• Fabry's disease in a female

      O'Loughlin, A; O'Donnell, B (2009-03)
      American Academy of Dermatology
    • Fabry’s disease in a female, still an under-recognised disease

      Lynch, M (Irish Medical Journal, 2013-05)
      A nine-year-old girl presented with an asymptomatic eruption on her right leg which had been present for 2 years. She complained of severe acral pain and paraesthesiae for several years, despite treatment with numerous analgaesics, amitriptyline, gabapentin and carbamazepine. On occasion she had been confined to a wheelchair and required home schooling. On examination she had a unilateral eruption affecting her right thigh and lower leg (Figure 1). On closer view, there were erythematous, hyperkeratotic and haemorrhagic papules. Histopathological examination of a skin biopsy showed hyperkeratosis and dilated blood vessels in the dermis consistent with . Electron microscopy demonstrated intralysosomal glycolipid deposits, arranged in a lamellar fashion, within the endothelial cells lining dermal blood vessels (Figure 2)
    • Facial talon cusps.

      McNamara, T; Haeussler, A M; Keane, J; Regional Orthodontic Department, St James's Hospital, Dublin, Ireland. (1997-12)
      This is a report of two patients with isolated facial talon cusps. One occurred on a permanent mandibular central incisor; the other on a permanent maxillary canine. The locations of these talon cusps suggests that the definition of a talon cusp include teeth in addition to the incisor group and be extended to include the facial aspect of teeth.
    • Factitious disorder as a differential diagnosis for recurrent skin graft failure.

      Seoighe, D M; Dempsey, M; Lawlor, C; O'Dwyer, A M; Department of Plastic and Reconstructive Surgery, St James's Hospital, Dublin, Ireland. Deirdre.seoighe@gmail.com (2011-04)
      This case report presents the history of a 43-year-old man who sustained a relatively minor burn to his face but who subsequently suffered significant morbidity. Although the wound was grafted on a number of occasions, it failed to heal. Multiple investigations were carried out to determine the cause of recurrent wound breakdown. It had been suspected that the patient was interfering with the wound but this could not be proven initially. He was eventually diagnosed with factitious disorder and it was only when this was managed in the multi-disciplinary setting that his wound finally healed.
    • Factors affecting length of stay in forensic hospital setting: need for therapeutic security and course of admission.

      Davoren, Mary; Byrne, Orla; O'Connell, Paul; O'Neill, Helen; O'Reilly, Ken; Kennedy, Harry G (Springer, 2015)
      Patients admitted to a secure forensic hospital are at risk of a long hospital stay. Forensic hospital beds are a scarce and expensive resource and ability to identify the factors predicting length of stay at time of admission would be beneficial. The DUNDRUM-1 triage security scale and DUNDRUM-2 triage urgency scale are designed to assess need for therapeutic security and urgency of that need while the HCR-20 predicts risk of violence. We hypothesized that items on the DUNDRUM-1 and DUNDRUM-2 scales, rated at the time of pre-admission assessment, would predict length of stay in a medium secure forensic hospital setting.
    • Factors affecting return to driving post-stroke.

      Tan, K M; O'Driscoll, A; O'Neill, D; Stroke Service, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. (2012-02-01)
      BACKGROUND: Stroke can affect a person's ability to drive, an important means of transportation in the developed world. AIMS: To determine percentage of patients and factors associated with return to driving post-stroke in a service with emphasis on driver assessment. METHODS: Retrospective study of patients discharged from the Stroke Service of our 470-bed teaching hospital from 1998 to 2002. RESULTS: Of 72 drivers pre-stroke, 54% recalled a driving assessment and 68% returned to driving. Younger patients (58.6 +/- 12.0 vs. 66.5 +/- 10.5, p = 0.008) with lower Modified Rankin Score (median 1 vs. 2, p = 0.0001) and normal cognition (55 vs. 43%, p = 0.45) were more likely to resume driving. More patients who were assessed returned to driving than those who were not (74 vs. 61%, p = 0.31). CONCLUSIONS: A relatively high level of return to driving can be achieved post-stroke with a pro-active approach to driver assessment and rehabilitation. A structured assessment and referral programme should be offered where appropriate.
    • Factors associated with duration of breastfeeding in ireland: potential areas for improvement.

      Tarrant, R C; Younger, Katherine M; Sheridan-Pereira, Margaret; Kearney, John M; Department of Clinical Nutrition and Dietetics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. (2011-08)
      There is a need to comprehensively examine why mothers in Ireland discontinue breastfeeding early and to explore the factors influencing duration of breastfeeding during the first 6 months postpartum. Findings from this study provide valuable direction for future strategies and interventions aimed at increasing breastfeeding duration rates in Ireland.
    • Factors Associated with Maternal Wellbeing at Four Months Post-Partum in Ireland.

      Bennett, Annemarie E; Kearney, John M; 1 Department of Clinical Medicine, Trinity Centre for Health Sciences, St. James' Hospital Campus, Dublin 8, Ireland. 2 School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland. (MDPI, 2018-05-14)
      This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p < 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p < 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49–20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20–12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02–1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29–6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland.
    • Factors associated with weaning practices in term infants: a prospective observational study in Ireland.

      Tarrant, R C; Younger, Katherine M; Sheridan-Pereira, Margaret; White, Martin J; Kearney, John M; School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland. (2010-11)
      The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant's diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers' weaning practices using semi-structured questionnaires and a short dietary history of the infant's usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.
    • Factors Contributing to Non-Exclusive Breastfeeding in Primigravid Mothers

      Panaviene, J.; Zakharchenko, L.; Olteanu, D.; Cullen, M.; EL-Khuffash, E.L (Irish Medical Journal, 2019-10)
      We aimed to examine the factors contributing to non-exclusive breastfeeding in primigravid mothers in a large Irish tertiary maternity hospital.
    • Factors influencing career choice after initial training in surgery.

      McHugh, Seamus; Corrigan, Mark; Sheikh, Athar; Lehane, Elaine; Tanner, William; Hill, Arnold; Department of Surgery, Beaumont Hospital, Dublin, Ireland. seamusmchugh@rcsi.ie (2011-03)
      Irish general surgery faces a recruitment crisis with only 87 of 145 (60%) basic surgical training (BST) places filled in 2009. We assessed basic surgical trainees to identify objective, and potentially modifiable, factors that influence ultimate recruitment into a general surgical career.
    • Factors influencing career choice after initial training in surgery.

      McHugh, Seamus; Corrigan, Mark; Sheikh, Athar; Lehane, Elaine; Tanner, William; Hill, Arnold; Department of Surgery, Beaumont Hospital, Dublin, Ireland. seamusmchugh@rcsi.ie (2012-02-01)
      INTRODUCTION: Irish general surgery faces a recruitment crisis with only 87 of 145 (60%) basic surgical training (BST) places filled in 2009. We assessed basic surgical trainees to identify objective, and potentially modifiable, factors that influence ultimate recruitment into a general surgical career. METHODS: Candidates commencing BST training during a 5-year period between 2004 and 2008 were included in a quantitative study. In addition a total of 2,536 candidates, representing all those who commenced surgical training in Ireland since 1960 were identified through the Royal College of Surgeons in Ireland (RCSI) database and invited to complete an online survey. Statistical analysis was performed using SPSS version 15, with p < 0.05 considered significant. RESULTS: During the 5-year quantitative study period there were 381 BST trainees. Gender was a significant predictor of career choice with women more likely to ultimately choose a nonsurgical career after initial surgical training (p = 0.049). Passing surgical membership examinations (MRCS) also was predictive of remaining in surgery (p = 0.005). Training region was not a significant predictor of ultimate career choice. There were 418 survey respondents. The influence of role models was most commonly cited as influencing candidates in choosing to commence surgical training. Candidates who rated "academic opportunity" (p = 0.023) and "intellectual challenge" (p = 0.047) as factors that influenced their decision to commence surgical training were more likely to ultimately continue their careers in a surgical speciality. CONCLUSIONS: This study describes the career pathway of surgical trainees and confirms the importance of academic achievement in discriminating between candidates applying for surgical training schemes.
    • Factors influencing conformity index in radiotherapy for non-small cell lung cancer.

      Brennan, Sinead M; Thirion, Pierre; Buckney, Steve; Shea, Carmel O; Armstrong, John; Department of Radiation Oncology, St. Lukes Hospital, Dublin, Ireland. sinead.brennan09@gmail.com (2010)
      The radiotherapy conformity index (CI) is a useful tool to quantitatively assess the quality of radiotherapy treatment plans, and represents the relationship between isodose distributions and target volume. A conformity index of unity implies high planning target volume (PTV) coverage and minimal unnecessary irradiation of surrounding tissues. We performed this analysis to describe the CI for lung cancer 3-dimensional conformal radiotherapy (3DCRT) and to identify clinical and technical determinants of CI, as it is not known which factors are associated with good quality 3D conformal radiotherapy treatment planning. Radiotherapy treatment plans from a database of 52 patients with inoperable Stage 1 to 3b lung cancer, on a hypofractionated 3DCRT trial were evaluated. A CI was calculated for all plans using the definition of the ICRU 62:CI = (TV/PTV), which is the quotient of the treated volume (TV) and the PTV. Data on patient, tumor, and planning variables, which could influence CI, were recorded and analyzed. Mean CI was 2.01 (range = 1.06-3.8). On univariate analysis, PTV (p = 0.023), number of beams (p = 0.036), medial vs. lateral tumor location (p = 0.016), and increasing tumor stage (p = 0.041) were associated with improved conformity. On multiple regression analysis, factors found to be associated with CI included central vs. peripheral tumor location (p = 0.041) and PTV size (p = 0.058). The term 3DCRT is used routinely in the literature, without any indication of the degree of conformality. We recommend routine reporting of conformity indices. Conformity indices may be affected by both planning variables and tumor factors.
    • Factors involved in unplanned admissions from general surgical day-care in a modern protected facility

      Awan, FN; Zulkifli, MS; Mc Cormack, O; Manzoor, T; Ravi, N; Mehigan, B; Reynolds, JV (Irish Medical Journal, 2013-05)
    • Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

      Agyapong, Vincent I O; Rogers, Cathy; Machale, Siobhan; Cotter, David; St. Patrick's University Hospital, Dublin, Ireland. israelhans@hotmail.com (2010)
      Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.
    • Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

      Agyapong, Vincent I O; Rogers, Cathy; Machale, Siobhan; Cotter, David; St. Patrick's University Hospital, Dublin, Ireland. israelhans@hotmail.com (2010)
      Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.
    • Factors predicting suicidal ideation in the preceding 12 months among patients attending a community psychiatric outpatient clinic.

      Anyansi, Tochukwu E; Agyapong, Vincent I O; Department of Psychiatry, Connolly Hospital, Dublin, Ireland. (2013-06)
      Predictive factors are used to alert the clinician to the necessity of carrying out a suicide risk assessment in those patients whose demographic and clinical characteristics suggest the possibility of suicide.
    • Factors that predict failure in home management of an acute exacerbation of COPD.

      Dunican, Eleanor M; Deering, Brenda M; Ryan, Dorothy M; McCormack, Niamh M; Costello, Richard W; Department of Respiratory Medicine, Beaumont Hospital, Dublin 9, Ireland. rcostello@rcsi.ie. (2011-04)