Now showing items 1-20 of 1595

    • 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.
    • Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study.

      Flynn, Daniel; Joyce, Mary; Spillane, Ailbhe; Wrigley, Conal; Corcoran, Paul; Hayes, Aoife; Flynn, Marian; Wyse, David; Corkery, Barry; Mooney, Brid (2019-08-15)
    • 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.
    • The Human Mesenteric Lymph Node Microbiome Differentiates Between Crohn's Disease and Ulcerative Colitis.

      Kiernan, Miranda G; Coffey, J Calvin; McDermott, Kieran; Cotter, Paul D; Cabrera-Rubio, Raul; Kiely, Patrick A; Dunne, Colum P (Journal of Crohn's and Colitis, 2019-01-01)
      Mesenteric lymph nodes are sites in which translocated bacteria incite and progress immunological responses. For this reason, understanding the microbiome of mesenteric lymph nodes in inflammatory bowel disease is important. The bacterial profile of Crohn’s disease mesenteric lymph nodes has been analysed using culture-independent methods in only one previous study. This study aimed to investigate the mesenteric lymph node microbiota from both Crohn’s disease and ulcerative colitis patients.
    • Activation of a TLR9 mediated innate immune response in preeclampsia.

      Williamson, Rachel D; McCarthy, Fergus P; Kenny, Louise C; McCarthy, Cathal M (Scientific Reports, 2019-04-11)
      Preeclampsia is a multisystemic disorder leading to the development of a placental ischemic microenvironment with a resultant increase in oxidative stress. There is evidence that mitochondrial dysfunction and the innate immune system both play a role in the pathophysiology of this disease. Mitochondrial DAMPs such as mtDNA bind specifc pattern recognition receptors such as Toll-like receptor 9 (TLR9) on the endosomal surface of immune cells, in particular neutrophils, subsequently activating them and triggering an innate response. We hypothesised that the exaggerated innate immune response seen in preeclampsia is provoked by dysfunctional mitochondria. Here we provide evidence that TLR9 activity is signifcantly increased at time of disease in women with preeclampsia. Furthermore, we show activation of neutrophil markers, Calprotectin, Myeloperoxidase (MPO), and IL-8 are signifcantly increased at time of disease compared to uncomplicated pregnancies. This research supports a potential role of TLR9 activation of an innate immune response evident in preeclampsia which may possibly be initially triggered by dysfunctional mitochondria.
    • Ustekinumab-induced subacute cutaneous lupus.

      Tierney, Emma; Kirthi, Shivashini; Ramsay, Bart; Ahmad, Kashif (JAAD Case Reports, 2019-03-01)
      Drug-induced lupus erythematosus (DILE) is a lupus-like syndrome temporally related to continuous drug exposure. DILE can be divided into systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus.1 Hydrochlorothiazide was the first drug associated with SCLE in 1985,2 but at least 100 other agents have since been reported to induce/exacerbate SCLE, with terbinafine, tumor necrosis factor (TNF)-α inhibitors, antiepileptics, and proton pump inhibitors, the most frequently associated medications. We present a case of ustekinumab-induced SCLE in a patient being treated for psoriasis.
    • High Rates of Diabetic Ketoacidosis in Patients with New and Known Type 1 Diabetes over a Six-Year Period

      Finn, B.P.; Trayer, J.; Cronin, C.; O’Connell, S.M (Irish Medical Journal, 2019-03)
      Ireland is a high incidence country for type 1 diabetes (T1DM) with 28.8 newly diagnosed cases/100,000/year1. Patients with new onset T1DM frequently (15-70%) present with diabetic ketoacidosis (DKA)2,3,4,5. Lansdown et al found that 25% of children with new onset T1DM under 19 years of age presented in DKA in Wales between 1991 and 20096. The rates of DKA in known T1DM on an international stage remains significant- Austria and Germany (5%), Wales and England (6.4%) and the United States (7.1%)7. The aim of our study was to analyse all admissions with diabetic ketoacidosis to the regional paediatric diabetes centre at Cork University Hospital, over the past six years. Our objectives include assessing the proportion of patients with new and known T1DM, treatment modalities (e.g. pump/multiple daily injections), patient demographics, severity, length of stay and outcomes.
    • Impact of oral rehabilitation on the quality of life of partially dentate elders in a randomised controlled clinical trial: 2 year follow-up.

      McKenna, Gerald; Allen, Patrick Finbarr; Hayes, Martina; DaMata, Cristiane; Moore, Ciaran; Cronin, Michael (Plos One, 2018-01-01)
      This randomised clinical trial aimed to compare the impact of two different tooth replacement strategies for partially dentate older patients namely; removable partial dentures (RPDs) and functionally orientated treatment based on the shortened dental arch (SDA) concept, on Oral Health-related Quality of Life (OHrQOL). 89 patients completed a randomised clinical trial. Patients were recruited in two centres: Cork University Dental Hospital (CUDH) and a Geriatric Day Hospital (SFDH). 44 patients were randomly allocated to the RPD group and 45 to the SDA group where adhesive bridgework was used to provide 10 pairs of occluding contacts. The impact of treatment on OHrQOL was used as the primary outcome measure. Each patient completed the Oral Health Impact Profile (OHIP-14) at baseline, 1, 6, 12 and 24 months after treatment. Both treatment groups reported improvements in OHIP-14 scores at 24 months (p<0.05). For the SDA group OHIP-14 scores improved by 8.0 scale points at 12 months (p<0.001) and 5.9 scale points at 24 months (p<0.05). For the RPD group OHIP-14 scores improved by 5.7 scale points at 12 months (p<0.05) and 4.2 scale points at 24 months (p<0.05). Analysis using ANCOVA showed that there were significant between group differences recorded in both treatment centres. 24 months after intervention the SDA group recorded better OHIP-14 scores by an average of 2.9 points in CUDH (p<0.0001) and by an average of 7.9 points in SFDH (p<0.0001) compared to the RPD group. Patients in the SDA group maintained their improvements in OHrQOL scores throughout the 24 month study period. For the RPD group the initial improvement in OHrQOL score began to diminish after 6 months, particularly for those treated in SFDH. Thus, the benefits of functionally orientated treatment increased over time, particularly for the older, more systemically unwell cohort in SFDH.
    • Counselling in Primary Care – A General Practitioner’s Perspective

      Rafferty, M.; Bradley, C.; 1. Mercy University Hospital 2. Department of General Practice, University College Cork (Irish Medical Journal, 2019-02)
      Counselling in Primary care (CIPC) is a new service introduced by the HSE in 2013, providing short-term counselling for medical-card holders, suffering from mild to moderate mental health problems.
    • Erectile Dysfunction and Ischaemic Heart Disease.

      Ibrahim, Abdalla; Ali, Mohamed; Kiernan, Thomas J; Stack, Austin G (European Cardiology Review, 2018-12-01)
      Erectile dysfunction (ED) is a common disorder that affects the quality of life of many patients. It is prevalent in more than half of males aged over 60 years. Increasing evidence suggests that ED is predominantly a vascular disorder. Endothelial dysfunction seems to be the common pathological process causing ED. Many common risk factors for atherosclerosis such as diabetes, hypertension, smoking, obesity and hyperlipidaemia are prevalent in patients with ED and so management of these common cardiovascular risk factors can potentially prevent ED. Phosphodiesterase type 5 inhibitors provide short-term change of haemodynamic factors to help initiate and maintain penile erection. They have been shown to be an effective and safe treatment strategy for ED in patients with heart disease, including those with ischaemic heart disease and hypertension.