• Aberrant DNA methylation associated with MTHFR C677T genetic polymorphism in cutaneous squamous cell carcinoma in renal transplant patients.

      Laing, M E; Cummins, R; O'Grady, A; O'Kelly, P; Kay, E W; Murphy, G M; Department of Dermatology, RCSI ERC Smurfit Building, Beaumont Hospital, Dublin 9, Ireland. mrylaing@yahoo.co.uk (2010-08)
      Changes in genomic DNA methylation associated with cancer include global DNA hypomethylation and gene-specific hyper- or hypomethylation. We have previously identified a genetic variant in the MTHFR gene involved in the methylation pathway which confers risk for the development of squamous cell carcinoma (SCC) in renal transplant patients. This genetic variant has also been discovered to confer SCC risk in nontransplant patients with low folate status.
    • Absence of consensus in diagnostic criteria for familial neurodegenerative diseases.

      Byrne, Susan; Elamin, Marwa; Bede, Peter; Hardiman, Orla; Trinity College Institute of Neurosciences, Beaumont Hospital, Trinity College, Dublin, Ireland. suabyrne@gmail.com (2012-04)
      A small proportion of cases seen in neurodegenerative conditions such as amyotrophic lateral sclerosis (ALS), Parkinson's disease and Alzheimer disease are familial. These familial cases are usually clinically indistinguishable from sporadic cases. Identifying familial cases is important both in terms of clinical guidance for family members and for gene discovery.
    • Access to in-patient stroke services and multidisciplinary team (MDT) rehabilitation: current demands and capacity

      O’Sullivan, EJ; Williams, DJ; Shanahan-O’Connell, J; Kirrane, K; Armitage, D; Leahy, W; O’Flaherty, E; Horgan, NF (Irish Medical Journal, 2014-06)
      The objective of this project was to analyse the current access to in-patient stroke services and MDT rehabilitation in an acute stroke centre and to compare these services to the recommended â National Clinical Guidelines and Recommendations for the Care of People with Stroke and TIAâ (IHF 2010). A retrospective chart review was carried out, recording activity statistics of all patients admitted with acute stroke over a three-month period. 73 patients (male=40, 54.8%) were included. Patients were discharged from the stroke service after a mean stay of 20.2 days (SD.= 19.3). 76.7% (N=56) of patients were admitted to the acute stroke unit (ASU). The mean length of time from admission to first assessment 3.4 days (SD.=2.68), with an average of 138 minutes of treatment received per day across all disciplines. This is compared to the IHFâ s recommendation of patients being assessed within 24-48 hours of admission and receiving 180 minutes of treatment across all disciplines. As demands for stroke MDT services increase, it is important to recognise the benefits of increasing staff and resources to maintain and continue to improve standards of care
    • Accidental ecstasy ingestion in a two year old.

      Cassidy, N; Casey, P B; Tracey, J A (2009-02)
    • Accuracy of death certification

      Tormey, W. P. (2011-11)
    • The accuracy of death certification for ALS/MND in Ireland

      Yeo, L; Lynch, C; Hardiman, O; Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. (2009)
    • Acromegaly associated with gangliocytoma.

      Crowley, R K; Al-Derazi, Y; Lynch, K; Rawluk, D; Thompson, C J; Farrell, M; Agha, A; Academic Department of Endocrinology, Beaumont Hospital, Dublin 9, Ireland, rachelcrowley@hotmail.com. (2009-09-30)
      BACKGROUND: Acromegaly secondary to growth hormone-releasing hormone (GHRH) excess is rare. AIMS/CASE DESCRIPTION: We report two patients with acromegaly who were diagnosed with sellar gangliocytomas that were immunopositive for GHRH. Tumour tissue persisted after debulking surgery and in the second case this was associated with persistent growth hormone hypersecretion, successfully suppressed by a somatostatin analogue. CONCLUSIONS: The development of functional pituitary adenomas in association with sellar gangliocytomas is poorly understood. We present a brief discussion of the possible aetiology of these unusual pituitary tumours.
    • Activation of stretch-activated channels and maxi-K+ channels by membrane stress of human lamina cribrosa cells.

      Irnaten, Mustapha; Barry, Richard C; Quill, Barry; Clark, Abbot F; Harvey, Brian J P; O'Brien, Colm J; Molecular Medicine Laboratories, RCSI Education and Research Centre, Beaumont Hospital, Dublin, Ireland. irnatenm@yahoo.fr (2009-01)
      The lamina cribrosa (LC) region of the optic nerve head is considered the primary site of damage in glaucomatous optic neuropathy. Resident LC cells have a profibrotic potential when exposed to cyclical stretch. However, the mechanosensitive mechanisms of these cells remain unknown. Here the authors investigated the effects of membrane stretch on cell volume change and ion channel activity and examined the associated changes in intracellular calcium ([Ca(2+)](i)).
    • Activation of the epidermal growth factor receptor (EGFR) by a novel metalloprotease pathway.

      Bergin, David A; Greene, Catherine M; Sterchi, Erwin E; Kenna, Cliona; Geraghty, Patrick; Belaaouaj, Abderrazzaq; Taggart, Clifford C; O'Neill, Shane J; McElvaney, Noel G; Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland. (2008-11-14)
      Neutrophil Elastase (NE) is a pro-inflammatory protease present at higher than normal levels in the lung during inflammatory disease. NE regulates IL-8 production from airway epithelial cells and can activate both EGFR and TLR4. TACE/ADAM17 has been reported to trans-activate EGFR in response to NE. Here, using 16HBE14o-human bronchial epithelial cells we demonstrate a new mechanism by which NE regulates both of these events. A high molecular weight soluble metalloprotease activity detectable only in supernatants from NE-treated cells by gelatin and casein zymography was confirmed to be meprin alpha by Western immunoblotting. In vitro studies demonstrated the ability of NE to activate meprin alpha, which in turn could release soluble TGFalpha and induce IL-8 production from 16HBE14o- cells. These effects were abrogated by actinonin, a specific meprin inhibitor. NE-induced IL-8 expression was also inhibited by meprin alpha siRNA. Immunoprecipitation studies detected EGFR/TLR4 complexes in NE-stimulated cells overexpressing these receptors. Confocal studies confirmed colocalization of EGFR and TLR4 in 16HBE14o- cells stimulated with meprin alpha. NFkappaB was also activated via MyD88 in these cells by meprin alpha. In bronchoalveolar lavage fluid from NE knock-out mice infected intra-tracheally with Pseudomonas aeruginosa meprin alpha was significantly decreased compared with control mice, and was significantly increased and correlated with NE activity, in bronchoalveolar lavage fluid from individuals with cystic fibrosis but not healthy controls. The data describe a previously unidentified lung metalloprotease meprin alpha, and its role in NE-induced EGFR and TLR4 activation and IL-8 production.
    • Activation of the ubiquitin proteasome pathway (UPP) in colon cancer; The potential of proteasome inhibition as a novel treatment modality

      McCawley, N; Conlon, S; Cummins, R J; Hector, S; Kay, E W; Concannon, C G; Prehn, J H M; Deasy, J; McNamara, D A (2011-01)
    • Acupuncture as an adjunct to pulmonary rehabilitation.

      Deering, Brenda M; Fullen, Brona; Egan, Claire; McCormack, Niamh; Kelly, Emer; Pender, Mary; Costello, Richard W; Department of Respiratory Medicine, Beaumont Hospital and the associated, Education and Research Centre, University College of Dublin, Dublin, Ireland. (2012-02-01)
      PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and by both systemic and airway inflammation. In COPD, acupuncture has been shown to improve quality-of-life scores and decrease breathlessness; similar findings have also been reported after pulmonary rehabilitation (PR). The hypothesis of this study was that acupuncture in conjunction with pulmonary rehabilitation would improve COPD outcome measures compared to pulmonary rehabilitation alone. METHODS: The design was a randomized prospective study; all subjects had COPD. There were 19 controls, 25 who underwent PR, and 16 who had both acupuncture and PR. The primary outcome measure was a change in measures of systemic inflammation at the end of PR and at 3 month followup. Lung function, including maximum inspiratory pressure (PiMax), quality-of-life scores, functional capacity including steps taken, dyspnea scores, and exercise capacity, were secondary endpoints. RESULTS: After PR, both groups had significantly improved quality-of-life scores, reduced dyspnea scores, improved exercise capacity, and PiMax, but no change in measures of systemic inflammation compared with the controls. There were no differences in most of the outcome measures between the 2 treatment groups except that subjects who had both acupuncture and PR remained less breathless for a longer period. CONCLUSION: The addition of acupuncture to PR did not add significant benefit in most of the outcomes measured.
    • Acute ischaemic colitis in a young woman

      Levins, K; Kelly, O; Beausang, A; Gulmann, C; Harewood, G; Cahill, R (Irish Medical Journal (IMJ), 2012-10)
    • Acute limb ischemia in cancer patients: should we surgically intervene?

      Tsang, Julian S; Naughton, Peter A; O'Donnell, Jill; Wang, Tim T; Moneley, Daragh S; Kelly, Cathal J; Leahy, Austin L; Department of Vascular Surgery, Royal College of Surgeons Ireland, Beaumont, Hospital, Dublin, Ireland. julianst@yahoo.com (2012-02-01)
      BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.
    • Acute subarachnoid haemorrhage following liquid sclerotherapy

      Danapal, M.; Garvin, J.; O'Brien, D.; Leahy, A. (2012-03)
    • Acute surgical management in idiopathic intracranial hypertension.

      Zakaria, Zaitun; Fenton, Eoin; Sattar, Muhammad Taufiq; Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland. zakariaz@tcd.ie (2012)
      Idiopathic intracranial hypertension is a headache syndrome with progressive symptoms of raised intracranial pressure. Most commonly, it is a slow process where surveillance and medical management are the main treatment modalities. We describe herein an acute presentation with bilateral sixth nerve palsies, papilloedema and visual deterioration, where acute surgical intervention was a vision-saving operation.
    • Acute upper arm ischaemia: a rare presentation of non-Hodgkin's lymphoma.

      Daruwalla, Z J; Razak, A R A; Duke, D; Grogan, L; Department of Orthopaedic Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Republic of Ireland. zubinjimmydaruwalla@rcsi.ie (2010-12)
      Digital ischaemia has been sparsely reported in current literature. Its association with lymphomatous conditions has been described in even more exceptional occurrences. We present the first case of upper arm ischaemia associated with non-Hodgkin's lymphoma. A brief literature review of this rare phenomenon is also accompanied with it.
    • Adenocarcinoma arising in a retrorectal teratoma: Case report and review of the literature.

      McCawley, N; Hanly, A; Solon, G; Shilling, C; Deasy, J; Kay, E W; McNamara, D A;  Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.  Department of Pathology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Ireland. (2010-10-19)
    • Adenocarcinoma arising in a retrorectal teratoma: case report and review of the literature.

      McCawley, N; Hanly, A; Solon, G; Shilling, C; Deasy, J; Kay, E W; McNamara, D A; Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland. (2012-02-01)
    • Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: Open-label, noncomparative, multicenter, long-term follow-up study.

      Delanty, Norman; Jones, John; Tonner, Francoise; Division of Neurology, Beaumont Hospital, Dublin, Ireland UCB Pharma, Raleigh,, North Carolina, U.S.A.1 UCB Pharma, Brussels, Belgium1. (2012-02-01)
      Purpose: To evaluate the long-term efficacy and tolerability of adjunctive levetiracetam (LEV) in patients with uncontrolled idiopathic generalized epilepsy (IGE). Methods: This phase III, open-label, long-term, follow-up study (N167; NCT00150748) enrolled patients (4 to <65 years) with primary generalized seizures (tonic-clonic, myoclonic, absence). Patients received adjunctive LEV at individualized doses (1,000-4,000 mg/day; 20-80 mg/kg/day for children/adolescents weighing <50 kg). Efficacy results are reported for all seizure types [intention-to-treat (ITT) population, N = 217] and subpopulations with tonic-clonic (n = 152), myoclonic (n = 121), and/or absence (n = 70) seizures at baseline. Key Findings: One hundred twenty-five (57.6%) of 217 patients were still receiving treatment at the end of the study. Mean (standard deviation, SD) LEV dose was 2,917.5 (562.9) mg/day. Median (Q1-Q3) exposure to LEV was 2.1 (1.5-2.8) years, and the maximum duration was 4.6 years. Most patients were taking one (124/217, 57.1%) or >/=2 (92/217, 42.4%) concomitant antiepileptic drugs (AEDs). Seizure freedom of >/=6 months (all seizure types; primary efficacy end point) was achieved by 122 (56.2%) of 217 patients, and 49 (22.6%) of 217 patients had complete seizure freedom. Seizure freedom of >/=6 months from tonic-clonic, myoclonic, and absence seizures was achieved by 95 (62.5%) of 152, 75 (62.0%) of 121, and 44 (62.9%) of 70 patients, respectively. Mean (SD) maximum seizure freedom duration was 371.7 (352.4) days. At least one treatment-emergent adverse event (TEAE) was reported by 165 (76%) of 217 patients; most TEAEs were mild/moderate in severity, with no indication of an increased incidence over time. Seventeen (7.8%) of 217 patients discontinued medication because of TEAEs. The most common psychiatric TEAEs were depression (16/217, 7.4%), insomnia (9/217, 4.1%), nervousness (8/217, 3.7%), and anxiety (7/217, 3.2%). Significance: Adjunctive LEV (range 1,000-4,000 mg/day) demonstrated efficacy as a long-term treatment for primary generalized seizures in children, adolescents, and adults with IGE, and was well tolerated.
    • Adjuvant chemotherapy for colorectal cancer in the over 75 age group: A 10-year experience

      Bambury, R M; Coleman, N H; Tharmabala, M M; Gough, D; Grogan, W; Breathnach, O S; Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. (2010-05)