• A randomised controlled trial of the effect of a connected inhaler system on medication adherence in uncontrolled asthmatic patients.

      Moore, Alison; Preece, Andrew; Sharma, Raj; Heaney, Liam G; Costello, Richard W; Wise, Robert A; Ludwig-Sengpiel, Andrea; Mosnaim, Giselle; Rees, Jamie; Tomlinson, Ryan; et al. (2021-06-04)
      Suboptimal adherence to maintenance therapy contributes to poor asthma control and exacerbations. This study evaluated the effect of different elements of a connected inhaler system (CIS), comprising clip-on inhaler sensors, a patient-facing app and a healthcare professional (HCP) dashboard, on adherence to asthma maintenance therapy.This was an open-label, parallel-group, 6-month, randomised controlled trial in adults with uncontrolled asthma (asthma control test (ACT) score less than 20) on fixed-dose inhaled corticosteroids/long-acting β-agonist maintenance therapy (n=437). All subjects received fluticasone furoate/vilanterol ELLIPTA dry-powder inhalers for maintenance and salbutamol/albuterol metered-dose inhalers for rescue, with a sensor attached to each inhaler. Participants were randomised to one of five CIS study arms (allocation ratio 1:1:1:1:1) reflecting the recipient of the data feedback from the sensors, as follows: 1) maintenance use to participants and HCPs (n=87); 2) maintenance use to participants (n=88); 3) maintenance and rescue use to participants and HCPs (n=88); 4) maintenance and rescue use to participants (n=88); and 5) no feedback (control) (n=86).For the primary endpoint, observed mean±sd adherence to maintenance therapy over months 4-6 was 82.2±16.58% (n=83) in the "maintenance to participants and HCPs" arm and 70.8±27.30% (n=85) in the control arm. The adjusted least squares mean±se was 80.9±3.19% and 69.0±3.19%, respectively (study arm difference: 12.0%, 95% CI 5.2-18.8%; p<0.001). Adherence was also significantly greater in the other CIS arms versus the control arm. The mean percentage of rescue medication free days (months 4-6) was significantly greater in participants receiving data on their rescue use compared with controls. ACT scores improved in all study arms with no significant differences between groups.A CIS can improve adherence to maintenance medication and reduce rescue medication use in patients with uncontrolled asthma.
    • A randomised, double-blind, placebo-controlled, pilot trial of intravenous plasma purified alpha-1 antitrypsin for SARS-CoV-2-induced Acute Respiratory Distress Syndrome: a structured summary of a study protocol for a randomised, controlled trial.

      McEvoy, Natalie L; Clarke, Jennifer L; Mc Elvaney, Oliver J; Mc Elvaney, Oisin F; Boland, Fiona; Hyland, Deirdre; Geoghegan, Pierce; Donnelly, Karen; Friel, Oisin; Cullen, Ailbhe; et al. (2021-04-19)
      The study will be conducted in Intensive Care Units in hospitals across Ireland. Patients with a laboratory-confirmed diagnosis of SARS-CoV-2-infection, moderate to severe ARDS (meeting Berlin criteria for a diagnosis of ARDS with a PaO2/FiO2 ratio <200 mmHg), >18 years of age and requiring invasive or non-invasive mechanical ventilation. All individuals meeting any of the following exclusion criteria at baseline or during screening will be excluded from study participation: more than 96 hours has elapsed from onset of ARDS; age < 18 years; known to be pregnant or breastfeeding; participation in a clinical trial of an investigational medicinal product (other than antibiotics or antivirals) within 30 days; major trauma in the prior 5 days; presence of any active malignancy (other than nonmelanoma skin cancer) which required treatment within the last year; WHO Class III or IV pulmonary hypertension; pulmonary embolism prior to hospital admission within past 3 months; currently receiving extracorporeal life support (ECLS); chronic kidney disease receiving dialysis; severe chronic liver disease with Child-Pugh score > 12; DNAR (Do Not Attempt Resuscitation) order in place; treatment withdrawal imminent within 24 hours; Prisoners; non-English speaking patients or those who do not adequately understand verbal or written information unless an interpreter is available; IgA deficiency.
    • Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease.

      AlQahtani, Manaf; Abdulrahman, Abdulkarim; Almadani, Abdulrahman; Alali, Salman Yousif; Al Zamrooni, Alaa Mahmood; Hejab, Amal Hamza; Conroy, Ronán M; Wasif, Pearl; Otoom, Sameer; Atkin, Stephen L; et al. (2021-05-11)
    • Rationalisation of Legionella urinary antigen testing

      Lynch, Breda (Royal College of Surgeons in Ireland, 2014-05)
    • A realist evaluation exploring simulated patient role-play in pharmacist undergraduate communication training.

      Kerr, Aisling; Strawbridge, Judith; Kelleher, Caroline; Barlow, James; Sullivan, Clare; Pawlikowska, Teresa (2021-06-07)
    • Reduced hippocampal volume in adolescents with psychotic experiences: A longitudinal population-based study.

      Calvo, Ana; Roddy, Darren W; Coughlan, Helen; Kelleher, Ian; Healy, Colm; Harley, Michelle; Clarke, Mary; Leemans, Alexander; Frodl, Thomas; O'Hanlon, Erik; et al. (2020-06-03)
    • Regulatory Mechanisms of the RNA Modification mA and Significance in Brain Function in Health and Disease.

      Mathoux, Justine; Henshall, David C; Brennan, Gary P (2021-05-19)
      RNA modifications have emerged as an additional layer of regulatory complexity governing the function of almost all species of RNA. N 6-methyladenosine (m6A), the addition of methyl groups to adenine residues, is the most abundant and well understood RNA modification. The current review discusses the regulatory mechanisms governing m6A, how this influences neuronal development and function and how aberrant m6A signaling may contribute to neurological disease. M6A is known to regulate the stability of mRNA, the processing of microRNAs and function/processing of tRNAs among other roles. The development of antibodies against m6A has facilitated the application of next generation sequencing to profile methylated RNAs in both health and disease contexts, revealing the extent of this transcriptomic modification. The mechanisms by which m6A is deposited, processed, and potentially removed are increasingly understood. Writer enzymes include METTL3 and METTL14 while YTHDC1 and YTHDF1 are key reader proteins, which recognize and bind the m6A mark. Finally, FTO and ALKBH5 have been identified as potential erasers of m6A, although there in vivo activity and the dynamic nature of this modification requires further study. M6A is enriched in the brain and has emerged as a key regulator of neuronal activity and function in processes including neurodevelopment, learning and memory, synaptic plasticity, and the stress response. Changes to m6A have recently been linked with Schizophrenia and Alzheimer disease. Elucidating the functional consequences of m6A changes in these and other brain diseases may lead to novel insight into disease pathomechanisms, molecular biomarkers and novel therapeutic targets.
    • The relationship of tobacco and alcohol use with ageing self-perceptions in older people in Ireland.

      Villiers-Tuthill, Amanda; Copley, Antoinette; McGee, Hannah; Morgan, Karen (BMC Public Health, 2016-07)
      Health behaviour patterns in older groups, including tobacco and alcohol use, are key factors in chronic disease prevention. We explore ageing self-perceptions as motivating factors behind smoking and drinking alcohol in older adults, and the complex reasons why individuals engage harmfully in these behaviours.
    • Repair of Acute Respiratory Distress Syndrome by Stromal Cell Administration in COVID-19 (REALIST-COVID-19): A structured summary of a study protocol for a randomised, controlled trial.

      Gorman, Ellen; Shankar-Hari, Manu; Hopkins, Phil; Tunnicliffe, William S; Perkins, Gavin D; Silversides, Jonathan; McGuigan, Peter; Jackson, Colette; Boyle, Roisin; McFerran, Jamie; et al. (2020-06-03)
      Intervention: Allogeneic donor CD362 enriched human umbilical cord derived mesenchymal stromal cells (REALIST ORBCEL-C) supplied as sterile, single-use cryopreserved cell suspension of a fixed dose of 400 x106 cells in 40ml volume, to be diluted in Plasma-Lyte 148 to a total volume of 200mls for administration. Comparator (placebo): Plasma-Lyte 148 Solution for Infusion (200mls). The cellular product (REALIST ORBCEL-C) was developed and patented by Orbsen Therapeutics.
    • Retention of patients in opioid substitution treatment: A systematic review.

      O'Connor, Aisling Máire; Cousins, Gráinne; Durand, Louise; Barry, Joe; Boland, Fiona (2020-05-14)
    • Return to Play After Patellar Tendon Autograft for Primary Anterior Cruciate Ligament Reconstruction in Rugby Players.

      Hurley, Eoghan T; Withers, Dan; King, Enda; Franklyn-Miller, Andrew; Jackson, Mark; Moran, Ray (2021-05-03)
    • Risks for Surgical Site Infection after Infra-inguinal Bypass

      AlMushcab, N.; Connolly, R.; Naughton, P.; Moneley, D.; McHugh, S.; Fitzpatrick, F. (Irish Medical Journal, 2019-09)
    • Robotic versus Laparoscopic Cholecystectomy: Case-Control Outcome Analysis and Surgical Resident Training Implications.

      Ghanem, Maher; Shaheen, Samuel; Blebea, John; Tuma, Faiz; Zayout, Majd; Conti, Nico; Qudah, Ghaith; Kamel, Mohamed K (2020-04-11)
    • Role of Common Genetic Variants for Drug-Resistance to Specific Anti-Seizure Medications.

      Wolking, Stefan; Campbell, Ciarán; Stapleton, Caragh; McCormack, Mark; Delanty, Norman; Depondt, Chantal; Johnson, Michael R; Koeleman, Bobby P C; Krause, Roland; Kunz, Wolfram S; et al. (2021-06-09)
      Objective: Resistance to anti-seizure medications (ASMs) presents a significant hurdle in the treatment of people with epilepsy. Genetic markers for resistance to individual ASMs could support clinicians to make better-informed choices for their patients. In this study, we aimed to elucidate whether the response to individual ASMs was associated with common genetic variation. Methods: A cohort of 3,649 individuals of European descent with epilepsy was deeply phenotyped and underwent single nucleotide polymorphism (SNP)-genotyping. We conducted genome-wide association analyses (GWASs) on responders to specific ASMs or groups of functionally related ASMs, using non-responders as controls. We performed a polygenic risk score (PRS) analyses based on risk variants for epilepsy and neuropsychiatric disorders and ASM resistance itself to delineate the polygenic burden of ASM-specific drug resistance. Results: We identified several potential regions of interest but did not detect genome-wide significant loci for ASM-specific response. We did not find polygenic risk for epilepsy, neuropsychiatric disorders, and drug-resistance associated with drug response to specific ASMs or mechanistically related groups of ASMs. Significance: This study could not ascertain the predictive value of common genetic variants for ASM responder status. The identified suggestive loci will need replication in future studies of a larger scale.
    • The role of PoCUS in the assessment of COVID-19 patients.

      Karp, John; Burke, Karina; Daubaras, Sarah-Marie; McDermott, Cian (2021-04-19)
    • Royal College of Surgeons in Ireland, President's report 2003-2004.

      Royal College of Surgeons in Ireland (RCSI) (Royal College of Surgeons in Ireland (RCSI), 2004)
    • Royal College of Surgeons in Ireland: good surgical practice, 2004.

      Royal College of Surgeons in Ireland (RCSI) (Royal College of Surgeons in Ireland (RCSI), 2004)