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Irish Journal of Medical Science

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https://www.readbyqxmd.com/read/28102480/dynamic-sentinel-node-biopsy-for-penile-cancer-an-initial-experience-in-an-irish-hospital
#1
P E Lonergan, A Nic An Riogh, F O'Kelly, D J Lundon, D O'Sullivan, M O'Connell, P K Hegarty
BACKGROUND: The presence of nodal metastases is the single most important prognostic factor in penile cancer. However, reliable assessment of nodal status in clinically node-negative (cN0) patients poses a challenge. Approximately 20% of these patients harbour occult nodal metastases. Currently available non-invasive radiological investigations are unreliable in excluding micrometastatic disease. AIM: Dynamic sentinel node biopsy (DSNB) is a minimally invasive procedure for assessing lymph node involvement...
January 19, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28101825/neurosarcoidosis-clinical-presentations-and-changing-treatment-patterns-in-an-irish-caucasian-population
#2
K O'Connell, L Williams, J Jones, D J H McCabe, D Murphy, R Killeen, N Tubridy, S O'Riordan, C McGuigan
BACKGROUND: The clinical manifestations of neurosarcoidosis are highly variable and it should be considered as a potential differential diagnosis in any neurological presentation. AIM: This study was designed to describe the clinical, diagnostic, and treatment patterns and functional outcome in a Caucasian neurosarcoidosis population. DESIGN: A retrospective analysis was performed on prospectively recorded data in patients attending our neurology clinic between 2008 and 2014 with a diagnosis of definite or probable neurosarcoidosis according to Zajiek criteria...
January 18, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28101824/empirically-derived-weights-for-gms-capitation-payments-to-general-practitioners
#3
B McElroy
AIM: Unlike other weighted capitation schemes used in Irish health service financing and in health systems internationally, the GMS capitation payments scheme for General Practitioners lacks transparency in both the data used and the model employed. In this study, evidence-based weights were generated and compared to current payment weights. METHODS: Four datasets on GP utilisation were interrogated. RESULTS: Evidence-based weights indicated that over 70s had higher payments per consultation than other groups...
January 18, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28084584/waterborne-outbreak-of-cryptosporidiosis-in-the-south-east-of-ireland-weighing-up-the-evidence
#4
M Mahon, S Doyle
BACKGROUND: In late Spring 2012, 12 cases of cryptosporidiosis in a town in the South East of Ireland were notified to the regional Department of Public Health. AIM: The purpose of this paper is to describe the outbreak and the investigative process which led to the conclusion that the source was a public drinking water supply. METHODS: Outbreak and incident control teams were convened to investigate and control the outbreak. RESULTS: Eleven cases were speciated as Cryptosporidium parvum...
January 13, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28070817/medicines-containing-codeine-perspectives-of-medical-professionals-in-the-republic-of-ireland
#5
M Foley, T Carney, R Harris, E Fitzpatrick, A Rapca-Veillet, M C Van Hout
AIMS: The aim of the study was to examine prescribing professional's perceptions on prescribed and OTC medicines, containing codeine in the Republic of Ireland. A secondary aim was to examine perceptions on codeine dependence, screening and treatment. METHODS: A cross-sectional study of a nationally representative group of prescribing professionals was conducted using a questionnaire containing a number of open and closed ended items. Data were analysed using SPSS version 21 and content analysis techniques...
January 9, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28070816/can-oral-isotretinoin-be-safely-initiated-and-monitored-in-primary-care-a-case-series
#6
D Buckley, S Yoganathan
BACKGROUND: Oral isotretinoin has traditionally been prescribed only in secondary care for severe or resistant acne. AIMS: To explore whether this drug can be safely initiated and monitored in primary care by a GP with extra training in dermatology. METHOD: One hundred consecutive patients who were started on oral isotretinoin therapy in a primary care centre were retrospectively reviewed. RESULTS: One hundred percent of the patients with acne who completed their course of isotretinoin were cleared at the end of treatment...
January 9, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28064426/the-impact-of-mode-of-presentation-on-distress-in-patients-with-early-stage-breast-cancer
#7
L Jane McSweeney, D O'Mahony, J E Battley, E Lee, L Nagle, S O'Reilly
AIMS: We set out to determine whether a difference exists between levels of psychological distress in women diagnosed with breast cancer through routine screening versus those who presented symptomatically. METHODS: We assessed levels of distress in comparable numbers of patients with screen-detected and non-screen-detected female breast cancer patients being treated with curative intent, using the Hospital Anxiety and Distress Scale (HADS) (total n = 93). RESULTS: In both cohorts, 50...
January 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28063126/a-retrospective-study-of-neurocombing-for-the-treatment-of-trigeminal-neuralgia-without-neurovascular-compression
#8
X Liang, X Dong, S Zhao, X Ying, Y Du, W Yu
BACKGROUND: Microvascular decompression (MVD) is the most effective and non-ablative treatment for trigeminal neuralgia (TN). However, it is not possible when neurovascular compression (NVC) is absent. Neurocombing is a possible treatment option for TN patients without NVC. AIM: To evaluate and describe the clinical outcome of neurocombing for the treatment of TN when NVC was absent. METHODS: We retrospectively reviewed the clinical data of the 37 patients of Type 1 TN without NVC who underwent neurocombing in our department between January 2013 and November 2014...
January 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28054237/what-is-the-future-for-general-surgery-in-model-3-hospitals
#9
K Mealy, F Keane, P Kelly, G Kelliher
BACKGROUND: General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland. AIM: The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning. METHODS: General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset. Current consultant staffing was ascertained from hospital personnel departments and all trainees on the National Surgical Training Programme were asked to complete a questionnaire on their career intentions...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28054236/antibiotic-resistance-patterns-of-escherichia-coli-urinary-isolates-and-comparison-with-antibiotic-consumption-data-over-10%C3%A2-years-2005-2014
#10
P J Stapleton, D J Lundon, R McWade, N Scanlon, M M Hannan, F O'Kelly, M Lynch
INTRODUCTION: Escherichia coli is a common cause of urinary tract infections (UTI). Reviews of antibiotic resistance of this organism can inform choice of empiric treatment of UTI and other infections and strategies for combating antimicrobial resistance. We reviewed laboratory and hospital pharmacy records to assess trends in non-susceptibility rates and the effect of antimicrobial stewardship interventions. METHODS: A retrospective observational study of isolates of E...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28050808/development-and-implementation-of-a-mental-health-finder-software-tool-within-an-electronic-medical-record-system
#11
D Swan, A Hannigan, S Higgins, R McDonnell, D Meagher, W Cullen
BACKGROUND: In Ireland, as in many other healthcare systems, mental health service provision is being reconfigured with a move toward more care in the community, and particularly primary care. Recording and surveillance systems for mental health information and activities in primary care are needed for service planning and quality improvement. AIMS: We describe the development and initial implementation of a software tool ('mental health finder') within a widely used primary care electronic medical record system (EMR) in Ireland to enable large-scale data collection on the epidemiology and management of mental health and substance use problems among patients attending general practice...
January 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28050807/radiotherapy-for-the-treatment-of-thyroid-eye-disease-a-prospective-comparison-is-orbital-radiotherapy-a-suitable-alternative-to-steroids
#12
P Grassi, D Strianese, R Piscopo, R Pacelli, G Bonavolontà
BACKGROUND AND AIMS: To evaluate the efficacy of orbital radiotherapy (OR) for the treatment of thyroid eye disease (TED). METHODS: Thirty-five consecutive patients with active TED with contraindications to steroid therapy received a course of OR. Bilateral retrobulbar irradiation was performed with a total dose of 20 Gy. 7-points clinical activity score (7-CAS), ocular motility, visual acuity (VA), exophthalmos and eyelid retraction were prospectively evaluated at 3, 6 and 12 months and compared with baseline data...
January 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28050806/nitrate-rich-beetroot-juice-selectively-lowers-ambulatory-pressures-and-ldl-cholesterol-in-uncontrolled-but-not-controlled-hypertension-a-pilot-study
#13
C P Kerley, E Dolan, L Cormican
BACKGROUND: Dietary nitrate has been shown to increase nitrate/nitrite levels in multiple populations, with potential blood pressure lowering effects. However, there are few reports among hypertensives. AIMS: We aimed to assess the effect of daily nitrate in subjects with controlled hypertension vs. uncontrolled hypertension. METHODS: On day 0, hypertensives wore an ambulatory BP monitor (ABPM) for 24 h and fasting blood was taken. Subjects then consumed concentrated beetroot juice (12...
January 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28040832/renal-transplantation-outcomes-following-heart-and-heart-lung-transplantation
#14
L Wong, Y R Chee, D G Healy, J J Egan, D M Sadlier, Y M O'Meara
BACKGROUND: Chronic kidney disease is a frequent complication following heart and combined heart-lung transplantation. The aim of this study was to analyse the outcome of a subsequent renal transplant in heart, lung and heart-lung transplantation recipients. METHODS: All heart, lung and heart-lung transplant recipients who received a subsequent renal transplant over a 27-year period in a national heart and lung transplant centre were included in this study. RESULTS: A total of 18 patients who had previously undergone heart (n = 6), lung (n = 7) and heart-lung (n = 5) transplantation received a renal transplant...
December 31, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28039598/patient-acceptability-and-experiences-of-therapeutic-switching-of-proton-pump-inhibitors-within-the-national-preferred-drugs-initiative-in-ireland
#15
G O'Connor, D O'Keeffe, C Darker, B O'Shea
INTRODUCTION: A 'Preferred Drugs' initiative was introduced into Ireland in 2013. This identified a single recommended drug to be prescribed to patients requiring treatment from a particular class of drugs. AIMS: This study investigates how patients on established proton pump inhibitor (PPI) therapy experienced the therapeutic switching of their medication to the 'preferred drug', and the extent to which they regarded it as an acceptable practice. METHODS: The experiences of 61 patients on established proton pump inhibitor (PPI) therapy were sought before and after their drug was switched to the 'preferred drug'...
December 30, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28039597/vinorelbine-induced-perforation-of-a-metastatic-gastric-lesion
#16
REVIEW
W J Mullally, C B O'Súilleabháin, C Brady, S O'Reilly
BACKGROUND: Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637-641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review. METHODS: A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously...
December 30, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28039596/optic-neuritis-secondary-to-antiandrogen-therapy
#17
REVIEW
Á Ní Mhéalóid, G Cunniffe
BACKGROUND: Optic neuropathy is a disorder characterised by dysfunction or destruction of the optic nerve tissues. Acquired causes include interruption in the blood supply, nutritional deficiency, compression by a tumour or aneurysm, trauma, and toxic types (Ambizas and Patel In US Pharm 36(4):HS2-HS6, 1). Drug-induced optic neuropathy is of the toxic type and can be defined as a clinical syndrome characterised by papillomacular bundle damage, central, or cecocentral scotoma, and reduced colour vision (Ambizas and Patel In US Pharm 36(4):HS2-HS6, 2011; Sharma and Sharma In Indian J Ophthalmol 59(2):137-141, 2)...
December 30, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28035483/chlamydia-pneumoniae-induces-interleukin-12-responses-in-peripheral-blood-mononuclear-cells-in-asthma-and-the-role-of-toll-like-receptor-2-versus-4-a-pilot-study
#18
T A Smith-Norowitz, J Perlman, Y M Norowitz, R Joks, H G Durkin, M R Hammerschlag, S Kohlhoff
BACKGROUND: Chlamydia pneumoniae causes respiratory infection in adults and children, and has been associated with asthma exacerbations and induction of Immunoglobulin (Ig) E responses. We previously reported that C. pneumoniae enhances T helper (Th) 2 responses of peripheral blood mononuclear cells (PBMC) from asthmatic patients. It is likely that toll like receptor (TLR)-2 and TLR-4 mediate cytokine responses and host defense against C. pneumoniae. Thus, we sought to determine whether engagement of TLR-2 or TLR-4 may induce IL-12 production in our C...
December 29, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27882501/a-review-of-a-gp-registrar-run-mobile-health-clinic-for-homeless-people
#19
A O'Carroll, N Irving, J O'Neill, E Flanagan
BACKGROUND: Homeless people have excessively high morbidity and mortality rates, yet they face barriers accessing primary care. A mobile health clinic, staffed by GP registrars, was developed to provide services to homeless people, particularly rough sleepers and sex workers. AIM: The aims were to improve access to primary care and to challenge the stereotypes and prejudices of GP registrars through direct contact with homeless people. DESIGN AND SETTING: This was a qualitative study; questionnaires were completed on the mobile health clinic and two focus groups were conducted...
November 24, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27873142/university-hospital-waterford-5-year-experience-of-cutaneous-melanoma
#20
R Sehgal, C X Cheung, R Alradadi, D A Healy, R Landers, G T O'Donoghue
INTRODUCTION: The incidence of cutaneous melanoma (CM) continues to rise in Ireland. Despite significant advances in melanoma molecular therapy, surgery remains the mainstay of treatment for CM. The University Hospital Waterford (UHW) prospectively maintained CM registry was established in 2010. AIM: To summarize 5-year experience (2010-2015) of primary CM presenting to UHW. METHODS: Data were retrospectively obtained from a central electronic pathology and radiology repository augmented by HIPE data and theatre logs...
November 21, 2016: Irish Journal of Medical Science
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