Irish Journal of Medical Science (1971 -)最新文献

{"title":"Efficacy of early combination of local radiotherapy and GM-CSF for advanced non-small cell lung cancer treated with icotinib.","authors":"Ye Qiu, Xinyun He, Zepei Li, Yulan Jiang, Yuming Jia","doi":"10.1007/s11845-019-02137-x","DOIUrl":"10.1007/s11845-019-02137-x","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a disease that severely endangers human health. Non-small cell lung cancer (NSCLC) accounts for approximately 4/5 of lung cancers.</p><p><strong>Aims: </strong>To investigate the efficacy of early combination of local radiotherapy and granulocyte macrophage colony-stimulating factor (GM-CSF) for advanced NSCLC treated with icotinib.</p><p><strong>Methods: </strong>Forty-two patients with stage IV NSCLC complicated with EGFR gene mutation were selected and randomly divided into two groups, with 21 patients in each group. Patients in control group were treated with icotinib, and patients in experimental group were treated with icotinib combined with local radiotherapy and subcutaneous injection of GM-CSF. One-year progression free survival between two groups was compared.</p><p><strong>Results: </strong>Three months after treatment, the efficacy in experimental group was significantly better than that in control group, and objective response rate was 95.24% in experimental group, which was higher than the 71.43% in control group. Patients in experimental group had no differences in white blood cell and neutrophil, but had significantly lower carcino-embryonic antigen and neuron-specific enolase levels and higher CD3+, CD4+, and CD4+/CD8+ than those in control group and before treatment. There were no differences in the proportion of patients with adverse reactions between two groups. One-year progression free survival was significantly better in experimental group than in control group.</p><p><strong>Conclusions: </strong>Early combination of local radiotherapy and GM-CSF has a significant efficacy for advanced NSCLC accounts for approximately 4/5 of lung cancers treated with icotinib, and it can improve patients' autoimmunity and lengthen progression free survival.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"1 1","pages":"791-797"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75900020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for potential drug-drug interactions in patients with chronic obstructive pulmonary disease.","authors":"Dobrivoje Stojadinovic, Radica Zivkovic Zaric, Slobodan Jankovic, Zorica Lazic, Ivan Cekerevac, Romana Susa","doi":"10.1007/s11845-019-02155-9","DOIUrl":"10.1007/s11845-019-02155-9","url":null,"abstract":"<p><p>Potential drug-drug interactions (pDDIs) are especially frequent in patients with chronic obstructive pulmonary disease (COPD) who, if hospitalized, experience, on average 6.5 pDDIs on admission, and 7.2 on discharge. The aim of our study was to identify and analyze risk and/or protective factors for occurrence of pDDIs in hospitalized patients with COPD. Main outcome was occurrence of pDDIs in COPD patients ascertained by Medscape, Epocrates, and Micromedex interaction checkers. The most serious pDDIs (contraindicated/serious/major/use alternative) were found in 16 (22%), 8 (11%), and 35 (49%) patients, according to the Medscape, Epocrates, and Micromedex, respectively. The COPD patients who were prescribed more drugs (especially antiarrhythmic and anticoagulants), by several independent prescribers, and having more comorbidities, were more prone to experience a pDDI; the only protective factor against pDDIs was age of the patients. In conclusion, COPD patients with the abovementioned risk factors should have their therapy more intensely monitored for pDDIs.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"29 1","pages":"1123-1125"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74988708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI for clinically suspected prostate cancer-the disparity between private and public sectors.","authors":"Lee Chien Yap, Thomas Hugh Lynch, Rustom P Manecksha","doi":"10.1007/s11845-019-02103-7","DOIUrl":"10.1007/s11845-019-02103-7","url":null,"abstract":"<p><strong>Background: </strong>There is increasing evidence to implement multiparametric magnetic resonance imaging (mpMRI) for biopsy-naive men with clinically suspected prostate cancer (PCa). This will reduce the number of unnecessary trans rectal ultrasound biopsies (TRUS-Bx) performed and reduce the number of indolent cancers diagnosed.</p><p><strong>Aims: </strong>To assess current clinical practices for investigating clinically suspected prostate cancer in Ireland and determine if private health insurance providers are offering mpMRI scans in biopsy-naive men.</p><p><strong>Methods: </strong>Each health insurance provider procedure code was reviewed. The indications and requirements for prostate mpMRI in the setting of diagnosis, staging, surveillance, and recurrence were assessed for each health care provider. Current practices adopted by accredited referral clinics for suspected prostate cancer were reviewed.</p><p><strong>Results: </strong>Two of the three leading health insurance providers, which between them cover 46% of the private health insurance market in Ireland, provide pre-biopsy mpMRI cover as of April 2019. This leaves almost half of those insured with no accessibility to pre-biopsy mpMRI. This is in contrast to the majority of public NCCP hospitals that offer pre-biopsy mpMRI for clinically suspected prostate cancer.</p><p><strong>Conclusions: </strong>Pre-biopsy mpMRI for clinically suspected prostate cancer is emerging as a standard of practice in Ireland. International guidelines are also changing to reflect latest clinical trial evidence. Private health insurance providers should amend their policies to reflect current clinical practices already adopted in the public sector.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"18 1","pages":"461-465"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84484886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between vitamin D status in early pregnancy and atopy in offspring in a vitamin D deplete cohort.","authors":"Maeve Smith, Eileen C O'Brien, Goiuri Alberdi, Aisling A Geraghty, Mark Kilbane, Malachi J McKenna, Fionnuala M McAuliffe","doi":"10.1007/s11845-019-02078-5","DOIUrl":"10.1007/s11845-019-02078-5","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D status may play a role in the development of atopic diseases due to its action on lung development and immune system development and function.</p><p><strong>Aims: </strong>Our objective was to assess whether 25-hydroxyvitamin D (25OHD) levels in maternal blood in pregnancy were associated with atopy in children.</p><p><strong>Methods: </strong>We analysed 279 mother-child pairs from the ROLO study conducted in Dublin, Ireland. Serum 25OHD was measured at 13 and 28 weeks of pregnancy. Development of childhood atopy was self-reported by mothers at follow-up appointments at 6 months, 2 years or 5 years. Logistic regression analysis was used to evaluate associations between maternal 25OHD status and development of atopy.</p><p><strong>Results: </strong>The mean (SD) 25OHD levels in early and late pregnancy were 41.9 (19.2) nmol/L and 40.2 (21.6) nmol/L, respectively. Maternal 25OHD status in early pregnancy, but not in late pregnancy, was associated with a reduced risk of atopy at 2 years (OR 0.972, CI 0.946-0.999). In early pregnancy, those with serum 25OHD levels < 30 nmol/L compared with those with 25OHD > 50 nmol/L had significantly greater risk of developing atopy at 2 years (OR 4.76, CI 1.38-16.47).</p><p><strong>Conclusions: </strong>The development of childhood atopy may be associated with maternal vitamin D deficiency in early pregnancy among a cohort of women at risk of vitamin D deficiency. Further research is required to explore the relationship between vitamin D and atopy, particularly among women with poor vitamin D status, and whether supplementation should be prioritised in early pregnancy to reduce childhood atopy.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"156 1","pages":"563-570"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90954588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An observational analysis of meal patterns in overweight and obese pregnancy: exploring meal pattern behaviours and the association with maternal and fetal health measures.","authors":"Kate M Ainscough, Maria A Kennelly, Karen L Lindsay, Eileen C O'Brien, Elizabeth J O'Sullivan, John Mehegan, Eileen R Gibney, Fionnuala M McAuliffe","doi":"10.1007/s11845-019-02099-0","DOIUrl":"10.1007/s11845-019-02099-0","url":null,"abstract":"<p><strong>Background: </strong>Nutrient intakes are known to be poorer among pregnant women with raised body mass index (BMI) than those with a healthy BMI. While meal patterns have the potential to influence obstetric, metabolic and anthropometric measures for mother and infant, limited data exists regarding meal patterns among pregnant women with raised BMI.</p><p><strong>Aim: </strong>To identify categories of meal patterns among pregnant women with overweight and obesity and determine whether patterns change with advancing gestation. To determine if maternal meal patterns are associated with dietary intakes and pregnancy outcomes.</p><p><strong>Methods: </strong>Prospective, observational analysis of pregnant women (n = 143) (BMI 25-39.9 kg/m²). Meal pattern data were analysed from 3-day food diaries at 16 and 28 weeks' gestation. Outcomes include maternal blood glucose, insulin resistance, gestational diabetes, gestational weight gain and infant anthropometry.</p><p><strong>Results: </strong>Three meal pattern categories were identified: 'main meal dominant' (3 main eating occasions + 0-3 snacks), 'large meal dominant' (≤ 2 main eating occasions + < 2 snacks), and 'snack dominant' (3 main eating occasions + > 3 snacks and ≤ 2 main + ≥ 2 snacks). A main meal-dominant pattern prevailed at 16 weeks' (85.3%) and a snack-dominant pattern at 28 weeks' (68.5%). Dietary glycaemic index was lower among the main meal versus large meal-dominant pattern at 28 weeks (P = 0.018). Infant birth weight (kg) and macrosomia were highest among participants with a large meal-dominant pattern at 28 weeks (P = 0.030 and P = 0.008, respectively).</p><p><strong>Conclusion: </strong>Women with raised BMI changed eating patterns as pregnancy progressed, moving from main meal-dominant to snack-dominant patterns. Large meal-dominant meal patterns in later pregnancy were associated with higher glycaemic index and greater prevalence of macrosomia.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"14 1","pages":"585-594"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86849437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connolly Hospital Trauma Assessment Clinic (TAC): a virtual solution to patient flow.","authors":"Martin Kelly, Nicholas O'Keeffe, Ara Francis, Conor Moran, Karen Gantley, Fintan Doyle, Paddy Kenny","doi":"10.1007/s11845-019-02126-0","DOIUrl":"10.1007/s11845-019-02126-0","url":null,"abstract":"<p><strong>Background: </strong>Trauma Assessment Clinics (TAC) were pioneered by the Glasgow Royal Infirmary Group. Patients deemed for non-operative management are referred to the TAC for review by an orthopaedic consultant with multidisciplinary team (MDT) support. Connolly Hospital launched a TAC on 11 September 2018.</p><p><strong>Aims: </strong>The goal of this study was to evaluate the effect the introduction of this initiative had on patient flow in our institution.</p><p><strong>Methods: </strong>We performed a retrospective review of the Connolly Hospital TAC for the 6-month period since its introduction. We evaluated patient demographics, injuries and outcomes. Furthermore, we retrospectively reviewed the fracture and elective clinic attendances pre- and post-TAC introduction.</p><p><strong>Results: </strong>Over the first 6 months of this initiative, there were 36 trauma assessment clinics. Two hundred forty-seven patients were reviewed with an average age of 42.3 years. 42.9% (N = 106) was reviewed directly by the physiotherapy department. 31.6% (N = 78) was scheduled directly for fracture clinic follow-up from the TAC. 8.2% (N = 45) was discharged directly to their GP from TAC. A review of fracture clinic attendances for the corresponding time period the previous year (from September 2017), highlighted a 22% decrease in new fracture clinic appointments.</p><p><strong>Conclusions: </strong>Following the introduction of the TAC, we noted a marked reduction in fracture clinic attendances. Our outcomes were consistent with results from other units. We established two injection clinics as a direct result of the time saved from the TAC. It has proven to be of benefit to both the trauma and elective patients in our institution.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"70 1","pages":"425-429"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84432407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco control and cigarette vending machines in Ireland: time to quit!","authors":"Frank Houghton","doi":"10.1007/s11845-019-02111-7","DOIUrl":"10.1007/s11845-019-02111-7","url":null,"abstract":"","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"120 1","pages":"449-450"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82853241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does maternal obesity explain trends in caesarean section rates? Evidence from a large Irish maternity hospital.","authors":"Aoife Brick, Richard Layte, Aoife McKeating, Sharon R Sheehan, Michael J Turner","doi":"10.1007/s11845-019-02095-4","DOIUrl":"10.1007/s11845-019-02095-4","url":null,"abstract":"<p><strong>Background: </strong>A feature of contemporary obstetrics in wealthy countries has been both the continuing increase in caesarean section (CS) rates and the emergence of high levels of maternal obesity.</p><p><strong>Aims: </strong>The purpose of this study was to examine whether the increasing CS rate in a large university maternity hospital was attributable in part to maternal obesity.</p><p><strong>Methods: </strong>We studied all women who delivered a baby weighing ≥ 500 g from 2009 to 2014 in one of the largest maternity hospitals in Europe. Logistic regression techniques were employed to examine the contribution of trends in maternal BMI on the prevalence of CS.</p><p><strong>Results: </strong>Obese women were more likely to be delivered by CS in 2014 than in 2009. Multivariate analysis shows that the increase in CS rates could not be explained by changes in obesity levels in either nulliparas or multiparas. The increase in CS rates during the 6 years was strongly associated with advancing maternal age, particularly for nulliparas.</p><p><strong>Conclusions: </strong>The study found that although the prevalence of being overweight or obese changed little over the period, the odds of having a CS if a woman is obese have increased for multiparas. For nulliparas, increasing CS rates were found to be strongly associated with an increase in maternal age over the period which is important because of the evidence that Irish women are choosing to defer having their first baby until later in life.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"13 1","pages":"571-579"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73174145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial tRNA^Ser(UCN) 7471delC may be a novel mutation associated with maternally transmitted hypertension.","authors":"Ping Yang, Peng Wu, Xing Liu, Jian Feng, Shuzhan Zheng, Yan Wang, Zhongcai Fan","doi":"10.1007/s11845-019-02143-z","DOIUrl":"10.1007/s11845-019-02143-z","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study was to investigate the association between mitochondrial DNA (mtDNA) mutations and essential hypertension (EH).</p><p><strong>Methods: </strong>One Han Chinese pedigree with maternally inherited EH was recruited in the current study. The matrilineal relatives from this family underwent clinical, genetic, and molecular analysis. Moreover, the mtDNA gene mutations were screened by PCR and direct Sanger sequence. Evolutionary conservation was performed and the secondary structure of mt-tRNA^Ser(UCN) with and without the 7471delC was evaluated by the RNA Fold Webserver program. Moreover, the pathogenicity scoring system was used to assess the 7471delC.</p><p><strong>Results: </strong>This Chinese pedigree exhibited a relative high penetrance and expressivity of EH. Of 13 matrilineal relatives, 5 of them suffered from high blood pressure (BP). Genetic analysis of the complete mtDNA genes showed the presence of a novel tRNA^Ser(UCN) 7471delC, together with a set of polymorphisms belonging to the human mitochondrial haplogroup G2a1. In fact, the 7471delC occurred within the T-stem and extra arm of tRNA^Ser(UCN), which was very conserved from bacteria to human mitochondria. Interestingly, the 7472insC which was located at the same position had been regarded as a pathogenic mutation associated with non-syndromic hearing loss. In addition, bioinformatics analysis revealed that the 7471delC affected the secondary structure of tRNA^Ser(UCN). The pathogenicity scoring system showed that the 7471delC may be \"possibly pathogenic\" associated with EH.</p><p><strong>Conclusion: </strong>We believed that the 7471delC may impair the mitochondrial functional and played an active role in the pathogenesis of EH in this pedigree. The 7471delC may be a novel risk factor for maternally transmitted EH.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"11 5 1","pages":"489-496"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78383020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A breath of fresh air\" for tackling chronic disease in Ireland? An evaluation of a self-management support service for people with chronic respiratory diseases.","authors":"Aishling Sheridan, Aisling Jennings, Shirley Keane, Averil Power, Paul Kavanagh","doi":"10.1007/s11845-019-02081-w","DOIUrl":"10.1007/s11845-019-02081-w","url":null,"abstract":"<p><strong>Objective: </strong>To describe the impact of a nurse-led telephone self-management support (SMS) service for people with asthma and COPD in Ireland.</p><p><strong>Methods: </strong>A cross-sectional survey of all (442) SMS users, July 2016 to May 2017, described user demographics, self-reported experience, process and outcome. Population utilisation was estimated and compared across groups. Factors associated with key outcomes were identified.</p><p><strong>Results: </strong>The response rate was 162 (36.7%). Utilisation varied across population groups. Reported satisfaction was high, and 56.0% of users without a written action plan reported developing one. Most users reported positive cognitive and affective outcomes indicating effective patient activation. Information pack receipt was independently associated with better outcomes (odds ratio = 11.4 (95% CI, 2.0, 216.6), p < 0.05).</p><p><strong>Conclusion: </strong>A nurse-led telephone SMS intervention positively impacted self-management for people with asthma and COPD in Ireland.</p><p><strong>Practice implications: </strong>Roll-out of SMS should include staff training to promote positive service user experience and should include routine monitoring and evaluation to assure equitable reach and quality of key evidence-based care processes.</p>","PeriodicalId":14616,"journal":{"name":"Irish Journal of Medical Science (1971 -)","volume":"164 1","pages":"551-556"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77296996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}