• Our role is education

      Stassen, JF (Journal of the Irish Dental Association, 2009-06)
    • Out of sight, out of mind? A national survey of paediatricians in Ireland regarding Fetal Alcohol Spectrum Disorders

      Gill, I; Sharif, F (Irish Medical Journal, 2017-03)
      Fetal Alcohol Spectrum Disorders (FASDs) are one of the major causes of preventable developmental delay. There is no register of children with FASDs in Ireland. Up to 81% of Irish women report drinking alcohol during the periconceptual period or pregnancy. We aimed to evaluate self-reported knowledge and practice of doctors working in paediatrics in Ireland with regards to FASDs and alcohol consumption during pregnancy. We circulated a survey to all paediatric doctors in Ireland, either enrolled in specialist training or registered as trainers. Fifty-six respondents (31.3%) were unaware of the existence of FASDs. Sixty-two (34.6%) believed most patients with FASDs have dysmorphic features. Seventy-three respondents (40.8%) routinely ask about maternal alcohol consumption during pregnancy in the context of developmental delay. Thirty-one respondents (17.3%) stated that mild alcohol intake in the third trimester of pregnancy is safe. Our survey suggests prenatal alcohol exposure may not be routinely considered in the evaluation of children with developmental delay by paediatric doctors in Ireland.
    • Outcome and complications of bronchial artery embolisation for life-threatening haemoptysis.

      Slattery, M M; Keeling, A N; Lee, M J; Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. mlslattery@hotmail.com (2009-06)
      Bronchial artery embolisation (BAE) has been established as an effective technique in the emergency treatment of life-threatening haemoptysis. However, few data concerning outcome are available.
    • Outcome and ethical decisions in infants born at the threshold of viability

      Clarke, T Prof.; Rotunda Hospital (Arab Neonatal Forum, 2009-05)
    • Outcome in cystic fibrosis liver disease.

      Rowland, Marion; Gallagher, Charles G; O'Laoide, Risteard; Canny, Gerard; Broderick, Annemarie; Hayes, Roisin; Greally, Peter; Slattery, Dubhfeassa; Daly, Leslie; Durie, Peter; et al. (The American journal of gastroenterology, 2011-01)
      Evidence suggests that cystic fibrosis liver disease (CFLD) does not affect mortality or morbidity in patients with cystic fibrosis (CF). The importance of gender and age in outcome in CF makes selection of an appropriate comparison group central to the interpretation of any differences in mortality and morbidity in patients with CFLD.
    • Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

      Casserly, Paula; Kirby, Rachel; Timon, Conrad; Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Eye and Ear, Hospital, Dublin, Ireland. paulacasserly@hotmail.com (2012-02-01)
      OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more favorable scar outcome when compared with BCE.
    • Outcome of children with Pentalogy of Cantrell following cardiac surgery.

      O'Gorman, Clodagh S; Tortoriello, Tia A; McMahon, Colin J; Department of Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin 12,, Ireland. (2012-02-01)
      Although single individual reports have documented outcomes in children with pentalogy of are few data available for postoperative outcome of this cohort of patients after cardiac surgery. The aim of this study was to retrospectively review the clinical details of patients with pentalogy of Cantrell managed at two centers. Two cardiac surgical institutions retrospectively studied all patients with pentalogy of Cantrell and significant congenital heart disease who underwent surgical intervention, excluding PDA ligation, between 1992 and 2004. Seven children with pentalogy of Cantrell underwent surgical intervention at a median age of 60 days (range, 1-11 months). Three patients had tetralogy of Fallot, two double outlet right ventricle, one patient had tricuspid atresia, and one patient a perimembranous ventricular septal defect. The mean duration of postoperative ventilation was 112.8 days (range, 4-335 days) but three patients required ventilation for more than 100 days. Patients who had a preoperative diaphragmatic plication required a longer duration of ventilation (mean = 186.5 days [range, 100-273 days] compared with mean = 132 days [range, 4-335 days]). Four patients survived, with three patients weaned from ventilation. Three patients had withdrawal of care following failure to wean from ventilation, following multisystem organ failure, and at the request of their parents. In conclusion, the postoperative care of children with pentalogy of Cantrell after cardiac surgery is often complicated by prolonged need for ventilatory support and multiple postoperative complications. Earlier surgical intervention does not necessarily reduce morbidity and mortality. These data may help in the counseling of parents prior to surgical intervention.
    • Outcome of congenital diaphragmatic hernias diagnosed antenatally

      Kent, E; Dominquez, M; Clarke, T; Geary, M (2010)
    • Outcome of Cushing's disease following transsphenoidal surgery in a single center over 20 years.

      Hassan-Smith, Zaki K; Sherlock, Mark; Reulen, Raoul C; Arlt, Wiebke; Ayuk, John; Toogood, Andrew A; Cooper, Mark S; Johnson, Alan P; Stewart, Paul M; Centre for Endocrinology, Diabetes, and Metabolism, Institute for Biomedical Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, United Kingdom. (The Journal of clinical endocrinology and metabolism, 2012-04)
      Historically, Cushing's disease (CD) was associated with a 5-yr survival of just 50%. Although advances in CD management have seen mortality rates improve, outcome from transsphenoidal surgery (TSS), the current first-line treatment, varies significantly between centers.
    • The outcome of laparoscopic cholecystectomy by ultrasonic dissection.

      Sasi, Walid; Department of Surgery, Our Lady of Lourdes Hospital Drogheda, Ireland. (2010-04)
      Electrocautery remains the main energy form used for dissection in laparoscopic cholecystectomy. However, due to its many risks the search continues for safer and more efficient forms of energy. This chapter assesses the outcomes of dissection using ultrasonic energy as compared to monopolar electrocautery during laparoscopic cholecystectomy. Studies included are trials of prospectively randomized adult patients with symptomatic gallstone disease subject either ultrasonic or monopolar electrocautery dissection during laparoscopic cholecystectomy. Seven trials were included in this review, with a total patient number of 695 randomized to two dissection methods: 340 in the electrocautery group and 355 in the ultrasonic group. Ultrasonic dissection is shown to be superior to monopolar electrocautery in laparoscopic cholecystectomy. Disadvantages include a difficult maneuvering technique and overall cost. Appropriate training programs may be implemented to overcome the first disadvantage, and it might be argued that given the combined cost of factors associated with standard clip and cautery technique, cost issues may be outweighed by the benefits of ultrasonic dissection. However, this necessitates further cost-benefit analysis.
    • Outcomes from the first mouth cancer awareness and clinical check-up day in the Dublin Dental University Hospital.

      MacCarthy, Denise; Nunn, June; Healy, Claire M; Stassen, Leo F A; Gorman, Tina; Martin, Breda; Toner, Mary; Clarke, Mary; Dougall, Alison; McLoughlin, Jacinta; et al. (Journal of the Irish Dental Association, 2012-04)
      To increase public awareness about mouth cancer, the Dublin Dental University Hospital (DDUH) hosted an awareness day and free mouth check-up in September 2010. The messages of information, self-examination and risk management, and the importance of early detection, were available to all attendees. The role of general dental and medical practitioners in examination of the mouth was stressed.
    • Outcomes of a Clinical Leadership Training Program Amongst Hospital Doctors

      Kelly, D; McErlean, S; Naff, K (Irish Medical Journal, 2018-04)
      To evaluate the effectiveness of formal leadership training amongst medical trainees and to review the current literature in this area
    • Outcomes of a Community-Based Paediatric Weight Management Programme in an Irish Midlands Setting

      Bennett, AE, N Canning, K Younger 2, MAT Flynn 1; Johnston Molloy, C; Glennon-Slattery, C; Loane, D (Irish Medical Journal, 2018-02)
      Ongoing investigation is needed into feasible approaches which reduce excess weight in childhood. This study aimed to assess the effectiveness of an adapted version of the Scottish Childhood Overweight Treatment Trial (SCOTT) in an Irish primary care setting. Families were offered monthly dietitian-led sessions for six months. These sessions targeted dietary habits, family meals, screen time and exercise. Of the 95 children (mean age 7.6 years) referred, 90.5% (n86) were obese and 9.5% (n9) were overweight. Fifty-one (53.7%) families opted into the programme from referral, and 18 completed the programme (64.7% attrition). Statistically significant reductions in body mass index (BMI) were observed between sessions one and six (25.7±4.2kg/m2 and 25.3±4.8kg/m2, respectively, p<0.01). BMI z-score modestly decreased by 0.2 (p=0.01). Despite these reductions, issues with programme referral, attrition and long-term effectiveness were evident. Further investigation into strategies which reduce paediatric overweight is warranted.
    • Outcomes of patients presenting to a dedicated rapid access lung cancer clinic.

      Dunican, E; Uzbeck, M; Clince, J; Toner, S; Royston, D; Logan, M P; Breathnach, O; Young, V; Linnane, S I; Morgan, R K; et al. (2012-02-01)
      We examined the outcomes of the first 500 patients referred to a dedicated Rapid Access Lung Cancer Clinic. A total of 206 patients (41.2%) were diagnosed with a thoracic malignancy; 179 had primary lung cancer and 27 had secondary or other thoracic cancers. Pulmonary nodules requiring ongoing surveillance were found in a further 79 patients (15.8%). Of those patients found to have primary lung cancer, 24 (13.4%) had Small Cell and 145 (81%) had Non Small Cell Lung Cancer. In patients with Non small cell tumours, 26 (21.1%) were stage 1, 14 (11.4%) stage II, 37 (30.1%) stage III and 46 (37.4%) stage IV at diagnosis. For the 129 patients (72%) in whom the thoracic MDT recommended active treatment, primary therapy was surgical resection in 44 (24.6%), combined chemoradiation in 31 patients (17.3%), chemotherapy alone in 39 (21.8%) and radiation in 15 (8.4%).
    • Outcomes of Siblings with Classical Galactosemia

      Hughes, Joanne; Ryan, Stephanie; Lambert, Deborah; Geoghegan, Olivia; Clark, Anne; Rogers, Yvonne; Hendroff, Una; Monavari, Ahmad; Twomey, Eilish; Treacy, Eileen P. (2012-04-30)
    • Outpatient parenteral antimicrobial therapy: A report of three years experience

      Glackin, L; Flanagan, F; Healy, F; Slattery, DM (Irish Medical Journal, 2014)
      Although outpatient parenteral antimicrobial therapy (OPAT) is practiced internationally, there is a paucity of data regarding outcomes of paediatric OPAT. A retrospective analysis, of 3 years experience (January 2010 to 2013) was performed at a tertiary paediatric Respiratory unit. There were 362 OPAT courses administered to 32 children, of which 30 had cystic fibrosis and the remaining two had recurrent pneumonia. A total of 3,688 days of antibiotics were administered. The median age was 8.8 years (range 2.75- 17.8 years). Sixteen (50%) were male. Each child received an average of 11 courses and median duration of OPAT was 10 days (range 2-21 days). Tobramycin was the commonest antimicrobial prescribed, with ceftazidime second. During this period, there was one readmission (0.3%) post discharge and 3 (2%) portocath infections. All patients attended for weekly review and laboratory monitoring. OPAT appears safe, effective and reduces the need for inpatient beds.
    • Ovarian inflammatory myofibroblastic tumour fistulating on to the anterior abdominal wall.

      Khan, G; Treacy, A; Garvey, J P; Png, B; Walshe, J; Leader, M; Byrne, P; Departments of Gynaecology, Beaumont Hospital, Beaumont, Dublin, Ireland. ghazala.sheraz.khan@gmail.com (2010-01)