1
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Hassan F, Wang JH, O'Leary DP, Corrigan M, Redmond HP. Association of preoperative and postoperative circulating tumour DNA (ctDNA) with PIK3CA gene mutation with risk of recurrence in patients with non-metastatic breast cancer. Surg Oncol 2024; 54:102060. [PMID: 38603927 DOI: 10.1016/j.suronc.2024.102060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/20/2023] [Revised: 02/14/2024] [Accepted: 02/28/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Circulating tumour DNA (ctDNA), contains tumour-specific gene mutation in blood circulation and could aid in postoperative risk stratification of non-metastatic breast cancer. In this study, we investigated the feasibility of detecting PIK3CA gene mutations in ctDNA in the preoperative (preop) and postoperative period (postop), and its prognostic significance in patients with breast cancer. METHODS A cohort of patients with breast cancer undergoing curative surgery with available blood samples preoperatively and postoperatively (Post op) at either Post op time period; week 1-2, week 3-4 or weeks 5-12 were enrolled. PIK3CA gene mutations at exons 9 and 20 were detected in ctDNA with High resolution melting (HRM) PCR and Allele specific fluorescence probe-based PCR. RESULTS A total of 62 patients (age, median (IQR), 51.50 (45.0-65.0) years), with a median follow-up of 90 months (interquartile range (IQR),60-120 months) were enrolled. In total, 25 (40.3%) and 22 (35%) patients with breast cancer had detectable PIK3CA gene mutations in ctDNA in preoperative and postoperative period, respectively. PIK3CA gene mutations in ctDNA in postoperative period (hazard ratio (H.R: 18.05, p = 0.001) were a negative prognostic factor for recurrencefree survival (RFS) and overall survival (OS) (H.R: 11.9, p = 0.01) in patients with breast cancer. Subgroup analysis of ctDNA indicate that positive ctDNA in both preoperative/postoperative period and post op period only were found to have prognostic effect on RFS and OS (RFS; p < 0.0001, O·S; p = 0.0007). Moreover, ctDNA-based detection preceded clinical detection of recurrence in patients with an average lead time of 12 months (IQR:20-28.5 months) across all the breast cancer subtypes. CONCLUSION We highlighted the prognostic ability of ctDNA in patients with breast cancer in perioperative period. However, future prospective studies are needed to assess the utility of ctDNA in clinical practice.
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Affiliation(s)
- Fara Hassan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland; SURGUVANT Research Lab, University College Cork, Cork, Ireland.
| | - Jiang Huai Wang
- SURGUVANT Research Lab, University College Cork, Cork, Ireland
| | | | - Mark Corrigan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland; SURGUVANT Research Lab, University College Cork, Cork, Ireland; Cork Breast Research Centre, University College Cork, Cork, Ireland
| | - Henry Paul Redmond
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland; SURGUVANT Research Lab, University College Cork, Cork, Ireland
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2
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Zaborowski AM, Doogan K, Clifford S, Dowling G, Kazi F, Delaney K, Yadav H, Brady A, Geraghty J, Evoy D, Rothwell J, McCartan D, Heeney A, Barry M, Walsh SM, Stokes M, Kell MR, Allen M, Power C, Hill ADK, Connolly E, Alazawi D, Boyle T, Corrigan M, O’Leary P, Prichard RS. Nodal positivity in patients with clinically and radiologically node-negative breast cancer treated with neoadjuvant chemotherapy: multicentre collaborative study. Br J Surg 2024; 111:znad401. [PMID: 38055888 PMCID: PMC10763529 DOI: 10.1093/bjs/znad401] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The necessity of performing a sentinel lymph node biopsy in patients with clinically and radiologically node-negative breast cancer after neoadjuvant chemotherapy has been questioned. The aim of this study was to determine the rate of nodal positivity in these patients and to identify clinicopathological features associated with lymph node metastasis after neoadjuvant chemotherapy (ypN+). METHODS A retrospective multicentre study was performed. Patients with cT1-3 cN0 breast cancer who underwent sentinel lymph node biopsy after neoadjuvant chemotherapy between 2016 and 2021 were included. Negative nodal status was defined as the absence of palpable lymph nodes, and the absence of suspicious nodes on axillary ultrasonography, or the absence of tumour cells on axillary nodal fine needle aspiration or core biopsy. RESULTS A total of 371 patients were analysed. Overall, 47 patients (12.7%) had a positive sentinel lymph node biopsy. Nodal positivity was identified in 22 patients (29.0%) with hormone receptor+/human epidermal growth factor receptor 2- tumours, 12 patients (13.8%) with hormone receptor+/human epidermal growth factor receptor 2+ tumours, 3 patients (5.6%) with hormone receptor-/human epidermal growth factor receptor 2+ tumours, and 10 patients (6.5%) with triple-negative breast cancer. Multivariable logistic regression analysis showed that multicentric disease was associated with a higher likelihood of ypN+ (OR 2.66, 95% c.i. 1.18 to 6.01; P = 0.018), whilst a radiological complete response in the breast was associated with a reduced likelihood of ypN+ (OR 0.10, 95% c.i. 0.02 to 0.42; P = 0.002), regardless of molecular subtype. Only 3% of patients who had a radiological complete response in the breast were ypN+. The majority of patients (85%) with a positive sentinel node proceeded to axillary lymph node dissection and 93% had N1 disease. CONCLUSION The rate of sentinel lymph node positivity in patients who achieve a radiological complete response in the breast is exceptionally low for all molecular subtypes.
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Affiliation(s)
| | - Katie Doogan
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
| | - Siobhan Clifford
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Gavin Dowling
- Department of Breast Surgery, Beaumont Hospital, Dublin, Ireland
| | - Farah Kazi
- Department of Breast Surgery, St James’s Hospital, Dublin, Ireland
| | - Karina Delaney
- Department of Breast Surgery, St James’s Hospital, Dublin, Ireland
| | - Himanshu Yadav
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Aaron Brady
- Department of Breast Surgery, Bon Secours Hospital Cork, Cork, Ireland
| | - James Geraghty
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
| | - Denis Evoy
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
| | - Jane Rothwell
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
| | - Damian McCartan
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
| | - Anna Heeney
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Mitchel Barry
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Siun M Walsh
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Maurice Stokes
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Malcolm R Kell
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Michael Allen
- Department of Breast Surgery, Beaumont Hospital, Dublin, Ireland
| | - Colm Power
- Department of Breast Surgery, Beaumont Hospital, Dublin, Ireland
| | - Arnold D K Hill
- Department of Breast Surgery, Beaumont Hospital, Dublin, Ireland
| | | | - Dhafir Alazawi
- Department of Breast Surgery, St James’s Hospital, Dublin, Ireland
| | - Terence Boyle
- Department of Breast Surgery, St James’s Hospital, Dublin, Ireland
| | - Mark Corrigan
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Peter O’Leary
- Department of Breast Surgery, Bon Secours Hospital Cork, Cork, Ireland
| | - Ruth S Prichard
- Department of Breast Surgery, St Vincent’s University Hospital, Dublin, Ireland
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3
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Bakierzynska M, Cullinane MC, Redmond HP, Corrigan M. Prophylactic aspirin intake and breast cancer risk; A systematic review and meta-analysis of observational cohort studies. Eur J Surg Oncol 2023; 49:106940. [PMID: 37321932 DOI: 10.1016/j.ejso.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/17/2023]
Abstract
Breast Cancer (BC) is the most common cancer amongst women. The chemo-preventative effects of aspirin on breast cancer have been demonstrated in several longitudinal studies however previous meta-analysis have shown inconsistent results. This study aimed to assess the relationship between aspirin use and BC risk, and to determine if there is a dose-response relationship between aspirin and BC risk. Studies incorporating BC risk with aspirin use published within the last twenty years were included. The study report is based on the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology. Twenty-eight cohort studies that reported BC incidence during a follow up of 4.4-32 years were included. Compared to non-users, aspirin users had a reduced risk of BC (HR = 0.91, c.i 0.81-0.97, p = 0.002). There was no obvious association between BC risk reduction and aspirin dose (HR = 0.94, c.i 0.85-1.04) or duration (HR = 0.86, c.i 0.71-1.03). Frequency, however, was associated with a reduced risk of BC (HR = 0.90, c.i 0.82-0.98). A risk reduction was observed in oestrogen receptor (ER) positive tumours (HR = 0.90, c.i 0.86-0.96, p = 0.0004) while no relationship was observed with ER negative tumours (HR = 0.94, c.i 0.85-1.05). This meta-analysis found an association between aspirin intake and BC risk reduction. A more favourable outcome was noted with ingestion of greater than 6 tablets of aspirin per week. Aspirin had a significant risk reduction in patients with ER positive tumours compared to ER negative BC.
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Affiliation(s)
| | | | - Henry Paul Redmond
- Department of Surgery, Cork University Hospital, University College Cork, Cork, Ireland
| | - Mark Corrigan
- Department of Surgery, Cork University Hospital, University College Cork, Cork, Ireland
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4
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Lehane E, Curtin C, Corrigan M. Teaching strategies for shared decision-making within the context of evidence-based healthcare practice: A scoping review. Patient Educ Couns 2023; 109:107630. [PMID: 36689886 DOI: 10.1016/j.pec.2023.107630] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/05/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To describe the nature of teaching Shared Decision Making (SDM) within the context of Evidence Based Practice (EBP) to support development of contemporaneous EBP education programmes for healthcare learners. METHODS A scoping review following the Joanna Briggs Institute (JBI) guidance was conducted with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) used to guide reporting. RESULTS The narrative overview of 23 studies provides insight into the 'what' and 'how' of teaching SDM within the context of EBP education. A minority of studies explicitly and concurrently incorporated EBP and SDM in terms of how programme content was organised. Teaching strategies most often used regardless of learner cohort or setting included didactic, face-to-face lectures, together with role-play/modelling, small group workshops and video recordings. Programme evaluation outcomes predominantly focused on participant reactions to training and participant learning. CONCLUSION While a disconnect between EBP and SDM remains evident in healthcare programmes, increased recognition by educators to actively facilitate this interdependent relationship is emerging. PRACTICE IMPLICATIONS Intentionally structuring learning activities in a manner which demonstrates the relevance and interdependence of SDM and EBP may mitigate 'learning silos' and enhance learners' abilities to make connections required in practice.
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Affiliation(s)
- Elaine Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.
| | - Catriona Curtin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mark Corrigan
- Cork Breast Research Centre, University College Cork, Cork, Ireland
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5
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O'Reilly S, Kathryn Carroll H, Murray D, Burke L, McCarthy T, O'Connor R, Kilty C, Lynch S, Feighan J, Cloherty M, Fitzpatrick P, Falvey K, Murphy V, Jane O'Leary M, Gregg S, Young L, McAuliffe E, Hegarty J, Gavin A, Lawler M, Kavanagh P, Spillane S, McWade T, Heffron M, Ryan K, Kelly PJ, Murphy A, Corrigan M, Redmond HP, Redmond P, Walsh PM, Tierney P, Zhang M, Bennett K, Mullooly M. Impact of the COVID-19 pandemic on cancer care in Ireland - Perspectives from a COVID-19 and Cancer Working Group. J Cancer Policy 2023; 36:100414. [PMID: 36841473 PMCID: PMC9951610 DOI: 10.1016/j.jcpo.2023.100414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
Upon the COVID-19 pandemic onset in Ireland, cancer service disruptions occurred due to prioritisation of COVID-19 related care, redeployment of staff, initial pausing of screening, diagnostic, medical and surgical oncology procedures, staff shortages due to COVID-19 infection and impacts on the physical and mental health of cancer healthcare workers. This was coupled with reluctance among people with symptoms suspicious for cancer to attend for clinical evaluation, due to concerns of contracting the virus. This was further compounded by a cyber-attack on national health service IT systems on May 14th 2021. The Irish Cancer Society, a national cancer charity with a role in advocacy, research and patient supports, convened a multi-disciplinary stakeholder group (COVID-19 and Cancer Working Group) to reflect on and understand the impact of the pandemic on cancer patients and services in Ireland, and discuss potential mitigation strategies. Perspectives on experiences were gathered across domains including timeliness of data acquisition and its conversion into intelligence, and the resourcing of cancer care to address cancer service impacts. The group highlighted aspects for future research to understand the long-term pandemic impact on cancer outcomes, while also highlighting potential strategies to support cancer services, build resilience and address delayed diagnosis. Additional measures include the need for cancer workforce recruitment and retention, increased mental health supports for both patients and oncology professionals, improvements to public health messaging, a near real-time multimodal national cancer database, and robust digital and physical infrastructure to mitigate impacts of the current pandemic and future challenges to cancer care systems.
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Affiliation(s)
- Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland; Cancer Trials Ireland, Dublin, Ireland.
| | - Hailey Kathryn Carroll
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
| | - Deirdre Murray
- School of Public Health, University College Cork, Cork, Ireland; National Cancer Registry Ireland, Cork, Ireland
| | - Louise Burke
- Department of Pathology, Cork University Hospital and University College Cork, Cork, Ireland
| | | | | | | | - Sonya Lynch
- PPI Contributor c/o Cancer Research, UCC University College Cork, T12 DCA4 Cork, Ireland
| | - Jennifer Feighan
- Irish Nutrition & Dietetic Institute, Airfield Estate, Overend Ave, Dundrum, Dublin, Ireland
| | - Maeve Cloherty
- Department of Medical Oncology, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
| | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; National Screening Service, Dublin, Ireland
| | | | | | - Mary Jane O'Leary
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland
| | - Sophie Gregg
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland
| | - Leonie Young
- Endocrine Oncology Research Group, Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Eilish McAuliffe
- UCD IRIS Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | | | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - Mark Lawler
- Faculty of Medicine, Health and Life Sciences, Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Northern Ireland, UK; DATA-CAN, the UK's Health Data Research Hub for Cancer, UK
| | - Paul Kavanagh
- National Health Intelligence Unit, Strategy and Research, Jervis House, Jervis St, Health Service Executive, Dublin 1, Ireland
| | - Susan Spillane
- Health Information and Quality Authority, Dublin, Ireland
| | - Terry McWade
- Royal College of Physicians of Ireland, Dublin, Ireland
| | | | - Karen Ryan
- Department of Palliative Medicine, Mater Misericordiae University Hospital and St Francis Hospice Dublin, Ireland
| | - Paul J Kelly
- Bon Secours Radiotherapy Centre, Bon Secours, Cork, Ireland; UPMC Hillman Cancer Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Mark Corrigan
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - H Paul Redmond
- Department of Breast Surgery, Cork University Hospital, Cork, Ireland
| | - Patrick Redmond
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Mengyang Zhang
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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6
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Kearns N, Raigal-Aran L, O’Connell K, Davis A, Bermingham K, O’Reilly S, Collins DC, Corrigan M, Coulter J, Cleary V, Cushen S, Flavin A, Byrne F, O’Grady A, O’Neill D, Murphy A, Dahly D, Palmer B, Connolly RM, Hegarty J. Correction: The Women's Health Initiative cancer survivorship clinic incorporating electronic patient-reported outcomes: a study protocol for the Linking You to Support and Advice (LYSA) randomized controlled trial. Pilot Feasibility Stud 2022; 8:255. [PMID: 36510292 PMCID: PMC9743670 DOI: 10.1186/s40814-022-01219-5] [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: 12/14/2022] Open
Affiliation(s)
- Noreen Kearns
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Laia Raigal-Aran
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Kate O’Connell
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Andrea Davis
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Katie Bermingham
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Seamus O’Reilly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.412702.20000 0004 0617 8029Department of Medical Oncology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Dearbhaile C. Collins
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Mark Corrigan
- grid.411916.a0000 0004 0617 6269Department of Academic Surgery, Cork University Hospital, Cork, Ireland
| | - John Coulter
- grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Vicki Cleary
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Samantha Cushen
- grid.7872.a0000000123318773School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Aileen Flavin
- grid.411916.a0000 0004 0617 6269Department of Radiation Oncology, Cork University Hospital, Cork, Ireland
| | - Fiona Byrne
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aisling O’Grady
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Deirdre O’Neill
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aileen Murphy
- grid.7872.a0000000123318773Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Darren Dahly
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Brendan Palmer
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Roisin M. Connolly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
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7
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Kearns N, Raigal-Aran L, O’Connell K, Davis A, Bermingham K, O’Reilly S, Collins DC, Corrigan M, Coulter J, Cleary V, Cushen S, Flavin A, Byrne F, O’Grady A, O’Neill D, Murphy A, Dahly D, Palmer B, Connolly RM, Hegarty J. The Women's Health Initiative cancer survivorship clinic incorporating electronic patient-reported outcomes: a study protocol for the Linking You to Support and Advice (LYSA) randomized controlled trial. Pilot Feasibility Stud 2022; 8:238. [PMID: 36357934 PMCID: PMC9648029 DOI: 10.1186/s40814-022-01186-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The improved survival rate for many cancers in high-income countries demands a coordinated multidisciplinary approach to survivorship care and service provision to ensure optimal patient outcomes and quality of life. This study assesses the feasibility of introducing a Women's Health Initiative cancer survivorship clinic in Ireland. METHODS The trial https://spcare.bmj.com/content/9/2/209.short comprises an intervention and control arm. Two hundred participants will be recruited. Key eligibility (1) women with early-stage hormone receptor-positive breast or gynecologic cancer (cervix or endometrial), within 12 months of completion of primary curative therapy, and (2) access to the Internet. The complex intervention comprises a nurse-led clinic targeting symptom management through a trigger alert system, utilizing electronic patient-reported outcome (ePRO) assessments at baseline, and 2, 4, 6, 8, 10, and 12 months. It also includes input from a dietitian monitoring diet and nutritional status. The control group will receive their usual care pathway standard of care and attend the cancer survivorship clinic and complete ePRO assessments at the start and end of the study. The primary endpoint (feasibility) includes the proportion of enrolled participants who complete baseline and follow-up ePRO surveys and partake in health professional consultations after ePRO data triggers. Secondary endpoints include changes in cancer-related symptom scores assessed by ePROs, health-related Quality of Life Questionnaire (QLQ) scores, Appraisal Self-Care Agency-R scores, and adjuvant endocrine therapy medication adherence. A process evaluation will capture the experiences of participation in the study, and the healthcare costs will be examined as part of the economic analysis. Ethical approval was granted in December 2020, with accrual commencing in March 2021. DISCUSSION This protocol describes the implementation of a parallel arm randomized controlled trial (RCT) which examines the feasibility of delivering a Cancer Survivorship Clinic. The ePRO is an innovative symptom monitoring system which detects the treatment-related effects and provides individualized support for cancer survivors. The findings will provide direction for the implementation of future survivorship care. TRIAL REGISTRATION ClinicalTrials.gov , NCT05035173 . Retrospectively registered on September 5, 2021.
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Affiliation(s)
- Noreen Kearns
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Laia Raigal-Aran
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Kate O’Connell
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Andrea Davis
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Katie Bermingham
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Seamus O’Reilly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.412702.20000 0004 0617 8029Department of Medical Oncology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Dearbhaile C. Collins
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Mark Corrigan
- grid.411916.a0000 0004 0617 6269Department of Academic Surgery, Cork University Hospital, Cork, Ireland
| | - John Coulter
- grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Vicki Cleary
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Samantha Cushen
- grid.7872.a0000000123318773School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Aileen Flavin
- grid.411916.a0000 0004 0617 6269Department of Radiation Oncology, Cork University Hospital, Cork, Ireland
| | - Fiona Byrne
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aisling O’Grady
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Deirdre O’Neill
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aileen Murphy
- grid.7872.a0000000123318773Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Darren Dahly
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Brendan Palmer
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Roisin M. Connolly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
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8
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Harvey H, Joyce R, Rock K, Browne TJ, Bennett MW, O'Connell F, Feeley L, Barry J, Ryan MF, Murphy R, Smiddy P, O'Connell C, O'Sullivan M, Kelly L, O'Hanlon D, Corrigan M, Redmond HP, Connolly RM, O'Reilly S. The impact of a ransomware cyber attack on a breast cancer center. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13620 Background: On the 14th of May 2021 the Irish Health Service Executive (HSE) was the victim of a “Conti” ransomware attack. The HSE is a nationwide organization providing Ireland’s public health service, consisting of approximately 4000 locations and more than 70,000 connected devices. The study aim is to quantify the impact of the cyber attack by examining the effect on the Breast Cancer services at Cork University Hospital 1 of 8 national cancer centres & 1 of 54 HSE acute hospitals. Methods: New patient referrals through the weekly Breast cancer MDT meeting were used as the study nidus. Patient referrals & key performance indexes for a period of 4 weeks prior, during & after the attack were examined. Time was the key metric examined. Results: The attack triggered a Critical Incident Protocol, resulting in the switching off of all HSE IT systems at national level. Disruption to patient care & operations within the HSE was immediate & without warning. Initially encrypted messaging groups were established to facilitate communication & paper based tracking & data management logs were created. Diagnostics, scheduling & radiotherapy services were most severely affected. The attack resulted in the immediate shut down of the hospitals radiotherapy department with all new treatments transferred off site to a private facility, ongoing treatments delayed, replanned or rescheduled. The effect on the radiology department was catastrophic, all outpatient & non-urgent scans were cancelled. Digital report & image stores were unavailable. Historic imaging & ongoing emergency imaging was unavailable. Taking 7 months to restore impacted data storage & to ensure accurate capture of all reports for examinations during the cyber downtime. The average time from surgery to completed pathology went from 7.04 to 15.03 & 11.8 days in the 4 weeks prior, during & after the attack respectively. Services that were least impacted during the IT outage were those that relied on paper records including chemotherapy administration. The average time from biopsy report to up front surgery decreased from 21.75 to 17 & 14 days in the 4 weeks prior, during & after the attack respectively. Likely due to the increased availability of theatre time, as all non cancer related elective procedures were cancelled. There was little effect on the time from MDT discussion to review by medical oncology, taking an average of 6, 5.7 & 5.8 days in the 4 weeks prior, during & after the attack respectively. The majority of new referrals to the service being seen off site in a satellite clinic & infusion unit that relied on a paper based booking system prior to the attack. Conclusions: The cyber attack had significant disruptive effects lasting months. The impact on patient outcome due to delayed or interrupted treatment will take years to clarify. The attack was facilitated by the presence of multiple, fragmented IT platforms & demonstrated a lack of preparedness in the system which needs to be addressed to prevent recurrence.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rose Murphy
- Cork University Hospital, Breast Check, Cork, Ireland
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9
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Lehane E, Agreli H, O' Connor S, Hegarty J, Leahy Warren P, Bennett D, Blake C, Burke F, Corrigan M, Drennan J, Hayes M, Heffernan E, Horgan F, Lynch H, McVeigh J, Müller N, O'Keeffe E, O'Rourke N, O'Toole E, O'Tuathaigh C, Sahm L, Savage E. Building capacity: getting evidence-based practice into healthcare professional curricula. BMJ Evid Based Med 2021; 26:246. [PMID: 32719051 PMCID: PMC8479751 DOI: 10.1136/bmjebm-2020-111385] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/17/2022]
Abstract
UNLABELLED Fostering a culture of clinical effectiveness in healthcare is crucial to achieving optimum outcomes for patients. Evidence-based practice (EBP) is a cornerstone of clinical effectiveness. An EBP capacity-building project commenced in Ireland in 2016, in collaboration with the Centre of Evidence-Based Medicine in Oxford. A key part of this project, reported here, was the development of a competency framework for education in EBP and clinical effectiveness to ensure responsiveness of education standards and curricula of healthcare professionals in this area. METHODS Following a review of national and international reports, professional guidance documents and empirical literature pertaining to clinical effectiveness education (CEE), a preliminary competency framework was developed. Stakeholder consultations were conducted over a 6-month period, which consisted of 13 focus groups (n=45) and included representatives from clinical practice, higher education and professional training sectors, regulator/accrediting bodies, the Department of Health (Ireland) and patient/service user groups. RESULTS An overarching interprofessional competency framework for CEE was proposed and included the following domains: EBP, quality improvement processes, implementation strategies and collaborative practice: a total of 16 competencies and 60 indicators. CONCLUSION A competency framework for CEE for health and social care professionals is presented. It is intended that this framework will provide guidance to healthcare educators and regulators in the construction and revision of curricula, learning outcomes, teaching and assessment strategies, and graduate/clinician attributes.
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Affiliation(s)
- Elaine Lehane
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Heloise Agreli
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Simone O' Connor
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Patricia Leahy Warren
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Deirdre Bennett
- Medical Education Unit, University College Cork National University of Ireland, Cork, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Frank Burke
- School of Dentistry, University College Cork National University of Ireland, Cork, Ireland
| | - Mark Corrigan
- Cork Breast Research Centre, Cork University Hospital Group/University College Cork, Cork, Ireland
| | - Jonathan Drennan
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | - Martina Hayes
- School of Dentistry, University College Cork National University of Ireland, Cork, Ireland
| | - Elizabeth Heffernan
- Nursing and Midwifery Planning and Development Unit, Kerry Centre for Nurse and Midwifery Education, Cork/Kerry, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Helen Lynch
- School of Clinical Therapies, University College Cork National University of Ireland, Cork, Ireland
| | - Joseph McVeigh
- School of Clinical Therapies, University College Cork National University of Ireland, Cork, Ireland
| | - Nicole Müller
- School of Clinical Therapies, University College Cork National University of Ireland, Cork, Ireland
| | - Elizabeth O'Keeffe
- Symptomatic Breast Imaging Unit, Cork University Hospital Group, Cork, Ireland
| | - Niamh O'Rourke
- Health Information and Quality Authority, Cork, Munster, Ireland
| | - Eve O'Toole
- National Cancer Control Programme, Health Service Executive, Dublin, Ireland
| | - Colm O'Tuathaigh
- School of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Laura Sahm
- School of Pharmacy, University College Cork National University of Ireland, Cork, Ireland
| | - Eileen Savage
- Catherine McAuley School of Nursing & Midwifery, University College Cork National University of Ireland, Cork, Ireland
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10
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Hashmi ZZ, Ahmed R, Alijarad F, Madanur M, Razzaq Z, Majeed M, Bughio M, Cagney D, Aakif M, Mustafa H, Amin A, Khan A, Aftab F, Corrigan M, Redmond HP. P9: MANAGEMENT OF ESOPHAGEAL FOOD BOLUS OBSTRUCTION AT A UNIVERSITY TEACHING HOSPITAL – A RETROSPECTIVE ANALYSIS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Despite the fact that esophageal food bolus obstruction is a common surgical problem, there are no clear guidelines on its management. Medical treatment with Buscopan and Glucagon is mostly in-effective, requiring a therapeutic Oesophago-Gastro-Duodenoscopy (OGD).
Method
All consecutive cases of food bolus obstructions (FBO) presenting to the Emergency Department (ED) for 18 month period between 01/01/2018 and 30/06/2019 were retrospectively reviewed.
Result
A total of 30 patients were admitted with food bolus obstruction via ED (1.67 per month). Females (67%) constituted most of these patients. Average age was 55 with range of 19-83. 84% of patients presented with Dysphagia, while Odynophagia (10%) and chest pain (6%) were other presenting symptoms. Average duration of symptoms was 17 hours (Range 2 – 48 hours). 44% of patients had OGD done under sedation while others (56%) had under General Anaesthesia (GA). In 70% of cases, food bolus was pushed into stomach, while it was retrieved out in 20%. In 10%, it had already spontaneously passed in stomach on OGD. The etiology of FBO was inflammatory in 60% cases, while an esophageal stricture was seen in 10% only. In 30% cases no cause of FBO was identified. Post-OGD length of stay was on average 1.15 days (range 12 hours – 7 days). 2 patients had aspiration pneumonia prolonging their hospital stay, there was no esophageal perforation or mortality.
Conclusion
Esophageal food bolus obstruction is a common surgical problem, OGD under GA is a safe recommended procedure, which often picks up an underlying pathology.
Take-home message
Esophageal food bolus obstruction is a common surgical problem, OGD under GA is a safe recommended procedure, which often picks up an underlying pathology.
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Affiliation(s)
- ZZ Hashmi
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - R Ahmed
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - F Alijarad
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Madanur
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - Z Razzaq
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Majeed
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Bughio
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - D Cagney
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Aakif
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - H Mustafa
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - A Amin
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - A Khan
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - F Aftab
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - M Corrigan
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
| | - HP Redmond
- Department of Emergency General Surgery, Cork University Hospital, Cork, Ireland
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11
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Walsh S, O'Mahony M, Lehane E, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, Hegarty J. Cancer and breast cancer awareness interventions in an intellectual disability context: A review of the literature. J Intellect Disabil 2021; 25:131-145. [PMID: 31104540 DOI: 10.1177/1744629519850999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Women with an intellectual disability (ID) have a similar risk of developing breast cancer as women in the general population yet present with later stage breast cancers, which have poorer outcomes. AIM To identify whether there is a need to develop a breast cancer awareness intervention for women with an ID. METHODS Interventions aimed at increasing cancer awareness and breast cancer awareness for people with an ID were identified and critically appraised. RESULTS Five interventions to increase cancer awareness or breast cancer awareness in people with an ID were identified. CONCLUSION The review highlighted the paucity of theoretically underpinned breast cancer awareness interventions specifically aimed at women with an ID. Facilitating breast cancer awareness for women with an ID could potentially lead to earlier presentation of potential symptoms of breast cancer, earlier treatment, better prognosis and ultimately, improved survival. This article establishes that there is a need for an intervention underpinned by theory to increase breast cancer awareness in women with an ID.
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Affiliation(s)
- S Walsh
- 8795University College Cork, Ireland
| | | | - E Lehane
- 8795University College Cork, Ireland
| | - D Farrell
- 8813Institute of Technology Tralee, Ireland
| | - L Taggart
- 2596Ulster University, Northern Ireland
| | - L Kelly
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - L Sahm
- 8795University College Cork, Ireland
| | - A Byrne
- 63976Cope Foundation, Ireland
| | - M Corrigan
- St. John of God Hospitaller Ministries, Ireland
| | - M Caples
- 8795University College Cork, Ireland
| | | | - S Tabirca
- 8795University College Cork, Ireland
| | - M A Corrigan
- 57983Cork Breast Research Centre-Cork University Hospital, Ireland
| | - J Hegarty
- 8795University College Cork, Ireland
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12
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Seltzer S, Corrigan M, O'Reilly S. The clinicomolecular landscape of de novo versus relapsed stage IV metastatic breast cancer. Exp Mol Pathol 2020; 114:104404. [PMID: 32067942 DOI: 10.1016/j.yexmp.2020.104404] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 12/16/2019] [Revised: 01/15/2020] [Accepted: 02/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND de novo metastatic breast cancer (dnMBC) is responsible for 6-10% of breast cancer presentations with increasing incidence and has remained resistant to detection by mammography screening. Recent publications hypothesized that in addition to poor screening uptake, the presentation of dnMBC may be due to its unfavourable biology which remains unknown at the molecular level. Here we investigated the tumour biology of dnMBC in the form of clinicopathology, genomic alterations and differential gene expression to create a comparative landscape of de novo versus relapsed metastatic breast cancer (rMBC). Additionally, to address the current screening limitations, we conducted a preliminary biomarker investigation for early dnMBC detection. METHODS In this retrospective case-control study, gene expression and clinical data were accessed from the Cancer Genome Atlas (TCGA) for primary tumours of treatment-naïve patients with dnMBC (n = 17), rMBC (n = 49), and normal tissue (n = 113). The clinical and histological data were assessed categorically using Fisher's Exact-Test for significance (p < .05), or continuously using the Mann-Whitney Test (p < .05) where appropriate. The differential gene expression analysis was performed using EdgeR's negative binomial distribution model with a false discovery rate (FDR) <0.05. The resulting gene list was analysed manually for roles in metastasis as well as ontologically using STRING-DB with FDR <0.05. RESULTS dnMBCs showed improved median survival vs rMBC (36 vs. 12 months). dnMBCs were more likely to be hormone receptor positive, less likely to be triple negative with lower histological lymphocytic infiltrate. In terms of genome alterations, dnMBCs had 4-fold increased PTEN mutations and poor survival with ABL2 and GATA3 alterations. Expression-wise, dnMBCs down-regulated TNFa, IL-17 signalling, and chemotaxis, while up-regulating steroid biosynthesis, cell migration, and cell adhesion. Biomarker analysis detected pre-existing and novel breast cancer biomarkers. CONCLUSION The comparative tumour landscape revealed significant clinical, pathological and molecular differences between dnMBC and rMBC, indicating that dnMBC may be a separate biological entity to rMBC at the primary level with differing paths to metastasis. Additionally, we provided a list of potential serum biomarkers that may be useful in detecting dnMBC in its pre-metastatic window if such a window exists.
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Affiliation(s)
- Sean Seltzer
- School of Medicine, University College Cork, Cork, Ireland.
| | - Mark Corrigan
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Seamus O'Reilly
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
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13
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Cagney D, Simmons L, O’Leary DP, Corrigan M, Kelly L, O’Sullivan MJ, Liew A, Redmond HP. The Efficacy of Prophylactic Negative Pressure Wound Therapy for Closed Incisions in Breast Surgery: A Systematic Review and Meta-Analysis. World J Surg 2020; 44:1526-1537. [DOI: 10.1007/s00268-019-05335-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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14
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Lehane E, Leahy-Warren P, O’Riordan C, Savage E, Drennan J, O’Tuathaigh C, O’Connor M, Corrigan M, Burke F, Hayes M, Lynch H, Sahm L, Heffernan E, O’Keeffe E, Blake C, Horgan F, Hegarty J. Evidence-based practice education for healthcare professions: an expert view. BMJ Evid Based Med 2019; 24:103-108. [PMID: 30442711 PMCID: PMC6582731 DOI: 10.1136/bmjebm-2018-111019] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2018] [Indexed: 11/03/2022]
Abstract
Internationally, evidence-based practice (EBP) is recognised as a foundational element of healthcare professional education. Achieving competency in this area is a complex undertaking that is reflected in disparities between 'best EBP' and actual clinical care. The effective development and implementation of professional education to facilitate EBP remains a major and immediate challenge. To ascertain nuanced perspectives on the provision of EBP education internationally, interviews were conducted with five EBP education experts from the UK, Canada, Australia and New Zealand. Definitive advice was provided in relation to (1) EBP curriculum considerations, (2) teaching EBP and (3) stakeholder engagement in EBP education. While a considerable amount of EBP activity throughout health profession education is apparent, effectively embedding EBP throughout curricula requires further development, with a 'real-world' pragmatic approach that engenders dialogue and engagement with all stakeholders required.
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Affiliation(s)
- Elaine Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Patricia Leahy-Warren
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Cliona O’Riordan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eileen Savage
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jonathan Drennan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Michael O’Connor
- Postgraduate Medical Training, Cork University Hospital/Royal College of Physicians, Cork, Ireland
| | - Mark Corrigan
- Postgraduate Surgical Training, Breast Cancer Centre, Cork University Hospital/Royal College of Surgeons, Cork, Ireland
| | - Francis Burke
- School of Dentistry, University College Cork, Cork, Ireland
| | - Martina Hayes
- School of Dentistry, University College Cork, Cork, Ireland
| | - Helen Lynch
- School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Laura Sahm
- School of Pharmacy, University College Cork, Cork, Ireland
| | - Elizabeth Heffernan
- Nursing and Midwifery Planning and Development Unit, Kerry Centre for Nurse and Midwifery Education, Cork, Ireland
| | - Elizabeth O’Keeffe
- Symptomatic Breast Imaging Unit, Cork University Hospital, Cork, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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15
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Narayanen N, Hogan G, Rettedal E, Murphy C, O'hanlon D, Corrigan M, Tangney M. Living microbes within tumours. Breast 2019. [DOI: 10.1016/s0960-9776(19)30453-9] [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: 11/25/2022] Open
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16
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Neville G, Neill CO, Murphy R, Corrigan M, Redmond PH, Feeley L, Bennett MW, O'Connell F, Browne TJ. Is excision biopsy of fibroadenomas based solely on size criteria warranted? Breast J 2018; 24:981-985. [DOI: 10.1111/tbj.13069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Grace Neville
- Department of Pathology; Cork University Hospital Group; Cork Ireland
| | | | - Rosemary Murphy
- Department of Radiology; Cork University Hospital Group; Cork Ireland
| | - Mark Corrigan
- Department of Surgery; Cork University Hospital Group; Cork Ireland
| | - Paul H. Redmond
- Department of Surgery; Cork University Hospital Group; Cork Ireland
| | - Linda Feeley
- Department of Pathology; Cork University Hospital Group; Cork Ireland
| | | | | | - Tara Jane Browne
- Department of Pathology; Cork University Hospital Group; Cork Ireland
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17
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Walsh S, Lehane E, Hegarty J, O’mahony M, Farrell D, Taggart L, Kelly L, Sahm L, Byrne A, Corrigan M, Caples M, Martin A, Tabirca S, Corrigan M. Breast awareness amongst women with a mild/moderate intellectual disability: Linking theory to practice. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30313-7] [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: 10/17/2022]
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18
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Murphy L, Quinn E, O'leary D, Razzaq Z, Livingstone V, Redmond H, Corrigan M. Assessing the accuracy of MRI in measuring nodal response to neoadjuvant chemotherapy (NAC) in breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30524-0] [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: 10/17/2022]
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19
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Shaffiq Izzad N, O'leary P, Quinn E, Butt A, Livingstone V, Redmond H, Corrigan M. A comparative analysis of breast cancer affecting young versus older women. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30368-x] [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]
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20
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Leong WL, Sharifpoor S, Battiston K, Charleton D, Corrigan M, McCready DR, Done SJ, Santerre JP. Abstract P2-12-15: ReFilx- synthetic biodegradable soft tissue fillers for breast conserving surgery in breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-12-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Breast conserving surgery (BCS) is the most common procedure performed in breast cancers, but it can often result in breast deformities that can have negative impacts on quality of life. With better treatments, more breast cancer survivors are expected to live longer, the demand for achieving optimal cosmetic outcomes has also increased accordingly. Currently, oncoplastic techniques involving local tissue rearrangement with or without contralateral balancing procedures are used in specialized centers to achieve breast symmetry in some patients. When a breast deformity occurs, corrective options include: fat grafting, autologous flap procedures and completion mastectomy with immediate reconstruction. These techniques have long operative times, longer length of hospital stay and higher complication rates. Commercially-available synthetic implants are fabricated in pre-determined sizes and thus are not suitable to reconstruct partial breast deformities of varying size and shape. We explored the use of amino-acid based biodegradable polyurethanes as tissue fillers for BCS due to their chemical versatility, superior mechanical properties and tailored biocompatibility. Objective: To evaluate novel biodegradable polymer constructs, referred to as ReFilx, as soft tissue fillers for BCS defects. Hypothesis: Implantation of ReFilx during BCS will maintain breast shape and size and promote tissue regeneration in and around the biodegradable biomaterial, in contrast to sham controls. Methods: Two ReFilx formulations with high porosity, mechanical properties (compressive modulus=45±6 kPa and 31±9 kPa) comparable to native breast tissue and a moderate degree of swelling (202±6% and 248±6%) were selected for implantation in porcine BCS defects. Three female Yucatan Minipigs (age=4 years, weight=100-120 kg, 12 breasts per pig) received BCS to remove normal breast tissue of approximately 2 cm diameter, after which the defects were filled with ReFilx Formulation A, ReFilx Formulation B, or no filler (sham control). At 6, 12, 24, and 36 weeks post-implantation (n=3 per group), ultrasound breast examinations and mastectomies of each selected group of breasts were performed. Samples were fixed in 10% buffered formalin and stained with H&E, Masson's Trichrome and immunohistomchemistry using CD31. Results: ReFilx formulations maintained breast size and shape, with similar stiffness to native breast tissue, while sham controls collapsed over 36 weeks. The ReFilx fillers supported cell and tissue infiltration and neovascularization, as indicated by Masson's Trichrome and CD31 staining, respectively, without eliciting foreign body giant cell formation, fibrosis, or chronic inflammation, commonly associated with implanted medical devices. Conclusions: ReFilx are promising soft tissue fillers for breast volume restoration, representing a simple, versatile, permanent, and aesthetically superior solution to prevent soft tissue deformities. Acknowledgements: MaRS PoP fund, grant # MI 2011-170, NSERC # SYN 430828. Haynes Connell Foundation Breast Cancer Fund.
Citation Format: Leong WL, Sharifpoor S, Battiston K, Charleton D, Corrigan M, McCready DR, Done SJ, Santerre JP. ReFilx- synthetic biodegradable soft tissue fillers for breast conserving surgery in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-12-15.
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Affiliation(s)
- WL Leong
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - S Sharifpoor
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - K Battiston
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - D Charleton
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - M Corrigan
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - DR McCready
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - SJ Done
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
| | - JP Santerre
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Translational Biology and Engineering Progra, University of Toronto, Toronto, ON, Canada; Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, ON, Canada; Laboratory Medicine Program, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Cork Breast Research Centre, Cork, Munster, Ireland; Grand River Hospital, Kitchener, ON, Canada
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Wentworth L, Nice D, Corrigan M, Seymour-Brown H, Pattison N. 23SUPPORTED DISCHARGE THE KEY TO REDUCING HOSPITAL EMERGENCY ATTENDANCES AND ADMISSIONS. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.23] [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: 11/13/2022] Open
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22
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Dubeau J, Heinmiller BE, Corrigan M. Multiple Methods for Assessing the Dose to Skin Exposed to Radioactive Contamination. Radiat Prot Dosimetry 2017; 174:371-376. [PMID: 27473702 DOI: 10.1093/rpd/ncw220] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
There is the possibility for a worker at a nuclear installation, such as a nuclear power reactor, a fuel production facility or a medical facility, to come in contact with radioactive contaminants. When such an event occurs, the first order of business is to care for the worker by promptly initiating a decontamination process. Usually, the radiation protection personnel performs a G-M pancake probe measurement of the contamination in situ and collects part or all of the radioactive contamination for further laboratory analysis. The health physicist on duty must then perform, using the available information, a skin dose assessment that will go into the worker's permanent dose record. The contamination situations are often complex and the dose assessment can be laborious. This article compares five dose assessment methods that involve analysis, new technologies and new software. The five methods are applied to 13 actual contamination incidents consisting of direct skin contact, contamination on clothing and contamination on clothing in the presence of an air gap between the clothing and the skin. This work shows that, for the cases studied, the methods provided dose estimates that were usually within 12% (1σ) of each other, for those cases where absolute activity information for every radionuclide was available. One method, which relies simply on a G-M pancake probe measurement, appeared to be particularly useful in situations where a contamination sample could not be recovered for laboratory analysis.
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Affiliation(s)
- J Dubeau
- DETEC, Gatineau, Quebec, CanadaJ8T 4J1
| | - B E Heinmiller
- Canadian Nuclear Laboratories, Chalk River, Ontario, CanadaK0J 1J0
| | - M Corrigan
- Canadian Nuclear Laboratories, Chalk River, Ontario, CanadaK0J 1J0
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Jeffery HC, Jeffery LE, Lutz P, Corrigan M, Webb GJ, Hirschfield GM, Adams DH, Oo YH. Low-dose interleukin-2 promotes STAT-5 phosphorylation, T reg survival and CTLA-4-dependent function in autoimmune liver diseases. Clin Exp Immunol 2017; 188:394-411. [PMID: 28176332 PMCID: PMC5422719 DOI: 10.1111/cei.12940] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 12/20/2022] Open
Abstract
CD4+CD25highCD127lowforkhead box protein 3 (FoxP3+) regulatory T cells (Treg) are essential for the maintenance of peripheral tolerance. Impaired Treg function and an imbalance between effector and Tregs contribute to the pathogenesis of autoimmune diseases. We reported recently that the hepatic microenvironment is deficient in interleukin (IL)−2, a cytokine essential for Treg survival and function. Consequently, few liver‐infiltrating Treg demonstrate signal transducer and activator of transcription‐5 (STAT‐5) phosphorylation. To establish the potential of IL‐2 to enhance Treg therapy, we investigated the effects of very low dose Proleukin (VLDP) on the phosphorylation of STAT‐5 and the subsequent survival and function of Treg and T effector cells from the blood and livers of patients with autoimmune liver diseases. VLDP, at less than 5 IU/ml, resulted in selective phosphorylation of STAT‐5 in Treg but not effector T cells or natural killer cells and associated with increased expression of cytotoxic T lymphocyte antigen‐4 (CTLA‐4), FoxP3 and CD25 and the anti‐apoptotic protein Bcl‐2 in Treg with the greatest enhancement of regulatory phenotype in the effector memory Treg population. VLDP also maintained expression of the liver‐homing chemokine receptor CXCR3. VLDP enhanced Treg function in a CTLA‐4‐dependent manner. These findings open new avenues for future VLDP cytokine therapy alone or in combination with clinical grade Treg in autoimmune liver diseases, as VLDP could not only enhance regulatory phenotype and functional property but also the survival of intrahepatic Treg.
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Affiliation(s)
- H C Jeffery
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK
| | - L E Jeffery
- Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - P Lutz
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK
| | - M Corrigan
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - G J Webb
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - G M Hirschfield
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - D H Adams
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
| | - Y H Oo
- Centre for Liver Research and National Institute for Health Research Liver Biomedical Research Unit, Institute of Immunology and Immunotherapy, University of Birmingham, UK.,Liver Transplant and Hepatobiliary Unit, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK
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Healy C, Brady C, Sze Yin Sui J, McSorley L, Barry J, Relihan N, Corrigan M, O’Connor T, O’Mahony T, O’Reilly S. An Irish regional cancer centre experience of impact of incidental pulmonary nodules detected during treatment for early stage breast cancer. Breast 2017. [DOI: 10.1016/s0960-9776(17)30273-4] [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: 11/29/2022] Open
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McGuire A, O'Leary DP, Livingstone V, Khan Z, O'Connell F, Redmond HP, Relihan N, Corrigan M, Ryan M. Contrast-Enhanced Spectrum Mammography-A Useful Adjunct to Digital Mammography in Predicting Tumor Size. Breast J 2017; 23:484-486. [DOI: 10.1111/tbj.12774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Andrew McGuire
- Department of Surgery; Cork University Hospital; Cork Ireland
| | | | | | - Zeb Khan
- Department of Surgery; Cork University Hospital; Cork Ireland
| | | | | | - Norma Relihan
- Department of Surgery; Cork University Hospital; Cork Ireland
| | - Mark Corrigan
- Department of Surgery; Cork University Hospital; Cork Ireland
| | - Max Ryan
- Department of Radiology; Cork University Hospital; Cork Ireland
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Corrigan M, Johnston JL, Reid H, Thomson C. Interdisciplinarity defines our identity as medical educators. MedEdPublish 2016. [DOI: 10.15694/mep.2016.000160] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article was migrated. The article was marked as recommended. Medical education is a broad church. As a young interdisciplinary group of educationalists we discuss some aspects of the relevance of interdisciplinarity to medical education, using our own experiences as exemplars.
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O'Hanlon R, Choiseul J, Corrigan M, Catarame T, Destefanis M. Diversity and detections of Phytophthora
species from trade and non-trade environments in Ireland. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/epp.12331] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. O'Hanlon
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - J. Choiseul
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - M. Corrigan
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - T. Catarame
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
| | - M. Destefanis
- Department of Agriculture, Food and the Marine; Celbridge Co. Kildare Ireland
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Rafee S, McHugh D, Greally M, Ayodele O, Keegan N, Lim M, Hassan A, O'Mahony D, Hennessy B, Kelly C, Kennedy J, Walshe J, O'Connor M, Leonard G, Murphy V, Livingstone V, Corrigan M, O'Reilly S. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as predictive biomarkers of pathologic complete response (pCR) in neoadjuvant breast cancer: an Irish Clinical Oncology Group study (ICORG 16-20). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw392.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gardner J, Legako J, Gardner T, Dinh T, Menard S, Broadway R, Spivey K, Hutcheson J, Corrigan M, Hergenreder J, Johnson B. Effects of beta agonists and muscle type on polar lipid fatty acid concentration. Meat Sci 2016. [DOI: 10.1016/j.meatsci.2015.08.165] [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: 11/16/2022]
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O’Connell E, Pegler J, Lehane E, Livingstone V, McCarthy N, Sahm LJ, Tabirca S, O’Driscoll A, Corrigan M. Near field communications technology and the potential to reduce medication errors through multidisciplinary application. Mhealth 2016; 2:29. [PMID: 28293602 PMCID: PMC5344100 DOI: 10.21037/mhealth.2016.07.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Received: 06/03/2016] [Accepted: 07/08/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. METHODS An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. RESULTS A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). CONCLUSIONS An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment.
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Affiliation(s)
- Emer O’Connell
- Cork Breast Research Centre, Cork University, Hospital, Wilton, Cork, Ireland
| | - Joe Pegler
- Department of Computer Science, University College Cork, Cork, Ireland
| | - Elaine Lehane
- School of Nursing, University College Cork, Cork, Ireland
| | - Vicki Livingstone
- Cork Breast Research Centre, Cork University, Hospital, Wilton, Cork, Ireland
| | - Nora McCarthy
- School of Medicine, University College Cork, Cork, Ireland
| | - Laura J. Sahm
- School of Pharmacy, University College Cork, Cork, Ireland
- Department of Pharmacy, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - Sabin Tabirca
- Department of Computer Science, University College Cork, Cork, Ireland
| | - Aoife O’Driscoll
- Cork Breast Research Centre, Cork University, Hospital, Wilton, Cork, Ireland
| | - Mark Corrigan
- Cork Breast Research Centre, Cork University, Hospital, Wilton, Cork, Ireland
- Royal College of Surgeons Ireland, 121 St Stephen’s Green, Dublin 2, Ireland
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Corrigan M, Lee K, Labour M, Jacobs C, Hoey D. Fluid flow-induced bending of the primary cilium triggers a distinct intraciliary calcium flux in mesenchymal stem cells. Cilia 2015. [PMCID: PMC4519150 DOI: 10.1186/2046-2530-4-s1-p22] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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32
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Rutherford C, Mansell J, O'Connell E, Corrigan M, Stallard S, Doughty J, Romics L. P157. Identifying factors within the sentinel lymph node biopsy to guide decisions regarding additional axillary treatment in women with early breast cancer. Eur J Surg Oncol 2015. [DOI: 10.1016/j.ejso.2015.03.195] [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: 11/25/2022] Open
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Woods CP, Corrigan M, Gathercole L, Taylor A, Hughes B, Gaoatswe G, Manolopoulos K, Hogan AE, O'Connell J, Stewart PM, Tomlinson JW, O'Shea D, Sherlock M. Tissue specific regulation of glucocorticoids in severe obesity and the response to significant weight loss following bariatric surgery (BARICORT). J Clin Endocrinol Metab 2015; 100:1434-44. [PMID: 25603461 DOI: 10.1210/jc.2014-4120] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 11/19/2022]
Abstract
CONTEXT Tissue cortisol exposure is under the control of the isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD). 11β-HSD1 in vivo, acts as an oxoreductase converting inactive cortisone to active cortisol. We hypothesized that 11β-HSD1 activity is dysregulated in obesity and alters following bariatric surgery induced weight loss in different tissues. METHODS We recruited 21 patients prior to undergoing bariatric surgery and performed cortisol generation profiles (following oral cortisone administration), urinary corticosteroid metabolite analysis, adipose tissue microdialysis, and tissue gene expression before and after weight loss, following bariatric surgery. Archived tissue samples from 20 previous bariatric surgery patients were also used for tissue gene expression studies. RESULTS Gene expression showed a positive correlation with 11β-HSD1 and BMI in omental adipose tissue (OM) (r = +0.52, P = .0001) but not sc adipose tissue (r = +0.28, P = .17). 11β-HSD1 expression in liver negatively correlated with body mass index (BMI) (r = -0.37, P = .04). 11β-HSD1 expression in sc adipose tissue was significantly reduced after weight loss (0.41 ± 0.28 vs 0.17 ± 0.1 arbitrary units, P = .02). Following weight loss, serum cortisol generation increased during a cortisol generation profile (area under the curve 26 768 ± 16 880 vs 47 579 ± 16 086 nmol/L/minute, P ≤ .0001.) Urinary corticosteroid metabolites demonstrated a significant reduction in total cortisol metabolites after bariatric surgery (15 224 ± 6595 vs 8814 ± 4824 μg/24 h, P = .01). Microdialysis of sc adipose tissue showed a threefold reduction in cortisol/cortisone ratio after weight loss. CONCLUSIONS This study highlights the differences in tissue specific regulation of cortisol metabolism in obesity and after weight loss. Following bariatric surgery hepatic 11β-HSD1 activity increases, sc adipose tissue 11β-HSD1 activity is reduced and total urinary cortisol metabolites are reduced indicating a possible reduction in hypothalamic pituitary adrenal axis drive. 11β-HSD1 expression correlates positively with BMI in omental adipose tissue and negatively within hepatic tissue. 11β-HSD1 expression is reduced in sc adipose tissue after weight loss.
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Affiliation(s)
- C P Woods
- Education and Research Centre (C.P.W., M.C., G.G., A.E.H., J.O., D.O., M.S.), St Vincent's University Hospital and St Columcille's Hospital, Dublin, Ireland; Centre for Endocrinology (L.G., A.T., B.H., K.M., J.T., M.S.), Diabetes and Metabolism, Institute of Biomedical Research, University of Birmingham, United Kingdom; Department of Endocrinology (P.M.S.), University of Leeds, Leeds, United Kingdom; and Department of Endocrinology (M.S.), Tallaght Hospital, Dublin and Trinity College, Dublin, Ireland
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O'Mahony M, Comber H, Fitzgerald T, Corrigan M, Fitzgerald E, Grunfeld EA, Flynn MG, Hegarty J. Interventions for raising breast cancer awareness in women. Cochrane Database Syst Rev 2014. [DOI: 10.1002/14651858.cd011396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
INTRODUCTION Peer-to-peer learning is a well-established learning modality, which has been shown to improve learning outcomes, with positive implications for clinical practice. The purpose of this pilot study was to explore the feasibility of linking students from North America and Europe with a peer-to-peer learning approach. METHODS Face and content validity studies were completed on the previously designed and validated online repository http://www.pilgrimshospital.com. Four medical students from the University of Toronto, Canada, were paired with four students from University College Cork, Ireland. Each student was invited to upload two pieces of information learned from a senior colleague that day. Each student was asked to review the information uploaded by their partner, editing with references if needed. Quantitative and qualitative evaluations of the e-peer system were conducted. RESULTS Over the study period, the system recorded a total of 10 079 individual page views. Questionnaires completed by participants demonstrated that 6/8 found the system either "very easy" or "easy" to use, whereas all found that the system promoted evidenced-based and self-directed learning. Structured interviews revealed 3 main themes: The Peer Connection, Trust in Data Veracity, and Aid to Clinical Learning. CONCLUSION This pilot study demonstrates it is feasible to link students from separate continents in a community of peer-to-peer learning. This is viewed positively by students and enhances evidenced-based learning, and the aspect of peer connectivity was important to participating students. Such an approach encourages peer cooperation and has the potential to disseminate key clinical learning experiences widely.
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Affiliation(s)
| | - Tulin Cil
- University of Toronto, Ontario, Canada Wilson Centre, UHN, Canada
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O'Shea D, Corrigan M, Dunne MR, Jackson R, Woods C, Gaoatswe G, Moynagh PN, O'Connell J, Hogan AE. Changes in human dendritic cell number and function in severe obesity may contribute to increased susceptibility to viral infection. Int J Obes (Lond) 2013; 37:1510-3. [PMID: 23439322 DOI: 10.1038/ijo.2013.16] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [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] [Received: 08/20/2012] [Revised: 01/04/2013] [Accepted: 01/09/2013] [Indexed: 02/03/2023]
Abstract
Dendritic cells (DCs) are key immune sentinels linking the innate and adaptive immune systems. DCs recognise danger signals and initiate T-cell tolerance, memory and polarisation. They are critical cells in responding to a viral illness. Obese individuals have been shown to have an impaired response to vaccinations against virally mediated conditions and to have an increased susceptibility to multi-organ failure in response to viral illness. We investigated if DCs are altered in an obese cohort (mean body mass index 51.7±7.3 kg m(-2)), ultimately resulting in differential T-cell responses. Circulating DCs were found to be significantly decreased in the obese compared with the lean cohort (0.82% vs 2.53%). Following Toll-like receptor stimulation, compared with lean controls, DCs generated from the obese cohort upregulated significantly less CD83 (40% vs 17% mean fluorescence intensity), a molecule implicated in the elicitation of T-cell responses, particularly viral responses. Obese DCs produced twofold more of the immunosuppressive cytokine interleukin (IL)-10 than lean controls, and in turn stimulated fourfold more IL-4-production from allogenic naive T cells. We conclude that obesity negatively impacts the ability of DCs to mature and elicit appropriate T-cell responses to a general stimulus. This may contribute to the increased susceptibility to viral infection observed in severe obesity.
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Affiliation(s)
- D O'Shea
- 1] Obesity Immunology Group, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin, Ireland [2] Department of Endocrinology, St Columcille's Hospital, Health Service Executive, Loughlinstown, Dublin, Ireland
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Ahern T, Tobin AM, Corrigan M, Hogan A, Sweeney C, Kirby B, O'Shea D. Glucagon-like peptide-1 analogue therapy for psoriasis patients with obesity and type 2 diabetes: a prospective cohort study. J Eur Acad Dermatol Venereol 2012; 27:1440-3. [PMID: 22691169 DOI: 10.1111/j.1468-3083.2012.04609.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Diabetes and obesity are more prevalent amongst psoriasis patients as is disturbance of the innate immune system. GLP-1 analogue therapy considerably improves weight and glycaemic control in people with type 2 diabetes and its receptor is present on innate immune cells. OBJECTIVE We aimed to determine the effect of liraglutide, a GLP-1 analogue, on psoriasis severity. METHODS Before and after 10 weeks of liraglutide therapy (1.2 mg subcutaneously daily) we determined the psoriasis area and severity index (PASI) and the dermatology life quality index (DLQI) in seven people with both psoriasis and diabetes (median age 48 years, median body mass index 48.2 kg/m(2) ). We also evaluated the immunomodulatory properties of liraglutide by measuring circulating lymphocyte subset numbers and monocyte cytokine production. RESULTS Liraglutide therapy decreased the median PASI from 4.8 to 3.0 (P = 0.03) and the median DLQI from 6.0 to 2.0 (P = 0.03). Weight and glycaemic control improved significantly. Circulating invariant natural killer T (iNKT) cells increased from 0.13% of T lymphocytes to 0.40% (P = 0.03). Liraglutide therapy also effected a non-significant 54% decrease in the proportion of circulating monocytes that produced tumour necrosis factor alpha (P = 0.07). CONCLUSION GLP-1 analogue therapy improves psoriasis severity, increases circulating iNKT cell number and modulates monocyte cytokine secretion. These effects may result from improvements in weight and glycaemic control as well as from direct immune effects of GLP-1 receptor activation. Prospective controlled trials of GLP-1 therapies are warranted, across all weight groups, in psoriasis patients with and without type 2 diabetes.
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Affiliation(s)
- T Ahern
- Obesity Research Group, andDermatology Research Group, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Abstract
Introduction. The aim of this study was to develop a new teaching strategy for medical students while creating a national online repository system (Surgent University). Then, the potential of this e-learning modality to facilitate learning of clinical surgery was evaluated. Methods. An online repository and Internet-based interface was designed and hosted on the medical education Web site, www.surgent.ie . Participation was by medical students across 3 Irish universities. Student use of the repository was quantitatively assessed over an 8-week period. They were then invited to complete an anonymous survey assessing the effectiveness of the online repository. Statistical analysis was performed using SPSS version 15, with P < .05 considered significant. Results. Over the study period, the online repository received 6105 uploaded facts by 182 final-year medical students from 3 different universities. The repository Web pages were accessed 54 061 times with 4609 individual searches of the repository. Of the 60 participating students invited to provide survey-based feedback, there were 40 respondents, giving a 66.7% response rate. Of those surveyed, 70% (n = 28) rated the online repository as highly beneficial and 75% (n = 30) as highly relevant. Overall, 87.5% (n = 35) felt that it should be continued, and 70% (n = 28) felt that it should be expanded beyond surgery to include other hospital specialties. Those finding the program interface user-friendly were more likely to find it beneficial ( P = .031) and relevant to their ongoing education ( P = .002). Conclusions. A user-friendly interface allows for high levels of usage, whereas a “student-centered” structure ensures that the facts uploaded are beneficial and relevant to medical students’ education.
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Affiliation(s)
- Mark Corrigan
- Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Seamus McHugh
- Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | - Conor Shields
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | - Arnold Hill
- Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Corrigan M, Shields C, O'Leary D, Fraher J, Winter D, Wang J, Redmond P. Hypertonic Saline Attenuates the Pro-metastatic Effects of LPS by Reducing Tumor Cell Migration, Proliferation and MMP-9 Expression. World J Oncol 2011; 2:289-297. [PMID: 29147264 PMCID: PMC5649713 DOI: 10.4021/wjon420w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2011] [Indexed: 11/17/2022] Open
Abstract
Background Lipopolysaccharide (LPS) promotes tumor metastases. The aim of this study was to determine the ability of a hypertonic environment to attenuate the pro metastatic properties of LPS both in vitro, and in vivo. Methods LPS stimulated, and unstimulated, 4T1 tumor cells were cultured in either an isotonic or hypertonic environment. The effect on invasion, migration, pro-matellomatrixproteinase 9 (proMMP-9) expression, proliferation, and microscopic cell structure was assessed. Lung metastases were induced in C57 mice with systemic hypertonicity in unstimulated and stimulated mice. The metastatic burden was assessed by estimation of lung/body weight ratio, pleural nodules and clonogenic assay. Results In vitro, a hypertonic environment reduced proMMP-9 expression (0.012 versus 1.16, P < 0.001) invasion (0.06 versus 0.119, P = 0.005), tumor cell proliferation (0.035 versus 0.041, P = 0.001), while inducing structural changes to tumor cells reducing overall cell volume. In vivo, the induction of transient systemic hypertonicity reduced metastatic burden as demonstrated by reduced lung nodules (4 versus 8, P = 0.004) and colonies on clonogenic assay (12 versus 43, P = 0.04). Conclusion The in vitro exposure of tumor cells to a hypertonic environment reduces tumor cell migration and proliferation. Transient systemic hypertonicity can reduce the metastatic burden following intra-operative exposure to LPS in vivo.
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Affiliation(s)
- Mark Corrigan
- Departments of Surgery and Anatomy, University College Cork, Ireland
| | - Conor Shields
- Departments of Surgery and Anatomy, University College Cork, Ireland
| | - Donald O'Leary
- Departments of Surgery and Anatomy, University College Cork, Ireland
| | - John Fraher
- Departments of Surgery and Anatomy, University College Cork, Ireland
| | - Desmond Winter
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Jianghuai Wang
- Departments of Surgery and Anatomy, University College Cork, Ireland
| | - Paul Redmond
- Departments of Surgery and Anatomy, University College Cork, Ireland
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Allen CS, Deyle GD, Wilken JM, Gill NW, Baker SM, Rot JA, Cook CE, Beaty S, Kissenberth M, Siffri P, Hawkins R, Cook CE, Hegedus EJ, Ross MD, Cook CE, Beaty S, Kissenberth M, Siffri P, Pill S, Hawkins R, Erhardt JW, Harris KD, Deyle GD, Gill NW, Howes RR, Koch WK, Kramer CD, Kumar SP, Adhikari P, Jeganathan PS, D’Souza SC, Misri ZK, Manning DM, Dedrick GS, Sizer PS, Brismée JM, Matthijs OC, Dedrick GS, Brismée JM, McGalliard MK, James CR, Sizer PS, Ross MD, Childs JD, Middel C, Kujawa J, Brown D, Corrigan M, Parsons N, Schmidt SG, Grant R, Spryopolous P, Dansie D, Taylor J, Wang H, Silvernail JL, Gill NW, Teyhen DS, Allison SC, Sueki DG, Almaria SM, Bender MA, Kamara M, Magpali A, Mancilla A, McConnell BJ, Montoya RC, Murphy AW, Romero ML, Viti JA, Rot JA, Augustsson H, Werstine RJ, Birmingham T, Jenkyn T, Yung EY, Tonley JC. AAOMPT platform presentations selection. J Man Manip Ther 2011; 19:239-46. [DOI: 10.1179/106698111x12998437860712] [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: 10/31/2022] Open
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Murphy RKJ, McHugh S, O'Farrell N, Dougherty B, Sheikh A, Corrigan M, Hill ADK. The financial imperative of physicians to control demand of laboratory testing. Ir Med J 2011; 104:15-17. [PMID: 21387879] [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: 05/30/2023]
Abstract
It is an integral component of doctor's duty of care to understand the significant impact laboratory testing has on the expense an ultimate quality of healthcare patients receive, yet the costs of these tests are poorly perceived. Utilising semi-structured interviews and questionnaires, we assessed surgeon's perceived costs of two commonly encountered clinical scenarios requiring out of hours laboratory testing. Of the 35 participants only 23.3% (n = 7) accurately estimated the overall cost. The most expensive test was "Type and Screen" at Euro 83, with 77.3% (n = 17) underestimating the cost. Non-consultant hospital doctors qualified for 3 years were more likely to underestimate on-call costs (p = 0.042). It is of utmost importance to improve the knowledge of all surgeons of the financial implications of investigations. Through education we can potentially reduce un-warranted costs and fulfill our duty of care in the most cost efficient manner.
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McHugh S, Corrigan M, Cowman S, Tierney S, Dimitrov B, Hill A, Humphreys H. P09.13 Development of a targeted e-learning programme for surgical infection prevention. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60102-8] [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: 11/25/2022]
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Dhillon P, Murphy R, Burukan Z, Ali H, Corrigan M, Sheikh A, Hill ADK. Sticking to the rules: are you documenting your Irish Medical Council Registration Number? Ir Med J 2010; 103:284. [PMID: 21186756] [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: 05/30/2023]
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Neary PM, Sung R, Corrigan M, O'Donovan M, Cahill RA, Redmond HP. The Benefits of an Interactive, Individualized Online Patient Pathway for Patients Undergoing Minimally Invasive Radioguided Parathyroidectomy: A Prospective, Double-Blinded, Randomized Clinical Trial. Surg Innov 2010; 17:236-41. [DOI: 10.1177/1553350610374603] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim. This study determined the usefulness of an interactive, individualized online patient pathway to patients undergoing elective operation for nonmalignant disease. Methods. An exploratory double-blind, prospective randomized controlled trial was established involving consecutive patients undergoing minimally invasive radioguided parathyroidectomy (MIRP). A total of 64 patients were randomly assigned to either a standard or an enhanced Web site (interactive with detailed, personalized timeline). Each patient completed validated Hospital Anxiety and Depression Scale questionnaires preoperatively and pain assessments and questionnaires concerning Web site usefulness postoperatively. Results . All patients found their Web site useful, although patient satisfaction was significantly higher with the enhanced Web site in regard to overall impression as well as ease, organization, usefulness, and specificity of information. There were no significant differences in mean anxiety or pain scores, in analgesia requirements, or adequacy of informed consent. Conclusion. Providing education and information through a tailored Web server is viewed positively by patients.
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Affiliation(s)
| | | | | | | | - Ronan A. Cahill
- Cork University Hospital, Cork, Ireland, European Institute of Surgical Research and Innovation, Dublin, Ireland
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McHugh SM, Corrigan M, Dimitrov B, Cowman S, Tierney S, Humphreys H, Hill A. A targeted e-learning program for surgical trainees to enhance patient safety in preventing surgical infection. J Contin Educ Health Prof 2010; 30:257-9. [PMID: 21171032 DOI: 10.1002/chp.20091] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. METHODS An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An educational Web site was developed targeting deficiencies highlighted in the audit. Interactive clinical cases were constructed using PHP coding, an HTML-embedded language, and then linked to a MySQL relational database. PowerPoint tutorials were produced as online Flash audiovisual movies. An online repository of streaming videos demonstrating best practice was made available, and weekly podcasts were made available on the iTunes© store for free download. Usage of the e-learning program was assessed quantitatively over 6 weeks in May and June 2010 using the commercial company Hitslink. RESULTS During the 5-month audit, deficiencies in practice were highlighted, including the timing of surgical prophylaxis (33% noncompliance) and intravascular catheter care in surgical patients (38% noncompliance regarding necessity). Over the 6-week assessment of the educational material, the SurgInfection.com Web pages were accessed more than 8000 times; 77.9% of the visitors were from Ireland. The most commonly accessed modality was the repository with interactive clinical cases, accounting for 3463 (43%) of the Web site visits. The average user spent 57 minutes per visit, with 30% of them visiting the Web site multiple times. DISCUSSION Interactive virtual cases mirroring real-life clinical scenarios are likely to be successful as an e-learning modality. User-friendly interfaces and 24-hour accessibility will increases uptake by surgical trainees.
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Czajkowski A, Alcock AJ, Bernard JE, Madej AA, Corrigan M, Chepurov S. Studies of saturated absorption and measurements of optical frequency for lines in the nu1 + nu3 and nu1 + 2nu4 bands of ammonia at 1.5 microm. Opt Express 2009; 17:9258-9269. [PMID: 19466177 DOI: 10.1364/oe.17.009258] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A cavity-enhanced absorption spectrometer was used to saturate several lines of ammonia in the 1510 nm - 1560 nm region. Analysis of power broadening of the saturated absorption feature for one of the ammonia lines yielded a dipole moment value comparable to that of the lines in the nu(1)+nu(3) band in acetylene. Highly reproducible frequency measurements of four ammonia line centres were carried out using a frequency comb generated by a mode-locked Cr(4+):YAG laser. These results demonstrate the possible application of ammonia saturated absorption lines for frequency metrology and calibration in a spectral region lacking strong absorbers. To our knowledge, this is the first frequency measurement of saturated absorption lines in ammonia at near infrared frequencies and the first reported observation of saturated absorption lines in the nu(1)+2nu(4) band.
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Affiliation(s)
- A Czajkowski
- Physics Department, University of Ottawa, 150 Louis Pasteur, Ottawa, Ontario, K1N 6N5, Canada.
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Corrigan M, Reardon M, Shields C, Redmond H. "SURGENT" -- student e-learning for reality: the application of interactive visual images to problem-based learning in undergraduate surgery. J Surg Educ 2008; 65:120-5. [PMID: 18439533 DOI: 10.1016/j.jsurg.2007.11.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2007] [Accepted: 11/06/2007] [Indexed: 05/22/2023]
Abstract
Information technology has the potential to transform surgical education. Combining symbolic, iconic, and enactive teaching modalities to construct an authentic conceptual model potentially can transform a primarily didactic learning experience into an interactive Web-enhanced one. This study sought to assess the introduction of a Web-based module to complement traditional surgical undergraduate curricula. Adopting the clinical case as its fundamental educational approach, an online resource simulating surgical clinical decision making ("SURGENT," http://www.surgent.ie) was developed, which consists of the interpretation of clinical photographs, laboratory data, and X-rays as well as the formulation of a management plan. Evaluation was in both a qualitative and a quantitative fashion. An anonymous postcourse survey (73% response) of 117 final medical students was used to by researchers to evaluate access, process, and outcome criteria. SURGENT was used by 98% of students, with 69% spending more than 30 minutes per session on the program. First-class honors in the final surgical clinical examination improved from 11% to 20% (p = 0.01) as compared with the previous control year. A Web-enhanced interactive surgical module in an undergraduate course can convey successfully information and understanding beyond the textbook. It is intended that SURGENT will supplement textbooks and ward experience, allowing students to develop their clinical decision-making skills.
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Affiliation(s)
- Mark Corrigan
- Department of Academic Surgery, Cork University Hospital, Cork, Ireland.
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Lucey M, McQuillan R, MacCallion A, Corrigan M, Flynn J, Connaire K. Access to medications in the community by patients in a palliative setting. A systems analysis. Palliat Med 2008; 22:185-9. [PMID: 18372383 DOI: 10.1177/0269216307085722] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study performed a systems analysis of the process by which patients under the care of a specialist palliative home care obtained medications, and highlighted factors that delay this process. Systems analysis is the science dealing with analysis of complex, large-scale systems and the interactions within those systems. This study used a mixed-methods approach of questionnaires of general practitioners, pharmacists and patients, and a prospective observational study of delays experienced by patients referred to the home care team over a three-month period. This study found the main factors causing delay to be: medications not being in stock in pharmacies, medications not being available on state reimbursed schemes and inability of patients and carers to courier medications.
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Affiliation(s)
- M Lucey
- St Francis Hospice, Raheny, Dublin, Ireland.
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Abstract
Laparoscopic alternatives to conventional surgical procedures confer many advantages to patients including reduced postoperative pain, shortened convalescence and, perhaps, improved disease-related outcomes. The diminished degree of immune dysfunction apparent with these techniques may underpin these beneficial aspects. However, minimal access is accompanied by various ancillary anesthetic and mechanical associations (including the induction of a carbon dioxide pneumoperitoneum), which must be considered in addition to reduced tissue trauma when attempting to correlate cause with effect. Furthermore, the opportunity to establish causation between the immunomodulatory aspects of laparoscopy and subsequent clinical outcome by prospective, randomized study is difficult because of the rapid incorporation of minimal access techniques into clinical practice. Therefore, experimental in vitro and in vivo studies must be used to complement the limitations of clinical studies in this area. Although the initial investigations into the immunological effects of laparoscopy are encouraging, many of the intricacies associated with this approach still await elaboration.
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Affiliation(s)
- Mark Corrigan
- Department of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland
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