• Nanotechnology and its relationship to interventional radiology. Part I: imaging.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9, Ireland. (2011-04)
      Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.
    • Nanotechnology and its relationship to interventional radiology. Part I: imaging.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Dublin 9, Ireland. (2012-02-01)
      Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.
    • Nanotechnology and its Relationship to Interventional Radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9, Ireland. (2010-09-16)
      Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.
    • Nanotechnology and its relationship to interventional radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

      Power, Sarah; Slattery, Michael M; Lee, Michael J; Department of Radiology, Beaumont Hospital, Beaumont Road, PO Box 1297, Dublin 9,, Ireland. (2012-02-01)
      Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.
    • National guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage.

      Tormey, William; O'Shea, Paula; Brennan, Paul; Department of Chemical Pathology, Beaumont Hospital, Dublin 9. (2012-02-01)
    • The natural history of surgically treated but radiotherapy-naïve nonfunctioning pituitary adenomas.

      O'Sullivan, Eoin P; Woods, Conor; Glynn, Nigel; Behan, Lucy Ann; Crowley, Rachel; O'Kelly, Patrick; Smith, Diarmuid; Thompson, Chris J; Agha, Amar; Division of Neuro-endocrinology, Beaumont Hospital and the RCSI Medical School, Dublin, Ireland. (2009-11)
      Transsphenoidal surgery is indicated for patients with nonfunctioning pituitary adenomas (NFPAs) causing compressive symptoms. Previous studies attempting to define the rate of recurrence/regrowth of surgically treated but radiation-naïve NFPAs were somewhat limited by selection bias and/or small numbers and/or lack of consistency of findings between studies. A better understanding of the natural history of this condition could allow stratification of recurrence risk and inform future management. We aimed to define the natural history of a large, mainly unselected cohort with surgically treated, radiotherapy (RT)-naïve NFPAs and to try to identify predictors of recurrence/regrowth.
    • Natural history of TPA-untreated minor stroke in the North Dublin population stroke study

      Marnane, M; Callaly, E; Hannon, N; Merwick, A; Ni Chroinin, D; Sheehan, O; Duggan, J; Moroney, J; Williams, D; McCormack, P M E; et al. (Karger, 2011-05)
      Introduction: Current guidelines recommend caution when considering emergency tissue plasminogen activator (tPA) therapy for patients with minor neurological deficits. However few data exist regarding the “natural history” (without tPA) of stroke in unselected population-based cohorts. We sought to evaluate the risk of long term disability in “minor stroke” patients. Methods: In the 294,529 residents of North Dublin we prospectively identified all transient ischaemic attacks (TIAs) and ischaemic strokes over a 1 year period in 2005-06, immediately before a regional stroke thrombolysis service was begun. National Institutes of Health Stroke Scale (NIHSS) at presentation and functional status (modified Rankin Score, mRS) at 90 days and 1 year were assigned by trained investigators. Results: 478 patients were identified. 37.4% (179/478) had TIA or NIHSS=0 at presentation, 31.4% (150/478) had minor stroke (NIHSS=1-4), and 31.2% (149/478) had moderate/severe stroke (NIHSS=5-42). By 90 days, 34% of minor stroke patients had some disability (mRS≥2) (vs. 9.7% TIA/NIHSS=0, p<0.0001) and 16.7% had at least moderate disability (mRS≥3) (vs 6.4% TIA/NIHSS=0, p=0.005). At 1 year, 37.9% of minor stroke patients had mRS≥2 (vs 13.4% TIA/NIHSS=0, p<0.0001) and 26.2% had at least moderate disability (vs 9.9% TIA/NIHSS=0, p<0.0001). 9.7% of minor stroke patients were dead at 1 year. Disability was more likely in patients with NIHSS scores of 3-4 compared to 1-2, at 90 days (46.3% vs. 23.4%, p=0.004) and 1 year (47.1% vs. 29.9%, p=0.03). Conclusions: In an unselected population-based cohort of TIA and ischaemic stroke patients nearly one third had NIHSS between 1-4 at presentation. Many, especially those with NIHSS scores of 3-4, had persistent stroke-related disability or were dead 1 year later. Routinely withholding thrombolytic therapy from such patients may represent a missed therapeutic opportunity.
    • Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging.

      Cahill, R A; Ris, F; Mortensen, N J; Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland., cahillra@gmail.com (2012-02-01)
      Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. While ultraviolet-range energies have limited penetration and hence are probably more useful for endoscopic mucosal interrogation, the near-infrared (NIR) spectrum is of greater potential utility for the purposes of examining inducible fluorescence in abdominopelvic tissue that can be achieved by administration of specific tracer agents, either directly into the circulation (e.g. for anastomotic perfusion assessment at the time of stapling) or into the lymphatic system (e.g. for lymph basin road-mapping and/or focussed target nodal assessment). This technology is also capable of supplementing anatomic recognition of the biliary system while implantable fibres can also be inserted intraoperatively for the purpose of safeguarding vital structures such as the oesphagus and ureters especially in difficult reoperations. It is likely that this technological capability will find a clear and common indication in colorectal specialist and general surgical departments worldwide in the near future.
    • Nebulized hypertonic saline decreases IL-8 in sputum of patients with cystic fibrosis.

      Reeves, Emer P; Williamson, Michael; O'Neill, Shane J; Greally, Peter; McElvaney, Noel G; Respiratory Research Division, Department of Medicine, Royal College of Surgeons , in Ireland, Beaumont Hospital, Dublin 9, Ireland. emerreeves@rcsi.ie (2012-02-01)
      RATIONALE: Inflammation within the cystic fibrosis (CF) lung is mediated by inflammatory chemokines, such as IL-8. IL-8 is protected from proteolytic degradation in the airways by binding to glycosaminoglycans, while remaining active. Evidence that increased hypertonicity of airway secretions induced by hypertonic saline treatment alters levels of IL-8 is lacking. OBJECTIVES: To investigate the antiinflammatory effect of hypertonic saline (HTS) treatment within the CF lung by focusing on IL-8. METHODS: Degradation of IL-8 in CF lung secretions after treatment with glycosaminoglycan lyases and HTS was analyzed by Western blot analysis and ELISA. The ex vivo chemotactic activity of purified neutrophils in response to CF airway secretions was evaluated post nebulization of HTS (7% saline). MEASUREMENTS AND MAIN RESULTS: In vivo CF bronchoalveolar lavage fluid (BALF) IL-8 levels were significantly higher than the control group (P < 0.05). Digesting glycosaminoglycans in CF BALF displaced IL-8 from glycosaminoglycan matrices, rendering the chemokine susceptible to proteolytic cleavage. High sodium concentrations also liberate IL-8 in CF BALF in vitro, and in vivo in CF sputum from patients receiving aerosolized HTS, resulting in degradation of IL-8 and decreased neutrophil chemotactic efficiency. CONCLUSIONS: Glycosaminoglycans possess the ability to influence the chemokine profile of the CF lung by binding and stabilizing IL-8, which promotes neutrophil chemotaxis and activation. Nebulized hypertonic saline treatment disrupts the interaction between glycosaminoglycans and IL-8, rendering IL-8 susceptible to proteolytic degradation with subsequent decrease in neutrophil chemotaxis, thereby facilitating resolution of inflammation.
    • Nebulized hypertonic saline decreases IL-8 in sputum of patients with cystic fibrosis.

      Reeves, Emer P; Williamson, Michael; O'Neill, Shane J; Greally, Peter; McElvaney, Noel G; Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland. emerreeves@rcsi.ie (2011-06-01)
      Inflammation within the cystic fibrosis (CF) lung is mediated by inflammatory chemokines, such as IL-8. IL-8 is protected from proteolytic degradation in the airways by binding to glycosaminoglycans, while remaining active. Evidence that increased hypertonicity of airway secretions induced by hypertonic saline treatment alters levels of IL-8 is lacking.
    • Necrotizing otitis externa: a new trend? Report of 6 atypical cases.

      Glynn, Fergal; Walsh, Rory McConn; Department of Otorhinolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin 9, Ireland. fglynn@rcsi.ie (2009-12)
      Necrotizing otitis externa (OE) is traditionally seen in elderly diabetics and immunocompromised patients. During a 7-year period at our institution, we treated 6 patients with necrotizing OE who were not diabetic, who were not immunocompromised, and who were relatively young (age range: 27 to 65 yr; mean: 42.8). The necrotizing OE in these patients was less aggressive but just as severe as its usual presentation in older diabetic or immunocompromised patients. All 6 patients had evidence of bony erosion on computed tomography of the temporal bones, although 4 had negative findings on technetium-99m scintigraphy. Four of the 6 patients required mastoid exploration and fascia lata grafting, and the other 2 chose to undergo extensive daily microdebridements and intravenous antibiotics followed by 6 weeks of oral antibiotics. We recommend that a diagnosis of necrotizing OE be kept in mind when evaluating any patient who presents with severe otalgia, particularly in the presence of Pseudomonas aeruginosa infection of the external auditory canal, edema, granulation tissue, and bony erosion.
    • Needs of informal caregivers across the caregiving course in amyotrophic lateral sclerosis: a qualitative analysis.

      Galvin, Miriam; Carney, Sile; Corr, Bernie; Mays, Iain; Pender, Niall; Hardiman, Orla (BMJ Open, 2018-01-27)
      Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is a debilitating terminal condition. Informal caregivers are key figures in ALS care provision. The physical, psychological and emotional impact of providing care in the home requires appropriate assistance and support. The objective of this analysis is to explore the needs of informal ALS caregivers across the caregiving course.
    • Neisseria meningitidis endocarditis: a case report and review of the literature.

      Ali, Mohammed; McAdam, Brendan; Cardiology Department, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland., mtali100@gmail.com (2012-02-01)
      Neisseria meningitidis is the leading cause of bacterial meningitis in children and young adults, with an overall mortality rate of up to 25%, but it is a rare cause of infective endocarditis. We present herein a case of N. meningitidis meningitis complicated with infective endocarditis.
    • Neisseria meningitidis endocarditis: A case report and review of the literature.

      Ali, Mohammed; McAdam, Brendan; Cardiology Department, Beaumont Hospital, Dublin, Ireland. (2011-04-08)
      Abstract Neisseria meningitidis is the leading cause of bacterial meningitis in children and young adults, with an overall mortality rate of up to 25%, but it is a rare cause of infective endocarditis. We present herein a case of N. meningitidis meningitis complicated with infective endocarditis.
    • Neoplasms escape selective COX-2 inhibition in an animal model of breast cancer.

      Barry, M; Cahill, R A; Roche-Nagle, G; Neilan, T G; Treumann, A; Harmey, J H; Bouchier-Hayes, D J; Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland. mitchelbarry@hotmail.com (2009-06)
      Cyclo-oxygenase-2 (COX-2) is up-regulated in malignant tumours rendering it an attractive target for cancer therapeutics. However, whether long-term antagonism maintains its initial efficacy on established tumours is unclear.
    • Neuroanatomical correlates of psychosis in temporal lobe epilepsy: voxel-based morphometry study.

      Sundram, Frederick; Cannon, Mary; Doherty, Colin P; Barker, Gareth J; Fitzsimons, Mary; Delanty, Norman; Cotter, David; Department of Psychiatry, Education and Research Centre, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland. fsundram@rcsi.ie (2010-12)
      Temporal lobe epilepsy is associated with a significant risk of psychosis but there are only limited studies investigating the underlying neurobiology.
    • Neurocognitive performance of a community-based sample of young people at putative ultra high risk for psychosis: support for the processing speed hypothesis.

      Kelleher, Ian; Murtagh, Aileen; Clarke, Mary C; Murphy, Jennifer; Rawdon, Caroline; Cannon, Mary; Royal College of Surgeons in Ireland, Department of Psychiatry, Education and Research Centre, Beaumont Hospital, Dublin, Ireland. iankelleher@rcsi.ie (2013)
      A wide variety of neurocognitive deficits have been reported for help-seeking individuals who are at clinical or ultra high risk for psychosis based on fulfilling set criteria for prodromal syndromes/at risk mental states. We wished to extend this research by conducting the first population-based assessment of prodromal syndromes and associated neurocognition.
    • The neuroproteomics of schizophrenia.

      English, Jane A; Pennington, Kyla; Dunn, Michael J; Cotter, David R; Proteome Research Centre, UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, and Medical Sciences, University College Dublin, Ireland. (2011-01-15)
      Proteomics is the study of global gene expression of an organ, body system, fluid, or cellular compartment at the protein level. Proteomic findings are reflective of complex gene × environment interactions, and the importance of this is increasingly appreciated in schizophrenia research. In this review, we outline the main proteomic methods available to researchers in this area and summarize, for the first time, the findings of the main quantitative neuroproteomic investigations of schizophrenia brain. Our review of these data revealed 16 gray matter proteins, and eight white matter proteins that were differentially expressed in the same direction in two or more investigations. Pathway analysis identified cellular assembly and organization as particularly disrupted in both gray and white matter, whereas the glycolysis-gluconeogenesis pathway was the major signaling pathway significantly altered in both. Reassuringly, these findings show remarkable convergence with functional pathways and positional candidate genes implicated from genomic studies. The specificity of schizophrenia proteomic findings are also addressed in the context of neuroproteomic investigations of neurodegenerative disorders and bipolar disorder. Finally, we discuss the major challenges in the field of neuroproteomics, such as the need for high throughput validation methods and optimal sample preparation. Future directions in the neuroproteomics of schizophrenia, including the use of blood-based biomarker work, the need to focus on subproteomes, and the increasing use of mass spectrometry-based methods are all discussed. This area of research is still in its infancy and offers huge potential to our understanding of schizophrenia on a cellular level.
    • New insights about vitamin d and cardiovascular disease: a narrative review.

      McGreevy, Cora; Williams, David; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland. (2012-02-01)
      The worsening worldwide trend toward nutritional insufficiency and the emerging knowledge of the nonhormonal actions of vitamin D and its metabolites have increased interest in the synthesis, metabolism, and action of vitamin D. Vitamin D deficiency has been linked with hypertension, myocardial infarction, and stroke, as well as other cardiovascular-related diseases, such as diabetes, congestive heart failure, peripheral vascular disease, atherosclerosis, and endothelial dysfunction. This review discusses the physiology and definition of vitamin D deficiency, evaluates the worldwide prevalence of vitamin D deficiency, and discusses recent evidence for the association between hypovitaminosis D and cardiovascular disease. Few randomized, controlled trials have evaluated the effect of vitamin D replacement on cardiovascular outcomes, and the results have been inconclusive or contradictory. Carefully designed randomized, controlled trials are essential to evaluate the role of vitamin D supplementation in reducing cardiovascular disease.
    • New technologies in the prevention and control of healthcare-associated infection.

      Humphreys, H; Department of Clinical Microbiology, RCSI Education and Research Centre, Beaumont Hospital, PO Box 9063 Dublin 9, Ireland. hhumphreys@rcsi.ie (2010-06)
      The increased interest in healthcare-associated infection (HCAI) among the public, patients and politicians has led to the development of potential new approaches to its prevention by industrial concerns and others. Such developments include better methods of assessing hospital hygiene, enhanced decontamination of the healthcare environment, biosynthetic tissue alternatives, antibiotic-impregnated medical devices and information technology that can help improve professional practice. Although promising, many of these have not been adequately evaluated in the clinical setting, highlighting the need for greater collaboration between industry and infection prevention and control practitioners to maximise the benefit of new products and to complement conventional approaches to HCAI prevention such as education, professional practice and the provision of better facilities.