• Safety in magnetic resonance units: an update.

      Farling, P A; Flynn, P A; Darwent, G; De Wilde, J; Grainger, D; King, S; McBrien, M E; Menon, D K; Ridgway, J P; Sury, M; et al. (2010-07)
    • Safety of trastuzumab (Herceptin (R)) During Pregnancy: two case reports

      Goodyer, Matthew J; Ismail, Jeffri RM; O'Reilly, Seamus P; Moylan, Eugene J; Ryan, C Anthony M; Hughes, Paul AF; O'Connor, Alan (2009-12-16)
      Abstract We report on two cases of women on trastuzumab therapy for breast cancer who became pregnant and delivered healthy live infants. At the time of reporting the children are growing and developing normally (ages 3 and 2).
    • Safety of trastuzumab (Herceptin) during pregnancy: two case reports.

      Goodyer, Matthew J; Ismail, Jeffri Rm; O'Reilly, Seamus P; Moylan, Eugene J; Ryan, C Anthony M; Hughes, Paul Af; O'Connor, Alan; Department of Medical Oncology, Cork University Hospital, Cork, Ireland. (2009)
      We report on two cases of women on trastuzumab therapy for breast cancer who became pregnant and delivered healthy live infants. At the time of reporting the children are growing and developing normally (ages 3 and 2).
    • Safety of trastuzumab (Herceptin®) during pregnancy: two case reports

      Goodyer, Matthew J; Ismail, Jeffri R; O'Reilly, Seamus P; Moylan, Eugene J; Ryan, C A M; Hughes, Paul A; O'Connor, Alan (2009-12-16)
      Abstract We report on two cases of women on trastuzumab therapy for breast cancer who became pregnant and delivered healthy live infants. At the time of reporting the children are growing and developing normally (ages 3 and 2).
    • Salmonella in meats, water, fruit and vegetables as disclosed from testing undertaken by Food Business Operators in Ireland from 2005 to 2009

      Duggan, Sharon; Jordan, Emily; Gutierrez, Montserrat; Barrett, Gaye; O’Brien, Tony; Hand, Darren; Kenny, Kevin; Fanning, June; Leonard, Nola; Egan, John (2012-09-22)
      Abstract Food Business Operators (FBO) are responsible for the safety of the food they produce and in Ireland those under the regulatory control of the Department of Agriculture, Food and Marine are required to provide summary data on microbiological tests undertaken as part of their food safety controls. These data are provided to the National Reference Laboratory through the 25 private laboratories undertaking the testing. Results Over the five-year period Salmonella sp. was isolated from 0.7% of the 254,000 raw meat or raw meat products tested with the annual prevalence ranging from 0.5 to 1.1%. Poultry meats were consistently more contaminated than other meats with higher recovery rates in turkey (3.3%), duck (3.3%), and chicken (2.5%) compared with meats of porcine (1.6%), ovine (0.2%) and bovine origin (0.1%). Salmonella sp. was also isolated from 58 (0.06%) of the 96,115 cooked or partially cooked meat and meat products tested during the reporting period with the annual percentage positive samples ranging from 0.01 to 0.16%. A total of 50 different serotypes were recovered from raw meats over this period with the greatest diversity found in poultry samples (n = 36). Four serotypes, Kentucky, Typhimurium, Agona and Derby accounted for over 70% of all isolates detected on FBO testing over the period 2005 to 2009. Conclusions Capturing microbiological data generated by Food Business Operators allows the regulatory sector access to a substantial amount of valuable data with the minimum financial outlay.
    • Saltwater nectotizing fasciitis following coral reef laceration possibly exacerbated by a long-haul flight: a case report.

      Byrne, Ann-Maria; Sullivan, Paul; Keogh, Peter; Department of Orthopaedics, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. (2009)
      INTRODUCTION: Necrotising fasciits is a rapidly progressive disease characterised by extensive necrosis of the fascia, skin, and subcutaneous tissue, with relative sparing of the underlying muscle. CASE PRESENTATION: We present the case of a 24-year old Irish male student who sustained a laceration to his right shin from contact with a coral reef while swimming in the Phuket region, off the west coast of Thailand. The following day, he returned to Ireland and presented with an aggressive and destructive variant of group A beta-hemolytic streptococcal necrotising fasciitis originating at the site of the coral reef injury, and exacerbated by the long-haul flight. He was successfully treated with aggressive surgical debridement, vacuum-assisted dressings, split skin grafting and broad spectrum antibiotics. CONCLUSION: Necrotising fasciitis can progress rapidly to systemic toxicity and even death without expedient diagnosis and aggressive treatment. Long-haul flights induce significant fluid accumulation in the lower extremity. These physiological fluid shifts may have contributed to the severity of our patient's necrotizing condition following his flight from Thailand.
    • Saving and Empowering Young Lives in Europe (SEYLE): a randomized controlled trial

      Wasserman, Danuta; Carli, Vladimir; Wasserman, Camilla; Apter, Alan; Balazs, Judit; Bobes, Julio; Bracale, Renata; Brunner, Romuald; Bursztein-Lipsicas, Cendrine; Corcoran, Paul; et al. (2010-04-13)
      Abstract Background There have been only a few reports illustrating the moderate effectiveness of suicide-preventive interventions in reducing suicidal behavior, and, in most of those studies, the target populations were primarily adults, whereas few focused on adolescents. Essentially, there have been no randomized controlled studies comparing the efficacy, cost-effectiveness and cultural adaptability of suicide-prevention strategies in schools. There is also a lack of information on whether suicide-preventive interventions can, in addition to preventing suicide, reduce risk behaviors and promote healthier ones as well as improve young people's mental health. The aim of the SEYLE project, which is funded by the European Union under the Seventh Framework Health Program, is to address these issues by collecting baseline and follow-up data on health and well-being among European adolescents and compiling an epidemiological database; testing, in a randomized controlled trial, three different suicide-preventive interventions; evaluating the outcome of each intervention in comparison with a control group from a multidisciplinary perspective; as well as recommending culturally adjusted models for promoting mental health and preventing suicidal behaviors. Methods and design The study comprises 11,000 adolescents emitted from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the scientific coordinating center. Each country performs three active interventions and one minimal intervention as a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents, and screening for at-risk adolescents by health professionals. Structured questionnaires are utilized at baseline, 3- and 12-month follow-ups in order to assess changes. Discussion Although it has been reported that suicide-preventive interventions can be effective in decreasing suicidal behavior, well-documented and randomized studies are lacking. The effects of such interventions in terms of combating unhealthy lifestyles in young people, which often characterize suicidal individuals, have never been reported. We know that unhealthy and risk-taking behaviors are detrimental to individuals' current and future health. It is, therefore, crucial to test well-designed, longitudinal mental health-promoting and suicide-preventive interventions by evaluating the implications of such activities for reducing unhealthy and risk behaviors while concurrently promoting healthy ones. Trial registration The German Clinical Trials Register, DRKS00000214.
    • Schizophrenia and quality of life: a one-year follow-up in four EU countries.

      Kovess-Masféty, Viviane; Xavier, Miguel; Moreno Kustner, Berta; Suchocka, Agnieszka; Sevilla-Dedieu, Christine; Dubuis, Jacques; Lacalmontie, Elisabeth; Pellet, Jacques; Roelandt, Jean-Luc; Walsh, Dermot; et al. (2006)
      BACKGROUND: This article systematically monitors the quality of life (QOL) of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain. METHODS: A one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up. RESULTS: We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items. CONCLUSION: The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.
    • School sociodemographic characteristics and obesity in schoolchildren: does the obesity definition matter?

      Bel-Serrat, Silvia; Heinen, Mirjam M; Mehegan, John; O’Brien, Sarah; Eldin, Nazih; Murrin, Celine M; Kelleher, Cecily C (2018-03-09)
      Abstract Background Existing evidence on the role of sociodemographic variables as risk factors for overweight and obesity in school-aged children is inconsistent. Furthermore, findings seem to be influenced by the obesity definition applied. Therefore, this study aimed to investigate if school sociodemographic indicators were associated with weight status in Irish primary schoolchildren and whether this association was sensitive to different obesity classification systems. Methods A nationally representative cross-sectional sample of 7542 Irish children (53.9% girls), mean age 10.4 (±1.2SD) years, participating in the Childhood Obesity Surveillance Initiative in the 2010, 2012/2013 or 2015/2016 waves were included. Height, weight and waist circumference were objectively measured. Five definitions of obesity were employed using different approaches for either body mass index (BMI) or abdominal obesity. Associations between overweight and obesity and sociodemographic variables were investigated using adjusted multilevel logistic regression analyses. Results Children attending disadvantaged schools were more likely to be overweight and obese than their peers attending non-disadvantaged schools, regardless of the obesity classification system used. Associations remained significant for the BMI-based obesity definitions when the sample was stratified by sex and age group, except for boys aged 8–10.5 years. Only boys aged ≥10.5 years in disadvantaged schools had higher odds of abdominal obesity (UK 1990 waist circumference growth charts: OR = 1.56, 95%CI = 1.09–2.24; waist-to-height ratio: OR = 1.78, 95%CI = 1.14–2.79) than those in non-disadvantaged schools. No associations were observed for school urbanisation level. Conclusions School socioeconomic status was a strong determinant of overweight and obesity in Irish schoolchildren, and these associations were age- and sex-dependent. School location was not associated with overweight or obesity. There remains a need to intervene with school-aged children in disadvantaged schools, specifically among those approaching adolescence, to prevent a trajectory of obesity into adult life.
    • The science of searching--how to find the evidence quickly and efficiently.

      Wallace, J (Irish Medical Journal (IMJ), 2012-04)
      One of the most common findings from health research is the failure to routinely translate research evidence into daily practice. Studies simply can't guarantee the use of their findings. There is just too much research to keep track of and so a large gap develops between what is known and what is done. Evidence that should change practice is often ignored for years. The literature is constantly changing and when an answer to a clinical question is sought, it often comes from an out-of-date textbook. Remaining knowledgeable of current, relevant research is difficult. Consequently, the development of skills in searching electronic databases is vital for the up-to-date clinician.
    • Scientific basis for opinion

      Gibney, Professor Mike; UCD (Irish Dental Association, 2011-08)
    • Screening for depression in medical research: ethical challenges and recommendations

      Sheehan, Aisling M; McGee, Hannah (2013-01-08)
      Abstract Background Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues. Discussion Deciding on whether to report positive screens to healthcare practitioners is both an ethical and a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol. Summary Further research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects.
    • Screening for diabetic retinopathy

      Lowe, Joanna (Nursing in General Practice, 2014-11)
    • Screening uptake rates and the clinical and cost effectiveness of screening for gestational diabetes mellitus in primary versus secondary care: study protocol for a randomised controlled trial.

      O Dea, Angela; Infanti, Jennifer J; Gillespie, Paddy; Tummon, Olga; Fanous, Samuel; Glynn, Liam G; McGuire, Brian E; Newell, John; Dunne, Fidelma P; National University of Ireland Galway (BioMed Central, 2014-01-17)
      The risks associated with gestational diabetes mellitus (GDM) are well recognized, and there is increasing evidence to support treatment of the condition. However, clear guidance on the ideal approach to screening for GDM is lacking. Professional groups continue to debate whether selective screening (based on risk factors) or universal screening is the most appropriate approach. Additionally, there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment. Furthermore, the implications of possible screening options on health care costs are not well established. In response to this uncertainty there have been repeated calls for well-designed, randomised trials to determine the efficacy of screening, diagnosis, and management plans for GDM. We describe a randomised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care settings. The objective of this study is to assess screening uptake rates, and the clinical and cost effectiveness of screening for GDM in primary versus secondary care.
    • Seasonality of congenital anomalies in Europe

      Luteijn, Johannes Michiel; Dolk, Helen; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bianchi, Fabrizio; Calzolari, Elisa; Draper, Elizabeth; Garne, Ester; Gatt, Miriam; et al. (2014-07-22)
    • Selective salpingography and recanalisation of blocked fallopian tubes.

      Allen, C; Browne, R; Merrion Fertility Clinic and National Maternity Hospital, Holles St, Dublin 2. callen@merrionfertility.ie (2010-09)
      Fallopian tubal disease is a common cause of subfertility. Reproductive surgery or assisted reproduction techniques such as in vitro fertilization (IVF) have been the main treatment options for patients with tubal disease in Ireland, although access to these treatments remains limited. We describe a case of pregnancy following selective salpingography and fallopian tube recanalisation.
    • Self Management Support – What is it?”

      Mullaney, Carmel; Quinn, Geraldine; O’Reilly, Oraith (Health Service Executive (HSE), 2015-10)
    • Self protection from anti-viral responses--Ro52 promotes degradation of the transcription factor IRF7 downstream of the viral Toll-Like receptors.

      Higgs, Rowan; Lazzari, Elisa; Wynne, Claire; Ní Gabhann, Joan; Espinosa, Alexander; Wahren-Herlenius, Marie; Jefferies, Caroline A; Molecular and Cellular Therapeutics and RSCI Research Institute, Royal College of Surgeons in Ireland, Dublin, Ireland. (2010)
      Ro52 is a member of the TRIM family of single-protein E3 ligases and is also a target for autoantibody production in systemic lupus erythematosus and Sjögren's syndrome. We previously demonstrated a novel function of Ro52 in the ubiquitination and proteasomal degradation of IRF3 following TLR3/4 stimulation. We now present evidence that Ro52 has a similar role in regulating the stability and activity of IRF7. Endogenous immunoprecipitation of Ro52-bound proteins revealed that IRF7 associates with Ro52, an effect which increases following TLR7 and TLR9 stimulation, suggesting that Ro52 interacts with IRF7 post-pathogen recognition. Furthermore, we show that Ro52 ubiquitinates IRF7 in a dose-dependent manner, resulting in a decrease in total IRF7 expression and a subsequent decrease in IFN-alpha production. IRF7 stability was increased in bone marrow-derived macrophages from Ro52-deficient mice stimulated with imiquimod or CpG-B, consistent with a role for Ro52 in the negative regulation of IRF7 signalling. Taken together, these results suggest that Ro52-mediated ubiquitination promotes the degradation of IRF7 following TLR7 and TLR9 stimulation. As Ro52 is known to be IFN-inducible, this system constitutes a negative-feedback loop that acts to protect the host from the prolonged activation of the immune response.
    • Self-harm in young people: Prevalence, associated factors and help-seeking in school-going adolescents

      Doyle, L; Treacy, M P; Sheridan, A; 1 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland 2 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland (Wiley, 2015-07-28)