• Global DNA methylation is altered by neoadjuvant chemoradiotherapy in rectal cancer and may predict response to treatment - A pilot study.

      Tsang, J S; Vencken, S; Sharaf, O; Leen, E; Kay, E W; McNamara, D A; Deasy, J; Mulligan, E D; Department of Surgical Research, Connolly Hospital & RCSI, Blanchardstown, Dublin, Ireland. Electronic address: julianst@yahoo.com. (2014-07-28)
      In rectal cancer, not all tumours display a response to neoadjuvant treatment. An accurate predictor of response does not exist to guide patient-specific treatment. DNA methylation is a distinctive molecular pathway in colorectal carcinogenesis. Whether DNA methylation is altered by neoadjuvant treatment and a potential response predictor is unknown. We aimed to determine whether DNA methylation is altered by neoadjuvant chemoradiotherapy (CRT) and to determine its role in predicting response to treatment.
    • Increased risk of severe hypoglycemic events with increasing frequency of non-severe hypoglycemic events in patients with Type 1 and Type 2 diabetes.

      Sreenan, Seamus; Andersen, Marc; Thorsted, Brian Larsen; Wolden, Michael L; Evans, Marc; Department of Endocrinology, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. (2014-07-15)
      Severe hypoglycemic events (SHEs) are associated with significant morbidity, mortality and costs. However, the more common non-severe hypoglycemic events (NSHEs) are less well explored. We investigated the association between reported frequency of NSHEs and SHEs among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in the PREDICTIVE study.
    • Impact of antihypertensive combination and monotreatments on blood pressure variability: assessment by old and new indices. Data from a large ambulatory blood pressure monitoring database.

      Parati, Gianfranco; Dolan, Eamon; Ley, Ludwin; Schumacher, Helmut (2014-06)
      High 24-h ambulatory blood pressure (ABP) variability is associated with poor cardiovascular outcomes. We analysed a large ABP monitoring database containing data from hypertensive patients treated with telmisartan/amlodipine combination or various monotherapies with the aim of quantifying the 24-h distribution of blood pressure (BP) reduction by treatment through the smoothness index and of developing and testing a new treatment-on-variability index (TOVI) to quantify the effects of treatment on both mean BP and BP variability.
    • Penetrating stab injuries at a single urban unit: are we missing the point?

      Kharytaniuk, N; Bass, G A; Salih, A; Twyford, M; O'Conor, E; Collins, N; Arumugasamy, M; Walsh, T N; Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland, n.nollaigin@gmail.com. (2014-05-28)
      Penetrating trauma-the classical presentation of disorganised crime-can pose a challenge in their management due to their complexity and unpredictability.
    • Intravesical foreign body: clinical features and diagnostic clues.

      Thatte, Amit; Rajendran, Simon; Murphy, Laura; Allen, Michael; Department of Surgery, Royal College of Surgeons, Dublin, Ireland. (2014-05-22)
    • Hip and low back pain in the presence of femoral anteversion. A case report.

      Tansey, Paula; Physiotherapy Department, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. Electronic address: paula.tansey@hse.ie. (2014-04-16)
      A change in hip morphology, such as femoral anteversion may be a factor in patients with lower quadrant pain. This case study highlights the importance of angle of torsion assessment and consideration of a patient's individual angle in designing rehabilitation programs. A patient who had a four year history of hip pain and a one year history of low back pain, in the presence of femoral anteversion is presented. She was successfully treated by altering her lower limb position as well as performing exercises in this alignment.
    • Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

      O'Neill, Barry James; O'hEireamhoin, Sven; Morrissey, David I; Keogh, Peter; Department of Trauma & Orthopaedics, Connolly Hospital, Dublin, Ireland. (2014-04-03)
      Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.
    • Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus.

      Bass, G A; Furlong, H; O'Sullivan, K E; Hennessy, T P J; Walsh, T N; Royal College of Surgeons in Ireland, Department of Surgery, Connolly Hospital, Dublin 15, Ireland. Electronic address: garybassmd@gmail.com. (2014-04)
      Oesophageal cancer usually presents with systemic disease, necessitating systemic therapy. Neo-adjuvant chemoradiotherapy improves short-term survival, but its long-term impact is disputed because of limited accrual, treatment-protocol heterogeneity and a short follow-up of randomised trials.
    • Publication rates of presentations at the Irish Orthopaedic Association annual meeting.

      O'Neill, B J; O'heireamhoin, S; Byrne, A-M; Kenny, P J; O'Flanagan, S J; Keogh, P; Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Dublin, Ireland, barryoneill1922@gmail.com. (2014-03)
      Presentation of scientific research at national and international meetings is an important forum for the dissemination of knowledge. Subsequent publication of a full-text paper in a peer-reviewed journal is the expected outcome of such presentations. The publication rate from these meetings is highly variable.
    • The Irish National Joint Registry: where are we now?

      O'Neill, B J; Nugent, M; Cashman, J P; O'Flanagan, S J; Keogh, P; Kenny, P J; Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Blanchardstown, Dublin, 15, Ireland, barryoneill1922@gmail.com. (2014-03)
      Ireland is currently in the process of establishing a National Joint Registry.
    • Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension.

      Faul, John; Schoors, Danny; Brouwers, Sofie; Scott, Benjamin; Jerrentrup, Andreas; Galvin, Joseph; Luitjens, Sandra; Dolan, Eamon (2014-01-28)
      Vasodilators are used with caution in patients with chronic obstructive pulmonary disease (COPD). We have developed a device for percutaneous arteriovenous shunt creation in the iliac region to increase cardiac output and oxygen delivery for patients with COPD. Although this device does not cause significant blood pressure changes in normotensive patients with COPD, we hypothesized that arteriovenous shunt creation might cause vasodilator effects in hypertensive patients because of a reduction in vascular resistance.
    • Consultant and trainee attitudes towards supervision of operative procedures in the UK and Ireland

      O’Neill, BJ; Rankn, KS; Banks, LN; Daruwall, ZJ; Sprowson, AP; Robinson, DP; Reed, MR; Kenny, PJ (Irish Medical Journal, 2014)
      The e-logbook is used to monitor progression through training and to assess training within teaching units. We document consultant and trainee opinions with regards to supervision status, and to inform guidelines for trainees and trainers using the e-logbook. A questionnaire was sent to consultants and trainees in the UK and Ireland. Eight theatre scenarios were described and respondents were asked to state what they felt was the appropriate supervision status for the trainee. Significantly more consultants in the UK use the e-logbook than those based in Ireland (58.5%:14.5%). There were differences in consensus response to the scenarios between consultants and trainees, and between Irish and UK based surgeons. We have documented the opinions of consultants and trainees from across the UK and Ireland with regards to supervision status for trainees under certain theatre situations. This information should support formal guidelines for all users of the logbook.
    • Clinical characteristics, management, and control of permanent vs. nonpermanent atrial fibrillation: insights from the RealiseAF survey.

      Murin, Jan; Naditch-Brûlé, Lisa; Brette, Sandrine; Chiang, Chern-En; O'Neill, James; Steg, P Gabriel; 5Connolly/Mater Hospitals/Royal College of Surgeons in Ireland, Dublin, Ireland. (PLoS ONE, 2014)
      Atrial fibrillation can be categorized into nonpermanent and permanent atrial fibrillation. There is less information on permanent than on nonpermanent atrial fibrillation patients. This analysis aimed to describe the characteristics and current management, including the proportion of patients with successful atrial fibrillation control, of these atrial fibrillation subsets in a large, geographically diverse contemporary sample.
    • Basic surgical training in Ireland: the impact of operative experience, training program allocation and mentorship on trainee satisfaction.

      O'Sullivan, K E; Byrne, J S; Walsh, T N; RCSI Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland, kaosulli@tcd.ie. (2013-12)
      Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs.
    • Validating the 5Fs mnemonic for cholelithiasis: time to include family history.

      Bass, Gary; Gilani, S Nadia S; Walsh, Thomas N (2013-11)
      The time-honoured mnemonic of '5Fs' is a reminder to students that patients with upper abdominal pain and who conform to a profile of 'fair, fat, female, fertile and forty' are likely to have cholelithiasis. We feel, however, that a most important 'F'-that for 'family history'-is overlooked and should be introduced to enhance the value of a useful aide memoire.
    • The effect of inclement weather on ankle fracture management in an Irish trauma unit.

      O'Neill, B J; Kelly, E G; Breathnach, O C; Keogh, P; Kenny, P J; O'Flanagan, S J; Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Blanchardstown, Dublin 15, Ireland. barryoneill1922@gmail.com (2013-09)
      Ireland is unfamiliar with extreme weather conditions. Such conditions occurred in winter 2009-2010 and 2010-2011, with much of the country being affected by snow and ice. We reviewed the effect that these conditions had on the treatment of ankle fractures in our trauma unit.
    • Association between Sleep Disruption and Levels of Lipids in Caucasians with Type 2 Diabetes.

      Wan Mahmood, Wan Aizad; Draman Yusoff, Mohd Shazli; Behan, Lucy Ann; Di Perna, Andrea; Kyaw Tun, Tommy; McDermott, John; Sreenan, Seamus; Department of Endocrinology and Diabetes, Royal College of Surgeons in Ireland, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. (2013-08-29)
      Aim. To investigate the association between sleep quality and duration with lipid and glycaemic control in Caucasian subjects with type 2 diabetes. Methods. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) in 114 type 2 diabetes (T2DM) subjects. Comparisons were made between subjects with different sleep quality and sleep duration. Hierarchical multiple regression analyses were used to determine contributors to metabolic parameters. Results. Subjects with poor sleep quality (PQ; PSQI ≥ 6) had higher systolic blood pressure, glycated haemoglobin, urine albumin : creatinine ratio (UAC), total cholesterol (TC), and triglycerides (TG) (P < 0.05 for all) compared to those with good sleep quality (GQ; PSQI ≤ 5). Long sleep duration (LSD) subjects had higher TC and short sleep duration (SSD) subjects had higher TG compared to those with medium sleep duration. Sleep duration and PSQI score were independent predictors of TC and low-density lipoprotein cholesterol (LDL), contributing to 14.0% and 6.1% of the total variance, respectively. Conclusions. In this Caucasian T2DM population, PQ is associated with adverse cardiovascular risk markers, and long and short sleep disruptions have an independent negative impact on lipids. Sleep assessment should be included as part of a diabetes clinic review.
    • Are boys and girls that different? An analysis of traumatic brain injury in children.

      Collins, Niamh C; Molcho, Michal; Carney, Peter; McEvoy, Linda; Geoghegan, Lourda; Phillips, Jack P; Nicholson, Alf J (2013-08)
      The Phillips Report on traumatic brain injury (TBI) in Ireland found that injury was more frequent in men and that gender differences were present in childhood. This study determined when gender differences emerge and examined the effect of gender on the mechanism of injury, injury type and severity and outcome.
    • Barriers to exercise in obese patients with type 2 diabetes.

      Egan, A M; Mahmood, W A W; Fenton, R; Redziniak, N; Kyaw Tun, T; Sreenan, S; McDermott, J H; Department of Endocrinology and Diabetes Mellitus, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. aoife.egan@gmail.com (2013-07)
      Although regular exercise is a critical component of the management of type 2 diabetes, many patients do not meet their exercise targets. Lack of exercise is associated with obesity and adverse cardiovascular outcomes.
    • Elective surgery: a comparison of in-patient versus day surgery practices in Ireland.

      Meshkat, B; Cowman, S; Gethin, G; Higgins, P; Ryan, K; Mulligan, E; Department of Surgery, Connolly Hospital Blanchardstown, Blanchardstown, Dublin 15, Ireland. b_meshkat@hotmail.com (2013-06)
      Currently, there is a paucity of research which has assessed practices at the point of care for day surgery patient.