• Galway University Hospitals Department of Critical Care annual clinical report 2008

      Galway University Hospitals (Galway University Hospitals, 2009)
    • Gene therapy for type 1 diabetes moves a step closer to reality.

      O'Brien, Timothy; Regenerative Medicine Institute and Department of Medicine, National Centre for Biomedical Engineering Science, National University of Ireland and Galway University Hospital, Galway, Ireland. timothy.obrien@nuigalway.ie (2013-05)
    • Generation of a vascularized organoid using skeletal muscle as the inductive source.

      Messina, Aurora; Bortolotto, Susan K; Cassell, Oliver C S; Kelly, Jack; Abberton, Keren M; Morrison, Wayne A; Bernard O'Brien Institute of Microsurgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. messinaa@svhm.org.au (2005-09)
      The technology required for creating an in vivo microenvironment and a neovasculature that can grow with and service new tissue is lacking, precluding the possibility of engineering complex three-dimensional organs. We have shown that when an arterio-venous (AV) loop is constructed in vivo in the rat groin, and placed inside a semisealed chamber, an extensive functional vasculature is generated. To test whether this unusually angiogenic environment supports the survival and growth of implanted tissue or cells, we inserted various preparations of rat and human skeletal muscle. We show that after 6 weeks incubation of muscle tissue, the chamber filled with predominantly well-vascularized recipient-derived adipose tissue, but some new donor-derived skeletal muscle and connective tissue were also evident. When primary cultured myoblasts were inserted into the chamber with the AV loop, they converted to mature striated muscle fibers. Furthermore, we identify novel adipogenesis-inducing properties of skeletal muscle. This represents the first report of a specific three-dimensional tissue grown on its own vascular supply.
    • Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study.

      Johnson, Nichola; Dudbridge, Frank; Orr, Nick; Gibson, Lorna; Jones, Michael E; Schoemaker, Minouk J; Folkerd, Elizabeth J; Haynes, Ben P; Hopper, John L; Southey, Melissa C; et al. (BioMed Central, 2014-05-26)
      We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years.
    • Gestational diabetes is more prevalent in women from lower socio-economic backgrounds.

      Owens, L; Cullinane, J; Gillespie, P; Avalos, G; O'Sullivan, EP; Dennedy, C; O'Sullivan, EP; O'Reilly, M (Diabetic Pregnancy Study Group, 2011)
      The link between socio-economic disadvantage and poor health has been observed across many spectrums of medicine. There is little evidence however, suggesting that Diabetes in Pregnancy is more prevalent in women from poorer backgrounds. This study was completed by the Atlantic Diabetes in Pregnancy partnership, which offered universal screening for Gestational Diabetes at 24-28 weeks gestation. Data was collected on women who delivered in 5 antenatal centres between 2007 and 2009. The calculated socio-economic background is based on a deprivation index derived from area of residence and national census data. The Deprivation Index is scored from 1-5, from least to most deprived, using various indicators; education, employment, percentage skilled/unskilled workers, demographic information, lone parents and number of persons/room. Using a ‘bivariate probit with sample selection’ model we controlled for poor attendance amongst women from disadvanted areas. We found that incidence of gestational diabetes is significantly higher for women living in the poorest areas, compared to women living in the richest areas. This gradient disappears when diabetes risk factors are controlled for, suggesting personal, clinical and lifestyle factors correlated with socioeconomic status are significant determinants for the development of Gestational Diabetes. These risk factors include; Body Mass Index, family history, smoking, sedentary lifestyle and higher immigrant population. Gestational Diabetes is more prevalent amongst women from lower socio-economic backgrounds.
    • Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

      Buckley, B S; Harreiter, J; Damm, P; Corcoy, R; Chico, A; Simmons, D; Vellinga, A; Dunne, F; School of Medicine, National University of Ireland, Galway, Ireland Department of Medicine, Medizinische Universität Wien, Austria University Hospital of Copenhagen - Rigshospitalet, Denmark Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK Department of General Practice, National University of Ireland, Galway, Ireland. (2011-12-12)
      Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.
    • Gestational diabetes mellitus results in a higher prevalence of small for gestational age babies

      Avalos, G; Owens, LA; Dennedy, C; O'Sullivan, EP; O'Reilly, MW; Dunne, F; Department of Medicine, National University of Ireland, Galway, Galway, Ireland. (European Association for the Study of Diabetes, 2011-09)
      Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM. Materials and methods: This retrospective study offered universal screening for GDM to pregnant women in 5 hospitals between 2007-2009. During this time 5,500 women underwent testing for GDM using a 75g Oral Glucose Tolerance Test at 24-28 weeks gestation. GDM was defined by the International Association of the Diabetes and Pregnancy Study Groups guidelines (IADPSG). Results: The prevalence of GDM was 12.4%. 4.5% of babies were small for gestational age (SGA) at birth in live births. Babies of mothers with GDM were more likely to have SGA than babies of non-diabetic women, OR 1.5, p=0.03, 95% CI {1.02-2.24. Mean Body Mass Index (BMI) was lower in mothers of SGA babies than mothers of babies who were average (AGA) or large for gestational age (LGA), 26.3 compared to 27.1, p<0.0001. Smoking (OR 3.1, p=0.000)) pre-ecampsia (OR 3.99,p=0.000), gestational hypertension, low parity (OR 0.8.p= 0.005), non-Caucasion ethnicity were also predictive of SGA These SGA babies had a worse clinical outcome, including; higher caesarean section rate, higher requirement for neonatal intensive care , higher rates of hypoglycaemia and respiratory distress. 76% of diabetic women were treated with insulin. Insulin treatment did not affect rates of SGA when compared with dietary management. Conclusion: This study shows another important negative outcome associated with GDM. Further research is required to identify the causative factor(s).
    • Gestational diabetes mellitus results in a higher prevalence of small for gestational babies

      Dunne, F; Owens, LA; Avalos, G; Dennedy, C; O'Sullivan, EP; O'Reilly, M; Department of Medicine, National University of Ireland, Galway, Galway, Ireland. (Diabetic Study Pregnancy Group (DSPG), 2011)
      Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM. Materials and methods: This retrospective study offered universal screening for GDM to pregnant women in 5 hospitals between 2007-2009. During this time 5,500 women underwent testing for GDM using a 75g Oral Glucose Tolerance Test at 24-28 weeks gestation. GDM was defined by the International Association of the Diabetes and Pregnancy Study Groups guidelines (IADPSG). Results: The prevalence of GDM was 12.4%. 4.5% of babies were small for gestational age (SGA) at birth in live births. Babies of mothers with GDM were more likely to have SGA than babies of non-diabetic women, OR 1.5, p=0.03, 95% CI {1.02-2.24}. Mean Body Mass Index (BMI) was lower in mothers of SGA babies than mothers of babies who were average (AGA) or large for gestational age (LGA), 26.3 compared to 27.1, p<0.0001. Smoking (OR 3.1, p=0.000)) pre-eclampsia (OR 3.99,p=0.000) , low parity (OR 0.8.p= 0.005), non- Caucasian ethnicity were also predictive of SGA These SGA babies had a worse clinical outcome, including; higher caesarean section rate, higher requirement for neonatal intensive care , higher rates of hypoglycaemia and respiratory distress. 76% of diabetic women were treated with insulin. Insulin treatment did not affect rates of SGA when compared with dietary management. Conclusion: This study shows another important negative outcome associated with GDM. Further research is required to identify the causative factor(s).
    • A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report.

      Chan, Jeffrey C Y; Tiong, William H; Hennessy, Michael J; Kelly, John L; Department of Plastic, Reconstructive and Hand Surgery, University Hospital Galway, Galway, Ireland. chancy@eircom.net (2008)
      Occupational overuse syndrome (OOS) can present as Guyon's canal syndrome in computer keyboard users. We report a case of Guyon's canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.
    • The health behaviour of school-aged children in the South Western Area Health Board

      Molcho, Michal; Nic Gabhainn, Saoirse; Health Promotion Research Centre, National University of Ireland, Galway (2005)
    • The healthcare burden of Gestational Diabetes in Ireland

      Gillespie, P; Avalos, G; O Reilly, M (2010)
    • High prevalence of abnormal glucose tolerance postpartum is reduced by breastfeeding in women with prior gestationIal diabetes mellitus

      O'Reilly, MW; Avalos, G; Dennedy, MC; O'Sullivan, EP; Dunne, F; Department of Medicine, National University of Ireland and University College Hospital, Galway, Ireland. (2011)
      Background and aims: Gestational diabetes (GDM) is associated with adverse fetal and maternal outcomes. It identifies women at risk of pre-diabetes, type 2 diabetes (T2DM) and cardiovascular risk in later life. Recent studies have suggested that breastfeeding may confer a beneficial effect on postpartum maternal glucose tolerance in both women with GDM and normal glucose tolerance (NGT) in pregnancy. Materials and methods: We compared results from 300 women with GDM and 220 women with NGT according to IADPSG criteria using a 75g oral glucose tolerance test (OGTT) at 24-28 weeks gestation by repeating the 75g OGTT postpartum to reassess glucose status. We also tested for postpartum metabolic syndrome (MetS) according to international criteria. Binary logistic regression was used to identify maternal factors that increased the risk of persistent glucose intolerance. Postpartum lactation status was categorised as breastfeeding alone, bottle-feeding alone, or both. Results: 520 women were tested. OGTT results were classified as normal (FPG<5.6mmol/l; 2h<7.8mmol/l) or abnormal (IFG; 5.6-6.9, IGT; 2h 7.8-11.0, IFG+IGT; T2DM FPG 7 ± 2h 11.1). Six of 220 (2.7%) women with NGT in pregnancy had postpartum dysglycaemia compared to 57 of 300 women (19%) with GDM in pregnancy (P<0.001). Non-Caucasian ethnicity (OR 3.40, 95% CI 1.45-8.02, P=0.005), family history of T2DM (OR 2.14, 95% CI 1.06-4.32, P=0.034) and insulin use in pregnancy (OR 2.62, 95% CI 1.17-5.87, P=0.019) were all predictive of persistent dysglycaemia. MetS was present postpartum in 31 of 300 women (10.3%) with GDM compared to 18 (8.2%) of 220 women with NGT (P=0.4). The prevalence of persistent dysglycaemia was lower in women who breast-fed versus bottle-fed their babies, or employed both techniques (7.1% v 18.4% and 11.2%, respectively, p<0.001). Conclusion: In this Irish population the prevalence of persistent glucose intolerance in women with GDM in pregnancy is 19% compared to 2.7% in NGT women. Breast-feeding confers a beneficial effect on postpartum glucose tolerance. The precise mechanism behind this association is unclear and requires further study.
    • High Prevalence of Stress Urinary Incontinence in Adult Patients with Bronchiectasis

      Duignan, N; McDonnell, MJ; Mokoka, MC; Rutherford, RM (Irish Medical Journal, 2016-07)
      Stress urinary incontinence (SUI) is frequently under-reported in patients with chronic lung disease and may have negative psychosocial consequences. We conducted a prospective study to determine the prevalence, severity and treatment outcomes of SUI in female bronchiectasis patients referred for airway clearance techniques. Nineteen out of 40 (48%) patients reported SUI symptoms. Of these, 14 (74%) reported a reduced quality of life secondary to SUI. Following personalised intervention, symptom improvement was observed in 13/19 (68%). Five out of 19 (26%) required specialist referral for further continence care. No associations with lung disease severity and SUI were noted. SUI is common in adult female bronchiectasis patients and should be routinely screened for to improve patients’ overall quality of life.
    • Home administration of bortezomib: making a difference to myeloma patients' lives.

      Meenaghan, Teresa; O'Dwyer, Michael; Hayden, Patrick; Hayat, Amjad; Murray, Margaret; Dowling, Maura; St Josephs Ward, Galway University Hospital, Newcastle Road, Galway, Ireland. onc.haematology@hse.ie (2010-04)
    • Homocysteine, the cholesterol of the 21st century. Impact of hyperhomocysteinemia on patency and amputation-free survival after intervention for critical limb ischemia.

      Heneghan, Helen M; Sultan, Sherif; Western Vascular Institute, Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland. (Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2008-08)
      To assess the prevalence of hyperhomocysteinemia and determine any correlation to the clinical and technical outcome of peripheral arterial revascularization for critical limb ischemia (CLI).
    • Horizontal strabismus surgical outcomes in a teaching hospital

      Idrees, Z; Dooley, I; Fahy, G (Irish Medical Journal (IMJ), 2014-06)
      Strabismus may result in impaired stereopsis, diplopia, undesirable appearance, amblyopia and negative psychological impact. This study provides epidemiological and surgical outcome information about patients attending University College Hospital Galway requiring strabismus surgery. We report a retrospective analysis of 75 consecutive patients, who underwent horizontal strabismus surgery. Sixty-one (81.3%) patients had clinically significant refractive errors, hyperopia being the most common. Thirty-four (45.3%) patients had amblyopia and nine (12%) required further treatment. A cosmetically acceptable result with a post-operative ocular deviation within 25 prism dioptres of straight (grade 2) was achieved in 70/75 (93.3%) of patients. The overall mean change in ocular deviation per mm of muscle operated was 3.25 prism dioptre/mm. The outcomes of strabismus surgery in an Irish hospital compare very favourably with other jurisdictions. This data will help plan service delivery.