• I Still Haven’t Found What I’m Looking For….. Bono, Google and Glaucoma Awareness

      Lyons, C; Ellard, R; McElnea, E; Townley, D (Irish Medical Journal, 2017-05)
      The effect of celebrity diagnosis on public awareness of health conditions has already been well documented. In October 2014, Bono, the lead singer with U2, revealed publicly for the first time that he has glaucoma. This study aimed to analyze the impact of Bono’s announcement on public awareness of glaucoma using Google Search trends as an indicator of public interest in the disease. Google Trends was used to examine Google Search activity for the term ‘Glaucoma’ between 2009 and 2015 in both Ireland and the United Kingdom. Trend analyses were performed using Microsoft Excel Version 14.3.5. Increased Google Search activity for ‘Glaucoma’ in October 2014 was found in both Ireland and the United Kingdom. A five-fold increase from the mean Google Search activity for this term was found in Ireland and a two-fold increase from the mean Google Search activity for this term was found in the United Kingdom. No such increase in Google Search activity occurred during each country’s 2014 Glaucoma Awareness week. Google Trends is useful in medical research as a means of assessing public awareness of, and/or interest in, health related topics. Current approaches to glaucoma related health promotion in both Ireland and the United Kingdom have failed to yield an increase in on-line Google Search activity. While there was an increase in interest in glaucoma it is unclear whether this led to an increase in health seeking behaviour.
    • Idiopathic ventricular tachycardia in a newborn: immediate response to lidocaine.

      Allen, Nicholas M; Azam, Muhammad; Dunne, Kevin P; Walsh, Kevin P; Department of Paediatrics, Galway University Hospital, Newcastle Road, Galway,, Ireland. nicholasallen@physicians.ie (2012-01-31)
    • Illness representations in patients with hand injury.

      Chan, Jeffrey C Y; Ong, Joshua C Y; Avalos, Gloria; Regan, Padraic J; McCann, Jack; Groarke, AnnMarie; Kelly, John L; Department of Plastic, Reconstructive and Hand Surgery, University College Hospital, Galway, Newcastle Road, Galway, Ireland. chancy@eircom.net (2009-07)
      Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.
    • The impact of new diagnostic criteria on prevalence of gestational diabetes in Ireland

      O Sullivan, E; Avalos, G; O Reilly, M (Irish Journal of Medical Science, 2010)
    • Impact of New UK Paracetamol overdose guidelines on patients presenting to the emergency department

      Nfila, G; Lee, S; Binchy, J (Irish Medical Journal (IMJ), 2014-02)
      Paracetamol is involved in a large proportion of overdoses that present to the Emergency Department (ED), either as lone or mixed overdoses. Non-treatment of toxic levels can lead to fulminant liver failure. This study is to determine the impact the new UK treatment guidelines 1 will have on patients presenting with paracetamol overdose. A retrospective review was performed on all patients who had paracetamol levels done in the ED between September 2011 and August 2012. A total of 523 patients were identified, 95(18%) of whom had detectable paracetamol levels. 74 patients from the 95 were evaluated. 18(24%) patients were treated with N-acetylcysteine as per the then paracetamol overdose guidelines. Using the new guidelines would have resulted in 3 more patients being admitted. Our study shows that most patients who present following paracetamol overdose do not require treatment with N-acetylcysteine and suggests that the introduction of the new UK treatment guidelines is likely to result in only a small increase in the number of patients requiring treatment.
    • The impact of Oncotype DX testing on breast cancer management and chemotherapy prescribing patterns in a tertiary referral centre

      McVeigh, Terri Patricia; Hughes, Lauren M.; Miller, Nicola; Sheehan, Margaret; Keane, Maccon; Sweeney, Karl J.; Kerin, Michael J. (European Journal of Cancer, 2014-09)
    • The impact of the National Treatment Purchase Fund on numbers of core urology training cases at University Hospital Galway.

      Harney, T J; Dowling, C M; Brady, C M; Department of Urology, University College Hospital Galway, Galway City, Ireland. harneyt@gmail.com (2011-06)
      Since the National Treatment Purchase Fund (NTPF) scheme was introduced in 2002, public patients waiting longer than three months for investigations and treatment are offered care in the private medical sector. Our aim was to assess the impact of the NTPF scheme on the number of training cases performed at University Hospital Galway (UHG). The number and type of urological procedures performed in the private medical sector under the NTFP scheme in 2008 were obtained from the UHG waiting list office. The number of these procedures performed on public patients by trainees at UHG in 2008 was determined retrospectively by reviewing theatre records. A significant number of core urology procedures were performed in the private sector via the NTPF scheme. Cancer centre designation and implementation of the EWTD will also place further pressures on urological training opportunities in Ireland.
    • Impaction-fracture of the capitate and lunate: a case report.

      Ong, Joshua Chong Yew; Devitt, Brian Meldan; O'Sullivan, Micheal Edmund; Department of Trauma and Orthopaedics, Galway University Hospital, Galway, Ireland. josh.cy.ong@gmail.com (2012-08)
      We report a 15-year-old girl who underwent a mid-carpal fusion for undiagnosed impaction-fractures of the capitate, lunate, and triquetrum after a fall on her outstretched left hand in a dorsiflexed and radially deviated position. The joint was dis-impacted, and the height of the lunate was restored using a cortical bone graft. The damaged proximal capitate articular surface was decorticated to facilitate fusion, as was the lunotriquetral articulation. Kirschner wires were inserted along the coronal plane. At the one-year follow-up, the patient had achieved a satisfactory range of motion and fusion of the capitate-lunate-triquetral articulations.
    • Implementation of the Continuous AutoTransfusion System (C.A.T.S) in open abdominal aortic aneurysm repair: an observational comparative cohort study.

      Tawfick, Wael A; O'Connor, Martina; Hynes, Niamh; Sultan, Sherif; Western Vascular Institute, Department of Vascular and Endovascular Surgery, University College Hospital, Galway, Newcastle RD, Galway, Ireland. (Vascular and endovascular surgery, 2008)
      The use of the Continuous AutoTransfusion System (C.A.T.S; Fresenius Hemotechnology, Bad Homburg v.d.H., Germany), which conserves allogenic blood, is reported in 187 patients having abdominal aortic aneurysm repair during a 9-year period. Patients were allocated to C.A.T.S if a Haemovigilance technician was available. A mean of 685 mL of retrieved blood was reinfused in 101 patients receiving C.A.T.S; 61% required 2 U or less. All control patients required 3 U or more of allogenic blood. Allogenic transfusion in C.A.T.S patients decreased significantly (P < .0001). Mean intensive care unit stay was significantly reduced in C.A.T.S patients (P = .042). Mean postoperative hospital stay was 18 days for C.A.T.S group and 25 days in control patients (P = .014). The respective 30-day mortality was 12% versus 19% (P = .199). The C.A.T.S markedly reduced the amount of blood transfused, was associated with reduced intensive care unit and postoperative hospital stay, and was cost-effective.
    • Increased use of multidisciplinary treatment modalities adds little to the outcome of rectal cancer treated by optimal total mesorectal excision.

      Chang, Kah Hoong; Smith, Myles J; McAnena, Oliver J; Aprjanto, Arifin S; Dowdall, Joe F; Department of Surgery, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland. (2012-10)
      Total mesorectal excision (TME) is the standard surgical treatment for rectal cancer. The roles of chemotherapy and radiotherapy have become more defined, accompanied by improvements in preoperative staging and histopathological assessment. We analyse our ongoing results in the light of changing patterns of treatment over consecutive time periods.
    • Increasing reporting of adverse events to improve the educational value of the morbidity and mortality conference.

      McVeigh, Terri P; Waters, Peadar S; Murphy, Ruth; O'Donoghue, Gerrard T; McLaughlin, Ray; Kerin, Michael J; Department of Surgery, Galway University Hospital, Galway, Ireland. terri.mcveigh@gmail.com (2013-01)
      The aim of this study was to investigate the impact of a validated complication proforma on surgical Morbidity and Mortality (M&M) conference reporting.
    • Independent tunability of the double-mode-locked cw dye laser.

      Bourkoff, E; Whinnery, J R; Dienes, A (1979-06-01)
      We report a new configuration that enables the double-mode-locked cw dye laser to be independently tunable. In addition, the output coupling at each of the two wavelengths can be independently specified. A series of oscillographs shows some interesting features unique to double mode locking and also shows the effects of varying the two cavity lengths with respect to each other.
    • An innovative community based cardiac diagnostics service prevents hospital attendances. [Presentation]

      Nolan, Paul; Harrington, O; Barton, J; MacNeill, BD; Crowley, JJ; Nash, PJ; Daly, K; Galway University Hospitals (Health Service Executive (HSE), 2014-02-28)
    • Introduction of an Oral Fluid Challenge Protocol in the Management of Children with Acute Gastroenteritis: A Regional Hospital Experience.

      Umana, E; Rana, A; Maduemem, K; Moylett, E (Irish Medical Journal, 2018-06)
      Oral rehydration therapy (ORT) remains the ideal first line therapy for acute gastroenteritis (AGE). Our aim was to assess the impact of introducing an Oral Fluid Challenge (OFC) protocol on outcomes such as intravenous fluid use and documentation in our institution. A single centre study with data collected retrospectively pre-implementation (April 2015) of the OFC protocol and post implementation (April 2016). Consecutive sampling of the first 55 patients presenting with GE like symptoms and underwent OFC were recruited. One hundred and ten patients were included in this study with 55 patients per cycle. The rates of IVF use decreased from 22% (12) in cycle one to 18% (10) in cycle two. There was an improvement in documentation by 26% (14) for level of dehydration and 52% (31) for OFC volume from cycle one to two. Overall, the addition of the OFC protocol to the management of patients with uncomplicated AGE would help streamline and improve care.
    • Investigating the role of healthcare accessibility and socio-economic background on the decision to attend for screening for gestational diabetes mellitus in Ireland

      Owens, L; Cullinane, J; Gillespie, P; Avalos, G; O'Sullivan, EP; O'Reilly, M; Dennedy, C; Dunne, F; Department of Medicine, National University of Ireland, Galway 2Department of Economics, National University of Ireland, Galway (Diabetic Pregnancy Study Group, 2011)
      Gestational diabetes mellitus (GDM) is associated with increased maternal and neonatal morbidity and mortality. We investigated the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems (GIS), econometric and simulation techniques. In particular, we focus on the extent to which ‘travel distance to screening site’ impacts upon the individual’s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level. We also aimed to assess whether Irish women of lower socio-economic status were less likely to attend for screening for Diabetes in Pregnancy than their higher status counterparts. This study was completed through the Atlantic Diabetes in Pregnancy (DIP) partnership, which offers universal screening for Gestational Diabetes at 24-28 weeks gestation. Data was collected on all women who delivered in 5 antenatal centres along the Irish Atlantic Seaboard between 2007-2009. Patients were ‘geocoded’, in order to provide precise spatial (x,y) coordinates for their residential locations. This facilitates geographic information systems -based route analysis of travel distances for each individual to their nearest screening site. We then model the decision to attend for screening, where control variables include travel distance to screening site, a range of other site accessibilityrelated variables, as well as a number of individual-level variables relating to personal, socioeconomic, clinical and lifestyle characteristics. The socio-economic status is based on the deprivation score derived from the 2006 Census of Population for the Republic of Ireland. The Deprivation Index is constructed from a combination of various indicators; education, employment, percentage skilled/unskilled workers, demographic information, lone parents and number of persons/room. 9,043 pregnant women offered screening, 5,218 (58%) of whom participated in testing. The probability of attending for screening was reduced by 1.8% [95% CI: 1.3% to 2.3%] for every additional 10kms required to travel for screening (p=0.000). We also find significant variation in uptake rates across hospitals after controlling for travel distance and other factors, suggesting that accessibility and quality-of-service are also important determinants of overall uptake rates. Using the deprivation index 60% of those who scored 1 (most affluent) attended for screening, 58% in score 2, 56% in score 3, 53% in score 4 and 46% in the score 5 (most deprived) group attended, p=0.0001. This shows a clear decrease in attendance levels in those who are deemed to be more disadvantaged. The most disadvantaged women overall were 40% less likely to attend than their most affluent counterparts (OR0.6, 95%CI {0.55-0.71},p=0.001). Accessibility to healthcare centres and socio-economic background both affect the decision to attend for screening for Gestational Diabetes Mellitus in Ireland.
    • Investigating the role of healthcare centre accessibility on the decision to attend for screening for gestational diabetes mellitus in Ireland [presentation]

      Cullinan, John; Dunne, F; Gillespie, Paddy; Owens, Lisa; John Cullinan (National University of Ireland, Galway. School of Economics), Paddy Gillespie (National University of Ireland, Galway. School of Economics), Lisa Owens (National University of Ireland, Galway. School of Medicine) and Fidelma Dunne (National University of Ireland, Galway. School of Medicine) (2011)
      Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with several serious maternal and neonatal complications and conditions. Screening practices for GDM vary within and across European countries, with some offering universal screening to all pregnant women and others only to selective high risk groups. In Ireland, no single policy with respect to GDM screening is implemented nationally and a debate exists as to what form such a policy should take. Within this context, the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) network was established in 2005 to provide robust information on pregnancy outcomes for women with diabetes. The network includes five healthcare centres along the Atlantic seaboard and provides testing for all pregnant women at 24-28 weeks using a 75g Oral Glucose Tolerance Test. The centres are linked using a clinical information system which allows for data to be captured within a central database, containing a comprehensive range of data on screening uptake rates, maternal characteristics, outcomes for mothers and infants, healthcare resource usage over the course of pregnancy, as well as the postal address of each individual. At present it contains observations on 9,043 pregnant women offered the screening, 5,218 (58%) of whom participated in testing. This paper uses the ATLANTIC DIP dataset to investigate the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems (GIS), econometric and simulation techniques. In particular, we focus on the extent to which ‘travel distance to screening site’ impacts upon the individual’s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level. In order to do so, the postal addresses contained within the ATLANTIC DIP dataset are first ‘geocoded’, in order to provide precise spatial (x,y) coordinates for patients’ residential locations. This facilitates GIS-based route analysis of travel distances for each individual to their nearest screening site. We then model the decision to attend for screening, where control variables include travel distance to screening site, a range of other site accessibility-related variables, as well as a number of individual-level variables relating to personal, socio-economic, clinical and lifestyle characteristics. Overall, our model suggests that after controlling for these different factors, the probability of attending for screening is reduced by 1.8% [95% CI: 1.3% to 2.3%] for every additional 10kms required to travel for screening (p=0.000). We also find significant variation in uptake rates across hospitals after controlling for travel distance and other factors, suggesting that accessibility and quality-of-service are also important determinants of overall uptake rates. The uptake model allows us to also estimate ‘two-part’ and ‘bivariate probit with sample selection’ models of the risk factors associated with GDM, which provide strong evidence of a socio-economic gradient in the prevalence of GDM in Ireland. Altogether, the findings have important implications for the provision of GDM screening services in Ireland.
    • Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial.

      Carney, John; Finnerty, Olivia; Rauf, Jassim; Curley, Gerard; McDonnell, John G; Laffey, John G; Department of Anaesthesia, Clinical Sciences Institute, National University of Ireland, Galway, Ireland. john.laffey@nuigalway.ie (2010-10)
      The transversus abdominis plane (TAP) block provides effective postoperative analgesia in adults undergoing major abdominal surgery. Its efficacy in children remains unclear, with no randomized clinical trials in this population. In this study, we evaluated its analgesic efficacy over the first 48 postoperative hours after appendectomy performed through an open abdominal incision, in a randomized, controlled, double-blind clinical trial.