Irish Journal of Medical Science最新文献

{"title":"CTRIAL-IE (ICORG) 15-34: The impact of the 21 gene breast recurrence score® assay on chemotherapy prescribing in oestrogen receptor positive, lymph node positive early stage breast cancer in Ireland.","authors":"W J Mullally, A Hassan, N Keegan, C O'Leary, L McSorley, T Mahgoub, S O'Reilly, J Walshe, M J Kennedy, L Coate, M O'Connor, M Keane, C M Kelly, K Duffy, C G Murphy, M Milewski, S Molloy, K Egan, V Murphy, O S Breathnach, L Grogan, B T Hennessy, P G Morris","doi":"10.1007/s11845-025-03922-7","DOIUrl":"10.1007/s11845-025-03922-7","url":null,"abstract":"<p><strong>Background: </strong>The 21-gene Breast Recurrence Score® (Oncotype DX®) assay has improved the selection of patients for chemotherapy in early breast cancer. Internationally, this test is used in lymph node positive disease, but at the time this study was conducted, it was not reimbursed for this indication in Ireland.</p><p><strong>Aims: </strong>Determine how access to the Recurrence Score® testing reduces chemotherapy use and quantifies the impact on oncologists' treatment recommendations.</p><p><strong>Methods: </strong>Between March and September 2017, 75 patients were enrolled in a prospective study across ten hospitals. Eligible patients had oestrogen/progesterone receptor positive and HER2 negative breast cancer with 1-3 involved lymph nodes. Following informed consent, demographics were collected and questionnaires completed by a consultant medical oncologist before and after the recurrence score testing, which examined expectations of tumour chemosensitivity, strength of chemotherapy recommendation, and planned treatment.</p><p><strong>Results: </strong>Recurrence Scores® were available on 74/75 patients. Overall, access to this test led to a 27% reduction in the recommendation for chemotherapy from 68 (92%) to 48 (65%) patients. This was most notable in patients with one (46 versus 34 patients) and two (13 versus seven patients) involved lymph nodes representing a 26% and 46% reduction, respectively. The reduction in chemotherapy use was marked in women aged 50-70 years with one lymph node involved (28 versus 18 patients)-a 36% reduction.</p><p><strong>Conclusion: </strong>Consistent with our hypothesis, broader access to the Recurrence Score® led to a reduction in the use of chemotherapy in Ireland and has subsequently become standard of care.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"839-846"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To the Editor, Commentary on the endoscopic sinus approach for ocular lymphoma.","authors":"Shiona Maria Benedict Fernandes, Ayaanuddin Syed Khaja, Arian Hizomi","doi":"10.1007/s11845-025-03967-8","DOIUrl":"10.1007/s11845-025-03967-8","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1177-1178"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of microleakage of four restorative materials using confocal laser scanning microscopy: an in vitro study.","authors":"Annapoorna Kini, Kavana M G, Shubhashini N, Nithin Shetty, Venkata Suresh Venkataiah, Mohammad Fareed, Mohmed Isaqali Karobari","doi":"10.1007/s11845-025-03927-2","DOIUrl":"10.1007/s11845-025-03927-2","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the sealing ability of restorative materials to prevent microleakage and its consequent complications-such as secondary caries, postoperative sensitivity, and restoration failure-is imperative in clinical dentistry. This study aims to compare the microleakage performance of four restorative materials-bioactive composite resin (Activa Pronto), alkasite restorative (Cention N), compomer (Dyract Flow), and glass ionomer cement (Type 2 GIC)-in Class V cavities of extracted premolar teeth.</p><p><strong>Materials and methods: </strong>Forty non-carious, intact premolar teeth were selected and prepared with standardized Class V cavities. The teeth were randomly assigned to one of four groups (n = 10) and restored with the respective materials. The restorations underwent thermocycling, followed by microleakage testing using rhodamine dye. Confocal laser scanning microscopy (CLSM), a technique that provides superior depth resolution and three-dimensional visualization of microleakage, was used to assess dye penetration at the tooth-restoration interface. Microleakage was then scored using a standardized grading system.</p><p><strong>Results: </strong>Significant differences in microleakage were observed among the groups (χ² = 45.69; p < 0.001). Group 1 (bioactive composite resin) demonstrated the lowest microleakage, with predominantly Grade 0 and Grade 1 scores, while Group 4 (GIC) exhibited the highest microleakage, characterized mainly by Grade 3 scores. Bioactive composite resin exhibited significantly lower microleakage than alkasite, compomer, and GIC (p < 0.05). No significant difference was observed between alkasite and compomer.</p><p><strong>Conclusions: </strong>Bioactive composite resin (Activa Pronto) provided the most effective seal against microleakage, followed by alkasite and compomer, with glass ionomer cement showing the least effective sealing properties.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1105-1111"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-92a-3p and miR-182-3p as potential biomarkers for the differential diagnosis of gestational diabetes mellitus and its correlation with pregnancy outcomes.","authors":"Xiaoshuang Du, Qi Li, Zhenlan Wu, Lin Xue","doi":"10.1007/s11845-025-03953-0","DOIUrl":"10.1007/s11845-025-03953-0","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) poses a significant threat to the health of both the mother and the fetus during pregnancy, potentially resulting in adverse pregnancy outcomes (APOs), including preterm labor and obstructed labor.</p><p><strong>Objective: </strong>This study aimed to evaluate the expression of serum microRNA (miR)-92a-3p and miR-182-3p in GDM and their clinical significance, providing ideas for clinical diagnosis and management.</p><p><strong>Methods: </strong>A total of 80 patients with GDM served as the GDM group, and 80 healthy pregnant females served as controls. Quantitative real-time PCR was utilized to examine the relative expression of miR-92a-3p and miR-182-3p. Logistic regression modeling and ROC curves were utilized to evaluate the clinical significance of serum miR-92a-3p and miR-182-3p in GDM.</p><p><strong>Results: </strong>miR-92a-3p and miR-182-3p was upregulated in GDM patients. The expression of miR-92a-3p and miR-182-3p were positively correlated with 1 h OGTT, 2 h OGTT, and HOMA-IR. The ROC curves demonstrated that the areas under the curve (AUCs) of miR-92a-3p, miR-182-3p, and the combination of the two in the diagnosis of GDM were 0.890, 0.813, and 0.921, respectively. Elevated levels of serum miR-92a-3p and miR-182-3p were linked to APOs. The AUCs of miR-92a-3p, miR-182-3p, and the combination of the two for predicting APOs were 0.795, 0.775, and 0.845, respectively.</p><p><strong>Conclusion: </strong>miR-92a-3p and miR-182-3p exhibited diagnostic value for GDM and were correlated with APOs in patients.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"909-916"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination therapy with vitamin E and ertugliflozin in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus: a randomized clinical trial.","authors":"Adil Khaliq, Haroon Badshah, Yasar Shah","doi":"10.1007/s11845-025-03945-0","DOIUrl":"10.1007/s11845-025-03945-0","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity in type 2 diabetes mellitus (T2DM), with shared pathophysiological mechanisms, including insulin resistance, oxidative stress, and inflammation.</p><p><strong>Objectives: </strong>This study evaluates the effects of vitamin E and ertugliflozin, individually and in combination, alongside standard pioglitazone therapy, on hepatic and metabolic parameters in patients with NAFLD and T2DM.</p><p><strong>Methods: </strong>A 24-week, double-blind, randomized, controlled clinical trial on 173 patients with NAFLD and T2DM was assigned into four groups: vitamin E (n = 42), pioglitazone (n = 43), ertugliflozin (n = 44), and vitamin E + ertugliflozin (n = 44) combination therapy. The primary outcome was to monitor changes in liver steatosis assessed via ultrasound. Secondary outcomes included evaluation of liver enzymes, glycemic control, fibrosis markers, and lipid profiles.</p><p><strong>Results: </strong>Combination therapy of vitamin E + ertugliflozin showed the highest decrease in liver fat content, with 11 participants achieving successful Grade 0 (p < 0.001). Significant improvements were also observed in glycemic control, HbA1c, triglycerides, and liver enzymes. Ertugliflozin monotherapy showed significant efficacy in improving liver enzymes, glycemic parameters, and fibrosis markers. Pioglitazone improved the initial stage of NAFLD but had a limited impact on advanced fibrosis. Ertugliflozin, in combination with vitamin E, decreases oxidative stress; however, vitamin E by itself has no impact on the metabolic and fibrosis index.</p><p><strong>Conclusion: </strong>The ertugliflozin and vitamin E combination is a very effective treatment for patients with NAFLD and T2DM. It improves hepatic steatosis and metabolic indicators. Exploration is required for combination therapy in order to assess the prolonged efficacy and safety of the treatment.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"899-908"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"John Stearne (1624-1669). Founder of the Royal College of Physicians of Ireland and first Professor of Medicine in Trinity College Dublin.","authors":"Joseph Harbison","doi":"10.1007/s11845-025-03921-8","DOIUrl":"10.1007/s11845-025-03921-8","url":null,"abstract":"<p><p>John Stearne was the first Regius Professor of Medicine in Trinity College Dublin and founded the Fraternity of Physicians of Trinity Hall that later became the Royal College of Physicians in Ireland. He was born in Ardbraccan, County Meath in 1624 and was a great nephew of the Archbishop of Armagh and renowned scholar James Ussher who was his patron. He entered Trinity College in 1639 and was elected Scholar in 1641, before fleeing Dublin at the outbreak of the Confederate Wars later that year. He moved to Cambridge and studied medicine in Sidney Sussex College. After a short period practicing medicine in Bedfordshire, he returned to Trinity in 1651 and was appointed Professor of Medicine and College medicus. He later also became Professor of Hebrew and Professor of Law. He wrote six books and became a Senior Fellow of the College. In 1654, he established the Fraternity of Physicians with some other Dublin physicians in a disused building on Trinity Street. Stearne resigned his Fellowship and Professorship in 1659 but had them restored by 1662 following the Restoration of the King Charles II. The Royal College of Physicians of Ireland received its first royal charter in 1667. Stearne died in 1669 at the age of 44. This paper, written to celebrate the quatercentenary of his birth, discusses Stearne's life and achievements in more detail particularly in the context of the political turmoil of the age and the important role of his extended family in the important events that occurred.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1075-1081"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between hand grip and pinch strength, body composition, pain threshold, and anxiety in dentists.","authors":"Sena Gizem Arslan, Abdurrahim Yildiz, Birgul Dingirdan Gultekinler","doi":"10.1007/s11845-025-03941-4","DOIUrl":"10.1007/s11845-025-03941-4","url":null,"abstract":"<p><strong>Background: </strong>Work-related musculoskeletal disorders are commonly observed across various occupational groups.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the relationships between hand grip and pinch strength, body composition, pain threshold, and anxiety levels in dentists.</p><p><strong>Methods: </strong>The study included 49 dentists working at Sakarya Oral and Dental Health Hospital. Participants' grip strength, including pinch and gross grip, was assessed using the Jamar hand dynamometer, while the muscle strength of the forearm flexor and extensor muscles was measured with a handheld dynamometer. Anxiety levels were evaluated using the Beck Anxiety Inventory, and pain threshold was assessed using an algometer.</p><p><strong>Results: </strong>A positive and significant correlation was found between body mass index (BMI) and dominant and non-dominant hand grip strength (r = 0.485, p = 0.003; r = 0.501, p = 0.002). BMI also showed a strong relationship with dominant and non-dominant finger strength (r = 0.511, p < 0.001; r = 0.557, p < 0.001). A negative correlation was found between Beck Anxiety Score and physical strength parameters, especially non-dominant hand grip strength (r = 0.619, p = 0.005) and dominant hand grip strength (r =  - 0.512, p = 0.025) and anxiety levels. Significant positive correlations were found between pain threshold and physical strength parameters, especially non-dominant wrist extensor strength (r = 0.283, p = 0.049) and dominant hand grip strength (r = 0.408, p = 0.015) which were found to increase pain threshold.</p><p><strong>Conclusions: </strong>Physical and psychological factors have an impact on occupational performance, especially in occupations that require prolonged use of the hands and wrists, such as dentistry.</p><p><strong>Trial registration: </strong>This study is prospectively registered at NCT06721117 ( http://clinicaltrials.gov ).</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"939-947"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic surgery utilisation and uptake.","authors":"Michael Devine","doi":"10.1007/s11845-025-03970-z","DOIUrl":"10.1007/s11845-025-03970-z","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1125-1126"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connected health in cancer survivorship: Evaluating the usability and utility of the cancer thriving and surviving programme in Ireland.","authors":"Isaiah Gitonga, Deirdre Desmond, Louise Mullen, Dorothy Thomas, Cathleen Osborne, Bernie O'Loughlin, Rebecca Maguire","doi":"10.1007/s11845-025-03931-6","DOIUrl":"10.1007/s11845-025-03931-6","url":null,"abstract":"<p><strong>Background: </strong>Cancer survivorship care has become increasingly complex, with a growing population of people living with and beyond the disease requiring holistic support and follow-up. Connected health (CH) offer a promising solution to enhance care delivery.</p><p><strong>Aim: </strong>This study evaluated the usability and effectiveness of CH, and motivations of participants in the Cancer Thriving and Surviving (CTS) programme in Ireland.</p><p><strong>Methods: </strong>A cross-sectional survey of persons living with and beyond cancer (PLWBC) who completed the CH-delivered CTS was conducted between December 2022 and April 2023. Closed and open-ended questions captured participants experiences and motivations. Telehealth Usability Questionnaire (TUQ) assessed the CH usability. Qualitative content analysis examined recurring themes in participant responses.</p><p><strong>Results: </strong>Forty-four participants who engaged in CTS completed the survey. Participants were predominantly female (88%), diagnosed with breast cancer (76%), and had third-level education or higher (86%). Slightly over one third (36%) were in full time employment. Motivations for engaging in CTS included seeking peer support, psychosocial assistance, and practical self-management tools. Most respondents agreed that the programme improved their psychological wellbeing (90%), quality of life (76%) and helped them take more control of their health (83%). TUQ scores indicated high usability of the CH systems.</p><p><strong>Conclusion: </strong>Findings suggest that the CH-delivered CTS programme effectively benefits PLWBC, improving psychological well-being and quality of life. The high CH system usability and positive user experiences highlight its potential to complement in-person care, supporting the continued development and evaluation of CH systems to enhance cancer survivorship, particularly within Irish digital health initiatives.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"827-838"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illuminating the path: the role of photodynamic therapy in comprehensive periodontal treatment.","authors":"Zahra Al-Timimi","doi":"10.1007/s11845-025-03924-5","DOIUrl":"10.1007/s11845-025-03924-5","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluating photodynamic therapy's efficacy and suitability for treating periodontal disease is the main goal of this review. What are the best conditions for using photodynamic therapy, and how can it improve conventional periodontal treatments?.</p><p><strong>Materials and methods: </strong>A comprehensive literature search has been conducted to identify peer-reviewed research published up until August 2024. This search utilized reputable databases, including PubMed, Scopus, and Google Scholar, ensuring a robust selection of relevant studies. Selected studies were meticulously analyzed to their methodologies, types of photosensitizers employed, light intensity levels applied, as well as the resultant clinical outcomes observed. Additionally, a comparative analysis has been performed between photodynamic therapy and traditional periodontal therapy as documented in numerous clinical studies.</p><p><strong>Results: </strong>Results show that photodynamic therapy considerably lowers the number of microorganisms present in periodontal pockets, which in turn reduces inflammation and improves healing responses. According to studies, photodynamic therapy is an efficient way to break up the biofilms that of harmful bacteria that cause periodontal disease produce.</p><p><strong>Conclusions: </strong>Photodynamic therapy is an intriguing alternative treatment option for periodontal disease. Because photodynamic therapy reduces biofilm resistance, improves blood flow, and promotes healing through anti-inflammatory effects, it may yield better clinical results when used in conjunction with conventional periodontal therapies. More research is required to create consistent guidelines for light dosage and photosensitizer selection in order to maximize therapeutic outcomes.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1083-1096"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}