Cliona; Lynch, Lydia; Department of Endocrinology, St. Vincent's University Hospital, Dublin, Ireland. (2010)
      BACKGROUND: Obese individuals who smoke have a 14 year reduction in life expectancy. Both obesity and smoking are independently associated with increased risk of malignancy. Natural killer cells (NK) are critical mediators of anti-tumour immunity and are compromised in obese patients and smokers. We examined whether NK cell function was differentially affected by cigarette smoke in obese and lean subjects. METHODOLOGY AND PRINCIPAL FINDINGS: Clinical data and blood were collected from 40 severely obese subjects (BMI>40 kg/m(2)) and 20 lean healthy subjects. NK cell levels and function were assessed using flow cytometry and cytotoxicity assays. The effect of cigarette smoke on NK cell ability to kill K562 tumour cells was assessed in the presence or absence of the adipokines leptin and adiponectin. NK cell levels were significantly decreased in obese subjects compared to lean controls (7.6 vs 16.6%, p = 0.0008). NK function was also significantly compromised in obese patients (30% +/- 13% vs 42% +/-12%, p = 0.04). Cigarette smoke inhibited NK cell ability to kill tumour cell lines (p<0.0001). NK cells from obese subjects were even more susceptible to the inhibitory effects of smoke compared to lean subjects (33% vs 28%, p = 0.01). Cigarette smoke prevented NK cell activation, as well as perforin and interferon-gamma secretion upon tumour challenge. Adiponectin but not leptin partially reversed the effects of smoke on NK cell function in both obese (p = 0.002) and lean controls (p = 0.01). CONCLUSIONS/SIGNIFICANCE: Obese subjects have impaired NK cell activity that is more susceptible to the detrimental effects of cigarette smoke compared to lean subjects. This may play a role in the increase of cancer and infection seen in this population. Adiponectin is capable of restoring NK cell activity and may have therapeutic potential for immunity in obese subjects and smokers.
    • 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. jeanoco@gmail.com (2010)
      Metabolically healthy individuals are a distinct subgroup of the severely obese. Both subcutaneous and omental adipocyte size correlated positively with the degree of fatty liver, but only omental adipocyte size was related to metabolic health, and possibly progression from hepatic steatosis to fibrosis.
    • Should we mobilise critically ill patients? A review.

      O'Connor, Enda D; Walsham, James; St Columcille's Hospital, Loughlinstown, County Dublin, Ireland. endamed@yahoo.com.au (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.
    • 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. conorlahiff@yahoo.com (2007-12)
      This report highlights a recognised but previously unreported complication of etanercept.
    • A rare case of segmental testicular infarction.

      Magill, Paul; Jacob, Thomas; Lennon, Gerard M; Department of Urology, St. Columcilles Hospital, Loughlinstown, Dublin, Ireland. paulmagill8@hotmail.com (2007-05)
      Segmental testicular infarction is a very rare entity. We present a case in a patient with prior retroperitoneal surgery who developed segmental infarction after routine vasectomy.
    • 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. binduakhter@hotmail.com (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.
    • Type IV hiatal hernia post laparoscopic Nissen fundoplication: report of a case.

      Awad, Z T; Magee, D J; Wanis, N; Firozvi, A; St. Columcilles Hospital, Loughlinstown, Co. Dublin, Republic of Ireland. (2001)
      A postoperative hiatal hernia is a rare but serious complication of fundoplication. We report herein a 62-year-old female who presented with abdominal pain and vomiting 2 years following laparoscopic Nissen fundoplication. At laparotomy, the stomach and the transverse colon were intrathoracic (type IV hiatal hernia); the esophageal hiatus was markedly dilated with no evidence that they had been approximated. At 18 months follow-up, she is doing very well apart from occasional heartburn. A high index of suspicion is needed to diagnose postoperative hiatal hernias. A routine closure of the crura with nonabsorbable suture material and an avoidance of iatrogenic pneumothorax may help to reduce the occurrence of this problem.