• N-Acetyl-Cystein improves results of long term culture of frozen thawed human ovarian tissue [Poster]

      Fabbri, R; Pasquinelli, G; Magnani, V; Keane, D; Cabello, Vives; Venturoli, S; Rotunda Hospital (2009-04-19)
    • N-cadherin is overexpressed in Crohn's stricture fibroblasts and promotes intestinal fibroblast migration.

      Burke, John P; Cunningham, Michael F; Sweeney, Catherine; Docherty, Neil G; O'Connell, P Ronan; Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland. (2012-02-01)
      BACKGROUND: Intestinal fibroblasts mediate stricture formation in Crohn's disease (CD). Transforming growth factor-beta (TGF-beta) is important in fibroblast activation, while cell attachment and migration is regulated by the adhesion molecule N-cadherin. The aim of this study was to investigate the expression and function of N-cadherin in intestinal fibroblasts in patients with fibrostenosing CD. METHODS: Intestinal fibroblasts were cultured from seromuscular biopsies from patients undergoing resection for terminal ileal fibrostenosing CD (n = 14) or controls patients (n = 8). N-cadherin expression was assessed using Western blot and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Fibroblasts were stimulated with TGF-beta and selective pathway inhibitors Y27632, PD98050, and LY294002 were used to examine the Rho/ROCK, ERK-1/2, and Akt signaling pathways, respectively. Cell migration was assessed using a scratch wound assay. N-cadherin was selectively overexpressed using a plasmid. RESULTS: Fibroblasts from fibrostenosing CD express increased constitutive N-cadherin mRNA and protein and exhibit enhanced basal cell migration relative to those from directly adjacent normal bowel. Control fibroblasts treated with TGF-beta induced N-cadherin in a dose-dependent manner which was inhibited by Rho/ROCK and Akt pathway modulation. Control fibroblasts exhibited enhanced cell migration in response to treatment with TGF-beta or transfection with an N-cadherin plasmid. CONCLUSIONS: Fibroblasts from strictures in CD express increased constitutive N-cadherin and exhibit enhanced basal cell migration. TGF-beta is a potent inducer of N-cadherin in intestinal fibroblasts resulting in enhanced cell migration. The TGF-beta-mediated induction of N-cadherin may potentiate Crohn's stricture formation.
    • N-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosus

      OFarombi-Oghuvbu, IO; Matthews, Thomas; Mayne, Philip D; Guerin, Hilda; Corcoran, David (BMJ, 2008-01-24)
      Background: B type natriuretic peptide (BNP) is a marker for ventricular dysfunction secreted as a pre-prohormone, Pro-B-type natriuretic peptide (ProBNP), and cleaved into BNP and a biologically inactive fragment, N-terminal pro-B-type natriuretic peptide (NT-proBNP). Little is known about the clinical usefulness of NT-proBNP in preterm infants. Objective: To evaluate the usefulness of plasma NT-proBNP in diagnosing hsPDA in neonates and examine some factors that could affect this. Methods: Infants born at <34 weeks gestation (GA) and < 2kg birth weight (BW) were prospectively enrolled within 6 to 12 hours of birth. Plasma NT-proBNP levels were measured on days 1, 3, 5 and 10 with simultaneous echocardiography done to detect hsPDA and assess ventricular function. Significant PDA diagnosed by large ductal flow with left to right shunt on colour Doppler measuring >1.6mm on 2D echocardiography along with clinical features of PDA. Results: Forty-nine infants analysed. Median GA 30 weeks (range: 24-33) and median BW 1220 grams (range: 550-1950gm). Eighteen hsPDA infants had higher day 3 plasma NT-proBNP values (median 32907pg/mL; range: 11396-127155) (p<0.001) compared with controls (median 3147pg/mL; range: 521-10343). Infants who developed sepsis had higher day 10 plasma NT-proBNP levels. Area under ROC curve for detection of hsPDA, by day 3 NT-proBNP value, was significant 0.978 (95% CI: 0.930-1.026). NT-proBNP was predictive of hsPDA (sensitivity 100%; specificity 95%) at cut-off value of 11395pg/mL. Conclusion: Plasma NT-proBNP level on day 3 is a good marker for hsPDA in preterm infants. Serial measurements of NT-proBNP may be useful in assessing the clinical course of PDA.
    • Nanodrug applications in photodynamic therapy.

      Paszko, Edyta; Ehrhardt, Carsten; Senge, Mathias O; Kelleher, Dermot P; Reynolds, John V; Medicinal Chemistry, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin, Ireland. (2011-03)
      Photodynamic therapy (PDT) has developed over last century and is now becoming a more widely used medical tool having gained regulatory approval for the treatment of various diseases such as cancer and macular degeneration. It is a two-step technique in which the delivery of a photosensitizing drug is followed by the irradiation of light. Activated photosensitizers transfer energy to molecular oxygen which results in the generation of reactive oxygen species which in turn cause cells apoptosis or necrosis. Although this modality has significantly improved the quality of life and survival time for many cancer patients it still offers significant potential for further improvement. In addition to the development of new PDT drugs, the use of nanosized carriers for photosensitizers is a promising approach which might improve the efficiency of photodynamic activity and which can overcome many side effects associated with classic photodynamic therapy. This review aims at highlighting the different types of nanomedical approaches currently used in PDT and outlines future trends and limitations of nanodelivery of photosensitizers.
    • Nanotechnologies for the study of the central nervous system.

      Ajetunmobi, A; Prina-Mello, A; Volkov, Y; Corvin, A; Tropea, D (2014-12)
      The impact of central nervous system (CNS) disorders on the human population is significant, contributing almost €800 billion in annual European healthcare costs. These disorders not only have a disabling social impact but also a crippling economic drain on resources. Developing novel therapeutic strategies for these disorders requires a better understanding of events that underlie mechanisms of neural circuit physiology. Studying the relationship between genetic expression, synapse development and circuit physiology in CNS function is a challenging task, involving simultaneous analysis of multiple parameters and the convergence of several disciplines and technological approaches. However, current gold-standard techniques used to study the CNS have limitations that pose unique challenges to furthering our understanding of functional CNS development. The recent advancement in nanotechnologies for biomedical applications has seen the emergence of nanoscience as a key enabling technology for delivering a translational bridge between basic and clinical research. In particular, the development of neuroimaging and electrophysiology tools to identify the aetiology and progression of CNS disorders have led to new insights in our understanding of CNS physiology and the development of novel diagnostic modalities for therapeutic intervention. This review focuses on the latest applications of these nanotechnologies for investigating CNS function and the improved diagnosis of CNS disorders.
    • Nanotechnology and its relationship to interventional radiology. Part I: imaging.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9, Ireland. (2011-04)
      Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.
    • Nanotechnology and its relationship to interventional radiology. Part I: imaging.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Dublin 9, Ireland. (2012-02-01)
      Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.
    • Nanotechnology and its Relationship to Interventional Radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9, Ireland. (2010-09-16)
      Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.
    • Nanotechnology and its relationship to interventional radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9,, Ireland. (2012-02-01)
      Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.
    • The nasal bridle: A useful approach to prevent the dislodgement of feeding tubes e-SPEN,

      Power, S; Smyth, N; Duggan, SN; Roddy, M; Feehan, S (Journal of Clinical Nutrition and Metabolism, 2010)
    • Nasal pillows as an alternative interface in patients with obstructive sleep apnoea syndrome initiating continuous positive airway pressure therapy.

      Ryan, Silke; Garvey, John F; Swan, Valerie; Behan, Renata; McNicholas, Walter T; Sleep Research Laboratory, St Vincent's University Hospital, Dublin, Ireland. (2012-02-01)
      Side-effects directly due to the nasal mask are common in patients with obstructive sleep apnoea syndrome (OSAS) commencing continuous positive airway pressure (CPAP). Recently, nasal pillows have been designed to overcome these issues. Limited evidence exists of the benefits and effectiveness of these devices. Twenty-one patients (19 male, 49+/-10years) with the established diagnosis of OSAS [apnoea/hypopnoea index (AHI): 52+/-22] and who had a successful CPAP titration were commenced on CPAP therapy (10+/-2cmH2O), and randomized to 4weeks of a nasal pillow (P) and a standard nasal mask (M) in a crossover design. Outcome measures were objective compliance, AHI, quality of life, Epworth Sleepiness Score (ESS) and CPAP side-effects. There was no difference in compliance (M versus P: 5.1+/-1.9h versus 5.0+/-1.7h; P=0.701) and AHI (2.6+/-2.7 versus 3.0+/-2.9; P=0.509). Quality of life and ESS improved with CPAP, but there was no difference in the extent of improvement between both devices. Usage of nasal pillows resulted in less reported pressure on the face and more subjects found the nasal pillow the more comfortable device. However, there was no clear overall preference for either device at the end of the study (mask=57%, pillow=43%; P=0.513). The applied CPAP pressure did not correlate with compliance, AHI and ESS. Furthermore, no differences in outcome parameters were noted comparing groups with CPAP pressure <10 and >/=10cm H(2) O. Nasal pillows are equally effective in CPAP therapy, but do not generally lead to improved compliance.
    • Natalizumab therapy of multiple sclerosis.

      Hutchinson, Michael; Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland., mhutchin@iol.ie (2012-02-01)
      Multiple sclerosis (MS) is the commonest disabling neurological disease of young and middle-aged adults affecting 1 million persons world wide. The illness begins with a relapsing-remitting MS course in 85%-90% of patients; the other 10%-15% have a primary progressive onset MS. Our current understanding is that MS is an autoimmune disorder with an inflammatory T-cell attack on myelin or some component of the oligodendrocyte--myelin structure. Relapses of disease activity result in plaques of demyelination with destruction of myelin and, to a lesser, extent axons. Lymphocytes within the central nervous system tissue recruit more cells leading to an inflammatory cascade that causes myelin damage, axonal disruption, and neuronal death. If the plaque occurs in a vocal area of the central nervous system then symptoms relating to that area result. However, magnetic resonance imaging shows that approximately 10 times more lesions occur in asymptomatic areas of the brain. Recovery from an initial relapse may appear relatively complete but persistent inflammation results in axonal injury and residual disability results. With time and accumulated lesion load, secondary degeneration of denuded axons results in the phase of secondary progressive MS usually 15-20 years after onset.
    • A National Audit of Smoking Cessation Services in Irish Maternity Units

      Reynolds C.M.E.; Egan B; Cawley S; Kennedy , R; Sheehan S R; Turner M.J (Irish Medical Journal, 2017-06)
      There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
    • National guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage.

      Tormey, William; O'Shea, Paula; Brennan, Paul; Department of Chemical Pathology, Beaumont Hospital, Dublin 9. (2012-02-01)
    • A national house-staff audit of medical prophylaxis in medical patients for the PREVENTion of Venous ThromboEmbolism (PREVENT-VTE)

      Adamali, H; Zaid, H; Suliman, AM; O’Donoghue, E; Burke, A; Suliman, AW; Salem, M; O’Toole, A; Ibrahim Yearoo, A; Javid, S; et al. (Irish Medical Journal (IMJ), 2013)
      We established a national audit to assess the thromboprophylaxis rate for venous thromoembolism (VTE) in at risk medical patients in acute hospitals in the Republic of Ireland and to determine whether the use of stickers to alert physicians regarding thromboprophylaxis would double the rate prophylaxis in a follow-up audit. 651 acute medical admission patients in the first audit and 524 in the second re-audit were recruited. The mean age was 66.5yrs with similar numbers of male and female patients and 265(22.6%) patients were active smokers. The first and second audits identified 549(84%) and 487(93%) of patients at-risk for VTE respectively. Of the at-risk patients, 163(29.7%) and 132(27.1%) received LMWH in the first and second audit respectively. Mechanical thromboprophylaxis was instigated in 75(13.6%) patients in the first and 86(17.7%) patients in the second audit. The placement of stickers in patient charts didnâ t produce a significant increase in the number of at risk patients treated in the second audit. There is unacceptably low adherence to the ACCP guidelines in Ireland and more complex intervention than chart reminders are required to improve compliance.
    • The national incidence and outcomes of gastroschisis repairs

      Barrett, MJ; Kozdoba, O; Al Assaf, N; Gillick, J; Mortell, A; Foran, A (Irish Medical Journal (IMJ), 2014-03)
      The birth prevalence of gastroschisis worldwide has increased over the past decades. We aim to determine the Irish national incidence of gastroschisis repairs (NIGR) over a 5 year period (2007- 2011) and clinical outcomes by a retrospective cohort review of cases admitted to all Irish paediatric surgical units. Seventy patients were identified. The NIGR per 10,000 live births was 1.96 (SD 0.51) per year. Fifty eight (82%) were antenatally detected. Twenty eight (40%) had primary repair day 1 with the remaining repaired in a median of 3(2-5.75) days. Thirty three (47%) experienced a central catheter related infection. Duration of stay was significantly correlated with decreasing gestational age (p=0.016), decreasing birthweight (p=0.005), increasing numbers of blood transfusions (p<0.001) and co-morbidity or complication (p<0.001). This study provides individual centres with patient outcomes and national data that can be provided to parents and clinical staff regarding the clinical course of gastroschisis.
    • National Maternity Hospital : Clinical report for the year 1997

      Boylan, Peter (National Maternity Hospital (NMH), 1997)
      The trend of previous years continued with a further increase in deliveries compared to 1996. There were 7682 babies delivered during the year. There has been a 46% increase in primigravidae and an 8% increase in multiparous women delivering at the hospital over the past 7 years. Most of this increase has taken place in the last 3 years. The increase in primigravidae is reflected in their changed portion of the total hospital population . Primjgravidae now make-up 45% of all women delivering at the hospital where as in 1991 they made-up 38%. The changing proportions of primigravidae are partly responsible for the increased incidence of Caesarean Section, from 9% in 1991 to 10.8% in 1997. The other major change in hospital practice has been the increase of epidural anaesthesia which grew from 18% of a1l women in 1991 to 49% in 1997. These changes in practice have strained hospital resources to the limit.
    • National Maternity Hospital annual report 2013

      National Maternity Hospital Holles St (National Maternity Hospital Holles St, 2014-07)
    • National Maternity Hospital Dublin Clinical report 1991

      Boylan, Peter (National Maternity Hospital (NMH), 1991)
      1991 was another busy year with a marginal increase in the number of mothers delivered, but a very substantial increase in gynaecological activity. A total of 7,077 mothers were delivered during 1991 , an increase of 0.2% compared to 1990. The number of primigravidae delivered was 2,322, an increase of 3.1% over the previous year. A total of 6,277 infants weighing 500 grams or more were delivered by 6,178 mothers. Eight hundred and seventy seven mothers miscarried before 24 weeks gestation. There were 4 molar pregnancies and 18 ectopic pregnancies. Two mothers died during the course of pregnancy. The first was a 31 year old from Libya who died from overwhelming infection associated with a spontaneous miscarriage at 18 weeks gestation. She died after a prolonged stay in the intensive care unit of a general hospital. The second mother was also from Libya and she died approximately four weeks following caesarean delivery for eclampsia, also following a prolonged stay in the intensive care unit of a general hospital. Both these tragic deaths occurred despite the full panoply of modern intensive care.