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1.
J Fish Biol ; 84(1): 263-6, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24354922

ABSTRACT

A population of African tigerfish Hydrocynus vittatus from the Schroda Dam, actively prey on barn swallows Hirundo rustica in flight. This behaviour was discovered during a radio telemetry study and documented using a motion picture video camera. These results show that an avivorous diet is a part of the feeding biology of H. vittatus, and may occur in other populations.


Subject(s)
Characiformes/physiology , Predatory Behavior , Animals , Flight, Animal , South Africa , Swallows , Telemetry , Video Recording
2.
Ir J Med Sci ; 181(3): 381-3, 2012 Sep.
Article in English | MEDLINE | ID: mdl-20333480

ABSTRACT

INTRODUCTION: The repair of thoracic aortic pathology by open techniques is associated with high morbidity and mortality. METHODS: We describe the first case of hybrid thoracic aortic repair performed in Ireland for a symptomatic thoracic intramural haematoma. CONCLUSION: Hybrid repair with extra-anatomical aortic visceral revascularisation and subsequent thoracic endograft exclusion offers an attractive alternative method of repair for thoracic aortic pathology.


Subject(s)
Aorta, Thoracic/surgery , Aortic Diseases/surgery , Hematoma/surgery , Aged , Female , Humans , Polyethylene Terephthalates , Vascular Grafting
3.
Ir J Med Sci ; 180(2): 553-5, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21365317

ABSTRACT

BACKGROUND: Delayed presentation of splenic trauma is a well described entity. METHOD: We report two patients who presented with splenic abnormality found incidentally on imaging for other medical problems. A remote history of splenic trauma was elicited during clinical evaluation; 18 months in one patient and 11 years in the second patient. Both patients underwent surgical exploration. CONCLUSIONS: Radiological investigations could not reassure us that the splenic abnormalities were benign, and their management was the subject of some debate.


Subject(s)
Rib Fractures/complications , Ribs/injuries , Splenic Diseases/diagnosis , Splenic Diseases/etiology , Adult , Cysts/etiology , Diagnosis, Differential , Female , Hematoma/etiology , Humans , Middle Aged , Splenic Diseases/surgery , Time Factors
4.
Vasc Health Risk Manag ; 7: 15-21, 2011 Jan 07.
Article in English | MEDLINE | ID: mdl-21339909

ABSTRACT

OBJECTIVE: To examine the current medical management of arteriopathic patients attending a vascular surgical service at a university teaching hospital over a 6-month period. The prescribing of antiplatelets, statins, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers and beta-blockers was specifically examined. Vascular patients are often under the care of multiple specialties, and therefore the influence of different medical specialties on the patients' medical management was also examined. DESIGN: Between January and June 2009, data were recorded on sequential patients with arterial disease attending the vascular surgical service. Patients' demographics, type of arterial disease, medical consultations within the previous 12 months, and current medications were recorded. RESULTS: The study included 180 patients with a mean age of 69 years (39-88 years). All but 4% were taking an antiplatelet or anticoagulant, predominantly aspirin. There were 86% taking a statin, 44% taking a beta-blocker, and 51% taking an ACE inhibitor. Suboptimal prescription of ACE inhibitors and beta-blockers was evident regardless of the type of medical consultations in the previous year. No specialty group differed significantly from vascular surgeons in their prescribing pattern. CONCLUSIONS: While almost all arteriopaths receive some form of antiplatelet and statin in line with clinical evidence, ACE inhibitors and beta-blockers appear to be under-prescribed in this arteriopathic population. We conclude that opportunity exists for vascular surgeons to embrace recent guidelines and lead the way in both surgical and medical optimization of arteriopathic patients through improving links with primary care physicians or taking greater responsibility themselves for the medical as well as the surgical care of their arteriopathic patients.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Cardiovascular Agents/therapeutic use , Peripheral Arterial Disease/drug therapy , Practice Patterns, Physicians' , Adrenergic beta-Antagonists/therapeutic use , Adult , Aged , Aged, 80 and over , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Cardiovascular Agents/adverse effects , Drug Therapy, Combination , Drug Utilization , Female , Guideline Adherence , Hospitals, University , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Ireland , Male , Middle Aged , Outpatient Clinics, Hospital , Peripheral Arterial Disease/surgery , Platelet Aggregation Inhibitors/therapeutic use , Practice Guidelines as Topic , Practice Patterns, Physicians'/statistics & numerical data , Prospective Studies , Referral and Consultation , Vascular Surgical Procedures
5.
Ir J Med Sci ; 177(4): 385-7, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18820990

ABSTRACT

In automobile accidents, the "seatbelt syndrome" (SBS) consists of a constellation of injuries, predominantly involving thoraco-lumbar vertebral fractures and intraabdominal organ injury. A recent amendment to Irish legislation has made the wearing of seatbelts mandatory for all rear seated passengers in an effort to protect children. Whilst rear seatbelts result in a significant reduction in morbidity and mortality following road traffic accidents (RTA), we present a case in which the rear lap seatbelt caused severe abdominal injuries. It is evident that the current rear seat lapbelt system is an inferior design associated with a significant morbidity and mortality when compared to three-point harness system and consideration should be given to replacing them in all motor vehicles.


Subject(s)
Abdominal Injuries/etiology , Accidents, Traffic , Automobiles , Pelvis , Safety , Seat Belts/adverse effects , Abdominal Injuries/diagnosis , Abdominal Injuries/surgery , Anastomosis, Surgical , Colon, Sigmoid/injuries , Colon, Sigmoid/surgery , Humans , Injury Severity Score , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Jejunum/injuries , Jejunum/surgery , Syndrome
6.
Surgeon ; 5(6): 368-70, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18080612

ABSTRACT

Presentations of acute appendicitis represent an ongoing challenge to surgeons. This case of retrocaecal perforated appendicitis presented clinically as a right lumbar abscess, with the concomitant new diagnosis of type 2 diabetes mellitus in a 66-year-old male. This case emphasises the importance of an abdominal CT scan in any patient presenting with unusual sepsis near the abdomen.


Subject(s)
Abscess/diagnosis , Appendicitis/diagnosis , Abscess/diagnostic imaging , Aged , Appendicitis/diagnostic imaging , Cellulitis/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Diagnosis, Differential , Emphysema/diagnosis , Fat Necrosis/diagnosis , Humans , Lumbosacral Region , Male , Tomography, X-Ray Computed
7.
Ir J Med Sci ; 176(2): 125-8, 2007.
Article in English | MEDLINE | ID: mdl-17516131

ABSTRACT

BACKGROUND: Acute appendicitis is common in older patients, however, the presentation may differ from the younger population and it is often complicated by coexistent disease and delays in presentation. AIMS: This case report describes an unusual presentation of acute appendicitis in an elderly patient and also demonstrates a unique anatomical pathway of disease extension. In addition, this case report highlights the advantages of CT in preoperative evaluation and subsequent management of these protean presentations of acute appendicitis. METHODS: This report describes a case of an asymptomatic retrocaecal perforated appendicitis which presented clinically as a right lumbar abscess with surrounding cellulitis, and was further complicated by a concomitant new diagnosis of type 2 diabetes mellitus in a 66-year-old male. CONCLUSION: Elderly or immunocompromised patients presenting with cellulitis or a cutaneous abscess of the abdominal wall or lumbar region may benefit from an abdominal CT to demonstrate an intraperitoneal source of sepsis.


Subject(s)
Abscess/diagnosis , Appendicitis/diagnosis , Abscess/diagnostic imaging , Aged , Appendicitis/diagnostic imaging , Cellulitis/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Diagnosis, Differential , Emphysema/diagnosis , Fat Necrosis/diagnosis , Humans , Lumbosacral Region , Male , Tomography, X-Ray Computed
8.
Ir J Med Sci ; 175(1): 10-4, 2006.
Article in English | MEDLINE | ID: mdl-16615221

ABSTRACT

BACKGROUND: Recombinant interleukin-2(rIL-2) therapy in metastatic melanoma is limited by toxicities, particularly vascular leak syndrome(VLS). Taurolidine potentiates the anti-neoplastic effects of IL-2 while reducing its associated endothelial cell dysfunction in experimental settings. We hypothesized that co-administration of rIL-2 with taurolidine could enhance tolerability without weakening effectiveness. METHODS: Eleven patients with progressive metastatic melanoma received high-dose rIL-2 with co-infusion of taurolidine. Patients were monitored for the development of toxicities and evidence of response. RESULTS: Ten patients tolerated twenty-nine courses of high-dose rIL-2 without dose-reduction. Most toxicities were low-grade. No patient developed VLS. Seven patients died from disease progression. Two had complete clinical and radiological responses to treatment. Two patients remain alive despite evidence of disease progression a mean of 17.5 months after diagnosing metastatic disease. CONCLUSION: Co-administration of taurolidine with high-dose rIL-2 in stage IV melanoma patients appears to greatly enhance the tolerability of this regime without diminishing its therapeutic value.


Subject(s)
Interleukin-2/therapeutic use , Melanoma/drug therapy , Skin Neoplasms/drug therapy , Skin Neoplasms/secondary , Taurine/analogs & derivatives , Thiadiazines/therapeutic use , Adult , Drug Combinations , Female , Humans , Immunotherapy , Ireland , Male , Melanoma/secondary , Middle Aged , Taurine/therapeutic use
10.
J Orthop Res ; 23(6): 1454-9, 2005 Nov.
Article in English | MEDLINE | ID: mdl-15994053

ABSTRACT

Activated protein C (APC) is an endogenous anti-coagulant with anti-inflammatory properties. The purpose of the present study was to evaluate the effects of activated protein C in the setting of skeletal muscle ischaemia reperfusion injury (IRI). IRI was induced in rats by applying rubber bands above the levels of the greater trochanters bilaterally for a period of 2h followed by 12h reperfusion. Treatment groups received either equal volumes of normal saline or activated protein C prior to tourniquet release. Following 12h reperfusion, muscle function was assessed electrophysiologically by electrical field stimulation. The animals were then sacrificed and skeletal muscle harvested for evaluation. Activated protein C significantly attenuated skeletal muscle reperfusion injury as shown by reduced myeloperoxidase content, wet to dry ratio and electrical properties of skeletal muscle. Further in vitro work was carried out on neutrophils isolated from healthy volunteers to determine the direct effect of APC on neutrophil function. The effects of APC on TNF-alpha stimulated neutrophils were examined by measuring CD18 expression as well as reactive oxygen species generation. The in vitro work demonstrated a reduction in CD18 expression and reactive oxygen species generation. We conclude that activated protein C may have a protective role in the setting of skeletal muscle ischaemia reperfusion injury and that this is in part mediated by a direct inhibitory effect on neutrophil activation.


Subject(s)
Muscle, Skeletal/blood supply , Protein C/therapeutic use , Reperfusion Injury/prevention & control , Acute Disease , Animals , CD18 Antigens/analysis , Humans , Male , Neutrophil Infiltration/drug effects , Neutrophils/drug effects , Neutrophils/metabolism , Rats , Rats, Sprague-Dawley , Reactive Oxygen Species/metabolism , Tumor Necrosis Factor-alpha/pharmacology
11.
Ir J Med Sci ; 170(2): 100-2, 2001.
Article in English | MEDLINE | ID: mdl-11491042

ABSTRACT

BACKGROUND: Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. AIMS: To establish clear guidelines for management of paediatric FB ingestion. METHODS: A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. RESULTS: Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. CONCLUSION: Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.


Subject(s)
Digestive System , Foreign Bodies/therapy , Adolescent , Child , Child, Preschool , Female , Foreign Bodies/epidemiology , Foreign Bodies/etiology , Humans , Infant , Male , Retrospective Studies
12.
Anaesthesia ; 49(9): 826-7, 1994 Sep.
Article in English | MEDLINE | ID: mdl-7978151
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