Recent Submissions

  • Covid-19: safe PPE - hand hygiene first in all cases.

    University of Limerick Hospitals (University pf Limerick Hospitals, 2020-04-03)
    Care of patients with respiratory symptoms/ suspected/confirmed COVID-19.
  • Perinatal factors affect the gut microbiota up to four years after birth.

    Fouhy, Fiona; Watkins, Claire; Hill, Cian J; O'Shea, Carol-Anne; Nagle, Brid; Dempsey, Eugene M; O'Toole, Paul W; Ross, R Paul; Ryan, C Anthony; Stanton, Catherine (2019-04-03)
    Perinatal factors impact gut microbiota development in early life, however, little is known on the effects of these factors on microbes in later life. Here we sequence DNA from faecal samples of children over the first four years and reveal a perpetual evolution of the gut microbiota during this period. The significant impact of gestational age at birth and delivery mode on gut microbiota progression is evident in the first four years of life, while no measurable effects of antibiotics are found in the first year. Microbiota profiles are also characteristic in children dependant on gestational age and maturity. Full term delivery is characterised by Bacteroides (year one), Parabacteroides (year two) and Christensenellaceae (year four). Preterm delivery is characterised by Lactobacillus (year one), Streptococcus (year two) and Carnobacterium (year four). This study reveals that the gut retains distinct microbial profiles of perinatal factors up to four years of age.
  • Standards for the management of cancer-related pain across Europe-A position paper from the EFIC Task Force on Cancer Pain.

    Bennett, Michael I; Eisenberg, Elon; Ahmedzai, Sam H; Bhaskar, Arun; O'Brien, Tony; Mercadante, Sebastiano; Krčevski Škvarč, Nevenka; Vissers, Kris; Wirz, Stefan; Wells, Chris; et al. (2019-01-06)
  • A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson's Disease.

    Sweeney, Dean; Quinlan, Leo R; Browne, Patrick; Richardson, Margaret; Meskell, Pauline; ÓLaighin, Gearóid (2019-03-13)
    Freezing of gait is one of the most debilitating symptoms of Parkinson's disease and is an important contributor to falls, leading to it being a major cause of hospitalization and nursing home admissions. When the management of freezing episodes cannot be achieved through medication or surgery, non-pharmacological methods such as cueing have received attention in recent years. Novel cueing systems were developed over the last decade and have been evaluated predominantly in laboratory settings. However, to provide benefit to people with Parkinson's and improve their quality of life, these systems must have the potential to be used at home as a self-administer intervention. This paper aims to provide a technological review of the literature related to wearable cueing systems and it focuses on current auditory, visual and somatosensory cueing systems, which may provide a suitable intervention for use in home-based environments. The paper describes the technical operation and effectiveness of the different cueing systems in overcoming freezing of gait. The "What Works Clearinghouse (WWC)" tool was used to assess the quality of each study described. The paper findings should prove instructive for further researchers looking to enhance the effectiveness of future cueing systems.
  • Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial.

    Cronin, Owen; Barton, Wiley; Moran, Carthage; Sheehan, Donal; Whiston, Ronan; Nugent, Helena; McCarthy, Yvonne; Molloy, Catherine B; O'Sullivan, Orla; Cotter, Paul D; et al. (2019-02-12)
    Improved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident.
  • Look-back Review Report

    Safety Incident Management Team (SIMT); South /South West Hospital Group (Health Service Executive (HSE), 2018-12-05)
    In September 2017 a major review of CT Scans, Ultrasounds and Chest X-Rays reported by an individual Consultant Radiologist commenced at University Hospital Kerry (UHK). This was prompted by the notification to hospital management of three Serious Reportable Events (SRE) in the category of Care Management Events where a diagnostic error was considered by the hospital's Safety Incident Management Team (SIMT) to have had a serious impact on patients through a delay in diagnosis, limiting treatment options available to them. The matter was escalated to the South/South West Hospital Group (S/SWHG) who recommended that a look-back review would be carried out. This was approved by the National Director of the Acute Hospital Division, HSE, on the 30th of August, 2017. A Group SIMT was then established, chaired by the Chief Operations Officer S/SWHG, to carry out the look-back review. Following the notification of a further Serious Incident (SI) the review was extended in October 2017 to include all images reported by the individual Consultant concerned. Therefore, the review set about auditing 46,234 images in order to identify if there was any missed pathology within the radiology reporting process; to identify if any further patients had been affected; to communicate with them in a timely and appropriate fashion, and ultimately to ensure that patients received appropriate care. The SIMT endeavoured at all times to treat patients with utmost sensitivity and honesty whilst at the same time minimising unnecessary anxiety or distress. Over the course of the look-back eleven patients were identified as having a delay in diagnosis which had an impact on their care. Four of the eleven patients have passed away over the course of the review period. The hospital and the HSE acknowledge that patients and families’ experiences were devastating for them and have had a profound and lasting effect on both the patients affected and their families. The South/South West Hospital Group, University Hospital Kerry and the Health Service Executive (HSE) would like to apologise sincerely and unreservedly to all patients and families harmed by delayed diagnoses.
  • DVD Versus Physiotherapist-Led Inhaler Education: A Randomised Controlled Trial.

    Khan, R; Yasin, F; O'Neill, S; Cahalane, E; O'Shea, R; Browne, B; Cournane, J; Rand, S; Shannon, H (2018-02-09)
    Correct technique with inhalers is vital for therapeutic effect. Efficacy of DVD inhaler instruction was investigated. Secondary aims were to examine feasibility of an inhaler technique outcome measure, and to compare knowledge and self-efficacy after DVD or individual education. This was a randomised controlled trial conducted in a regional hospital paediatric ward, involving new or existing paediatric inhaler users. Inhaler technique was assessed pre-education in existing inhaler users. Participants were then randomised to message equivalent education by DVD or individually with a physiotherapist. Inhaler technique, self-efficacy and knowledge were assessed immediately post- and three months after education. Twenty one participants received DVD or individual education. There were no significant differences between groups for technique, self-efficacy or knowledge at any time. The outcome measure was feasible for use in a research study. DVD education was equivalent to individual instruction to teach parents how to use inhalers with their child.
  • Distance as a Barrier to Melanoma Care

    McCarthy, S; Feeley, K; Murphy, M; Bourke, J F (2019-08-01)
    Our aim was to review cases of melanoma diagnosed histologically in UHK in 2016 and to compare them to cases of melanoma nationally and in Kerry. Methods For each patient we recorded age, Breslow depth, and shortest distance to travel by car and travelling time (without traffic) to the South Infirmary Victoria University Hospital (SIVUH) from their primary residence (calculated using Google maps™ (2018)). Results 20 cases of invasive melanoma were diagnosed in UHK in 2016. Of the 20 cases, 9 (45%) presented at a very advanced stage with a Breslow depth of greater than 4mm. A further 7 (35%) cases had a depth of 1.5-4mm. These patients with invasive melanoma had a mean age of 72.5 (±15). The mean shortest distance to travel from the patient’s primary residence to the SIVUH was 114.8km (±15.5) taking an average of 102 minutes (±14.6) by car. Conclusion Cases of melanoma diagnosed locally in UHK presented at an advanced stage compared to the national average. We suspect that the long distances to travel to the SIVUH pigmented lesion clinic is a barrier for these patients.
  • Development of an Insulin-Prescribing Chart for Paediatric Diabetes

    Finn, B.P; O’Neill, T.; Bradfield, A.; O’Sullivan, T.; Beattie, S.; O’Connell, S.M. (Irish Medical Journal, 2019-10)
    Our aim was to design a new insulin prescribing tool in compliance with the Irish Medicines Safety Network recommendations.
  • High-flow Nasal Cannulae, Bronchopulmonary Dysplasia and Retinopathy of Prematurity

    Healy, L.I; Corcoran, P.; Murphy, B.P (Irish Medical Journal, 2019-09)
    To determine if HFNC use was associated with changes in incidence of BPD and ROP.
  • Telephone Follow-Up of Mild Traumatic Brain Injury; A Feasibility Study

    Underwood, S.; Campbell, S.; Deasy, C. (Irish Medical Journal, 2019-09)
    This study investigates the prevalence of Post-Concussion Syndrome (PCS) one-year post-injury in patients that were treated for Mild Traumatic Brain Injury (mTBI) in the Clinical Decision Unit (CDU) of Cork University Hospital’s (CUH) Emergency Department.
  • Audit of compliance with HSE standards and recommended practices for healthcare records management for discharge summaries in St. Michael's Unit, Mercy University Hospital, Cork

    Vrabec, Michal; Geary, Eoin; O'Brien, Sinead; North Lee Mental Health Services, HSE Southern Area (Centre for Recovery and Social Inclusion (CRSI), 2019-06-07)
  • European Pain Federation position paper on appropriate opioid use in chronic pain management.

    O'Brien, T; Christrup, L L; Drewes, A M; Fallon, M T; Kress, H G; McQuay, H J; Mikus, G; Morlion, B J; Perez-Cajaraville, J; Pogatzki-Zahn, E; et al. (2017-01-01)
  • Challenges of Cancer Screening

    Kelly, D; OConnor, M (Irish Medical Journal, 2019-06)
    The goal of cancer screening is to detect presymptomatic disease and commence treatment sooner, thereby reducing the incidence of advanced disease and the associated morbidity and mortality1. Challenges exist around designing, managing and evaluating national screening strategies. Programs require clear governance, reporting structures, accountability and regular appraisal of staff. The Scally report highlighted the vital role Public health expertise should play in delivering and integrating these services along with managing the flow of patient information between the National Cancer Control Programme and the National Cancer Registry2. All screening programmes must have a robust Quality Assurance (QA) process and be able to conduct audit effectively1.
  • A Dedicated Perineal Clinic – An Audit in Support

    Corry, E; O’Connor, E; Eogan, M; Fitzpatrick, M; O’Sullivan, S; Imcha, M (Irish Medical Journal, 2019-04)
    To assess the quality of care in both the initial management of obstetric anal sphincter injury (OASI) and subsequent follow up postnatally in a tertiary maternity hospital without direct access to a perineal clinic.
  • Listeria Meningitis in an Immunocompetent Child: Case Report and Literature Review

    McCarthy, K.N; Leahy, T.R; Murray, D.M (Irish Medical Journal, 2019-05)
    Listeria monocytogenes is a facultatively anaerobic Gram-positive bacillus that is an unusual cause of illness among immunocompetent individuals1. Infection with listeria is most commonly encountered in pregnancy, the neonatal period, and in immunocompromised patients2. Risk factors include food-borne exposures, particularly to soft cheeses and delicatessen meats, and life stock exposure3. Meningitis is the most frequently encountered clinical syndrome. L. monocytogenes accounts for 20% of cases of meningitis in neonates and in those >60 years and is the most common cause of meningitis among immunocompromised individuals1. Listeriosis is a rare disease in Ireland with a crude incidence rate of 0.41 per 100,000 which is lower than the EU average of 0.48 per 100,000 4.
  • Surgical Parathyroidectomy Services

    Burke, E; Waris, A; O’Donoghue, G (Irish Medical Journal, 2019-04)
    Retrospectively audit our experience with surgical parathyroidectomy over a 5 year period from the beginning of 2013 to June 2018.
  • Estimated Weight of Paediatric Patients versus Measured Weight – A Prospective Comparison

    Lineen, C; O’Donnell, S; Birrane, K; O’Riordan, A; Twomey, J; Murphy, A.M; O’Gorman, C (Irish Medical Journal, 2019-04)
    Weight measurement is fundamental in the management of paediatric patients. Many methods have been described for estimating a patient’s weight. The aim of this study was to assess the accuracy of the APLS 2017 estimated weight guidelines.
  • Bereavement Counselling for Healthcare Workers in the Aftermath of Child Death

    O’Sullivan, D; Stone, G; Mahomed, H; O’Reilly, P; Stewart, P; Noonan, H; Murphy, A.M (Irish Medical Journal, 2019-05)
    To assess the views and experiences of bereavement counselling services among healthcare staff dealing with paediatric ward death at UHL.

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