• Human Papilloma Virus- Associated Head and Neck Cancer: A 21st Century Pandemic; Assessing Student Awareness and Knowledge

      Kavanagh, F.G; McNamara, A.T; Fopohunda, O; Keogh, I.J (Irish Medical Journal, 2018-11)
      The Human Papillomavirus (HPV) is a causal agent in a subset of Head and Neck Cancers (HNC) being diagnosed in younger patients without significant tobacco and alcohol use. This survey assessed the awareness level of HNC and HPV vaccinations in university students.
    • The human POLH gene is not mutated, and is expressed in a cohort of patients with basal or squamous cell carcinoma of the skin.

      Flanagan, Annabelle M; Rafferty, Gerard; O'Neill, Anne; Rynne, Leonie; Kelly, Jack; McCann, Jack; Carty, Michael P; Department of Biochemistry, National University of Ireland, Galway, Ireland. (2007-04)
      Skin cancer, the most common cancer in the general population, is strongly associated with exposure to the ultraviolet component of sunlight. To investigate the relationship between DNA damage processing and skin tumour development, we determined the POLH status of a cohort of skin cancer patients. The human POLH gene encodes DNA polymerase eta (poleta), which normally carries out accurate translesion synthesis past the major UV-induced photoproduct, the dithymine cyclobutane dimer. In the absence of active poleta in xeroderma pigmentosum variant (XPV) patients, mutations accumulate at sites of UV-induced DNA damage, providing the initiating step in skin carcinogenesis. Forty patients diagnosed with skin cancer were genotyped for polymorphisms in the POLH protein-coding sequence, using glycosylase-mediated polymorphism detection (GMPD) and direct DNA sequencing of POLH PCR products derived from white blood cell genomic DNA. All individuals carried the wild-type POLH sequence. No POLH mutations were identified in genomic DNA from skin tumours derived from 15 of these patients. As determined by RT-PCR, POLH mRNA was expressed in all normal and skin tumour tissue examined. Poleta protein was also detectable by Western blotting, in two matched normal and skin tumour extracts. An alternatively spliced form of POLH mRNA, lacking exon 2, was more readily detected in skin tissue than in white blood cells from the same patient. Real-time PCR was used to quantify POLH expression in matched normal and skin tumour-derived mRNA from a series of patients diagnosed with either basal or squamous cell carcinoma. Compared to matched normal skin tissue from the same patient, 1 of 7 SCC, and 4 of 10 BCC tumours examined showed at least a 2-fold reduction in POLH expression, while 1 of 7 SCC, and 3 of 10 BCC tumours showed at least a 2-fold increase in POLH expression. Differences in gene expression, rather than sequence changes may be the main mechanism by which POLH status varies between normal and skin tumours in the population under investigation. Knowledge of the POLH status in skin tumours could contribute to an understanding of the role of this gene in the development of the most common cancer in the general population.
    • Hydrocolloid dressing in pediatric burns may decrease operative intervention rates.

      Martin, Fiachra T; O'Sullivan, John B; Regan, Padraic J; McCann, Jack; Kelly, Jack L; Department of Plastic, Reconstructive and Hand Surgery, National University of Ireland, Galway, Ireland. fiachra1978@yahoo.com (2010-03)
      Partial-thickness scalds are the most common pediatric burn injury, and primary management consists of wound dressings to optimize the environment for reepithelialization. Operative intervention is reserved for burns that fail to heal using conservative methods. Worldwide, paraffin-based gauze (Jelonet) is the most common burn dressing; but literature suggests that it adheres to wounds and requires more frequent dressing change that may traumatize newly epithelialized surfaces. Hydrocolloid dressings (DuoDERM) provide an occlusive moist environment to optimize healing and are associated with less frequent dressing changes.
    • Hypovitaminosis D in a healthy female population, aged from 40 to 85 years, in the west of Ireland.

      Lardner, E; Fitzgibbon, M; Wilson, S; Griffin, D; Mulkerrin, E; Biochemistry Laboratory, Galway University Hospital, Newcastle Road, Galway,, Ireland. eleanorlardner@gmail.com (2012-01-31)
      BACKGROUND: Increasing attention has been focused on diseases associated with ageing, as the mean age of the population in developed countries increases. Vitamin D and parathyroid hormone play key roles in calcium homeostasis, which is integral to skeletal health. AIMS: To assess the vitamin D status of healthy, community dwelling, middle-aged and older females. METHODS: General biochemistry and bone profiles, including ALP, PTH and 25(OH)D, were determined. RESULTS: Of 143 healthy white women receiving no supplementation or bone modifying treatments, 47% were vitamin D insufficient (<50 nmol/L) and only 4% were sufficient for the time of year. There was no statically significant correlation between age and 25(OH)D concentrations; neither was there a statistically significant seasonal variation in 25(OH)D levels noted. CONCLUSION: Vitamin D status should be assessed more often in middle-aged and older females. Expected age-related and seasonal variations in 25(OH)D levels were not confirmed in this study.
    • 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.