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McCartney DM, O'Shea PM, Healy M, Walsh JB, Griffin TP, Walsh C, Byrne DG, Kenny RA, Faul JL. The Causal Role of Vitamin D Deficiency in Worse Covid-19 Outcomes: Implications for Policy and Practice Development. Ir Med J 2023; 116:733. [PMID: 37555788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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2
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Aljulayfi I, O'Toole S, Healy M, Sumaidaa S, Ali Z, Bartlett D, Austin R. The interplay of saliva, erosion and attrition on enamel and dentine. Saudi Dent J 2022; 34:232-236. [PMID: 35935719 PMCID: PMC9346941 DOI: 10.1016/j.sdentj.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This investigation aimed to compare the protective role of saliva against erosion and attrition challenges. Method Polished enamel and dentine samples (n = 160) were prepared and randomly assigned to either the saliva or saliva-free group (n = 40 enamel and n = 40 dentine/group). Within each subgroup, they were allocated to four subgroups: negative control (deionized water exposure 10 min), erosion (0.3% citric acid 10 min), attrition (120 S of 300 g force), or combined erosion/attrition (0.3% citric acid 10 min then 120 S of 300 g force). Experimental cycles were repeated three times. Data analysis was performed using SPSS. Results The mean and standard deviation (SD) of step heights produced by the attrition and erosion/attrition groups in enamel in the saliva-free group were 5.6 µm (2.4) and 13.4 µm (2.8), respectively, while they were 2.4 µm (3.8) and 12.9 µm (3.5) in the saliva group, with no significant difference between the saliva and saliva-free groups. For dentine, the corresponding step heights were 25.2 µm (5.5) and 35.9 µm (7.9) for the saliva-free group, but 21.8 µm (5.3) and 27.3 µm (6.4) for the saliva group (p < 0.001). Conclusion There was a trend that saliva decreased wear, but this was only statistically significant for erosion/attrition dentine wear.
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Affiliation(s)
- I. Aljulayfi
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
- Prince Sattam bin Abdulaziz University, College of Dentistry, Alkharj, Saudi Arabia
- Corresponding author at: Prince Sattam bin Abdulaziz University, College of Dentistry, Alkharj, 16245, Saudi Arabia.
| | - S. O'Toole
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - M. Healy
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - S. Sumaidaa
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - Z. Ali
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - D. Bartlett
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - R. Austin
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
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Johnson A, Healy M, Lundquist D, Nipp R, Jimenez R. The Impact of Early Palliative Radiation Among Patients Enrolled on Early Phase Clinical Trials. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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4
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O'Keefe R, LaRiviere M, Vachani C, Hampshire M, Bach C, Arnold-Korzeniowski K, Healy M, Metz J, Hill-Kayser C. Contribution of Family History of Head and Neck Cancer and Associated Risk Factors: Analysis of an Internet Based Risk Assessment Tool. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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5
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Kerr C, Dunne J, Hughes G, Cox F, Healy M, Holmes P, O'Rourke F, O'Brien C, Coyne D, Crowley V, Crowley B, Conlon N, Bergin C. A Comparison of the Performance of SARS-CoV-2 Antibody Assays in Healthcare Workers with COVID-19. Ir Med J 2021; 114:414. [PMID: 34520649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Aims Since its emergence, significant interest surrounds the use of SARS-CoV-2 serological tests as an alternative or as an adjunct to molecular testing. However, given the speed of this pandemic, paralleled with the pressure to develop and provide serological tests in an expediated manner, not every assay has undergone the rigorous evaluation that is usually associated with medical diagnostic assays. We aimed to examine the performance of several commercially available SARS-CoV-2 IgG antibody assays among participants with confirmed COVID-19 disease and negative controls. Methods Serum taken between day 17 and day 40 post onset of symptoms from 41 healthcare workers with RT-PCR confirmed COVID-19 disease, and pre-pandemic serum from 20 negative controls, were tested for the presence of SARS-CoV-2 IgG using 7 different assays including point-of-care (POC) and laboratory-based assays. Results Assay performance varied. The lab-based Abbott diagnostics SARS-CoV-2 IgG assay proved to be the assay with the best positive and negative predictive value, and overall accuracy. The POC Nal von Minden GmbH and Biozek assays also performed well. Conclusion Our research demonstrates the variations in performance of several commercially available SARS-CoV-2 antibody assays. These findings identify the limitations of some serological tests for SARS-CoV-2. This information will help inform test selection and may have particular relevance to providers operating beyond accredited laboratories.
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Affiliation(s)
- C Kerr
- Genitourinary Medicine and Infectious Diseases Department (GUIDe), St. James's Hospital, Dublin
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin
| | - J Dunne
- Department of Immunology, St. James's Hospital, Dublin
| | - G Hughes
- Genitourinary Medicine and Infectious Diseases Department (GUIDe), St. James's Hospital, Dublin
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin
| | - F Cox
- Department of Immunology, St. James's Hospital, Dublin
| | - M Healy
- Department of Biochemistry, St. James's Hospital, Dublin
| | - P Holmes
- Department of Biochemistry, St. James's Hospital, Dublin
| | - F O'Rourke
- Department of Microbiology, St. James's Hospital, Dublin
| | - C O'Brien
- Department of Immunology, St. James's Hospital, Dublin
| | - D Coyne
- Department of Virology, National Blood Centre, St James's Hospital, Dublin
| | - V Crowley
- Department of Biochemistry, St. James's Hospital, Dublin
| | - B Crowley
- Department of Microbiology, St. James's Hospital, Dublin
| | - N Conlon
- Department of Immunology, St. James's Hospital, Dublin
| | - C Bergin
- Genitourinary Medicine and Infectious Diseases Department (GUIDe), St. James's Hospital, Dublin
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin
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Abstract
EBV is the sole causative agent of the acute illness in humans described either as infectious mononucleosis (IM), or glandular fever. IM, when not clinically silent, can present in patients with at least two of the classic triad of symptoms of fever, pharyngitis, and lymphadenopathy. Challenges for the clinician arise when atypical cases present. Early, accurate and informed laboratory test results are vital for diagnosis, appropriate treatment, and management. A key challenge for the practitioner, particularly in cases where the illness can present atypically, is distinguishing bacterial tonsillitis infections from early acute IM. The ability to draw on timely, clear, and insightful laboratory results to distinguish viral from bacterial infection is vital. Correct and prompt diagnosis of IM can help prevent the unnecessary administration of antibiotics and mitigate the need for other expensive exploratory tests in cases of IM that present with splenomegaly, lymphadenopathy, or suspect haematological conditions. Good communication between the requesting clinician and those carrying out the investigative process, and between the different laboratory departments involved, is good practice and would ultimately benefit the patient. This communication will comprehensively review the aetiology, clinical presentation, and laboratory findings in IM with a view to promoting further research and so derive a standard diagnostic algorithm of the condition.
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Affiliation(s)
- P Naughton
- Department of Biological Sciences, Munster Technological University, Bishopstown, Cork, Ireland.,Department of Haematology, Mercy University Hospital, Cork, Ireland
| | - M Healy
- Department of Biological Sciences, Munster Technological University, Bishopstown, Cork, Ireland
| | - F Enright
- Department of Paediatrics, Mercy University Hospital, Cork, Ireland
| | - B Lucey
- Department of Biological Sciences, Munster Technological University, Bishopstown, Cork, Ireland
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7
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O'Keefe R, Lariviere M, Vachani C, Hampshire M, Bach C, Arnold-Korzeniowski K, Healy M, Metz J, Hill-Kayser C. FP09.04 Association Between Family History and Other Risk Factors for Lung Cancer: Analysis of an Internet-Based Risk Assessment. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Andrews PJD, Verma V, Healy M, Lavinio A, Curtis C, Reddy U, Andrzejowski J, Foulkes A, Canestrini S. Targeted temperature management in patients with intracerebral haemorrhage, subarachnoid haemorrhage, or acute ischaemic stroke: consensus recommendations. Br J Anaesth 2018; 121:768-775. [PMID: 30236239 DOI: 10.1016/j.bja.2018.06.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/30/2018] [Accepted: 07/02/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A modified Delphi approach was used to identify a consensus on practical recommendations for the use of non-pharmacological targeted temperature management in patients with intracerebral haemorrhage, subarachnoid haemorrhage, or acute ischaemic stroke with non-infectious fever (assumed neurogenic fever). METHODS Nine experts in the management of neurogenic fever participated in the process, involving the completion of online questionnaires, face-to-face discussions, and summary reviews, to consolidate a consensus on targeted temperature management. RESULTS The panel's recommendations are based on a balance of existing evidence and practical considerations. With this in mind, they highlight the importance of managing neurogenic fever using a single protocol for targeted temperature management. Targeted temperature management should be initiated if the patient temperature increases above 37.5°C, once an appropriate workup for infection has been undertaken. This helps prevent prophylactic targeted temperature management use and ensures infection is addressed appropriately. When neurogenic fever is detected, targeted temperature management should be initiated rapidly if antipyretic agents fail to control the temperature within 1 h, and should then be maintained for as long as there is potential for secondary brain damage. The recommended target temperature for targeted temperature management is 36.5-37.5°C. The use of advanced targeted temperature management methods that enable continuous, or near continuous, temperature measurement and precise temperature control is recommended. CONCLUSIONS Given the limited heterogeneous evidence currently available on targeted temperature management use in patients with neurogenic fever and intracerebral haemorrhage, subarachnoid haemorrhage, or acute ischaemic stroke, a Delphi approach was appropriate to gather an expert consensus. To aid in the development of future investigations, the panel provides recommendations for data gathering.
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Affiliation(s)
- P J D Andrews
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - V Verma
- Royal London Hospital, London, UK
| | - M Healy
- Royal London Hospital, London, UK
| | - A Lavinio
- Neurosciences and Trauma Critical Care Unit, Addenbrooke's Hospital, Cambridge, UK
| | - C Curtis
- University College London Hospital, London, UK
| | - U Reddy
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - J Andrzejowski
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - A Foulkes
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - S Canestrini
- King's College Hospital NHS Foundation Trust, London, UK
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9
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O’Halloran A, Laird E, Healy M, Moran R, Nolan J, Beatty S, Molloy A, Kenny R. CIRCULATING BIOMARKERS PREDICT INCIDENT FRAILTY: THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA). Innov Aging 2017. [DOI: 10.1093/geroni/igx004.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - E.A. Laird
- Trinity College Dublin, Dublin, Ireland,
| | - M. Healy
- St. James’s Hospital, Dublin, Ireland,
| | - R. Moran
- Waterford Institute of Technology, Waterford, Ireland
| | - J. Nolan
- Waterford Institute of Technology, Waterford, Ireland
| | - S. Beatty
- Waterford Institute of Technology, Waterford, Ireland
| | - A. Molloy
- Trinity College Dublin, Dublin, Ireland,
| | - R. Kenny
- Trinity College Dublin, Dublin, Ireland,
- St. James’s Hospital, Dublin, Ireland,
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10
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Doyle Y, Healy M, McMahon C, Crowe S. Vaccine-Preventable Admissions to an Irish Paediatric Intensive Care. Ir Med J 2017; 110:560. [PMID: 28737301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the Republic of Ireland, the schedule of state-funded immunisation for children is comprehensive and includes diphtheria, pertussis, tetanus, pneumococcus, hepatitis B, meningococcus C, haemophilus B, polio, measles, rubella and mumps. Varicella and meningococcal B vaccines are commercially available but are not currently funded by the government. Each of the illnesses preventable by these vaccines can cause substantial morbidity, and rarely mortality, in infants and children. Our PICU continues to see serious illness due to avoidable infection. There were 39 admissions in a 4 year period, with 34 children surviving to discharge. Nine children were infected with pneumococcus, with 4 deaths. There was one case of pertussis, causing death. Most infections occurred in previously healthy children. These preventable conditions represent a significant burden on children, families, and on social and healthcare resources.
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Affiliation(s)
- Y Doyle
- Paediatric Intensive Care Unit, Our Lady's Children's Hospital, Crumlin, Dublin 12
| | - M Healy
- Paediatric Intensive Care Unit, Our Lady's Children's Hospital, Crumlin, Dublin 12
- University of Dublin, Trinity College, Dublin 2
| | - C McMahon
- Paediatric Intensive Care Unit, Our Lady's Children's Hospital, Crumlin, Dublin 12
- University of Dublin, Trinity College, Dublin 2
| | - S Crowe
- Paediatric Intensive Care Unit, Our Lady's Children's Hospital, Crumlin, Dublin 12
- University of Dublin, Trinity College, Dublin 2
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11
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Todd JJ, McSorley EM, Pourshahidi LK, Madigan SM, Crowe W, Laird EJ, Healy M, McNeilly A, Magee PJ. Oral spray wintertime vitamin D 3 supplementation has no impact on inflammation in Gaelic footballers. Scand J Med Sci Sports 2016; 27:1300-1307. [PMID: 27704631 DOI: 10.1111/sms.12785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/25/2022]
Abstract
Vitamin D inadequacy [total 25(OH)D <50 nmol/L] is widespread in athletes. The biologically active metabolite, 1,25-dihydroxyvitamin D, may be involved in regulating inflammation although in vitro findings have not been consistently replicated in human intervention trials. This study, conducted at a latitude of 55°N, aimed to assess inflammatory biomarkers in Gaelic footballers before and after a wintertime vitamin D3 intervention. Samples from a 12-week double-blind, randomized, placebo-controlled trial, in which 42 Gaelic footballers received 3000 IU (75 μg) vitamin D3 daily or placebo via oral spray solutions, were analysed for a range of inflammatory biomarkers. Cytokines (interleukin-8 and tumor necrosis factor-α), cathelicidin and high sensitivity C-reactive protein were quantified by multiplex assay, enzyme-linked immunosorbent assay and clinical biochemistry, respectively. White blood cell, lymphocyte, and neutrophil concentrations were determined by full blood profile. Data on total 25-hydroxyvitamin D, measured by LC-MS/MS, were available from the previous study. Vitamin D3 supplementation significantly increased mean total 25-hydroxyvitamin D concentrations from 47 to 84 nmol/L (P = 0.006); yet this had no effect on white blood cell count (P = 0.699), lymphocyte (P = 0.694), neutrophil (P = 0.594), interleukin-8 (P = 0.334), tumor necrosis factor-α (P = 0.587), cathelicidin (P = 0.745) or high sensitivity C-reactive protein concentration (P = 0.621) compared to placebo. 12-weeks vitamin D3 supplementation did not impact the immune profile of Gaelic footballers. This is likely because biomarkers were within their respective normal range or at a concentration similar to that of the general population at baseline. Future studies are encouraged to use inflammation as their primary outcome measure and recruit athletes at risk of compromised immunity.
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Affiliation(s)
- J J Todd
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - E M McSorley
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - L K Pourshahidi
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | | | - W Crowe
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - E J Laird
- School of Biochemistry and Immunology, Trinity College, Dublin, Ireland
| | - M Healy
- Department of Biochemistry, Central Pathology Laboratory, St. James's Hospital, Dublin, Ireland
| | - A McNeilly
- Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown, Northern Ireland
| | - P J Magee
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
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12
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Power C, Bates H, Healy M, Gleeson P, Greene E. Cognitive screening in the acute hospital: Preliminary findings from a cognitive screening program in a university-affiliated, tertiary-referral hospital with 6-month interval outcomes. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionCognitive impairment impacts on patient outcomes [1] but is under-recognised in acute hospitals [2]. Data on rates and degree of impairment among hospital inpatients remain sparse. This information is vital for strategic planning of health services as the European population ages.ObjectivesTo examine the rates and degree of cognitive impairment among patients aged 65 and older who were admitted to an acute general hospital and to assess its impact on patient outcomes.MethodsAll patients aged over 65 who were admitted over a 2-week period were invited to participate. Those who met the inclusion criteria were screened for delirium then underwent a cognitive screening battery. Normative values for age and level of education were obtained from the TILDA study [3]. Demographic and outcome data were obtained from medical records.ResultsOne hundred and forty-eight patients underwent cognitive screening. Thirty-nine over 148 (26%) met the DSM-IV criteria for dementia of whom only 16 (41%) had a previously-documented impairment. Thirty over 148 (20%) had evidence of cognitive impairment that did not meet criteria for dementia, only 3 (10%) of whom were previously documented. Seventy-three over 148 (49%) were normal. Six over 148 (4%) were not classifiable. The impact of cognitive status on length of hospital stay, number of readmissions in 6 months and discharge destination was investigated. Impact on length of stay was significant (P = 0.017) but significance was not achieved against number of readmissions or discharge destination.ConclusionsCognitive impairment is pervasive and under-recognised in the acute hospital and impacts on length of hospital stay. Longer interval analysis is necessary to investigate further implications.References 1–3 available upon request.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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13
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O'Connor ME, Livingstone T, Healy M, Beane A. Success of an interdisciplinary educational program on nursing knowledge about epidural analgesia in a critical care setting. Intensive Care Med Exp 2015. [PMCID: PMC4797403 DOI: 10.1186/2197-425x-3-s1-a928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Leahy S, O' Halloran AM, O' Leary N, Healy M, McCormack M, Kenny RA, O' Connell J. Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA). Diabetes Res Clin Pract 2015; 110:241-9. [PMID: 26520567 DOI: 10.1016/j.diabres.2015.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/07/2015] [Accepted: 10/08/2015] [Indexed: 12/11/2022]
Abstract
AIMS The prevalence of type 2 diabetes and pre-diabetes has increased rapidly in recent decades and this trend will continue as the global population ages. This study investigates the prevalence of, and factors associated with, diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults in Ireland. METHODS Cross-sectional data from 5377 men and women aged 50 and over from Wave 1 of the Irish Longitudinal Study on Ageing (TILDA) was analysed. Diagnosed diabetes was defined using self-reported doctors' diagnosis and medications data. Glycated haemoglobin (HbA1c) analysis was used to identify undiagnosed and pre-diabetes. Age and sex-specific prevalence estimates were generated. Logistic regression was used to investigate the association between diabetes classification and the demographic, health and lifestyle characteristics of the population. RESULTS The prevalence of diagnosed and undiagnosed type 2 diabetes was 8.6% (95% confidence interval (CI): 7.6-9.5%) and 0.9% (95% CI: 0.6-1.1%) respectively. Diabetes was more prevalent in men than women and increased with age. The prevalence of pre-diabetes was 5.5% (95% CI: 4.8-6.3%) and increased with age. Diabetes and pre-diabetes were independently associated with male sex, central obesity and a history of hypertension, while undiagnosed diabetes was associated with geographic location and medical costs cover. CONCLUSION Despite high rates of obesity and other undiagnosed health conditions, the prevalence of undiagnosed and pre-diabetes is relatively low in community-dwelling older adults in Ireland. Addressing lifestyle factors in this population may help to further reduce the prevalence of pre-diabetes and improve outcomes for those with a previous diagnosis.
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Affiliation(s)
- S Leahy
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland.
| | - A M O' Halloran
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - N O' Leary
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - M Healy
- Department of Biochemistry, Central Pathology Laboratory, St. James' Hospital, Dublin 8, Ireland
| | - M McCormack
- Department of Biochemistry, Central Pathology Laboratory, St. James' Hospital, Dublin 8, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - J O' Connell
- Blackrock Clinic, Blackrock, Co. Dublin, Ireland
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15
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Coyne I, McNamara N, Healy M, Gower C, Sarkar M, McNicholas F. Adolescents' and parents' views of Child and Adolescent Mental Health Services (CAMHS) in Ireland. J Psychiatr Ment Health Nurs 2015; 22:561-9. [PMID: 25977175 DOI: 10.1111/jpm.12215] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2015] [Indexed: 11/29/2022]
Abstract
Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services (CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents (n = 15) and parents (n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team.
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Affiliation(s)
- I Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - N McNamara
- Department of Psychology, University of Bedfordshire, Luton, UK
| | - M Healy
- CAMHS North Lee East, Health Service South, Cork, Ireland
| | - C Gower
- Suffolk Family Focus, West Suffolk House, Bury St Edmunds, UK
| | - M Sarkar
- Child and Family Consultation Services, Raphael House, Romford, UK
| | - F McNicholas
- Lucena Clinic, St John of God's Services, Dublin, Ireland
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16
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Weir RR, Carson EL, Mulhern MS, Laird E, Healy M, Pourshahidi LK. Validation of a food frequency questionnaire to determine vitamin D intakes using the method of triads. J Hum Nutr Diet 2015; 29:255-61. [DOI: 10.1111/jhn.12328] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- R. R. Weir
- Northern Ireland Centre for Food and Health (NICHE); University of Ulster; Coleraine UK
| | - E. L. Carson
- Northern Ireland Centre for Food and Health (NICHE); University of Ulster; Coleraine UK
| | - M. S. Mulhern
- Northern Ireland Centre for Food and Health (NICHE); University of Ulster; Coleraine UK
| | - E. Laird
- Institute of Molecular Medicine; School of Medicine; Trinity College; Dublin Ireland
| | - M. Healy
- The Department of Clinical Biochemistry; St James's Hospital; Dublin Ireland
| | - L. K. Pourshahidi
- Northern Ireland Centre for Food and Health (NICHE); University of Ulster; Coleraine UK
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17
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Laird E, McNulty H, Ward M, Hoey L, McSorley E, Wallace JMW, Carson E, Molloy AM, Healy M, Casey MC, Cunningham C, Strain JJ. Vitamin D deficiency is associated with inflammation in older Irish adults. J Clin Endocrinol Metab 2014; 99:1807-15. [PMID: 24606079 DOI: 10.1210/jc.2013-3507] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Inadequate vitamin D status is common within elderly populations and may be implicated in the etiology of autoimmune disease and inflammation. Few studies have investigated the relationship between vitamin D status and age-related immune dysfunction in humans. OBJECTIVE The aim of this study was to investigate the association between vitamin D status and immune markers of inflammation in a large sample of older adults. DESIGN, SETTING, AND PARTICIPANTS An observational investigation of 957 Irish adults (>60 years of age) recruited in Northern Ireland (55°N latitude) as part of the Trinity Ulster Department of Agriculture aging cohort study. MAIN OUTCOME MEASURE We measured serum 25-hydroxyvitamin D (25(OH)D) by liquid chromatography tandem mass spectrometry and serum cytokines IL-6, TNF-α, IL-10, and C-reactive protein (CRP) by ELISA. RESULTS Concentrations of IL-6, CRP, and the ratios of IL-6 to IL-10 and CRP to IL-10 were significantly higher in individuals with deficient (<25 nmol/L) serum 25(OH)D compared with those with sufficient (>75 nmol/L) status after adjustment for age, sex, and body mass index (P < .05). Vitamin D status was a significant predictor of the IL-6 to IL-10 cytokine ratio, and those participants defined as deficient were significantly more likely to have an IL-6 to IL-10 ratio >2:1 compared with those defined as sufficient. CONCLUSIONS This study demonstrated significant associations between low vitamin D status and markers of inflammation (including the ratio of IL-6 to IL-10) within elderly adults. These findings suggest that an adequate vitamin D status may be required for optimal immune function, particularly within the older adult population.
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Affiliation(s)
- E Laird
- Institute of Molecular Medicine (E.L., A.M.M.), School of Medicine, Trinity College, Dublin, Ireland; Northern Ireland Centre for Food and Health (H.M., M.W., L.H., E.M., J.M.W.W., E.C., J.J.S.), University of Ulster, Coleraine, Londonderry BT52 1SA, Northern Ireland; Department of Clinical Biochemistry (M.H.), St James's Hospital, Dublin, Ireland; and The Mercers Institute for Research on Ageing (M.C.C., C.C.), St James's Hospital, Dublin, Ireland
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O'Connor R, Mannix M, Cullen W, Mullen J, Healy M, Saunders J, Griffin M, O'Sullivan G. Care of type 2 diabetes in unresourced general practice: current practice in the Mid-West. Ir Med J 2014; 107:43-45. [PMID: 24654481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It is estimated that 4.5% of the Irish population have type 2 diabetes. The HSE intends to move the care of uncomplicated type 2 diabetes to General Practice (GP). The study reviewed current General Practice diabetes care in the Irish Mid-West. The files of randomly selected patients from 12 GP teaching practices attached to the University of Limerick were audited. 842 patients were identified (62% male, 38% female). The mean age was 66 years. 75% were GMS patients. A practice protocol was used in 71% of patients. Average Cholesterol (4.3 mmol/l), creatinine (85.3 mmol/l), HbA1c (56.7 mmol/mol) and systolic blood pressure (SBP) (134 mmHg) measurements were well documented and controlled. However the rates of and mean intervals for foot review (60.2%), BMI measurement (52.3%), retinopathy screening (62.0%) and influenza vaccination (63.0%) were unacceptably low. Current management of type 2 diabetes in unresourced general practices is suboptimal although some biochemical parameters are well controlled.
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Barrass L, Healy M, Kennedy D, Drewery H. Development of the novel Tracoe Twist Plus tracheostomy tube. Crit Care 2014. [PMCID: PMC4069459 DOI: 10.1186/cc13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Yau F, Healy M. Propofol: monitoring for complications. Crit Care 2014. [PMCID: PMC4069385 DOI: 10.1186/cc13608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Zhou N, Nowicka-Sans B, McAuliffe B, Ray N, Eggers B, Fang H, Fan L, Healy M, Langley DR, Hwang C, Lataillade M, Hanna GJ, Krystal M. Genotypic correlates of susceptibility to HIV-1 attachment inhibitor BMS-626529, the active agent of the prodrug BMS-663068. J Antimicrob Chemother 2013; 69:573-81. [DOI: 10.1093/jac/dkt412] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Callaghan M, Doyle Y, O'Hare B, Healy M, Nölke L. Economics and ethics of paediatric respiratory extra corporeal life support. Ir Med J 2013; 106:252-253. [PMID: 24282901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Extra corporeal membrane oxygenation (ECMO) is a form of life support, which facilitates gas exchange outside the body via an oxygenator and a centrifugal pumping system. A paediatric cardiac ECMO programme was established in 2005 at Our Lady's Children's Hospital, Crumlin (OLCHC) and to date 75 patients have received ECMO, the majority being post operative cardiac patients. The outcome data compares favourably with international figures. ECMO has been most successful in the treatment of newborn infants with life threatening respiratory failure from conditions such as meconium aspiration, respiratory distress syndrome and respiratory infections. There is no formal paediatric respiratory ECMO programme at OLCHC, or anywhere else in Ireland. Currently, neonates requiring respiratory ECMO are transferred to centres in Sweden or the UK at an average cost of 133,000 Euros/infant, funded by the Health Service Executive E112 treatment abroad scheme. There is considerable morbidity associated with the transfer of critically ill infants, as well as significant psycho-social impact on families. OLCHC is not funded to provide respiratory ECMO, although the equipment and expertise required are similar to cardiac ECMO and are currently in place. The average cost of an ECMO run at OLCHC is 65,000 Euros. There is now a strong argument for a fully funded single national cardiac and respiratory paediatric ECMO centre, similar to that for adult patients.
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MESH Headings
- Extracorporeal Membrane Oxygenation/economics
- Extracorporeal Membrane Oxygenation/ethics
- Extracorporeal Membrane Oxygenation/instrumentation
- Extracorporeal Membrane Oxygenation/methods
- Female
- Hernia, Diaphragmatic/complications
- Hernia, Diaphragmatic/diagnosis
- Hernia, Diaphragmatic/economics
- Hernia, Diaphragmatic/therapy
- Hernias, Diaphragmatic, Congenital
- Hospitals, Pediatric/economics
- Hospitals, Pediatric/ethics
- Humans
- Infant
- Ireland
- Male
- Medical Tourism/economics
- Medical Tourism/ethics
- Respiratory Distress Syndrome, Newborn/diagnosis
- Respiratory Distress Syndrome, Newborn/economics
- Respiratory Distress Syndrome, Newborn/etiology
- Respiratory Distress Syndrome, Newborn/therapy
- Respiratory Insufficiency/diagnosis
- Respiratory Insufficiency/economics
- Respiratory Insufficiency/etiology
- Respiratory Insufficiency/therapy
- Sweden
- Treatment Outcome
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Affiliation(s)
- M Callaghan
- Our Lady's Children's Hospital, Crumlin, Dublin 12.
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Conrick-Martin I, Foley M, Roche FM, Fraher MH, Burns KM, Morrison P, Healy M, Power MW, Fitzpatrick F, Phelan D, Walshe CM. Catheter-related infection in Irish intensive care units diagnosed with HELICS criteria: a multi-centre surveillance study. J Hosp Infect 2013; 83:238-43. [PMID: 23394814 DOI: 10.1016/j.jhin.2012.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs). AIM To examine the feasibility of multi-centre CRI surveillance in nine Irish ICUs, using Hospitals in Europe Link for Infection Control through Surveillance (HELICS) definitions (CRI 1, CRI 2 and CRI 3). METHODS All non-tunnelled central venous catheters (CVCs) inserted in patients aged >18 years with an ICU stay ≥48 h were included over a three-month study period. FINDINGS Feasibility was demonstrated by the 99.5% return rate for study forms. Data on 1209 CVCs in 614 patients over 7587 CVC-days showed 17 episodes of CRI, representing a national rate of 2.2 per 1000 CVC-days [95% confidence interval (CI) 1.2-3.3]. Rates of CRI 1, CRI 2 and CRI 3 were 0.13 (95% CI 0.00-0.39), 0.79 (95% CI 0.16-1.42) and 1.39 (95% CI 0.60-2.17) per 1000 CVC-days, respectively. CRI was associated with length of ICU stay (P < 0.001), number of CVCs inserted (P < 0.001) and total number of CVC-days per patient (P < 0.001). CRI was higher in CVCs inserted in operating theatres (incident rate ratio 3.9, 95% CI 1.3-11.5; P = 0.02) compared with CVCs inserted in ICUs. Participant feedback reported minimal difficulty with surveillance implementation, and data collection required approximately 1 h per patient per week. CONCLUSION The study demonstrated that multi-centre ICU surveillance using HELICS CRI definitions was practical, feasible and provided clinically relevant information. CRI surveillance in ICUs, although labour intensive, is recommended to reduce CRI and allow ongoing evaluation of processes aimed at CRI reduction.
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Affiliation(s)
- I Conrick-Martin
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
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Kao R, Rajagopalan A, Beckett A, Beckett A, Rex R, Shah S, Waddell J, Boitano M, Faidi S, Babatunde O, Lawson F, Grant A, Sudarshan M, Sudarshan M, Takashashi M, Waggott M, Lampron J, Post A, Beale E, Bobrovitz N, Zakrison T, Smith A, Bawazeer M, Evans C, Leeper T, Kagedan D, Grenier T, Rezendo-Neto J, Roberts D, Roberts D, Stark P, Berg R, Mehta S, Gardner P, Moore L, Vassilyadi M, Moore L, Moore L, Hoshizaki B, Rezende-Neto J, Slaba I, Ramesh A, Grigorovich A, Parry N, Pajak C, Rosenbloom B, Grunfeld A, van Heest R, Fernandes J, Doucet J, Schooler S, Ali J, Klassen B, Santana M, McFarlan A, Ball C, Blackmore C, Rezende-Neto J, Kidane B, Hicks C, Brennan M, Brennan M, Harrington A, Sorvari A, Stewart TC, Biegler N, Chaubey V, Tsang B, Benjamin S, Hogan A, Fraser J, Martin M, Bridge J, Faidi S, Waligora M, Hsiao M, Sharma S, Sankarankutty A, Mckee J, Mckee J, Mckee J, Snider C, Szpakowski J, Brown R, Shah S, Shiu M, Chen M, Bell N, Besserer F, Bell N, Trudeau MO, Alhabboubi M, Rezende-Neto J, Rizoli S, Hill A, Joseph B, Lawless B, Jiao X, Xenocostas A, Rui T, Parry N, Driman D, Martin C, Stewart TC, Walsh J, Parry N, Merritt N, Elster E, Tien H, Phillips L, Bratu I, Nascimento B, Pinto R, Callum J, Tien H, Rizoli S, McMullan J, McGlasson R, Mahomed N, Flannery J, Bir C, Baillie F, Coates A, Asiri S, Foster P, Baillie F, Bhandari M, Phillips L, Bratu I, Schuurman N, Oliver L, Nathens A, Yazdani A, Alhabboubi M, St. Louis E, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, St. Louis E, Alhabboubi M, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, Takada M, Sawano M, Ito H, Tsutsumi H, Keenan A, Waggott M, Hoshizaki B, Brien S, Gilchrist M, Janis J, Phelan H, Minei J, Santana M, Stelfox H, McCredie V, Leung E, Garcia G, Rizoli S, Nathens A, Dixon E, Niven D, Kirkpatrick A, Feliciano D, D’Amours S, Ball C, Ahmed N, Izadi H, McFarlan A, Nathens A, Pavenski K, Nathens A, Bridge J, Tallon J, Leeper W, Vogt K, Stewart TC, Gray D, Parry N, Ameer A, Alhabboubi M, Alzaid S, Deckelbaum D, Fata P, Khwaja K, Razek T, Deckelbaum D, Drudi L, Boulva K, Rodrigue N, Khwaja K, Chughtai T, Fata P, Razek T, Rizoli S, Carreiro P, Lisboa T, Winter P, Ribeiro E, Cunha-Melo J, Andrade M, Zygun D, Grendar J, Ball C, Robertson H, Ouellet JF, Cheatham M, Kirkpatrick A, Ball C, Ouellet JF, McBeth P, Kirkpatrick A, Dixon E, Groff P, Inaba K, Okoye O, Pasley J, Demetriades D, Al-Harthi F, Cheng A, Lalani A, Mikrogianakis A, Cayne S, Knittel-Keren D, Gomez M, Stelfox H, Turgeon A, Lapointe J, Bourgeois G, Karton C, Rousseau P, Hoshizaki B, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Rousseau P, Braga B, Faleiro R, Magaldi M, Cardoso G, Lozada W, Duarte L, Rizoli S, Ball C, Oddone-Paolucci E, Doig C, Kortbeek J, Gomez M, Fish J, Leach L, Leelapattana P, Fleming J, Bailey C, Nolan B, DeMestral C, McFarlan A, Zakirova R, Nathens A, Dabbs J, Duff D, Michalak A, Mitchell L, Nathens A, Singh M, Topolovec-Vranic J, Tymianski D, Yetman L, Canzian S, MacPhail I, Constable L, van Heest R, Tam A, Mahadevan P, Kim D, Bansal V, Casola G, Coimbra R, Gladwin C, Misra M, Kumar S, Gautam S, Sorvari A, Blackwood B, Coates A, Baillie F, Stelfox H, Nathens A, Wong C, Straus S, Haas B, Lenartowicz M, Parkovnick M, Parry N, Inaba K, Dixon E, Salim A, Pasley J, Kirkpatrick A, Ouellet JF, Niven D, Kirkpatrick A, Ball C, Neto C, Nogueira G, Fernandes M, Almeida T, de Abreu EMS, Rizoli S, Abrantes W, Taranto V, Parry N, Forbes T, Knight H, Keenan A, Yoxon H, Macpherson A, Bridge J, Topolovec-Vranic J, Mauceri J, Butorac E, Ahmed N, Holmes J, Gilliland J, Healy M, Tanner D, Polgar D, Fraser D, McBeth P, Crawford I, Tiruta C, Ball C, Kirkpatrick A, Roberts D, Ferri M, Bobrovitz N, Khandwala F, Stelfox H, Widder S, Mckee J, Hogan A, Benjamin S, Atkinson P, Benjamin S, Watson I, Hogan A, Benjamin S, Woodford S, Jaramillo DG, Nathens A, Alonazi N, Coates A, Baillie F, Zhang C, McFarlan A, Sorvari A, Chalklin K, Canzian S, Nathens A, DeMestral C, Hill A, Langer J, Nascimento B, Alababtain I, Fung SY, Passos E, Luz L, Brnjac E, Pinto R, Rizoli S, Widder S, Widder S, Widder S, Nathens A, Van Heest R, Constable L, Mancini F, Heidary B, Bell N, Appleton L, Hennecke P, Taunton J, Khwaja K, O’Connor M, Hameed M, Garraway N, Simons R, Evans D, Taulu T, Quinn L, Kuipers D, Rizoli S, Rogers C, Geerts W, Rhind S, Rizoli S, George K, Quinn L, Babcock C, Hameed M, Simons R, Caron N, Hameed M, Simons R, Prévost F, Razek T, Khwaja K, Sudarshan M, Razek T, Fata P, Deckelbaum D, Khwaja K, de Abreu EMS, Neto C, Almeida T, Pastore M, Taranto V, Fernandes M, Rizoli S, Nascimento B, Sankarankutty A, Pinto R, Callum J, Tremblay L, Tien H, Fowler R, Pinto R, Nathens A, Sadoun M, Harris J, Friese R, Kulvantunyou N, O’Keeffe T, Wynne J, Tang A, Green D, Rhee P, Trpkovski J, Blount V. Trauma Association of Canada Annual Scientific Meeting abstractsErythroopoietin resuscitated with normal saline, Ringer’s lactate and 7.5% hypertonic saline reduces small intestine injury in a hemorrhagic shock and resuscitation rat model.Analgesia in the management of pediatric trauma in the resuscitative phase: the role of the trauma centre.Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices.Does computed tomography for penetrating renal injury reduce renal exploration? An 8-year review at a Canadian level 1 trauma centre.The other side of pediatric trauma: violence and intent injury.Upregulation of activated protein C leads to factor V deficiency in early trauma coagulopathy.A provincial integrated model of improved care for patients following hip fracture.Sports concussion: an Olympic boxing model comparing sex with biomechanics and traumatic brain injury.A multifaceted quality improvement strategy to optimize monitoring and management of delirium in trauma patients: results of a clinician survey.Risk factors for severe all-terrain vehicle injuries in Alberta.Evaluating potential spatial access to trauma centre care by severely injured patients.Incidence of brain injury in facial fractures.Surgical outcomes and the acute care surgery service.The acute care general surgery population and prognostic factors for morbidity and mortality.Disaster preparedness of trauma.What would you like to know and how can we help you? Assessing the needs of regional trauma centres.Posttraumatic stress disorder screening for trauma patients at a level 1 trauma centre.Physical and finite element model reconstruction of a subdural hematoma event.Abdominal wall reconstruction in the trauma patient with an open abdomen.Development and pilot testing of a survey to measure patient and family experiences with injury care.Occult shock in trauma: What are Canadian traumatologists missing?Timeliness in obtaining emergent percutaneous procedures for the severely injured patient: How long is too long?97% of massive transfusion protocol activations do not include a complete hemorrhage panel.Trauma systems in Canada: What system components facilitate access to definitive care?The role of trauma team leaders in missed injuries: Does specialty matter?The adverse consequences of dabigatran among trauma and acute surgical patients.A descriptive study of bicycle helmet use in Montréal.Factor XIII, desmopressin and permissive hypotension enhance clot formation compared with normotensive resuscitation: uncontrolled hemorrhagic shock model.Negative pressure wound therapy for critically ill adults with open abdominal wounds: a systematic review.The “weekend warrior:” Fact or fiction for major trauma?Canadian injury preventon curriculum: a means to promote injury prevention.Penetrating splenic trauma: Safe for nonoperative management?The pediatric advanced trauma life support course: a national initiative.The effectiveness of a psycho-educational program among outpatients with burns or complex trauma.Trauma centre performance indicators for nonfatal outcomes: a scoping review.The evaluation of short track speed skating helmet performance.Complication rates as a trauma care performance indicator: a systematic review.Unplanned readmission following admission for traumatic injury: When, where and why?Reconstructions of concussive impacts in ice hockey.How does head CT correlate with ICP monitoring and impact monitoring discontinuation in trauma patients with a Marshall CT score of I–II?Impact of massive transfusion protocol and exclusion of plasma products from female donors on outcome of trauma patients in Calgary region of Alberta Health Services.Primary impact arthrodesis for a neglected open Weber B ankle fracture dislocation.Impact of depression on neuropsychological functioning in electrical injury patients.Predicting the need for tracheostomy in patients with cervical spinal cord injury.Predicting crumping during computed tomography imaging using base deficit.Feasibility of using telehomecare technology to support patients with an acquired brain injury and family care-givers.Program changes impact the outcomes of severely injured patients.Do trauma performance indicators accurately reflect changes in a maturing trauma program?One-stop falls prevention information for clinicians: a multidisciplinary interactive algorithm for the prevention of falls in older adults.Use of focused assessment with sonography for trauma (FAST) for combat casualties in forward facilities.Alberta All-terrain Vehicle Working Group: a call to action.Observations and potential role for the rural trauma team development course (RTTDC) in India.An electronic strategy to facilitate information-sharing among trauma team leaders.Development of quality indicators of trauma care by a consensus panel.An evaluation of a proactive geriatric trauma consultation service.Celebrity injury-related deaths: Is a gangster rapper really gangsta?Prevention of delirium in trauma patients: Are we giving thiamine prophylaxis a fair chance?Intra-abdominal injury in patients who sustain more than one gunshot wound to the abdomen: Should non-operative management be used?Retrospective review of blunt thoracic aortic injury management according to current treatment recommendations.Telemedicine for trauma resuscitation: developing a regional system to improve access to expert trauma care in Ontario.Comparing trauma quality indicator data between a pediatric and an adult trauma hospital.Using local injury data to influence injury prevention priorities.Systems saving lives: a structured review of pediatric trauma systems.What do students think of the St. Michael’s Hospital ThinkFirst Injury Prevention Strategy for Youth?An evidence-based method for targeting a shaken baby syndrome prevention media campaign.The virtual mentor: cost-effective, nurse-practitioner performed, telementored lung sonography with remote physician guidance.Quality indicators used by teaching versus nonteaching international trauma centres.Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting.Closing the quality improvement loop: a collaborative approach.National Trauma Registry: “collecting” it all in New Brunswick.Does delay to initial reduction attempt affect success rates for anterior shoulder dislocation (pilot study)?Use of multidisciplinary, multi-site morbidity and mortality rounds in a provincial trauma system.Caring about trauma care: public awareness, knowledge and perceptions.Assessing the quality of admission dictation at a level 1 trauma centre.Trauma trends in older adults: a decade in review.Blunt splenic injury in patients with hereditary spherocytosis: a population-based analysis.Analysis of trauma team activation in severe head injury: an institutional experience.ROTEM results correlate with fresh frozen plasma transfusion in trauma patients.10-year trend of assault in Alberta.10-year trend in alcohol use in major trauma in Alberta.10-year trend in major trauma injury related to motorcycles compared with all-terrain vehicles in Alberta.Referral to a community program for youth injured by violence: a feasibility study.New impaired driving laws impact on the trauma population at level 1 and 3 trauma centres in British Columbia, Canada.A validation study of the mobile medical unit/polyclinic team training for the Vancouver 2010 Winter Games.Inferior vena cava filter use in major trauma: the Sunny-brook experience, 2000–2011.Relevance of cellular microparticles in trauma-induced coagulopathy: a systemic review.Improving quality through trauma centre collaboratives.Predictors of acute stress response in adult polytrauma patients following injury.Patterns of outdoor recreational injury in northern British Columbia.Risk factors for loss-to-follow up among trauma patients include functional, socio-economic, and geographic determinants: Would mandating opt-out consent strategies minimize these risks?Med-evacs and mortality rates for trauma from Inukjuak, Nunavik, Quebec.Review of open abdomens in McGill University Health Centre.Are surgical interventions for trauma associated with the development of posttraumatic retained hemothorax and empyema?A major step in understanding the mechanisms of traumatic coagulopathy: the possible role of thrombin activatable fibrinolysis inhibitor.Access to trauma centre care for patients with major trauma.Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted.Improving trauma system governance. Can J Surg 2012. [DOI: 10.1503/cjs.006312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Charyk-Stewart T, Tanner DA, Gilliland J, Healy M, Williamson J, McKenzie S, Girotti MJ, Fraser DD. Injury and spatial epidemiology of severe adult trauma: implications for prevention. Inj Prev 2011. [DOI: 10.1136/ip.2010.029215.403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Maruthappu M, Manuel A, Christian A, Hollington A, Ramsden M, Alexopoulou Z, Healy M, Giles M. P257 A comparison of scoring systems in the management of a range of pulmonary embolism patients in a university hospital. Thorax 2010. [DOI: 10.1136/thx.2010.151076.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chong FY, Healy M, Soon KH. Cardiac tamponade due to haemorrhagic effusion: an unusual first manifestation of systemic lupus erythematosus. Heart Asia 2010; 2:73. [DOI: 10.1136/ha.2009.001628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chukwu J, Iro C, Donoghue V, McCallion N, Murphy JF, Quinn F, Healy M, Molloy EJ. Congenital diaphragmatic hernia: neonatal outcomes following referral to a paediatric surgical centre. Ir Med J 2009; 102:260-261. [PMID: 19873868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Congenital diaphragmatic hernia (CDH) is a rare malformation observed in approximately 1 in 3000 live births. Estimates of postnatal survival range from 50 to 70% despite advances in neonatal care. Antenatal diagnosis is associated with termination of pregnancy in 25-50% pregnancy internationally which may not be reflective of the Irish population. We aimed to evaluate the mortality of infants with CDH who survived to admission in a tertiary referral paediatric hospital between 1996 and 2007. The Hospital In-Patient Enquiry system was used to determine the number of neonatal referrals for CDH to OLHSC between 1996 and 2007. Mortality, sex distribution, length of patient stay and the number of cases per year were examined. 141 neonates with CDH were over 12 years with approximately 12 referrals per annum of which 82 (58%) were male and 59 (42%) female. The average length of stay in the hospital was 33 (range 0-364) days. Overall 71% of the patients survived to discharge. In the first epoch (1996-2001) survival was 63% compared with 78% in the later epoch (2002-7). The overall survival for neonates with CDH presenting to OLCHC during the 12 year-period was 71% although this improved to 78% in recent epoch. Further study of associated congenital anomalies, number of terminations of pregnancy, complexity of the diaphragmatic defect and degree of pulmonary hypertension are required to compare this population with other international centres.
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Affiliation(s)
- J Chukwu
- Department of Neonatology, Our Lady's Children's Hospital, Crumlin, Dublin 12
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Adeel S, Arain M, Healy M. Preoperative fasting time in children. Ir Med J 2009; 102:117-118. [PMID: 19552293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of preoperative fasting is to prevent regurgitation and pulmonary aspiration while limiting potential problems of thirst, dehydration and hypoglycaemia. The American Society of Anaesthesiologists (ASA) has suggested guidelines for preoperative fasting for children undergoing elective surgery. We did a postal survey to determine the current practice regarding these guidelines amongst all specialist registrars in anaesthesia in Ireland. A questionnaire was sent to all specialist registrars in anaesthesia (90 in total), 60 (67%) were returned and analysed. The question asked was how long children should be kept fasting before elective surgery. The results of our survey suggest that most of the respondents are following the ASA guidelines for clear fluids and solids however there were differing opinion regarding the duration of fasting for formula milk and breast milk. In conclusion, we would recommend greater awareness and collaboration between anaesthetists, nurses and surgeons to ensure that fasting instructions are consistent with the ASA guidelines and that patient and their parents understand these directives as well.
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Affiliation(s)
- S Adeel
- Department of Anaesthesia, Our Lady's Children's Hospital, Crumlin, Dublin.
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Diaz S, Liu P, Kuhnert WL, Healy M, Prince AM, El-Nageh MM. Development of the International Consortium for Blood Safety (ICBS) HCV panels. East Mediterr Health J 2008; 14:427-437. [PMID: 18561736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
To evaluate the sensitivity and specificity of assays used to screen blood for antibody to hepatitis C virus (HCV) infection, the International Consortium for Blood Safety (ICBS) established fully characterized CBS panels. lCBS collected and characterized 1007 anti-HCV-positive plasma units from geographically diverse origins by ELISA, RIBA, RT-PCR, and sequence-based genotyping, 539 of which met the definition of a true positive. Of these, 200 confirmed positive plasma units, representing the 6 major HCV genotypes, were selected to assemble the true-positive constituents of the panel. The negative panel comprises 181 plasma units collected from the USA. The panels have proved valuable for determining the performance of anti-HCV assays thus permitting national authorities, especially in resource-limited countries, to make informed decisions on selection of affordable and reliable assays.
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Affiliation(s)
- S Diaz
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Montgomery H, Waldmann C, Taylor B, Healy M, Kemp V. Critical Care Contingency Planning Preparations for an Influenza Pandemic. J Intensive Care Soc 2006. [DOI: 10.1177/175114370600700304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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34
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Harrold J, Field M, Hall C, Healy M, Williams N, Lowe M, Halford J. Individual differences in sensitivity to food stimuli: Relationship between cognitive biases and trait eating behavior. Appetite 2006. [DOI: 10.1016/j.appet.2006.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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35
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Shirley PJ, Thavasothy M, McAuley D, Kennedy D, Mandersloot G, Verma V, Healy M. Reflections on the Clinical Learning Points from the the Royal London Hospital Intensive Care Unit following July 7th 2005 Terrorist Attacks. J Intensive Care Soc 2006. [DOI: 10.1177/175114370600700216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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36
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Wang C, Healy M, Chen D. TU-EE-A2-02: New Field Splitting Algorithms for Intensity-Modulated Radiation Therapy. Med Phys 2006. [DOI: 10.1118/1.2241594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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37
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Healy M, Reece K, Walton D, Huong J, Frye S, Raad II, Kontoyiannis DP. Use of the Diversi Lab System for species and strain differentiation of Fusarium species isolates. J Clin Microbiol 2005; 43:5278-80. [PMID: 16207996 PMCID: PMC1248465 DOI: 10.1128/jcm.43.10.5278-5280.2005] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Advances in molecular typing of fusariosis would facilitate the study of its epidemiology. We tested 26 such isolates by the commercially available Diversi Lab System. The system utilizes automated repetitive sequence-based PCR (rep-PCR) and web-based data analyses. rep-PCR dendrogram cluster analysis showed agreement with species sequence identification (elongation factor 1 alpha gene). Additionally, subtype differences within the same species were noted.
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Affiliation(s)
- M Healy
- Bacterial Barcodes, Inc., Houston, TX 77030, USA.
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38
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Abstract
BACKGROUND Clinical vital signs in children (temperature, heart rate, respiration rate, and blood pressure) are an integral part of clinical assessment of degree of illness or normality. Despite this, only blood pressure and temperature have a reliable evidence base. The accepted ranges of heart and respiration rate vary widely. METHODS This study examined 1109 children aged 4-16 years in their own schools. Age, sex, height, weight, and resting respiration rate and heart rate were recorded. The data were used to produce age related reference ranges for everyday clinical use. RESULTS Reference intervals are presented for the range of heart rate and respiration rate of healthy resting children aged 4-16 years. The recorded values are at variance with standard quoted ranges in currently available texts.
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Affiliation(s)
- L A Wallis
- Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
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39
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Ezra DG, Lewis G, Healy M, Coombes A. Preventing exposure keratopathy in the critically ill: a prospective study comparing eye care regimes. Br J Ophthalmol 2005; 89:1068-9. [PMID: 16024871 PMCID: PMC1772779 DOI: 10.1136/bjo.2004.062406] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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40
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Martin AJ, Casey M, Healy M, Walsh JB. Effect of atorvastatin on markers of bone turnover. Osteoporos Int 2005; 16:446. [PMID: 15703864 DOI: 10.1007/s00198-004-1824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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42
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Healy M, Reece K, Walton D, Huong J, Shah K, Kontoyiannis DP. Identification to the species level and differentiation between strains of Aspergillus clinical isolates by automated repetitive-sequence-based PCR. J Clin Microbiol 2004; 42:4016-24. [PMID: 15364984 PMCID: PMC516350 DOI: 10.1128/jcm.42.9.4016-4024.2004] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A commercially available repetitive-sequence-based PCR (rep-PCR) DNA fingerprinting assay adapted to an automated format, the DiversiLab system, enables rapid microbial identification and strain typing. We explored the performance of the DiversiLab system as a molecular typing tool for 69 Aspergillus isolates (38 A. fumigatus, 15 A. flavus, and 16 A. terreus isolates) had been previously characterized by morphological analysis. Initially, 27 Aspergillus isolates (10 A. fumigatus, 9 A. flavus, and 8 A. terreus isolates) were used as controls to create a rep-PCR-based DNA fingerprint library with the DiversiLab software. Then, 42 blinded Aspergillus isolates were typed using the system. The rep-PCR-based profile revealed 98% concordance with morphology-based identification. rep-PCR-based DNA fingerprints were reproducible and were consistent for DNA from both hyphae and conidia. DiversiLab dendrogram reports correctly identified all A. fumigatus (n = 28), A. terreus (n = 8), and A. flavus (n = 6) isolates in the 42 blinded Aspergillus isolates. rep-PCR-based identification of all isolates was 100% in agreement with the contiguous internal transcribed spacer (ITS) region (ITS1-5.8S-ITS2) sequence-based identification of the respective isolates. Additionally, the DiversiLab system could demonstrate strain-level differentiation of A. flavus and A. terreus. Automated rep-PCR may be a time-efficient, effective, easy-to-use, novel genotyping tool for identifying and determining the strain relatedness of fungi. This system may be useful for epidemiological studies, molecular typing, and surveillance of Aspergillus species.
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Affiliation(s)
- M Healy
- Bacterial Barcodes, Inc., Houston, TX, USA
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Abstract
A postal questionnaire survey of neurosurgery and spinal injury departments in the UK was conducted to determine how they assessed the cervical spine in unconscious, adult trauma patients, and at what point immobilisation was discontinued. Of the 32 units contacted, 27 responded (response rate, 84%). Most centres had no protocols to guide initial imaging or when immobilisation devices should be removed. Most responding centres performed fewer than three plain radiographs, and most did not use computerised tomography routinely. Routine use of magnetic resonance imaging or dynamic flexion-extension fluoroscopy was rare, and few units regarded the latter as safe in unconscious patients. There was no consensus on when immobilisation of the cervical spine should be discontinued. Most centres that terminated immobilisation immediately after imaging did so on the basis of plain radiographs alone. Unconscious adult trauma patients remain at risk of inadequate assessment of potential cervical spine injuries.
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Affiliation(s)
- P S Jones
- Department of Anaesthesia, The Royal London Hospital, Whitechapel, London E1 1BB, UK.
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45
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Castro VA, Thrasher AN, Healy M, Ott CM, Pierson DL. Microbial characterization during the early habitation of the International Space Station. Microb Ecol 2004; 47:119-26. [PMID: 14749908 DOI: 10.1007/s00248-003-1030-y] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2003] [Accepted: 06/23/2003] [Indexed: 05/20/2023]
Abstract
An evaluation of the microbiota from air, water, and surface samples provided a baseline of microbial characterization onboard the International Space Station (ISS) to gain insight into bacterial and fungal contamination during the initial stages of construction and habitation. Using 16S genetic sequencing and rep-PCR, 63 bacterial strains were isolated for identification and fingerprinted for microbial tracking. Of the bacterial strains that were isolated and fingerprinted, 19 displayed similarity to each other. The use of these molecular tools allowed for the identification of bacteria not previously identified using automated biochemical analysis and provided a clear indication of the source of several ISS contaminants. Strains of Bradyrhizobium and Sphingomonas unable to be identified using sequencing were identified by comparison of rep-PCR DNA fingerprints. Distinct DNA fingerprints for several strains of Methylobacterium provided a clear indication of the source of an ISS water supply contaminant. Fungal and bacterial data acquired during monitoring do not suggest there is a current microbial hazard to the spacecraft, nor does any trend indicate a potential health risk. Previous spacecraft environmental analysis indicated that microbial contamination will increase with time and will require continued surveillance.
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Affiliation(s)
- V A Castro
- EASI/Wyle Laboratories, Microbiology Laboratory, Johnson Space Center, Houston, TX 77058, USA.
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46
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Doherty MJ, Healy M, Richardson SG, Fisher NC. Total body iron overload in welder's siderosis. Occup Environ Med 2004; 61:82-5. [PMID: 14691279 PMCID: PMC1757815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Welder's siderosis occurs as a consequence of the inhalation of iron dust. The iron overload of welder's siderosis is usually considered to be confined to the lungs. Here we present three proven cases of welder's siderosis associated with evidence of increased total systemic iron stores, as evidenced by increased serum ferritin levels. Multiple investigations including molecular genotyping for the common mutations found in genetic haemochromatosis failed to prove this was due to haemochromatosis, nor was there any evidence of any other recognised cause of systemic iron overload. Thus the systemic iron overload described seems likely to be due to either occupational exposure, an uncharacterised genetic haemochromatosis, or a combination of both.
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Affiliation(s)
- M J Doherty
- Department of Respiratory Medicine, Dudley Group of Hospitals, West Midlands, UK.
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Crowe S, Mannion D, Healy M, O'Hare B, Lyons B. Paediatric near-drowning: mortality and outcome in a temperate climate. Ir Med J 2003; 96:274-6. [PMID: 14753583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The decision whether to continue to resuscitate the paediatric victim of near-drowning is influenced by potential poor neurological outcome. A low core body temperature at presentation is frequently cited as a reason to continue resuscitation. We report the case of an 11 month old infant admitted to the intensive care unit following near-drowning and a prolonged resuscitation. The infant's core body temperature was 29 degrees C. Cardiac output was restored, but the child remains in a persistent vegetative state. We present the results of a ten year review of near-drowning in a tertiary referral institution, to evaluate the mortality and outcome in a temperate climate. Thirteen patients were identified in the review. The mortality was 23%. The incidence of a persistent vegetative state was 15%. Asystole, immersion time greater than 15 minutes, resuscitation time longer than 30 minutes, the administration of epinephrine, and a low core body temperature were associated with a poor outcome.
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Affiliation(s)
- S Crowe
- Department of Anaesthesia and Intensive Care Medicine, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland.
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49
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Abstract
In Ireland, constructed wetland systems are increasingly being used to perform tertiary treatment on municipal waste effluent from small towns and villages located in areas whose receiving waters are deemed sensitive. The bedrock formation in the west of Ireland is primarily karst limestone and where the overburden-soil cover is very shallow, such waters are highly sensitive to pollution sources, as little or no natural attenuation and/or treatment will occur. Constructed wetland technology has been seen to offer a relatively low-cost alternative to the more conventional tertiary treatment technologies, particularly when dealing with low population numbers in small rural communities. This paper examines the waste treatment performance, in terms of nutrient (P and N) reduction, of a recently constructed surface-flow wetland system at Williamstown, County Galway, Ireland. Performance evaluation is based on more than two years of water quality and hydrological monitoring data. The N and P mass balances for the wetland indicate that the average percentage reduction over the two-year study period is 51% for total N and 13% for total P. The primary treatment process in the wetland system for suspended solids (between 84 and 90% reduction), biological oxygen demand (BOD) (on average, 49% reduction), N, and P is the physical settlement of the particulates. However, the formation of algal bloom during the growing season reduces the efficiency of the total P removal.
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Affiliation(s)
- M Healy
- Dep. of Civil Engineering, National University of Ireland, Galway, Ireland.
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Dunn DT, Gibb DM, Healy M, Goodall RL, Butler K, Cafferkey M, Neave P. Timing and interpretation of tests for diagnosing perinatally acquired hepatitis C virus infection. Pediatr Infect Dis J 2001; 20:715-6. [PMID: 11465848 DOI: 10.1097/00006454-200107000-00016] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The diagnosis of hepatitis C virus (HCV) infection in children born to HCV-infected women is based on serologic assays and HCV RNA measurement by PCR. Interpretation of the results of these tests is hampered by uncertainty about the age distribution of loss of maternal antibody and the sensitivity and specificity of PCR at different ages. On the basis of findings from a recent vertical transmission study, we estimated the posttest probability of a child's being infected or uninfected under several test result scenarios. These estimates may assist clinicians in assessing the likelihood of infection in an individual child and in using the currently available assays cost effectively.
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Affiliation(s)
- D T Dunn
- Medical Research Council Clinical Trials Unit, Institute of Child Health, London, UK
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