• UK experience of azacitidine therapy in patients with myelodysplastic syndromes

      Killick, S; Enright, H; Vyas, P; Das-Gupta, E; Dennis, M; Culligan, D; Milic, M; Chacko, J (Leukemia Research, 2011)
    • A UK NEQAS ISH multicenter ring study using the Ventana HER2 dual-color ISH assay.

      Bartlett, J M S; Campbell, Fiona M; Ibrahim, Merdol; O'Grady, Anthony; Kay, Elaine; Faulkes, Catherine; Collins, Nadine; Starczynski, Jane; Morgan, John M; Jasani, Bharat; et al. (2011-01)
      We performed a multicenter assessment of a new HER2 dual-color chromogenic in situ hybridization (CISH) test and herein report on concordance of CISH data with fluorescence in situ hybridization (FISH) data and intraobserver and interlaboratory scoring consistency. HER2 results were evaluated using duplicate cores from 30 breast cancers in 5 laboratories using the Ventana HER2 dual-color ISH assay (Ventana Medical Systems, Cambridgeshire, England) and in 1 central laboratory using a standard FISH assay. Overall 93.3% of cases were successfully analyzed by CISH across the 5 participating laboratories. There was excellent concordance (98.0% overall) for diagnosis of HER2 amplification by CISH compared with FISH. Intraobserver variability (7.7%) and intersite variability (9.1%) of absolute HER2/chromosome enumeration probe 17 ratios were tightly controlled across all participating laboratories. The Ventana HER2 dual-color ISH assay is robust and reproducible, shows good concordance with a standard FISH assay, and complies with requirements in national and international guidelines for performance of ISH-based diagnostic tests.
    • Ultra high risk of psychosis on committal to a young offender prison: an unrecognised opportunity for early intervention.

      Flynn, Darran; Smith, Damian; Quirke, Luke; Monks, Stephen; Kennedy, Harry G; National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland. (BioMed Central, 2012-08)
      The ultra high risk state for psychosis has not been studied in young offender populations. Prison populations have higher rates of psychiatric morbidity and substance use disorders. Due to the age profile of young offenders one would expect to find a high prevalence of individuals with pre-psychotic or ultra-high risk mental states for psychosis (UHR). Accordingly young offender institutions offer an opportunity for early interventions which could result in improved long term mental health, social and legal outcomes. In the course of establishing a mental health in-reach service into Ireland's only young offender prison, we sought to estimate unmet mental health needs.
    • Ultrasonically detectable cerebellar haemorrhage in preterm infants.

      McCarthy, Lisa Kenyon; Donoghue, V; Murphy, J F A; Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. lmccarthy@nmh.ie (2011-07)
      To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).
    • Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

      Henari, Shwan; Banks, Louisa N; Radovanovic, Ingrid; Queally, Joseph; Morris, Seamus; Department of Trauma and Orthopedics, Adelaide and Meath Hospital, Dublin, Ireland. shwanhenari@hotmail.com (Orthopedics, 2011-10)
      The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.
    • Ultrasound appearances of Implanon implanted contraceptive devices.

      McNeill, G; Ward, E; Halpenny, D; Snow, A; Torreggiani, W; Department of Radiology, AMNCH Tallaght, Dublin 24, Ireland. (JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 2009-09)
      Subdermal contraceptive devices represent a popular choice of contraception. Whilst often removed without the use of imaging, circumstances exist where imaging is required. Ultrasound is the modality of choice. The optimal technique and typical sonographic appearances are detailed in this article.
    • Ultrasound assessment of placental function: the effectiveness of placental biometry in a low-risk population as a predictor of a small for gestational age neonate.

      McGinty, Patricia; Farah, Nadine; Dwyer, Vicky O; Hogan, Jennifer; Reilly, Amanda; Turner, Michael J; Stuart, Bernard; Kennelly, Máireád M; Ultrasound and Fetal Medicine Centre, Coombe Women & Infants University Hospital, Dublin, Ireland. (2012-07)
      The aims of the study were to establish reference ranges for placental length and thickness in a low-risk obstetric population and to assess the likelihood of a small for gestational age (SGA) neonate on the basis of placental length at 18-24 weeks' gestation.
    • Ultrasound in obstetric anaesthesia: a review of current applications.

      Ecimovic, P; Loughrey, J P R; Mater Misercordiae Hospital, Dublin, Ireland. (2010-07)
      Ultrasound equipment is increasingly used by non-radiologists to perform interventional techniques and for diagnostic evaluation. Equipment is becoming more portable and durable, with easier user-interface and software enhancement to improve image quality. While obstetric utilisation of ultrasound for fetal assessment has developed over more than 40years, the same technology has not found a widespread role in obstetric anaesthesia. Within the broader specialty of anaesthesia; vascular access, cardiac imaging and regional anaesthesia are the areas in which ultrasound is becoming increasingly established. In addition to ultrasound for neuraxial blocks, these other clinical applications may be of value in obstetric anaesthesia practice.
    • Ultrasound in Rheumatology

      Kane, David ((Hochberg), 2013)
    • Ultrasound in the evaluation of enthesitis: status and perspectives.

      Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick; Wakefield, Richard J; Naredo, Esperanza; D'Agostino, Maria Antonietta; Rheumatology Department, Université Paris 6-Pierre et Marie Curie, Hôpital La Pitié Salpetrière, APHP, 83 Boulevard de l’hôpital 75013 Paris, France. (Arthritis research & therapy, 2011)
      An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter.
    • Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

      Solon, Jacqueline G; Power, Colm; Al-Azawi, Dhafir; Duke, Deirdre; Hill, Arnold D K; Department of Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery,, Royal College of Surgeons in Ireland, Dublin, Ireland. (2012-02-01)
      BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient's preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.
    • Ultrasound-guided removal of Implanon devices.

      Persaud, T; Walling, M; Geoghegan, T; Buckley, O; Stunell, H; Torreggiani, W C; Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. (European radiology, 2008-11)
      Our study has shown that ultrasound-guided localisation and removal of Implanon rods is safe, practical and highly successful. Over a 4-year period, 119 patients had successful, uncomplicated removal of their subdermal devices.The technique is particularly useful for removal of the device when it is not palpable or when an attempt at removal of a palpable device has not been successful.
    • Ultraviolet radiation and immunosuppression.

      Murphy, G M; Department of Dermatology, Beaumont & Mater Misericordiae Hospital, Dublin, Ireland. gmurphyoffice@eircom.net (2009-11)
      Ultraviolet (UV) radiation is a complete carcinogen. The effects of UV radiation are mediated via direct damage to cellular DNA in the skin and suppression of image surveillance mechanisms. In the context of organ transplantation, addiction of drugs which suppress the immune system add greatly to the carcinogenicity of UV radiation. This review considers the mechanisms of such effects.
    • Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report.

      Good, Daniel W; Royds, Jonathan E; Smith, Myles J; Neary, Paul C; Eguare, Emmanuel; Minimally Invasive Surgical Unit, Division of Colorectal Surgery, AMNCH, Tallaght, Dublin 24, Ireland. goodd@tcd.ie. (Journal of medical case reports, 2011)
      The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.
    • Uncomfortably numb: suicide and the psychological undercurrent of COVID-19.

      Hughes, H; Macken, M; Butler, J; Synnott, K (2020-05-21)
    • An Under-Recognised Cause of Iatrogenic, Severe Metabolic Acidosis

      Spring, A; Owens, R; Fratita, M; O’Dwyer, M (Irish Medical Journal, 2019-04)
      Pyroglutamic acidosis is an uncommonly diagnosed but important cause of a high anion gap metabolic acidosis. Our case report concerns an elderly male admitted to the Intensive Care Unit (ICU) following the acute onset of coma which developed during treatment of a prosthetic joint infection. A diagnosis of pyroglutamic acidosis was ultimately made and later confirmed with laboratory testing. Blood gas analysis revealed a profound high anion gap metabolic acidosis.
    • The underdetection of cognitive impairment in nursing homes in the Dublin area. The need for on-going cognitive assessment.

      Cahill, Suzanne; Diaz-Ponce, Ana M; Coen, Robert F; Walsh, Cathal; Dementia Services Information and Development Centre, St. James Hospital, Dublin,, Ireland. cahillsu@tcd.ie (2012-02-01)
    • Undergraduate medical education in substance use in Ireland: a review of the literature and discussion paper.

      O'Brien, S; Cullen, W; UCD General Practice, UCD School of Medicine and Medical Science, Coombe Healthcare Centre, Dolphins Barn, Dublin 8, Ireland. sarahob17@gmail.com (2011-12)
      Medical complications of substance use are a considerable cause of morbidity and the role of the physician in the care of such problems has consistently been demonstrated. Appropriate knowledge and skills are necessary to carry out this role.