1
|
O'Halloran N, Lowery A, Kalinina O, Sweeney K, Malone C, McLoughlin R, Kelly J, Hussey A, Kerin M. Trends in breast reconstruction practices in a specialized breast tertiary referral centre. BJS Open 2017; 1:148-157. [PMID: 29951617 PMCID: PMC5989961 DOI: 10.1002/bjs5.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/29/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Breast reconstruction is an important component of multidisciplinary breast cancer management. The practice of breast reconstruction after mastectomy has evolved significantly in the past decade as a result of both increasing mastectomy rates and advances in reconstructive strategy. These changes have significantly influenced the contemporary surgical management of breast cancer. The aim of this study was to examine trends in breast reconstruction after mastectomy in an Irish population. METHODS Data were reviewed from a database of all patients who had mastectomy with or without breast reconstruction at Galway University Hospital, a tertiary breast cancer referral centre, between 2004 and 2014. Trends in breast reconstruction after mastectomy were explored with respect to patient demographics, clinicopathological features, and neoadjuvant and adjuvant therapy. RESULTS Of 1303 patients who underwent mastectomy during interval studied, 706 (54.2 per cent) had breast reconstruction after mastectomy. In 629 patients (89·1 per cent), breast reconstruction was performed in the immediate setting. Reconstruction rates increased over time from 20·5 per cent in 2004 to 44·7 per cent in 2014. Reconstruction was more commonly performed in younger patients and those with benign, in situ and early-stage disease. A negative relationship between radiotherapy and reconstruction was observed. A pedicled flap with or without an implant was the most commonly used reconstructive approach in patients receiving radiotherapy. CONCLUSION Breast reconstruction after mastectomy has become the standard of care in the surgical treatment of breast cancer. Recent trends show a transition favouring implant-based approaches.
Collapse
Affiliation(s)
- N. O'Halloran
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - A. Lowery
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - O. Kalinina
- Department of MathematicsNational University of Ireland GalwayGalwayIreland
| | - K. Sweeney
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - C. Malone
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - R. McLoughlin
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - J. Kelly
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - A. Hussey
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| | - M. Kerin
- Department of SurgeryNational University of Ireland GalwayGalwayIreland
| |
Collapse
|
2
|
Moloney BM, Malone C, Sweeney K, Barry K, McLoughlin R, Larke A, Walsh S, O Connell AM, Ennis R, McCarthy PA, Kerin MJ. Abstract P5-02-06: The impact of the introduction of breast cancer screening on a symptomatic breast cancer unit. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-02-06] [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: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
Collapse
Affiliation(s)
- BM Moloney
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - C Malone
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - K Sweeney
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - K Barry
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - R McLoughlin
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - A Larke
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - S Walsh
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - AM O Connell
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - R Ennis
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - PA McCarthy
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| | - MJ Kerin
- Lambe Institute of Translational Research, National University of Ireland, Galway, Connaught, Ireland; National University of Ireland, Galway, Connaught, Ireland
| |
Collapse
|
3
|
Chi A, Wildfire J, McLoughlin R, Wood RA, Bloomberg GR, Kattan M, Gergen P, Gold DR, Witter F, Chen T, Holick M, Visness C, Gern J, O'Connor GT. Umbilical cord plasma 25-hydroxyvitamin D concentration and immune function at birth: the Urban Environment and Childhood Asthma study. Clin Exp Allergy 2011; 41:842-50. [PMID: 21481021 DOI: 10.1111/j.1365-2222.2011.03712.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Recent studies have reported conflicting data on the association between maternal intake of vitamin D during pregnancy and asthma. OBJECTIVE To assess the influence of prenatal vitamin D status on immune function at birth. METHODS In an inner-city birth cohort of 568 newborns, 520 of whom had at least one atopic parent, we measured the umbilical cord (UC) plasma concentration of 25-hydroxyvitamin D (25(OH)D) and the cytokine responses of UC blood mononuclear cells (UCMCs) to stimuli including phytohaemagglutinin (PHA), lipopolysaccharide (LPS), and peptidoglycan. In a subset, the UCMC expression of regulatory T cell markers and the suppressive activity of CD4(+) CD25(+) UCMCs were measured. Results The 25th, 50th, and 75th percentiles of UC plasma 25(OH)D level were 15.0, 20.2, and 25.6 ng/mL, respectively. Most cytokine responses of UCMC were not correlated with UC 25(OH)D concentration; however, IFN-γ release after LPS stimulation was weakly positively correlated with UC 25(OH)D concentration (r=0.11, P=0.01). PHA responses were not significantly correlated with 25(OH)D concentration. The UC plasma 25(OH)D concentration was inversely related to the number of CD25(+) (r=-0.20, P=0.06), CD25(Bright) (r=-0.21, P=0.05), and CD25(+) FoxP3 (r=-0.29, P=0.06) cells as a proportion of CD4(+) T cells in UC blood (r=-0.26, P=0.04) but not to the suppressive activity of CD4(+) CD25(+) cells (r=0.17, P=0.22). CONCLUSION AND CLINICAL RELEVANCE UC 25(OH)D concentration was not correlated with most UCMC cytokine responses to multiple stimuli. There was a suggestion of a weakly positive correlation with IFN-γ release after LPS stimulation. The proportions of CD25(+) , CD25(Bright) , and CD25(+) FoxP3 cells to total CD4(+) T cells were inversely correlated with UC 25(OH)D concentration. Our findings suggest that higher vitamin D levels at birth may be associated with a lower number of T-regulatory cells. Vitamin D status in utero may influence immune regulation in early life.
Collapse
Affiliation(s)
- A Chi
- Division of Pulmonary and Critical Care Medicine, Tufts University School of Medicine, Boston, MA 02111–1800, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Shuhaibar M, Walsh C, Lindsay F, Lee N, Walsh P, O’Gorman P, Boran G, McLoughlin R, Qasim A, Breslin N, Ryan B, O’Connor H, O’Morain C. A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers. Ir J Med Sci 2010; 180:103-8. [DOI: 10.1007/s11845-010-0605-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 09/30/2010] [Indexed: 12/22/2022]
|
5
|
Sebastian S, McLoughlin R, Qasim A, O'Morain CA, Buckley MJ. Endoscopic argon plasma coagulation for the treatment of gastric antral vascular ectasia (watermelon stomach): long-term results. Dig Liver Dis 2004; 36:212-7. [PMID: 15046192 DOI: 10.1016/j.dld.2003.11.028] [Citation(s) in RCA: 61] [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: 12/11/2022]
Abstract
INTRODUCTION Gastric antral vascular ectasia is a rare but well-recognised cause of occult gastrointestinal bleeding. Various endoscopic treatments have been tried in this condition. We report our experience with argon plasma coagulation in the treatment of gastric antral vascular ectasia. PATIENTS AND METHODS Twelve patients with endoscopically proved gastric antral vascular ectasia were included. All patients received argon plasma coagulation with power of 40 W at a median interval of 4 weeks. The pre-treatment haemoglobin and transfusion requirements were compared with the post-treatment values. RESULTS There was a sustained increase in mean haemoglobin levels post-treatment. The mean haemoglobin levels pre- and post-treatment were 8.13 +/- 0.70 and 12.2 +/- 0.32 g/dl, respectively (P = 0.008). All patients were anaemic and 58.3% of the patients were transfusion dependent. The mean number of units of blood transfusion in the period 6 months prior to treatment was 11.3 +/- 5.68. Following argon plasma coagulation, the number of transfusions decreased significantly to 1.1 +/- 0.57 units (P = 0.018). No significant procedure-related complications were identified. CONCLUSION Argon plasma coagulation is a safe and effective alternative to the currently available endoscopic modalities of treatment for gastric antral vascular ectasia.
Collapse
Affiliation(s)
- S Sebastian
- Department of Gastroenterology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
| | | | | | | | | |
Collapse
|
6
|
Affiliation(s)
- R McLoughlin
- Department of Gastroenterology, Adelaide and Meath Hospitals, Dublin, Ireland.
| | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
BACKGROUND Seven-day proton pump inhibitor triple therapy is currently the treatment of choice for Helicobacter pylori infection. It is unclear whether triple therapy for less than 7 days might preserve efficacy while at the same time improving patient acceptability and compliance. AIM To evaluate the Helicobactericidal efficacy, ulcer healing capacity and patient acceptability of a 5-day lansoprazole-based triple therapy regimen. METHODS Sixty-nine consecutive patients with H. pylori-positive peptic ulcer received lansoprazole 30 mg twice daily in combination with metronidazole 400 mg twice daily and clarithromycin 250 mg twice daily for 5 days. Ulcer healing medication was not continued after the 5-day regimen. H. pylori status was assessed before and at least 4 weeks after therapy by rapid urease test and histology. Adverse events and compliance were assessed by direct questioning. RESULTS All 69 patients attended for repeat endoscopy and 63 were H. pylori-negative after therapy giving a cure rate of 91%, (95%, Cl: 85-98%). Of the 59 patients with active ulcers, 58 were healed at repeat endoscopy giving an ulcer healing rate of 98% (95% Cl: 92-100%). All patients fully complied with therapy and mild adverse events, mainly gastrointestinal, were reported by 11 patients (16%). CONCLUSIONS Five-day lansoprazole triple therapy is an effective regimen for H. pylori infection which combines a high cure rate and ulcer healing efficacy with the advantages of excellent patient acceptability and compliance.
Collapse
Affiliation(s)
- H J O'Connor
- Department of Medicine, General Hospital, Tullamore, Co. Offaly, Ireland
| | | | | | | | | |
Collapse
|
8
|
McLoughlin R, McQuillan R. Transdermal fentanyl and respiratory depression. Palliat Med 1997; 11:419. [PMID: 9472602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
9
|
McLoughlin R, McQuillan R. Using nifedipine to treat tenesmus. Palliat Med 1997; 11:419-20. [PMID: 9472603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
10
|
McLoughlin R. EN wins victory over right to nurse in Ireland. Interview by Dina Leifer. Nurs Stand 1996; 11:14. [PMID: 8945296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
11
|
McLoughlin R. An EN by any other name.... Interview by Dina Leifer. Nurs Stand 1995; 9:17. [PMID: 7669602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
12
|
Abstract
This report compares the presentations and outcome of pneumothorax in 11 patients aged over 65 with 15 patients aged 20-35 years. Information was retrospectively collected from the charts regarding modes of presentation and the course of the illness. A questionnaire was sent to the general practitioners of the older group asking about the long-term outcome relating to functional status. Older patients were more likely than younger to present primarily with dyspnoea. The classical symptom of acute onset of pleuritic chest pain was present in ten of the 15 younger patients but in only two of the older patients. There were also statistically significant associations of the elderly patients with the following: radiological evidence of pre-existing lung disease; absence of pleuritic chest pain on admission; atypical or absent pain; a major delay from symptom onset to presentation; the diagnosis being clinically missed prior to chest radiography; and prolonged hospitalization. Nine of the 11 elderly patients were eventually independent at home.
Collapse
Affiliation(s)
- R Liston
- Department of Medicine for the Elderly, Limerick Regional Hospital, Dooradoyle, Ireland
| | | | | |
Collapse
|
13
|
|
14
|
McLoughlin R, O'Leary G, Fitzgerald LP, O'Donnell JA. The effect of distal anastomotic site on PTFE graft patency in lower extremity bypass. Eur J Vasc Surg 1989; 3:417-9. [PMID: 2806572 DOI: 10.1016/s0950-821x(89)80048-9] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The site of distal anastomosis of polytetrafluorethylene (PTFE) lower extremity bypass grafts may significantly affect results. We examined patency in 144 cases; 45 femoro-popliteal above knee (AK), 55 femoro-popliteal below the knee (BK) and 44 femoro-distal (D) PTFE bypasses, the groups being comparable with regard to other risk factors studied. Cumulative graft patency at 3 years was 71.3% for AK, 36.7% for BK, 16.4% for D and overall 35%. The site of distal anastomosis is an important determinant, of PTFE lower extremity bypass patency. We have abandoned the use of PTFE for BK and D, but feel that AK PTFE is a suitable alternative to autogenous reversed saphenous vein.
Collapse
Affiliation(s)
- R McLoughlin
- Department of Surgery, University College Cork, Regional Hospital, Wilton, Ireland
| | | | | | | |
Collapse
|
15
|
O'Beirne J, McLoughlin R, Dowling F, Fogarty E, Regan B. Slipped upper femoral epiphysis: internal fixation using single central pins. J Pediatr Orthop 1989; 9:304-7. [PMID: 2723049] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Eighteen patients with slipped upper femoral epiphyses were treated by internal fixation using single pins in the centre of the femoral head. In 15 patients, prophylactic pinning of the unaffected side was performed; therefore, 33 hips were pinned. Results were encouraging in that no slip progressed following fixation, no pins broke, and no late reslips occurred. The optimum position for a pin is in the centre of the femoral head, with subsequent pins in suboptimal sites. The method of single pinning is simple and, theoretically, minimizes the risk of joint penetration.
Collapse
Affiliation(s)
- J O'Beirne
- Department of Orthopaedics, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Republic of Ireland
| | | | | | | | | |
Collapse
|
16
|
McLoughlin R, Geally P, Monaghan H, O’Connell E, Cullen S, Blake NS, Ward OC, Stewart M, Savage JM, Scott MJ, Puri P, O’Donnell B, Stewart RJ, Boston VB, Glasgow J, Thomas P, Sweeney L, Parks TGP, Dodge J, Hoey H, Loftus E, Farrell F, McAlcon J, Moneypenny B, Carson D, Naughton E, Kiely B, Saul I, Thornton PS, Donoghue V, Buckley I, Bourke A, Walshe M, Murphy JF, Lowery M, Lillis D, Fitzsimons R, Kearney P, McKieman J, Cole M, Fox G, Matthews T, Devlin J, Leahy F, McClean P, Dodge JA, Akhtar T, Roghain MTF, Ahmed A, Bergin A, Gill D, Carson JWK, Gleeson JGA, Price JF, Bell AH, McClure G, McCullagh PJ, Halliday HL, Hicks EM, Geraghty M, King M, Farrell M, Murphy F, Quinn MW, Hayward R, Grant N, McMenamin J, O’Brien P, Denham B, Wilson DC, Carson DJ, Quinn RJM, Murphy E, Heame R, O’Sullivan BJ, Murphy A, Rabie I, McShane D, Ward D, King M, Harte C, Connolly K, Carr C. Irish Paediatric Association. Ir J Med Sci 1989. [DOI: 10.1007/bf02942014] [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: 10/21/2022]
|
17
|
|
18
|
|