• Targeting breast cancer outcomes-what about the primary relatives?

      Johnston, Alison; Sugrue, Michael (Wiley-Blackwell, 2017-07)
      Up to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately.
    • A toddler with a yellow nose and excessive intake of sweet potato.

      Eltayeb, Mohamed; Paediatric Department, Letterkenny General Hospital, Letterkenny, Ireland. meltayeb12@yahoo.com (2011-12)
    • Understanding phenomenology.

      Flood, Anne; Letterkenny General Hospital, Letterkenny, County Donegal, Ireland. (2012-01-31)
      Phenomenology is a philosophic attitude and research approach. Its primary position is that the most basic human truths are accessible only through inner subjectivity, and that the person is integral to the environment. This paper discusses the theoretical perspectives related to phenomenology, and includes a discussion of the methods adopted in phenomenological research.
    • Update from the Abdominal Compartment Society (WSACS) on intra-abdominal hypertension and abdominal compartment syndrome: past, present, and future beyond Banff 2017.

      Kirkpatrick, Andrew W; Sugrue, Michael; McKee, Jessica L; Pereira, Bruno M; Roberts, Derek J; De Waele, Jan J; Leppaniemi, Ari; Ejike, Janeth C; Reintam Blaser, Annika; D'Amours, Scott; et al. (Via Medica Journals, 2017)
    • A user's guide to intra-abdominal pressure measurement.

      Sugrue, Michael; De Waele, Jan J; De Keulenaer, Bart L; Roberts, Derek J; Malbrain, Manu L N G (Anaesthesiology intensive therapy, 2015)
      The intra-abdominal pressure (IAP) measurement is a key to diagnosing and managing critically ill medical and surgical patients. There are an increasing number of techniques that allow us to measure the IAP at the bedside. This paper reviews these techniques. IAP should be measured at end-expiration, with the patient in the supine position and ensuring that there is no abdominal muscle activity. The intravesicular IAP measurement is convenient and considered the gold standard. The level where the mid-axillary line crosses the iliac crest is the recommended zero reference for the transvesicular IAP measurement; moreover, marking this level on the patient increases reproducibility. Protocols for IAP measurement should be developed for each ICU based on the locally available tools and equipment. IAP measurement techniques are safe, reproducible and accurate and do not increase the risk of urinary tract infection. Continuous IAP measurement may offer benefits in specific situations in the future. In conclusion, the IAP measurement is a reliable and essential adjunct to the management of patients at risk of intra-abdominal hypertension.
    • Variations in Abnormal Nipple Discharge Management in Women- a Systematic Review and Meta-analysis

      Leong, Alison; Johnston, Alison; Sugrue, Michael (Journal of surgery, 2018-07)
      Nipple discharge accounts for 5% of referrals to breast units; breast cancer in image negative nipple discharge patients varies from 0 to 21%. This systematic review and meta-analysis determined variability in breast cancer rates in nipple discharge patients, diagnostic accuracy of modalities and surgery rates. An ethically approved meta-analysis was conducted using databases PubMed, EMBASE, and Cochrane Library from January 2000 to July 2015. For the breast cancer rates’ review, studies were excluded if no clinical follow-up data was available. For the diagnostic accuracy meta-analysis, studies were excluded if there was no reference standard, or the number of true and false positives and negatives were not known. Pooled sensitivities were determined using Mantel-Haenszel method. For the surgery rates’ review, only studies with consecutive nipple discharge patients were included. Average risk of having a breast cancer is 10.2% in nipple discharge patients. Most studies reported an age threshold of 50 above which breast cancer risk greatly increases. Pooled sensitivities of ultrasound, mammogram, mammogram and ultrasound, breast MRI, conventional galactography, smear cytology, ductal lavage cytology and ductoscopy were 0.64, 0.34, 0.65, 0.81, 0.75, 0.37, 0.49 and 0.82 respectively. Average surgery rate was 43.4%. Malignancy rate of 10.2% indicates the need to continue surgery, especially for patients aged over 50. Patients below 50, in the absence of risk factors such as family history, can be managed conservatively with close follow up.