• Day case shoulder surgery: satisfactory pain control without regional anaesthesia. A prospective analysis of a perioperative protocol.

      Daruwalla, Z J; Halpenny, M; Mullett, H; Department of Orthopaedic Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Republic of Ireland, zubinjimmydaruwalla@rcsi.ie. (2009-03)
      Pain control is an issue which may limit patients' acceptance of day case shoulder surgery. This study prospectively examined the outcome of a protocol for day case shoulder surgery to determine if satisfactory pain relief could be achieved without regional anaesthesia.
    • Day-case laparoscopic Nissen fundoplication.

      Khan, S A; Stephens, L; Department of Surgery, Naas General Hospital, Naas, Co. Kildare, Ireland. tahirkheli73@gmail.com (2012)
      For day-case laparoscopic surgery to be successful, patient selection is of the utmost importance. This study aimed to assess the feasibility of day-case laparoscopic Nissen fundoplication and to identify factors that may lead to readmission and overstay.
    • Day-surgery patients anesthetized with propofol have less postoperative pain than those anesthetized with sevoflurane.

      Tan, Terry; Bhinder, Rajesh; Carey, Michael; Briggs, Liam; Department of Anaesthesia and Perioperative Medicine, Coombe Women and Infants, University Hospital, Cork St., Dublin 8, Ireland. tutan@me.com (2012-02-01)
      BACKGROUND: There have been recent studies suggesting that patients anesthetized with propofol have less postoperative pain compared with patients anesthetized with volatile anesthetics. METHODS: In this randomized, double-blind study, 80 patients undergoing day-case diagnostic laparoscopic gynecological surgery were either anesthetized with IV propofol or sevoflurane. The primary outcome measured was pain on a visual analog scale. RESULTS: Patients anesthetized with propofol had less pain compared with patients anesthetized with sevoflurane (P = 0.01). There was no difference in any of the other measured clinical outcomes. CONCLUSIONS: The patients anesthetized with propofol appeared to have less pain than patients anesthetized with sevoflurane.
    • "Dead in bed": a tragic complication of type 1 diabetes mellitus.

      O'Reilly, M; O'Sullivan, E P; Davenport, C; Smith, D; Department of Endocrinology and Diabetes Mellitus, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland. micilino@hotmail.com (2010-12)
      "Dead in bed" is a tragic description of a particular type of sudden death in type 1 diabetes mellitus (DM). Patients are typically found dead in the early morning, lying in an undisturbed bed, having been well the previous evening. The incidence of "dead in bed" syndrome is not known but studies suggest figures of between 4.7 and 27.3% of all unexplained deaths in type 1 DM. The pathogenesis is unclear but patients typically have a preceding history of recurrent severe hypoglycaemia. We describe two cases of "dead in bed" syndrome which occurred at our institution within a 12-month period.
    • Dealing with cultural difference

      Parkinson, Ger; Rotunda Hospital (2009)
    • A deceiving wheeze.

      Chotirmall, S H; Branagan, P; Logan, M P; O'Neill, S J; Department of Respiratory Medicine, Beaumont Hospital, Dublin 9, Republic of Ireland, schotirmall@rcsi.ie. (2009-08-07)
      'Wheeze' is a common symptom in both paediatric and adult populations. Unexplained wheeze is concerning and warrants investigation. We present a case of a young girl with childhood asthma suffering with 'persistent wheeze'. This was explained by the presence of a dual aortic arch which only became apparent during her teenage years. This report serves as a reminder to all clinicians that "not all that wheezes is asthma".
    • Decision-support guide and use of prenatal genetic testing--reply.

      Kuppermann, Miriam; Norton, Mary E; Rotunda Hospital (2015-01-13)
    • The decline and fall of the cardiac biomarker: a good indicator of resolution of cardiac dysfunction following perinatal asphyxia. commentary on D.C. Vijlbrief et al.: Cardiac biomarkers as indicators of hemodynamic adaptation during postasphyxial hypothermia treatment (Neonatology 2012;102:243-248).

      Molloy, Eleanor J; Paediatrics, National Maternity Hospital, Paediatrics, Royal College of Surgeons of Ireland, Neonatology, Our Lady's Children's Hospital, Crumlin, and UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland. (Karger, 2012)
    • Decline in age of drinking onset in Ireland, gender and per capita alcohol consumption.

      Smyth, Bobby P; Kelly, Alan; Cox, Gemma; Department of Public Health & Primary Care, Trinity College Dublin, Addiction Service, Bridge House, Cherry Orchard Hospital, Dublin 10, Ireland. smythbo@tcd.ie (2011)
      We sought to examine the fall in age of first drinking in Ireland and to determine whether there were gender differences. We also aimed to determine whether there was a relationship between the per capita alcohol consumption evident when people entered later adolescence and their age of drinking onset.
    • The decline of hysterectomy for benign disease.[commentary]

      Ward, E; Browne, R; Torreggiani, W C (Irish medical journal, 2009)
    • The decline of TURP – An Irish experience

      Quinlan, Mark R; Connolly, Stephen S; McDermott, T.E.D (British Journal of Medical and Surgical Urology, 2009)
    • Decontamination in Hospitals and Healthcare

      Coleman, D.C.; O’Donnell, M.J.; Miller, A.S.; Boyle, M.A.; Dublin Dental University Hospital (2015-07-03)
    • Deep brain stimulation in Ireland for Parkinson's disease and essential tremor

      Mulroy, E; Quigley, G; K Roberts, K; Cummins, G; Magennis, B; Fortune, G; O’Brien, D; Blunnie, WP; Harrington, E; Gillivan-Murphy, P; et al. (Irish Medical Journal, 2012-09)
    • Deep full thickness burn to a finger from a topical wart treatment

      Tong, E; Dorairaj, J; O’Sullivan, JB; Kneafsey, B (Irish Medical Journal, 2015-10)
      We present a case of a deep full thickness burn from topical formic acid. Our patient developed a burn over her proximal interphalangeal joint (PIPJ) of her finger, secondary to inappropriate application of an anti-wart treatment. The burn required extensive debridement, and the resultant defect was reconstructed using a subcutaneous flap from the adjacent finger (a reverse cross finger flap). She was reviewed six months post-surgery, and overall she has a sub-optimal result. This incident was referred to the Irish Medicines Board who have since reviewed the case and ordered the manufacturer to alter their usage instructions.
    • Defining familial ALS: A worldwide survey

      Byrne, S; Hardiman, O (2011-11)
    • Defining useful surrogates for user participation in online medical learning.

      Beddy, Peter; Ridgway, Paul F; Beddy, David; Clarke, Eric; Traynor, Oscar; Tierney, Sean; Department of Surgery, Adelaide and Meath Hospital (AMNCH) incorporating the, National Children's Hospital, Tallaght, Dublin 24, Ireland. pbeddy@eircom.net (2012-02-01)
      "School for Surgeons" is a web-based distance learning program which provides online clinical-based tutorials to surgical trainees. Our aim was to determine surrogates of active participation and to assess the efficacy of methods to improve usage. Server logs of the 82 participants in the "School for Surgeons" were assessed for the two terms of the first year of the program. Data collected included total time online, mean session time, page requests, numbers of sessions online and the total number of assignments. An intervention regarding comparative peer usage patterns was delivered to the cohort between terms one and two. Of the 82 trainees enrolled, 83% (85% second term) logged into the program. Of all participants 88% (97% second term) submitted at least one assignment. Median submissions were four (eight second term) per trainee. Assignment submission closely correlated with number of sessions, total time online, downloads and page requests. Peer-based comparative feedback resulted in a significant increase in the number of assignments submitted (p < 0.01). Despite its recent introduction, "School for Surgeons" has a good participation rate. Assignment submission is a valid surrogate for usage. Students can be encouraged to move from passive observation to active participation in a virtual learning environment by providing structured comparative feedback ranking their performance.
    • Definition and management of fetal growth restriction: a survey of contemporary attitudes.

      Unterscheider, Julia; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; McAuliffe, Fionnuala M; O'Donoghue, Keelin; Hunter, Alyson; Morrison, John J; Burke, Gerard; Dicker, Patrick; et al. (2014-03)
      To evaluate opinions among Irish obstetricians and obstetric trainees regarding the optimal definition, assessment and management of pregnancies affected by intrauterine growth restriction (IUGR).
    • Definition of coordinate system for three-dimensional data analysis in the foot and ankle.

      Green, Connor; Fitzpatrick, Clare; FitzPatrick, David; Stephens, Michael; Quinlan, William; Flavin, Robert; Department of Trauma and Orthopaedics, St. Vincent's University Hospital,, Donnybrook, Dublin 4, Ireland. connorjgreen@gmail.com (2012-02-01)
      BACKGROUND: Three-dimensional data is required to have advanced knowledge of foot and ankle kinematics and morphology. However, studies have been difficult to compare due to a lack of a common coordinate system. Therefore, we present a means to define a coordinate frame in the foot and ankle and its clinical application. MATERIALS AND METHODS: We carried out ten CT scans in anatomically normal feet and segmented them in a general purpose segmentation program for grey value images. 3D binary formatted stereolithography files were then create and imported to a shape analysis program for biomechanics which was used to define a coordinate frame and carry out morphological analysis of the forefoot. RESULTS: The coordinate frame had axes standard deviations of 2.36 which are comparable to axes variability of other joint coordinate systems. We showed a strong correlation between the lengths of the metatarsals within and between the columns of the foot and also among the lesser metatarsal lengths. CONCLUSION: We present a reproducible method for construction of a coordinate system for the foot and ankle with low axes variability. CLINICAL RELEVANCE: To conduct meaningful comparison between multiple subjects the coordinate system must be constant. This system enables such comparison and therefore will aid morphological data collection and improve preoperative planning accuracy.
    • Definition of intertwin birth weight discordance.

      Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; et al. (OVID Lippincott Williams and Wilkins, 2011-07)
      To establish the level of birth weight discordance at which perinatal morbidity increases in monochorionic and dichorionic twin pregnancy.
    • The deformation and strength of a dental ceramic following resin-cement coating.

      Isgró, G; Addison, O; Fleming, G J P; Materials Science Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland. g_isgro@tiscali.it (2011-02)
      The hypothesis tested was that processing, pre-cementation and cementation techniques can modify the profilometrically measured deformation of a ceramic.