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Murphy B, Miller P, Molley A, O'Toole G, Curtin P, Flavin R, O'Shea K, Cassar-Gheiti A, Hurson C. COVID-19, "Lockdown" and Achilles Tendon Ruptures. Ir Med J 2021; 114:437. [PMID: 38224027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
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Sheridan G, Hughes H, Storme J, Kelleher U, Curtin P, Hurson C. Intramedullary Nailing and Prolonged Operative Time Increase Transfusion Rates in Hip Fracture Surgery. Ir Med J 2021; 114:234. [PMID: 37555844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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Perets Avraham G, Bains T, Lemieux A, Slater S, Kovacsovics T, Curtin P, Gajewski J, Meyers G, Maziarz R. Improved Outcome of Elderly Patients After Reduced Intensity Allogeneic Hematopoietic Cell Transplantation (HCT). Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.378] [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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Phillips L, Struthers C, Curtin P, Cooper C, Frattini E, Pugliese C, Roberts A. N053 Heart failure (HF) and palliative care: Is using the LACE index helpful? Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.08.054] [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: 11/28/2022] Open
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Cawley D, Hennessy A, Curtin P, Bergin D, Shannon F. 'Ready-access' CT imaging for an orthopaedic trauma clinic. Ir Med J 2011; 104:81-83. [PMID: 21667612] [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
'Ready-Access' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.
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Affiliation(s)
- D Cawley
- Department Trauma & Orthopaedics, Galway University Hospital, Newcastle Rd, Galway
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Curtin P, Harty J, Sheehan E, Nicholson P, McElwain J. Self-reported complication rates following primary total hip arthroplasty in Ireland: fact or fiction. Ir J Med Sci 2010; 180:167-71. [PMID: 20936508 DOI: 10.1007/s11845-010-0576-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 08/06/2009] [Accepted: 09/03/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are little data available on complication rates following primary total hip arthroplasty (THA) surgery in Ireland. AIMS To determine self-reported complication rates and national data for primary THA. METHODS A postal questionnaire surveyed Irish orthopaedic association consultant members. Additional data were obtained from the economic and social research institute (ESRI). RESULTS We achieved an 83% response rate. 5,424 THAs were self-reported. Mean dislocation rates were 1%, but higher using a posterior surgical approach (p < 0.05). Mean deep infection rates were 0.4%. 29% were MRSA. No reduction was reported from additional barrier prophylaxes. Mean venous thrombo-embolism (VTE) rates were 3.5%. No reduction was reported from commencing prophylaxis preoperatively or extending treatment duration. National rates for dislocation, deep infection and VTE were 25.7, 0.87, and <0.1%, respectively. CONCLUSIONS The creation of a National Hip Register is strongly recommended. A register would improve surgical practices and patient outcomes, and provide significant healthcare savings.
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Affiliation(s)
- P Curtin
- Department of Elective Orthopaedics, The Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland.
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Strasfeld L, Espinoza L, Green J, Graeme F, Meyers G, Ball E, Castro J, Mulroney C, Curtin P, Maziarz R, Taplitz R. Novel H1N1 Influenza A (S-OIV) Infection In Recipients Of Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.074] [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: 10/19/2022]
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Lu Y, Ma B, Guo R, Wang Y, Zhang J, Wu Y, Pang G, Xin J, Ye W, Zou Y, Wang X, Hitos K, Curtin P, Fletcher J. Deep vein thrombosis in trauma: a prospective study of lower limb orthopedic trauma patients in Tianjin Hospital, China. INT ANGIOL 2007; 26:165-70. [PMID: 17489081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
AIM Pulmonary embolism is a third leading cause of death in trauma patients. The prevalence of deep vein thrombosis (DVT) in Asian countries is considered to be less than in Western countries. Our aim was to establish the rate of DVT in orthopedic trauma patients in Tianjin Hospital, to identify DVT risk factors and to support the use of prophylaxis. METHODS Patients admitted between November 2003 and October 2004 with recent fracture had data collected prospectively to record type of fracture, mechanism of injury, history of DVT, blood transfusion requirements, operation details, extent of postoperative swelling, use of traction, immobilization, bandaging and patient positioning. Each patient had 3 duplex ultrasound examinations, the first within 24 h of admission. Patients requiring surgery had a second ultrasound within 2 days preoperatively, then 7 days postoperatively. Patients not requiring surgery had second and third ultrasound examinations 5 and 14 days after admission. RESULTS There were 547 patients, median age 39.6 years (interquartile range: 28-50 years). DVT developed in 12.4% (95% confidence interval: 9.7-15.2%), most occurring with femoral shaft fractures (30.6%), 15.8% occurred with hip fractures, 14.5% with fractures around the knee and 10.8% with fractured tibia and fibula. Over half of DVTs (56.7%) developed within 3 days following injury. CONCLUSION The incidence of DVT in Chinese orthopedic trauma patients approaches that in Western countries. Guidelines for DVT prophylaxis should be applied in China as in Western countries.
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Affiliation(s)
- Y Lu
- Tianjin Orthopedic Hospital, Tianjin, China
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Affiliation(s)
- P Curtin
- Department of Trauma and Orthopaedics, Adelaide and Meath incorporating the National Children's Hospital, Dublin, Tallaght, Ireland.
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Abstract
A fracture of the normal humerus in a healthy young adult most commonly results from significant direct trauma. Throwing sports have become increasingly popular outside of North America and bring with them a novel injury mechanism for clinicians. A 21 year old woman sustained a "thrower's fracture" of the distal humerus and radial nerve palsy while throwing a softball. She was treated by internal fixation. Her fracture united, and radial nerve neurapraxia resolved after 8 weeks. Clinicians should be aware of this entity so that prodromal symptoms can be recognised early and thrower's fractures are not investigated unnecessarily.
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Affiliation(s)
- P Curtin
- Adelaide and Meath Hospital, Trauma and Orthopaedics, Dublin, Ireland.
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Abstract
C2-C3 pseudosubluxation is a well recognized normal anatomical variant in children and this physiological spondylolisthesis often makes the interpretation of paediatric cervical spine radiographs difficult. In direct contrast, this finding is rare in adults and has not been reported as a diagnostic difficulty following neck injury. We report a case of C2-C3 pseudosubluxation occurring in a 27 year old woman presenting with neck pain 1 week after a road traffic accident. Although there are effective radiological guidelines for cervical spine radiograph evaluation in children, there is no evidence that these can be applied to the adult cervical spine. Flexion and extension cervical spine views have limitations. In such cases, magnetic resonance imaging is required to definitively exclude pathological injury.
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Affiliation(s)
- P Curtin
- Department of Trauma and Orthopaedics, Adelaide and Meath incorporating the National Children's Hospital, Tallaght, Dublin 24, Republic of Ireland.
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Medis R, Hoffman A, Marlowe M, Partel R, Tomines E, Vara P, Wetzsteon P, Curtin P, Maziarz R, Norman D, Drevenak J, Cognato M, Williams T, Endres R. The null allele HLA-B*5111N accounted for a discrepancy between serological and low resolution DNA typing methods. Hum Immunol 2005. [DOI: 10.1016/j.humimm.2005.08.149] [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: 10/25/2022]
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Curtin P, Harty J, Sheehan E, Nicholson P, Rice J, McElwain J. Primary total hip replacement--a survey of current practice and identifying changing trends. Ir Med J 2005; 98:166, 168. [PMID: 16097505] [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: 05/03/2023]
Abstract
Primary total hip replacement (THR) surgery is the most commonly performed and successful reconstructive procedure in orthopaedic surgery. We performed a survey of Irish Orthopaedic consultants to elucidate current practices of primary THR in elderly and young patients and identify changing trends. There was an 83% response rate. Most respondents use a cemented THR in elderly patients. 69% use a different THR in younger patients compared to older patients. 9% refer younger patients to hip replacement specialist consultant colleagues. 70% report changing to a new implant or new technique in younger patients and 45% use a hybrid THR, 15% an uncemented THR, 15% perform hip resurfacing and 47% use different bearing surfaces. Only 17% use the Charnley hip prosthesis in younger patients. Young and active patients will place high demands on a new THR and newer techniques, implants and bearing surfaces are being adopted in the hope of better outcomes.
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Affiliation(s)
- P Curtin
- Department of Orthopaedics, The Adelaide and Meath incorporating the National Children's Hospital, Dublin.
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Westervelt P, Brown RA, Adkins DR, Khoury H, Curtin P, Hurd D, Luger SM, Ma MK, Ley TJ, DiPersio JF. Sudden death among patients with acute promyelocytic leukemia treated with arsenic trioxide. Blood 2001; 98:266-71. [PMID: 11435292 DOI: 10.1182/blood.v98.2.266] [Citation(s) in RCA: 186] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Arsenic trioxide has been shown to be effective in treating acute promyelocytic leukemia (APL), with minimal overall toxicity reported to date. A phase I/II study was initiated in June 1998 using arsenic trioxide for relapsed APL to determine the maximum tolerated or minimal effective dose and to determine the efficacy of treatment at that dose. Ten patients received 1 to 4 monthly cycles of treatment with 0.1 mg/kg per day intravenous arsenic trioxide. Six of 7 patients evaluable for response achieved cytogenetic or molecular complete remission. However, 3 patients died suddenly during the first cycle of treatment. Autopsies obtained on 2 of these failed to identify a cause of sudden death, despite evidence of pulmonary hemorrhage in one. A third patient, for whom an autopsy was not performed, became asystolic and died while on continuous cardiac telemetry. These observations suggest that arsenic trioxide may be significantly or even fatally toxic at doses currently used and that caution is warranted in its use.
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Affiliation(s)
- P Westervelt
- Division of Bone Marrow Transplantation and Stem Cell Biology, and the Division of Molecular Oncology, Washington University School of Medicine, St Louis, MO 63110, USA.
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Abstract
Gauze swabs soaked in normal saline are frequently used as dressing on open wounds. Their exact mechanism of action is not known. This study was designed to assess the hypothesis that normal saline dressings act in part as an osmotic dressing. Ten patients had skin ulcers (n = 10) dressed with normal saline soaked sponges. Acting as controls (n = 10) identical sponges were placed upon intact skin. The sponge fluid osmolarity and electrolyte concentrations were serially assayed to test our hypothesis. In the control group, the osmolarity, sodium and chloride concentrations increased with time as a result of evaporation, altering it from an isotonic to a hypertonic dressing. However, in the ulcer group, the osmolarity, sodium and chloride concentrations in the sponge fluid remained relatively isotonic with time. This result is statistically significant (P< 0.05). We postulate that, as a result of evaporation, the sponge dressing increases its tonicity. This draws fluid from the wound into the dressing so that a dynamic equilibrium occurs and the sponge dressing regains isotonicity. The dressing remains functional provided that the wound fluid is absorbed freely from the wound. This process is terminated when either the dressing completely absorbs the wound fluid or the dressing dries out. The latter often occurs prematurely in a contaminated wound or in a wound where exudate forms a non-permeable barrier which prevents osmosis and allows the remaining water in the dressing to evaporate completely. This correlates with the observation in clinical practice that for maximum efficacy the dressing should be changed regularly.
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Affiliation(s)
- J K Lim
- Department of Plastic and Reconstructive Surgery, Westmead Hospital, Westmead, New South Wales, Australia
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Rubin EM, Witkowska HE, Spangler E, Curtin P, Lubin BH, Mohandas N, Clift SM. Hypoxia-induced in vivo sickling of transgenic mouse red cells. J Clin Invest 1991; 87:639-47. [PMID: 1991848 PMCID: PMC296354 DOI: 10.1172/jci115041] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To develop an animal model for sickle cell anemia, we have created transgenic mice that express a severe naturally occurring human sickling hemoglobin, Hb S Antilles. Due to its low solubility and oxygen affinity, Hb S Antilles has a greater propensity to cause red cell sickling than Hb S. To make transgenic animals that express a high level of Hb S Antilles, the erythroid-specific DNAse I hypersensitive site II from the human beta-globin cluster was linked independently to the human alpha 2-globin gene and to the beta S Antilles gene. Embryos were injected with both constructs simultaneously and seven transgenic mice were obtained, three of which contained both the human alpha and the human beta S Antilles transgene. After crossing the human transgenes into the mouse beta-thalassemic background a transgenic mouse line was derived in which approximately half the beta-globin chains in the murine red cells were human beta S Antilles. Deoxygenation of the transgenic red cells in vitro resulted in extensive sickling. An increase of in vivo sickling was achieved by placing these transgenic mice in a low oxygen environment. This murine model for red cell sickling should help to advance our understanding of sickle cell disease and may provide a model to test therapeutic interventions.
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Affiliation(s)
- E M Rubin
- Division of Cell and Molecular Biology, Lawrence Berkeley Laboratory, University of California, Berkeley 94720
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Curtin P, Pirastu M, Kan YW, Gobert-Jones JA, Stephens AD, Lehmann H. A distant gene deletion affects beta-globin gene function in an atypical gamma delta beta-thalassemia. J Clin Invest 1985; 76:1554-8. [PMID: 2997283 PMCID: PMC424127 DOI: 10.1172/jci112136] [Citation(s) in RCA: 86] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We describe an English family with an atypical gamma delta beta-thalassemia syndrome. Heterozygosity results in a beta-thalassemia phenotype with normal hemoglobin A2. However, unlike previously described cases, no history of neonatal hemolytic anemia requiring blood transfusion was obtained. Gene mapping showed a deletion that extended from the third exon of the G gamma-globin gene upstream for approximately 100 kilobases (kb). The A gamma-globin, psi beta-, delta-, and beta-globin genes in cis remained intact. The malfunction of the beta-globin gene on a chromosome in which the deletion is located 25 kb away suggests that chromatin structure and conformation are important for globin gene expression.
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Lehman JA, Curtin P, Haas DG. Closure of anterior palate fistulae. Cleft Palate J 1978; 15:33-8. [PMID: 342140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Attempts at closure of anterior palate fistulas using local tissue have resulted in a high rate of failure. In addition most of these patients have associated maxillary collapse which must be corrected prior to surgery. A technique using a buccal mucosal flap to gain unscarred tissue for the anterior closure and bone grafts to fill the bony defect has been performed in nineteen patients with anterior palate fistulas. The results have been satisfactory from a functional and esthetic standpoint. In addition associated deformities have been corrected simultaneously.
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Abstract
Temperature-sensitive mutants of bacteriophage Mu, which grow at 32 C but not at 42 C, have been isolated. These mutants fall into two groups. Group 1 mutants fail to lyse host cells at nonpermissive temperatures, whereas lysis occurs normally with the group 2 mutants. All of the group 1 mutants apparently belong to the cistrons mapping to the left of gene C, whereas the group 2 mutants have lesions in various genes between D and S.
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