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1. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: 'AbSeS', a multinational observational cohort study and ESICM Trials Group Project

Author

Blot, S. Antonelli, M. Arvaniti, K. Blot, K. Creagh-Brown, B. de Lange, D. De Waele, J. Deschepper, M. Dikmen, Y. Dimopoulos, G. Eckmann, C. Francois, G. Girardis, M. Koulenti, D. Labeau, S. Lipman, J. Lipovestky, F. Maseda, E. Montravers, P. Mikstacki, A. Paiva, J.-A. Pereyra, C. Rello, J. Timsit, J.-F. Vogelaers, D. Lamrous, A. Rezende-Neto, J. Cardenas, Y. Vymazal, T. Fjeldsoee-Nielsen, H. Kott, M. Kostoula, A. Javeri, Y. Einav, S. Makikado, L.D.U. Tomescu, D. Gritsan, A. Jovanovic, B. Venkatesan, K. Mirkovic, T. Creagh-Brown, B. Lamrous, A. Emmerich, M. Canale, M. Dietz, L.S. Ilutovich, S. Miñope, J.T.S. Silva, R.B. Montenegro, M.A. Martin, P. Saul, P. Chediack, V. Sutton, G. Couce, R. Balasini, C. Gonzalez, S. Lascar, F.M. Descotte, E.J. Gumiela, N.S. Pino, C.A. Cesio, C. Valgolio, E. Cunto, E. Dominguez, C. Nelson, N.F. Abegao, E.M. Pozo, N.C. Bianchi, L. Correger, E. Pastorino, M.L. Miyazaki, E.A. Pozo, N.C. Grubissich, N. Garcia, M. Bonetto, N. Quevedo, N.E. Gomez, C.D. Queti, F. Estevarena, L.G. Fernandez, R. Santolaya, I. Pozo, N.C. Grangeat, S.H. Doglia, J. Zakalik, G. Pellegrini, C. Lloria, M.M. Chacon, M.E. Fumale, M. Leguizamon, M. Hidalgo, I.B. Tiranti, R.J. Capponi, P. Tita, A. Cardonnet, L. Bettini, L. Ramos, A. Lovesio, L. Miranda, E.M. Farfan, A.B. Tolosa, C. Segura, L. Bellocchio, A. Alvarez, B. Manzur, A. Lujan, R. Fernandez, N. Scarone, N. Zazu, A. Groh, C. Fletcher, J. Smith, J. Azad, R. Chavan, N. Wong, H. Kol, M. Campbell, L. Starr, T. Roberts, B. Wibrow, B. Warhurst, T. Chinthamuneedi, M. Ferney, B.B. Simon, M. De Backer, D. Wittebole, X. De Bels, D. Collin, V. Dams, K. Jorens, P. Dubois, J. Gunst, J. Haentjens, L. De Schryver, N. Dugernier, T. Rezende-Neto, J. Rizoli, S. Santillan, P. Han, Y. Biskup, E. Qu, C. Li, X. Yu, T. Weihua, L. Molano-Franco, D. Rojas, J. Oviedo, J.M.P. Pinilla, D. Cardenas, Y. Celis, E. Arias, M. Vukovic, A. Vudrag, M. Belavic, M. Zunic, J. Kuharic, J. Kricka, I.B. Filipovic-Grcic, I. Tomasevic, B. Obraz, M. Bodulica, B. Dohnal, M. Malaska, J. Kratochvil, M. Satinsky, I. Schwarz, P. Kos, Z. Blahut, L. Maca, J. Protus, M. Kieslichová, E. Nielsen, L.G. Krogh, B.M. Rivadeneira, F. Morales, F. Mora, J. Orozco, A.S. MorochoTutillo, D.R. Vargas, N.R. Yepez, E.S. Villamagua, B. Alsisi, A. Fahmy, A. Dupont, H. Lasocki, S. Paugam-Burtz, C. Foucrier, A. Nica, A. Barjon, G. Mallat, J. Marcotte, G. Leone, M. Duclos, G. Burtin, P. Atchade, E. Mahjoub, Y. Misset, B. Timsit, J.-F. Dupuis, C. Veber, B. Debarre, M. Collange, O. Pottecher, J. Hecketsweiler, S. Fromentin, M. Tesnière, A. Koch, C. Sander, M. Kott, M. Elke, G. Wrigge, H. Simon, P. Chalkiadaki, A. Tzanidakis, C. Pneumatikos, I. Sertaridou, E. Mastora, Z. Pantazopoulos, I. Papanikolaou, M. Papavasilopoulou, T. Floros, J. Kolonia, V. Diakaki, C. Rallis, M. Paridou, A. Kalogeromitros, A. Romanou, V. Nikolaou, C. Kounougeri, K. Tsigou, E. Psallida, V. Karampela, N. Mandragos, K. Kontoudaki, E. Pentheroudaki, A. Farazi-Chongouki, C. Karakosta, A. Chouris, I. Radu, V. Malliotakis, P. Kokkini, S. Charalambous, E. Kyritsi, A. Koulouras, V. Papathanakos, G. Nagky, E. Lampiri, C. Tsimpoukas, F. Sarakatsanos, I. Georgakopoulos, P. Ravani, I. Prekates, A. Sakellaridis, K. Christopoulos, C. Vrettou, E. Stokkos, K. Pentari, A. Marmanidou, K. Kydona, C. Tsoumaropoulos, G. Bitzani, M. Kontou, P. Voudouris, A. Elli-Nikki Flioni Antypa, E. Chasou, E. Anisoglou, S. Papageorgiou, E. Paraforou, T. Tsioka, A. Karathanou, A. Vakalos, A. Shah, B. Thakkar, C. Jain, N. Gurjar, M. Baronia, A. Sathe, P. Kulkarni, S. Paul, C. Paul, J. Masjedi, M. Nikandish, R. Zand, F. Sabetian, G. Mahmoodpoor, A. Hashemian, S.M. Bala, M. Flocco, R. Torrente, S. Pota, V. Spadaro, S. Volta, C. Serafini, G. Boraso, S. Tiberio, I. Cortegiani, A. Misseri, G. Barbagallo, M. Nicolotti, D. Forfori, F. Corradi, F. De Pascale, G. Pelagalli, L. Brazzi, L. Vittone, F.G. Russo, A. Simion, D. Cotoia, A. Cinnella, G. Toppin, P. Johnson-Jackson, R. Hayashi, Y. Yamamoto, R. Yasuda, H. Kishihara, Y. Shiotsuka, J. Sanchez-Hurtado, L.A. Tejeda-Huezo, B. Gorordo, L. Ñamendys-Silva, S.A. Garcia-Guillen, F.J. Martinez, M. Romero-Meja, E. Colorado-Dominguez, E. van den Oever, H. Kalff, K.M. Vermeijden, W. Cornet, A.D. Beck, O. Cimic, N. Dormans, T. Bormans, L. Bakker, J. Van Duijn, D. Bosman, G. Vos, P. Haas, L. Henein, A. Miranda, A.M. Makikado, L.D.U. Malca, G.E.G. Arroyo-Sanchez, A. Misiewska-Kaczur, A. Akinyi, F. Czuczwar, M. Luczak, K. Sulkowski, W. Tamowicz, B. Swit, B. Baranowski, B. Smuszkiewicz, P. Trojanowska, I. Rzymski, S. Sawinski, M. Trosiak, M. Mikaszewska-Sokolewicz, M. Alves, R. Leal, D. Krystopchuk, A. Mendonca, P.M.H. Pereira, R.A. de Carvalho, M.R.L.M. Candeias, C. Molinos, E. Ferreira, A. Castro, G. Pereira, J.-M. Santos, L. Ferreira, A. Pascoalinho, D. Ribeiro, R. Domingos, G. Gomes, P. Nora, D. Costa, R.P. Santos, A. Alsheikhly, A.S. Tomescu, D. Popescu, M. Grigoras, I. Patrascanu, E. Zabolotskikh, I. Musaeva, T. Gaigolnik, D. Kulabukhov, V. Belskiy, V. Zubareva, N. Tribulev, M. Abdelsalam, A. Aldarsani, A. Al-Khalid, M. Almekhlafi, G. Mandourah, Y. Jovanovic, B. Doklestic, K. Velickovic, J. Velickovic, D. Jankovic, R. Vukovic, A. Skoric-Jokic, S. Radovanovic, D. Richards, G. Alli, A. del Carmen Cordoba Nielfa, M. Iniesta, R.S. Martínez, A.B.-C. Bernedo, C.G. Gil, S.A.P. Nuvials, X. Garcia, J.G. Peña, J.M.G. Jimenez, R. Herrera, L. Barrachina, L.G. Monzon, I.C. Redondo, F.J. Villazala, R. Zapata, D.F.M. Lopez, I.M.V. Moreno-Gonzalez, G. Lopez-Delgado, J.C. Marin, J.S. Sanchez-Zamora, P. Vidal, M.V. González, J.F. Salinas, I. Hermosa, C. Martinez-Sagasti, F. Domingo-Marín, S. Victorino, J.A. Garcia-Alvarez, R. Calleja, P.L.-A. de la Torre-Prados, M.-V. Vidal-Cortes, P. del Río-Carbajo, L. Izura, J. Minguez, V. Alvarez, J.T. Prous, A.P. Paz, D. Roche-Campo, F. Aguilar, G. Belda, J. Rico-Feijoo, J. Aldecoa, C. Zalba-Etayo, B. Lang, M. Dullenkopf, A. Trongtrakul, K. Chtsomkasem, A. Akbas, T. Unal, M.N. Ozcelik, M. Gumus, A. Ramazanoglu, A. Memis, D. Mehmet, I. Urkmez, S. Ozgultekin, A. Demirkiran, O. Aslan, N.A. Kizilaslan, D. Kahveci, F. Ünlü, N. Ozkan, Z. Kaye, C. Jansen, J. O’Neill, O. Nutt, C. Jha, R. Hooker, N. Grecu, I. Petridou, C. Shyamsundar, M. McNamee, L. Trinder, J. Hagan, S. Kelly, C. Silversides, J. Groba, C.B. Boyd, O. Bhowmick, K. Humphreys, S. Summers, C. Polgarova, P. Margarson, M. Dickens, J. Pearson, S. Chinery, E. Hemmings, N. O’Kane, S. Austin, P. Cole, S. Plowright, C. Box, R. Wright, C. Young, L. Montague, L. Parker, R. Morton, B. Ostermann, M. Bilinska, J. Rose, B.O. Reece-Anthony, R. Ryan, C. Hamilton, M. Hopkins, P. Wendon, J. Brescia, G. Ijaz, N. Wood, J. George, M. Toth-Tarsoly, P. Yates, B. Armstrong, M. Scott, C. Boyd, C. Szakmany, T. Rees, D. Pulak, P. Coggon, M. Saha, B. Kent, L. Gibson, B. Camsooksai, J. Reschreiter, H. Morgan, P. Sangaralingham, S. Lowe, A. Vondras, P. Jamadarkhana, S. Cruz, C. Bhandary, R. Hersey, P. Furneval, J. Innes, R. Doble, P. Attwood, B. Parsons, P. Page, V. Zhao, X. Grecu, I. Dalton, J. Hegazy, M. Awad, Y. Naylor, D. Naylor, A. Lee, S. Brevard, S. Davis, N. the Abdominal Sepsis Study (AbSeS) group on behalf of the Trials Group of the European Society of Intensive Care Medicine

Abstract

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection. © 2019, The Author(s).

Published
2019

2. Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence-based treatment options

Author

T. Creagh, C. M. Brady, and Niall F. Davis

Subjects
medicine.medical_specialty, Evidence-Based Medicine, Evidence-based practice, business.industry, Incidence (epidemiology), Cystitis, Interstitial, Obstetrics and Gynecology, Interstitial cystitis, medicine.disease, Pathophysiology, Surgery, Reproductive Medicine, Quality of life, Internal medicine, Epidemiology, Cohort, medicine, Humans, Adverse effect, business
Abstract

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic debilitating condition that can have a severely negative impact on a patient's quality of life. Its prevalence ranges from 52 to 500/100,000 in females compared to 8-41/100,000 in males, and its incidence is increasing globally. Treatment algorithms are sub-classified into behavioural, pharmacological, intravesical, interventional and surgical therapies. Short-term (i.e.

Published
2014
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3. Outcomes after urinary diversion for benign disease

Author

J. Forde, T. Creagh, M. Broe, T. Murray, M. Hegazy, and P. Ryan

Subjects
medicine.medical_specialty, Benign disease, business.industry, medicine.medical_treatment, Urinary diversion, Urology, medicine, Surgery, General Medicine, business
Published
2018
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4. Experience with Intradetrusor Injection of Botulinum-A Toxin for the Treatment of Idiopathic Detrusor Overactivity in a Single Irish Institution

Author

P. Redmond, K. Siddiqui, T. Creagh, and Rustom P. Manecksha

Subjects
medicine.medical_specialty, Botulinum a toxin, Oncology, Reproductive Medicine, business.industry, Urology, medicine, business, complex mixtures, Botulinum toxin, medicine.drug
Abstract

Background: Intradetrusor botulinum toxin (BTX) therapy has been shown to be effective in treating neurogenic detrusor overactivity. Recently, BTX has been extended to patients with

Published
2008
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5. Design and Performance of Inkjet Print Heads for Non-Graphic-Arts Applications

Author

Marlene Mcdonald and Linda T. Creagh

Subjects
Multimedia, business.industry, Condensed Matter Physics, computer.software_genre, The arts, Graphic arts, Energy materials, Dependability, General Materials Science, Digital printing, Physical and Theoretical Chemistry, Graphics, business, computer, Digitization, Inkjet printing
Abstract

Inkjet print heads have become the dominant printing element for home and office printers; they have been a key driver forthe digitization of wide-format graphic arts printing and other printing areas as diverse as addressing and carton coding. In the past few years, inkjet print heads have begun to have an impact in areas outside the graphics arts. In these applications, the inkjet print head may be considered a manufacturing tool; this implies that it will differ in design depending on the application. Also, standards forreliability, consistency, and dependability will differ from those in graphic arts areas. Even though non-graphic-arts applications differ widely in their details, there are general considerations in terms of the systems that are required. Each nontraditional application has specific goals for manufacturing, and a unique inkjet print head designed to meet these goals may be required. This article focuses on a specific piezo-based inkjet print head that has been engineered to meet the manufacturing requirements for flat-panel displays basedon light-emitting polymeric materials.

Published
2003
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6. Human Immunodeficiency Virus Type 1 RNA Level and CD4 Count as Prognostic Markers and Surrogate End Points: A Meta-Analysis

Author

Schlomo Staszewski, Donna Mildvan, Julio S. G. Montaner, Heather R. Ribaudo, Robert T. Schooley, Raphael Dolin, Margaret A. Fischl, Camlin Tierney, John D. Hamilton, T. Creagh, Sunyoung Kim, M. Seligmann, Michael J. Daniels, Anastasios A. Tsiatis, David A. Cooper, David Katzenstein, Janet Darbyshire, Joseph J. Eron, Michael S. Saag, Abdel Babiker, James D. Neaton, A. Cross, Gary Collins, Christine Katlama, M. D. Hughes, Victor DeGruttola, Louis D. Saravolatz, Seth L. Welles, William A. O'Brien, Robert W. Coombs, Douglas D. Richman, Keith Henry, A. Breckenridge, Miklos Salgo, Pamela M. Hartigan, John Bartlett, Andrew M. Hill, Mark D. Moore, James G. Kahn, R.A. DeMasi, L. Struthers, Grossberg Se, Michael Hughes, D. Dawson, and Scott M. Hammer

Subjects
Univariate analysis, medicine.medical_specialty, Multivariate analysis, business.industry, Immunology, Hazard ratio, Area under the curve, RNA, Lamivudine, Gastroenterology, Confidence interval, law.invention, Infectious Diseases, Randomized controlled trial, law, Virology, Internal medicine, medicine, business, medicine.drug
Abstract

Objective: To evaluate treatment-mediated changes in HIV-1 RNA and CD3 count as prognostic markers and surrogate end points for disease progression (AIDS/death). Methods: Data from 13,045 subjects in all 16 randomized trials comparing nucleoside analogue reverse transcriptase inhibitors and having HIV-1 RNA measurements at 24 weeks were obtained. A total of 3146 subjects had HIV-1 RNA and CD3 count determinations at 24 weeks after starting treatment. Results: At Week 24, the percentage of subjects experiencing an HIV-1 RNA decrease of >1 log(10) copies/ml or a CD4 count increase of >33% was similar (22% vs 25%). Changes in both markers at Week 24 mere significant independent predictors of AIDS/death: across trials, the average reduction in hazard was 51% per 1 log(10) HIV-1 RNA copies/ml decrease (95% confidence interval: 41%, 59%) and 20% per 33% CD4 count increase (17%, 24%). In univariate analyses, the hazard ratio for AIDS/death in randomized treatment comparisons was significantly associated with differences between treatments in mean area under the curve of HIV-1 RNA changes to Weeks 8 and 24 (AUCMB) and mean CD3 change at Week 24, but, in multivariate analysis, only mean CD4 change was significant. Conclusions: Change in HIV-1 RNA, particularly using AUCMB, and in CD4 count should be measured to aid patient management and evaluation of treatment activity in clinical trials. However, short-term changes in these markers are imperfect as surrogate end points for long-term clinical outcome because two randomized treatment comparisons may show similar differences between treatments in marker changes but not similar differences in progression to AIDS/death.

Published
2000
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7. A rare case of recurrent urachal adenocarcinoma of the bladder

Author

J F, Sullivan, D M, Fanning, I, Cheema, and T, Creagh

Subjects
Adult, Diagnostic Imaging, Urinary Bladder Neoplasms, Humans, Female, Neoplasm Invasiveness, Adenocarcinoma, Neoplasm Recurrence, Local, Pelvic Exenteration
Abstract

Urachal carcinoma is a rare, aggressive malignancy accounting for less than 1% of bladder neoplasms. These tumours are usually adenocarcinomas and occur at the dome or anterior wall of the bladder. They often escape early clinical detection, growing for prolonged periods prior to diagnosis, resulting in local invasion and systemic spread before therapeutic intervention is initiated. We present the case of a recurrent urachal carcinoma in a young female.

Published
2013

8. Injectable biomaterials for the treatment of stress urinary incontinence: their potential and pitfalls as urethral bulking agents

Author

T. Creagh, F. Kheradmand, and Niall F. Davis

Subjects
medicine.medical_specialty, Bovine collagen, Biocompatibility, business.industry, Urology, Open surgery, Urinary Incontinence, Stress, Obstetrics and Gynecology, Treatment options, Biomaterial, Urinary incontinence, Biocompatible Materials, English language, Surgical procedures, Surgery, Biomechanical Phenomena, Injections, Treatment Outcome, Urethra, Medicine, Humans, Collagen, medicine.symptom, business
Abstract

Injectable urethral bulking agents composed of synthetic and biological biomaterials are minimally invasive treatment options for stress urinary incontinence (SUI). The development of an ideal urethral bulking agent remains challenging because of clinical concerns over biocompatibility and durability. Herein, the mechanical and biological features of injectable urethral biomaterials are investigated, with particular emphasis on their future potential as primary and secondary treatment options for SUI. A literature search for English language publications using the two online databases was performed. Keywords included “stress urinary incontinence”, “urethral bulking agent” and “injectable biomaterial”. A total of 98 articles were analysed, of which 45 were suitable for review based on clinical relevance and importance of content. Injectable biomaterials are associated with a lower cure rate and fewer postoperative complications than open surgery for SUI. They are frequently reserved as secondary treatment options for patients unwilling or medically unfit to undergo surgery. Glutaraldehyde cross-linked bovine collagen remains the most commonly injected biomaterial and has a cure rate of up to 53 %. Important clinical features of an injectable biomaterial are durability, biocompatibility and ease of administration, but achieving these requirements is challenging. In carefully selected patients, injectable biomaterials are feasible alternatives to open surgical procedures as primary and secondary treatment options for SUI. In future, higher cure rates may be feasible as researchers investigate alternative biomaterials and more targeted injection techniques for treating SUI.

Published
2012

9. Reconstruction for basal cell carcinoma in an anatomical region where the sun does not shine: an attractive option!

Author

T Creagh and P Lohana

Subjects
Male, Skin Neoplasms, business.industry, General Medicine, Anatomy, Middle Aged, Perianal region, medicine.disease, Surgical Flaps, Online Case Report, Carcinoma, Basal Cell, Soft tissue reconstruction, Medicine, Humans, Surgery, Basal cell carcinoma, business
Abstract

Basal cell carcinoma is one of the common skin malignancies but it is rarely found in sun-protected areas. The soft tissue reconstruction at the perianal region can be challenging and a variety of options are described in the literature. The keystone design perforator island flap is an excellent and attractive option for soft tissue reconstruction. We present a case of perianal basal cell carcinoma that was reconstructed with a unilateral keystone flap.

Published
2012

10. Sylvester O’halloran surgical scientific meeting

Author

F. Malone, Michael J. Duffy, W. A. Tanner, L. Young, Joseph Deasy, T. P. O≿dwyer, F. Flanagan, J. Drumm, R. G. Barclay, P. V. Delaney, J. McCarthy, Terry Boyle, J. A. Thornhill, T. M. Feeley, R. O≿donnel, S. Duggan, P. Sweeney, J. Callahan, G. M. Lennon, D. J. Hehir, J. M. O≿donoghue, F. Graham, H. S. Rogers, M. D. McCaigue, B. Strunz, O. Traynor, F. Jakoubek, H. Naama, P. R. O≿connell, S. J. Sheehan, H. Grimes, T. E. D. Mcdermott, I. Shuaib, M. Barry, Ivan Keogh, C. Campbell, Enda W. McDermott, P. Burke, R. O≿sullivan, Henry Paul Redmond, G. O. Sullivan, H. Mcloughlin, P. Horgan, P. A. Grace, T. Gorey, Seamus Morris, P. Broe, John Russell, M. A. Stokes, J. G. Johnston, Mary-Paula Colgan, M. I. Halliday, Q. Y. Ma, F. Loughnane, G. D. Magee, D. Kelly, J. Shou, Frank B. V. Keane, Jill J. F. Belch, F. Khan, D. O≿hanlon, T. Nyhan, A. Hennessy, P. W. Eustace, S. K. Al-Ghazal, H. F. Given, David Mulvin, P. J. Meagher, B. J. Rowlands, C. B. O. Suilleabhain, S. Baldota, J. Ennis, C. Waters, I. M. Halliday, M. D. Morasch, P. Madhavan, David Bouchier-Hayes, R. I. Holdsworth, M. Ahearne, H. Abdih, S. Dolan, P. Gillen, Alfred E. Wood, John M. Fitzpatrick, R. Vashisht, M. Akram, J. A. McKeever, D. Bouchier Hayes, C. J. Kelly, K. Stokes, P. Mohan, G. Mccluggage, John Hyland, T. Creagh, S. Reid, L. S. Young, C. Malone, N. Barrett, Hannah McGee, G. R. Campbell, R. B. Stephens, M.J. Kerin, Oliver J. McAnena, G. N. Collins, M. R. Butler, J. Dolan, T. Carroll, M. P. Brady, D. Waldron, Denis Evoy, A. R. Mundy, T. V. Keaveny, S. E. A. Attwood, M. Koppikar, P. Neary, Michael Walsh, P. Kent, K. S. Cross, W. D. B. Clements, B. Bulle, N. F. Couse, N. Williams, J. M. Fitzpatrick, C. O≿herlihy, D. Maher, M. C. Regan, J. K. Lyerly, John R. Kelly, B. Boyle, G. D. Shanik, K. F. McGeeney, Thomas F. Gorey, Conor Patrick Delaney, M. Durkan, Dermot J. Moore, J. H. Wang, Stewart R. Walsh, W. P. Joyce, R. Waldron, G. Lynch, R. Grainger, T. Smalley, C. A. O. Boyle, D. Mehigan, D. Mcavinchey, J. K. Collins, W. Norwood, J. A. O≿donnell, P. Mccarthy, J. Russell, N. H. Anderson, V. S. Donnelly, J. O≿donnell, P. M. Mercer, R. W. G. Watson, Peter T. McCollum, C. P. Delaney, S. Brown, J. Barrett, S. W. Macgowan, S. Kennedy, T. Hall, N. J. O≿higgins, D. M. O≿hanlon, D. Chin, Peter A. Stonebridge, M. Morrin, John M. Daly, J. Mccann, H. Gallagher, and J. Egan

Subjects
business.industry, Medicine, Art history, General Medicine, business
Published
1994
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11. Proceedings of meeting held November 6th & 7th, 1992 in the Sir Charles Parsons Theatre, University of Limerick

Author

Martin O'Connell, T. V. Keaveney, R. Hussain, J. T. Ennis, David Bouchier-Hayes, W. G. Humphreys, M. P. Brady, O. Traynor, W. Angerson, John G. Murray, D. T. Croke, A. O’Mahony, N. Barrett, M. S. Dudley, A. D. K. Hill, E. C. Coveney, Peter A. Dervan, J. Gerghty, R. G. Barclay, S. K. Al-Ghazal, J. Drumm, R. Alvi, A. Qureshi, P. B. Cotton, P. G. Horgan, P. Fitzgerald, B. O’Leary, I. Kelly, P. M. Mercer, C. Delaney, E. F. Mooney, B. Lane, T. Creagh, P. A. Grace, J. McCann, Y. Ellias, J. Reynolds, J Hyland, D. Breslin, R. O’Donnell, F. O. Cunningham, A. Murphy, J. Smith, Conor Patrick Delaney, J. Geraghty, John M. Fitzpatrick, R. Moloney, P. Keeling, N. Williams, J. A. O’Donnell, N. Brindley, A. Darzi, A. H. Anderson, J. Byrne, Thomas F. Gorey, I. Solomon, S. McDermott, W. Norwood, T. A. Creagh, W. O. Kirwan, J. C. McCarthy, R. G. K. Watson, D. J. Bouchier-Hayes, P. Puri, D. McAvinchey, D. A. Luke, G. L. Hill, W. Watson, S. Johnston, J. G. Geoghegan, K. Khan, C. I. Timon, T. Pembroke, Declan G. Murphy, A. M. Hetherton, M. Morrin, M. Kennedy, A. Hamdy, K. J. Cronin, Gerald C. O'Sullivan, Patrick Collins, P. V. Delaney, J. McCarthy, C. M. Reardon, Mary Leader, B. J. Rowlands, N. J. O’Higgins, P. M. Murchan, A. O’Donnell, P. Kent, R. W. G. Watson, S. Al-Ghazal, John V. Reynolds, H. Browne, Austin Leahy, T. N. Pappas, S. E. Refsum, C. J. Kelly, R. Samsunden, E. McGovern, P. Burke, M. Istarabadi, S. Monkhouse, T. P. Corrigan, A. Young, D. P. McShane, N. N. Williams, P. Irwin, N. Menzies-Gow, M. S. Branch, R. Rasheed, J. K. Collins, M. J. Murray, T. J. Egan, R. Surana, N. F. Couse, M. McKiernan, W. P. Joyce, M. A. Stokes, S. Syed, F. H. Khan, Mukhtar Ahmed, M. D. McCaigue, A. Bohan, J. Callaghan, K. Rasheed, S. T. O’Sullivan, W. A. Tanner, P. E. Burke, M. K. Kerin, M. J. Donnelly, G. K. Ninan, C. Hardiman, Frank Keeling, Henry Paul Redmond, P. P. A. Smyth, F. Khan, S. O’Domhnaill, D. Ramsbottom, Frank B. V. Keane, B. Clements, H. F. Given, L. Rehman, M. Dowling, A. Sarazen, E. J. Guiney, I. M. Halliday, D. Ryan, B. O’Donnell, G. Lynch, Elaine W. Kay, J. Hegarty, S. E. A. Attwood, Michael J. Kerin, J. Dolan, N. Stokes, T. F. Gorey, V. E. Boston, R. J. Fitzgerald, F. Malone, J. O’Neill, and M. Fitzgerald

Subjects
business.industry, Art history, Medicine, General Medicine, business
Published
1993
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13. Sixteenth sir peter freyer memorial lecture and surgical symposium September 13th & 14th, 1991 Session I

Author

J. Coulter, R. G. Molloy, K. T. Moran, R. Waldron, W. O. Kirwan, C. O’Suilleabhain, A. Horgan, K. Mealy, P. Burke, J. Hyland, A. F. Horgan, M. Sheehan, R. M. Browne, O. Austin, A. P. Clery, J. M. Deasy, S. Sulaiman-Shoaib, J. Soeda, D. S. O’Briain, P. Puri, E. C. Coveney, V. McAllister, E. W. M. McDermott, N. J. O’Higgins, M. Maher, M. T. P. Caldwell, P. Murchan, W. Beesley, T. M. Feeley, W. A. Tanner, F. B. V. Keane, F. Abbasakoor, S. E. A. Attwood, L P. McGrath, R. B. Stephens, E. O’Broin, M. G. Davies, J. McGinley, C. Mannion, S. Gupta, M. F. Shine, F. Lennon, G. Ninan, R. J. Fitzgerald, E. J. Guiney, B. O’Donnell, A. F. O’Donnell, D. Luke, A. E. Wood, P. G. Murphy, T. N. Walsh, A. D. K. Hill, H. Li, T. P. J. Hennessy, N. Noonan, B. Breslin, P. W. N. Keeling, A. J. Curran, D. B. Gough, I. R. Davidson, P. Keeling, D. P. O’Leary, A. Smythe, N. C. Bird, A. G. Johnson, P. Nicholson, O. Traynor, K. Dawson, J. Aitken, B. A. Cooke, S. P. Parbhoo, N. N.Williams, J. M. Daly, M. Herlyn, D. Bouchier-Hayes, R. C. Stuart, M. J. Allen, W. D. Thompson, A. L. G. Peel, D. T. Hehir, K. Cronin, A. McCann, P. A. Dervan, S. J. Heffernan, W. P. Hederman, M. H. Galea, B. Dilks, A. Gilmour, L. O. Ellis, C. W. Elston, R. W. Blarney, S. O’Rourke, A. Mookens, R. Carter, D. Parkin, N. F. Couse, C. P. Delaney, P. G. Horgan, J. M. Fitzpatrick, T. F. Gorey, J. M. O’Byrne, J. P. McCabe, M. Stephens, F. McManus, J. L.Mangan, D. A. Barr, G. J. Mulvenna, P. Maginn, W. G. Kernohan, R. A. B. Mollan, S. J. O’Flanagan, J. P. Stack, P. Dervan, B. Hurson, S. Tierney, P. Fitzgerald, T. O’Sullivan, P. Grace, J. P. Wyatt, R. J. Evans, S. P. Cusack, S. McGowan, E. McGovem, S. D. Schwaitzberg, R. J. Connolly, R. P. Sullivan, G. Mortimer, J. G. Geraghty, P. J. O’Dwyer, B. S. McGlone, D. P. O’Brien, H. A. Younis, H. F. Given, C. Phelan, J. Byrne, K. Barry, D. Gough, L. Hanrahan, F. Given, J. P. Sweeney, A. M. Korebrits, J. V Reynolds, T. F Gorey, D. M. O’Hanlon, M. A. Stokes, H. P. Redmond, J. McCarthy, P. Losty, M. Murphy, P. E. M. Butler, P. G. Grace, J. R. Novell, S. K. Hobbs, O. Smith, G. Hazlehurst, B. Brozovic, K. Rolles, A. Burroughs, S. Mallett, A. Mehta, D. Buckley, D. Waldron, D. O’Brien, C. Curran, L. Grey, A. Leahy, A. Darzi, D. Leader, P. Broe, J. G. Geoghegan, C. A. Cheng, D. C. Lawson, T. N. Pappas, D. O’Sullivan, M. M. Lieber, T. V Colby, D. M. Barrett, E. Rogers, J. Greally, H. C. Bredin, M. O. Corcoran, M. Kenny, P. Horgan, D. Headon, A. Grace, P. A. Grace, S. Cross, D. Hehir, S. O’Briain, P. Hartigan, M. P. Colgan, D. Moore, G. Shanik, S. Z. Zaidi, D. J. Hehir, K. S. Cross, D. J. Moore, D. G. Shanik, P. Lacy, J. E. Coleman, C. S. McEnroe, J. A. Gelfand, T. F. O’Donnell, A. D. Callow, D. J. Buckley, D. S. O’Riordain, J. A. O’Donnell, P. Meagher, K. Boos, P. Gillen, T. Corrigan, R. Vashisht, M. Sian, E. J Sharp, M. K. O’Malley, M. J. Kerin, D. Wilkinson, A. Parkin, R. C. Kester, M. M. Maher, R. P. Waldron, D. J. Waldron, M. P. Brady, M. Allen, T. H Lyncy, B. Waymont, L. Emtage, G. R. Blackledge, M. A. Hughes, D. M. A. Wallace, L. Mynderse, H. Grimes, F. Chambers, D. Lowe, B. Prasad, D. C. O’Sullivan, M. Barry P. Gillen, M. McNicholas, H. Bredin, T. H. O’Dowd, M. Corcoran, J. M. O’Donoghue, M. McGuire, A. McNamara, T. Creagh, R. Grainger, T. B. D. McDermott, M. R. Butler, M. Gleeson, T. E. D. McDermott, J. P. Hurley, R. Hone, M. Neligan, J. Hurley, M. White, P. McDonagh, D. Phelan, E. McGovern, F. Quinn, F. Breatnach, A. O’Meara, J. P. McGrath, S. R. McCann, E. F. Gaffney, A Hennessy, M. Leader, F. S. Taleb, M. V. McKiernan, P. J. Leyden, J. J. McCann, J. Coleman, A. Quereshi, N. Ajayi, G. McEntee, H. Osborne, D. J. Bouchier-Hayes, S. Johnston, K. O’Malley, E. Smyth, D. L Bouchier-Hayes, P. R. O’Connell, T. Gorey, O. J. McAnena, M. W. Reed, J. L. Duncan, C. S. Reilly, C. McGibney, P. Lawlor, B. Lawless, E. McGuinness, and S. Leahy

Subjects
business.industry, Medicine, General Medicine, Session (computer science), business, Classics
Published
1992
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14. Fifteenth Sir Peter Freyer Memorial Lecture and Surgical Symposium Proceedings of meeting held 14th & 15th September, 1990 at University College, Galway

Author

C. Bolger, G. Fry, D. Coakley, J. Philips, N. Sheahan, J. Malone, W. P. Gray, M. O’Sullivan, T. F. Buckley, T. P. O’Dwyer, P. J. Gullane, B. P. Kneafsey, K. T. Moran, S. T. O’Sullivan, M. P. Brady, E. C. Coveney, J. G. Geraghty, N. J. O’Higgins, J. O’Beirne, P. Seighe, J. P. McElwain, J. P. McCabe, B. Waldron, J. Byme, N. Hickey, J. McCabe, J. McMahon, J. Colville, B. J. Moran, R. A. Frost, M. J. Kerin, J. J. Jaeger, C. J. Mitchell, J. MacFie, T. O’Hanrahan, N. A. Scott, D. Leinhardt, M. H. Irving, D. Gough, M. White, M. Morrin, W. Joyce, D. Phelan, J. Fitzpatrick, T. Gorey, D. Wilkinson, A. Parkin, R. C. Kester, E. J. Gibney, K. McGrath, A. J. Cunningham, D. Bouchier-Hayes, M. Barry, M. Farrell, W. Monkhouse, K. J. Dawson, D. Hehir, G. Hamilton, P. A. Grace, A. Quereschi, R. Keane, P. Broe, G. Stansby, B. Fuller, A. Connolly, J. O’Donnell, D. Little, R. M. Keane, M. Regan, P. G. Horgan, C. Curran, D. O’Brien, D. Waldron, E. Mooney, J. Greally, H. F. Given, M. J. Duffy, D. Reilly, E. Coveney, J. Geraghty, J. J. Fennelly, N. O’Higgins, C. M. O’Hare, P. L. Jones, T. A. Zoma, G. P. Hemstreet, R. G. Postier, J. E. Coleman, E. L. Chaikof, E. W. Merrill, A. D. Callow, N. N. Williams, J. M. Daly, M. Herlyn, R. Gaffney, M. Walsh, D. McShane, C. Timon, D. Hamilton, J. Connolly, P. J. Byrne, R. B. Stuart, E. Kay, T. P. J. Hennessy, D. P. O’Leary, M. Booker, T. E. Scott, W. W. LaMorte, J. G. Geraty, W. A. Angerson, D. C. Carter, J. Lyons, A. Stack, J. M. Fitzpatrick, C. Kelly, C. Augustine, J. Kennedy, T. Creagh, D. Mannion, P. Seigne, G. Fitzpatrick, M. Feeley, P. Butler, P. Grace, M. Leader, B. Curren, C. Barry-Walsh, R. Waldron, M. Shearer, S. O’Rourke, M. Galea, A. Gilmour, R. Carter, D. Parkin, R. W. Blarney, D. J. Hehir, S. P. Parbhoo, N. Rothnie, J. Crowe, C. Wells, F. Sherry, P. O’Grady, J. Byrne, S. England, J. O’Callaghan, H. Grimes, Ursula Mulcahy, P. P. A. Smyth, V. McAlister, M. J. Murray, M. J. O’Higgins, R. O. Laoide, J. B. Hourihane, E. F. Mooney, C. Brougham, D. R. Headon, C. Coleman, E. C. Coveny, S. Jazawi, T. N. Walsh, P. Lawlor, H. Li, H. Sanfey, W. P. Joyce, D. B. Gough, P. V. Delaney, T. F. Gorey, S. E. A. Attwood, A. Watson, E. Rogers, R. P. Waldron, G. Glynn, K. U. El-Bouri, J. Flynn, P. Keeling, M. G. Davies, J. Lavelle, M. F. Shine, F. Lennon, R. C. Stewart, T. P. Hennessy, M. V. McKiernan, J. G. Johnston, L. Hanrahan, H. C. Bredin, M. O. Corcoran, M. Norton, R. Flynn, M. Gleeson, R. Grainger, T. E. D. McDermott, D. Lanigan, P. McLean, B. Curran, M. J. Gleeson, D. P. Griffin, H. J. Gallagher, T. A. Creagh, D. M. Mulvin, M. G. Donovan, D. M. Murphy, P. A. McLean, D. W. Mulvin, A. O’Brien, K. L. O’Flynn, R. McDonagh, D. G. Thomas, T. H. Lynch, P. Anderson, A. T. M. Vaughan, R. P. Beaney, D. M. A. Wallace, L. Solomon, D. S. O’Riordain, P. R. O’Connell, W. O. Kirwan, Hui Li, R. C. Stuart, S. Jazrawi, T. N. Koh, S. J. Sheehan, J. McKeever, J. Donohoe, M. Carmody, D. H. Osborne, D. E. Waldron, E. Rodgers, F. Patel, P. Horgan, M. Corcoran, K. Walsh, J. M. O’Donoghue, O. J. McAnena, M. McGuire, J. Smyth, G. Keye, A. Bahadursingh, C. Delaney, A. J. Richie, J. R. P. Gibbons, M. Marples, J. Banacewicz, H. Troidl, L. Cassidy, E. J. Prenderville, P. E. Burke, M. -.P Colgan, B. L. Wee, D. J. Moore, G. D. Shanik, K. S. Cross, M. El-Sanadiki, J. J. Murray, E. Mikat, R. McCann, P. -O. Hagen, T. R. Cheatle, E. Steibe, P. D. Colebridge Smith, J. H. Scurr, K. Barry, E. Bresnihan, D. F. Courtney, D. S. Quill, D. Buckley, D. S. O’Riordan, J. A. O’Donncll, J. A. O’Donnell, A. D. K. Hill, P. J. O’Dwycr, D. P. MacErlean, N. F. Couse, D. Campbell, K. McBride, D. MacErlean, J. J. Murphy, K. Kaar, H. Docrat, S. Malik, J. Egan, I. R. Davidson, J. Hurley, and H. Rowley

Subjects
Artificial urinary sphincter, medicine.medical_specialty, Fifteenth, Chronic venous insufficiency, business.industry, Intestinal failure, General surgery, medicine, General Medicine, medicine.disease, business, Laparoscopic cholecystectomy
Published
1991
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17. Is there a role for in vivo methylene blue staining in the prediction of bladder tumour recurrence?

Author

Ted McDermott, T. Creagh, D. Travis, M. R. Butler, Ronald Grainger, and M. J. Gleeson

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Urology, Biopsy, chemistry.chemical_compound, In vivo, medicine, Humans, Prospective Studies, Aged, Urinary bladder, medicine.diagnostic_test, business.industry, Carcinoma in situ, Histology, Middle Aged, medicine.disease, Staining, Methylene Blue, medicine.anatomical_structure, Transitional cell carcinoma, chemistry, Urinary Bladder Neoplasms, Female, Neoplasm Recurrence, Local, business, Methylene blue, Carcinoma in Situ, Follow-Up Studies
Abstract

Objective To assess the role of in vivo staining with intravesical methylene blue in predicting tumour recurrence. Patients and methods Thirty-nine patients (2 7 men and 12 women, age range 43–75 years) newly diagnosed with bladder tumours were prospectively studied and followed for a minimum of 2 years. Potential biopsy sites were identified by staining intravesically with a 1% methylene blue solution and compared with random biopsy sites. Results Biopsy directed by methylene blue staining detected carcinoma in situ more often than random biopsy. Rates of recurrence were similar in both stained and unstained groups. Conclusion methylene blue staining does not add significantly to the management of patients presenting with bladder tumours.

Published
1995

18. Seventeenth sir peter freyer memorial lecture and surgical symposium

Author

D. O’Gradaigh, P. J. Byrne, P. Gillen, P. Lawlor, T. N. Walsh, T. P. J. Hennessy, S. T. O’Sullivan, G. C. O’Sullivan, W. O. Kirwan, H. Li, M. T. P. Caldwell, S. Hone, S. E. A. Attwood, I. P. Kelly, T. P. Corrigan, E. Mulligan, M. J. Kerin, N. N. Williams, K. J. Cronin, M. El Sadar, P. Dervan, J. M. Fitzpatrick, T. F. Gorey, M. Maher, D. Hehir, A. Horgan, R. Stuart, J. A. O’Donnell, M. P. Brady, J. M. O’Donoghue, J. R. Flynn, J. Doyle, M. Gallagher, K. Connolly, M. Barry, M. G Davies, M. West, E. O’Broin, J. A. Connolly, D. Long, M. F. Shine, F. Lennon, K. J. Dawson, J. R. Novell, A. K. Burroughs, K. Rolles, W. P. Joyce, J. Dolan, J. Hyland, O. Traynor, M. Bennett, O. Tighe, H. Mulcahy, D. O’Donoghue, D. Bouchier-Hayes, D. T. Croke, G. Santos, G. Khoury, M. C. Winslet, A. A. M. Lewis, E. Beausang, K. Mealy, L. Joyce, M. McNicholls, D. McErlean, M. A. Stokes, K. Barry, R. Sullivan, J. Byrne, J. Callaghan, T. O’Gorman°, H. F. Given, M. S. Dudeney, M. P. Redmond, J. M. Deasy, V. K. Young, R. G. K. Watson, G. O’Kane, K. Murphy, C. McDowell, K. Khan, S. K. Al-Ghazal, J. McCann, R. C. Stuart, M. O’Connor, J. McCabe, J. O’Byrne, D. O’Farrell, M. Walsh, J. O’Beirne, S. O’Flannagan, A. McGuinness, O. Brady, W. Quinlan, J. P. McCabe, B. Curtin, M. Stephens, J. Stack, P. McCarthy, M. Schnall, H. Pollack, T. H. Lynch, B. Waymont, J. A. Dunn, M. A. Hughes, D. M. A. Wallace, T. E. D. McDermott, R. Grainger, E. Rogers, M. Corcoran, H. Bredin, H. Grimes, D. Lanigan, C. Roobottom, P. A. Dubbins, R. G. Choa, T. Creagh, M. R. Butler, K. J. O’Flynn, R. P. MacDonagh, D. G. Thomas, K. Dawson, J. Aitken, B. Cooke, S. P. Parbhoo, P. M. Cannon, S. C. Low, A. Dixon, I. O. Ellis, C. W. Elston, R. W. Blarney, E. D. Mulligan, K. Cronin, A. Stack, J. Ennis, F. Abbaskoor, M. K. O’Donoghue, G. Fulton, W. A. Tanner, F. B. V. Keane, B. V. Joseph, F. O. Cunningham, M. Dowling, E. Conveney, J. G. Geraghty, P. Byrne, G. Clarke, J. Duffy, N. O’Higgins, D. O’Hanlon, P. G. Horgan, D. O’Brien, C. Phelan, P. Given, P. Kent, S. Sheehan, M. P. Colgan, D. Moore, G. Shanik, P. Murphy, R. Vashisht, M. Sian, P. Franks, M. K. O’Malley, Y. Gul, D. Waldron, W. P. Hederman, H. P. Singh, S. Dias, T. Aherne, D. J. Hehir, J. A. McKeever, C. A. Bannon, D. Mehigan, T. V. Keaveney, T. F. Browne, U. M. Sivananthan, M. R. Rees, S. Whittaker, G. A. Davies, R. Vashisght, E. Sharp, A. Coady, A. Sterpetti, R. M. Greenhalgh, D. P. O’Brien, D. B. Gough, M. C. Regan, I. E. Efron, S. I. Kirk, M. Hurson, H. L. Wasserkrug, A. Barbul, S. Haynes, J. Thornton, J. Sparkes, A. D. K. Hill, C. J. Kelly, J. Gallagher, L. Modyka, H. P. Redmond, J. M. Daly, O. M. Austin, R. J. Cunney, P. A. Grace, C. Curran, J. O’Donoghue, M. Abernathy, N. Sharpe, M. Lucy, E. W. D. McDermott, P. M. Mercer, N. J. O’Higgins, G. Murugasu, A. Groeschel, M. Carmody, J. Donohue, D. H. Osborne, M. McLaughlin, J. Devlin, J. P. Phillips, Y. Ellias, M. Tahir, J. McKeever, M. Tighe, V. Lynch, M. Ahmed, P. P. A. Smyth, A. M. Hetherton, P. Horgan, M. Little, D. S. Quill, C. O. Duncan, M. O’Donnell, J. A. E. Hobby, D. Little, M. Murphy, P. Burke, P. Broe, M. McKiernan, S. J. Kirk, J. Crowe, P. MacMathuna, J. Lennon, T. Corrigan, R. O’Connell, A. Browne, A. Quershi, A. Leahy, G. Courtney, P. Grace, H. Osborne, D. J. Buckley, M. Goggin, T. A. Farrell, J. Geraghty, F. K. Keeling, P. R. O’Connell, H. Naama, E. Moore, E. Barry, C. Duffy, P. Hogan, G. Nee, M. Fahy, D. P. Kenny, V. Ellias, E. Gibney, W. Joyce, E. Gaffney, J. McMahon, M. McCabe, P. Kelly, M. Leader, C. I. Timon, P. Gullane, I. Dardick, I. McCarthy, N. F. Couse, M. Morrin, and P. V. Delaney

Subjects
General Medicine
Published
1994
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20. Incidence and natural history of Mycobacterium avium-complex infections in patients with advanced human immunodeficiency virus disease treated with zidovudine. The Zidovudine Epidemiology Study Group

Author

R E, Chaisson, R D, Moore, D D, Richman, J, Keruly, and T, Creagh

Subjects
CD4-Positive T-Lymphocytes, Male, Acquired Immunodeficiency Syndrome, AIDS-Related Opportunistic Infections, Incidence, Pneumonia, Pneumocystis, Racial Groups, Anemia, Prognosis, Severity of Illness Index, Survival Analysis, Leukocyte Count, Hematocrit, AIDS-Related Complex, Actuarial Analysis, Predictive Value of Tests, Risk Factors, Case-Control Studies, Humans, Blood Transfusion, Female, Zidovudine, Follow-Up Studies, Mycobacterium avium-intracellulare Infection, Proportional Hazards Models
Abstract

To determine the incidence and natural history of Mycobacterium avium-complex infections in persons with advanced human immunodeficiency virus (HIV) infection, we studied a multicenter cohort of 1,020 persons with acquired immunodeficiency syndrome (AIDS) or the AIDS-related complex (ARC) and CD4 cell count0.250 x 10(9)/L initially treated with zidovudine between April 1987 and April 1988. M. avium-complex infections developed in 123 (12%) patients during follow-up, with a 2-yr actuarial risk of 19%. Patients with an initial diagnosis of Pneumocystis carinii pneumonia were more likely to develop M. avium-complex infections than patients with an initial diagnosis of another opportunistic disease or of ARC (p = 0.002). Individuals developing M. avium-complex infections had lower baseline CD4 cell counts, hematocrits, lymphocyte counts, and total white blood cell counts than those who did not develop M. avium-complex infection. During follow-up, individuals who developed M. avium-complex infections were more likely to have severe anemia, to experience zidovudine dose reductions, and to die than were patients without M. avium-complex (p0.001). By proportional hazards analysis, a baseline CD4 cell count0.100 x 10(9)/L, development of severe anemia, P. carinii pneumonia during follow-up, and zidovudine dose interruption were significantly associated with subsequently developing M. avium-complex infection. A proportional hazards analysis of survival showed that M. avium-complex infection, severe anemia, zidovudine dose interruption, occurrence of an opportunistic infection, CD4 cell count0.100 x 10(9)/L, baseline AIDS diagnosis, and transfusion independently predicted an increased risk of death.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1992

21. Natural history of advanced HIV disease in patients treated with zidovudine. The Zidovudine Epidemiology Study Group

Author

R D, Moore, J, Keruly, D D, Richman, T, Creagh-Kirk, and R E, Chaisson

Subjects
Adult, Male, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Humans, Multicenter Studies as Topic, Female, HIV Infections, Longitudinal Studies, Prospective Studies, Middle Aged, Zidovudine, United States
Abstract

To describe the natural history of advanced HIV disease in patients treated with zidovudine.Longitudinal, observational study.Twelve academic and community-based sites.Eight hundred and sixty-three patients with AIDS or AIDS-related complex (ARC) with a CD4+ lymphocyte count less than 250 x 10(6)/l, who first received zidovudine between 15 April 1987 and 14 April 1988.Survival, progression to AIDS and first development of specific opportunistic illness.Median survival after initiation of zidovudine therapy ranged from greater than 900 days in patients with a baseline CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 560 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age greater than or equal to 40 years, hematocrit less than 35%, and diminished functional status. In patients with ARC at enrollment, median time of progression to AIDS ranged from 810 days in patients with a CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 310 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/l. Rates of development of specific opportunistic infections or neoplasms and HIV encephalopathy were determined for different baseline CD4+ lymphocyte count ranges. Myelosuppression was significantly more common in patients with CD4+ lymphocyte counts greater than or equal to 100 x 10(6)/l. Sixty-five per cent of patients with a CD4+ lymphocyte count greater than or equal to 100 x 10(6)/l and 51% with a CD4+ lymphocyte count less than 100 x 10(6)/l continued to receive zidovudine 2 years after starting therapy.We describe the natural history of a cohort of patients treated with zidovudine for advanced HIV disease. These CD4+ lymphocyte count-stratified estimates of disease progression should provide prognostic information useful in the clinical management of advanced disease and the design of future studies.

Published
1992

22. Treatment strategy for piezoelectric shock wave lithotripsy of upper ureteral calculi

Author

M. J. Gleeson, M. R. Butler, T.E.D. McDermott, T. Creagh, and Ronald Grainger

Subjects
Adult, Male, medicine.medical_specialty, Ureteral Calculi, Adolescent, Urology, Urinary stone, medicine.medical_treatment, Shock wave lithotripsy, Lithotripsy, urologic and male genital diseases, Extracorporeal shockwave lithotripsy, Ureter, medicine, Humans, Calculus (medicine), Aged, business.industry, Ultrasound, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Surgery, medicine.anatomical_structure, Treatment strategy, Female, business, Follow-Up Studies
Abstract

In situ piezoelectric lithotripsy monotherapy for upper ureteral stones is an attractive option because it can be conducted on an outpatient basis. Difficulty in calculus localization with ultrasound is the limiting factor. We reviewed our experience with 99 patients treated for upper ureteral calculi with the EDAP LT.01 lithotriptor. For stones above the lower renal border we achieved a 53% stone-free rate compared to 25% for calculi below the lower renal border. In situ piezoelectric lithotripsy of upper ureteral calculi may be considered for stones above the lower renal border.

Published
1992

23. PR41P�RECONSTRUCTIVE SURGERY FOR PELVIC EXENTERATION IN ADVANCED MALIGNANCY

Author

K. L. Phang, Frank A. Frizelle, and T. Creagh

Subjects
Reconstructive surgery, medicine.medical_specialty, Pelvic exenteration, business.industry, medicine.medical_treatment, Patient survival, General Medicine, Malignancy, medicine.disease, Pre operative, Surgery, Cohort, Medicine, Case note, business, Pelvic surgery
Abstract

Objectives: Extended radical pelvic resection for advanced primary or recurrent pelvic malignancy is an increasingly common procedure in major colorectal units. Aggressive pre operative chemo-radio therapy creates a cohort of patients with difficult reconstructive variables. We review our plastic surgical reconstructions in this highly heterogeneous population. Method: Utilizing the coding system at our institution we identified a cohort of patients whom underwent Vertical Rectus Abdominis Musculocutaneous (VRAM) reconstruction for exenterative pelvic surgery. A thorough retrospective case note analysis was performed specifically looking at three variable subsets. Demographic data and peri-operative care Reconstructive surgical procedures and complications Tumour variables and patient survival outcomes Results: Statistical analysis of the patient cohort and subsets will be presented Conclusions: This study has demonstrated the versatility of the VRAM flap in obtaining a stable and supple reconstructive cover in advanced pelvic malignancy surgery. Our series confirms strong support for immediate VRAM reconstruction in all pelvic exenterative procedures. We have shown patients undergoing multi-visceral resection after prior chemo-radiotherapy can achieve early, healed and stable perineal closure with low morbidity.

Published
2009
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26. Long-term safety and efficacy of zidovudine in patients with advanced human immunodeficiency virus disease. Zidovudine Epidemiology Study Group

Author

R D, Moore, T, Creagh-Kirk, J, Keruly, G, Link, M C, Wang, D, Richman, and R E, Chaisson

Subjects
Adult, CD4-Positive T-Lymphocytes, Male, HIV Infections, Middle Aged, Opportunistic Infections, Hematologic Diseases, Drug Administration Schedule, Survival Rate, Drug Combinations, Leukocyte Count, Hematocrit, Humans, Female, Prospective Studies, Zidovudine, Follow-Up Studies
Abstract

An epidemiologic study was initiated in 1987 to evaluate the long-term safety and efficacy of zidovudine in patients with advanced human immunodeficiency virus disease. Data from 886 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex and CD4+ lymphocyte count less than 0.25 x 10(9)/L are reported. Eighteen-month survival was 67% for the cohort. Pretreatment factors associated with increased survival time included index diagnosis of AIDS-related complex, hematocrit of 0.35 or greater, CD4+ lymphocyte count of 0.15 x 10(9)/L or greater, high functional status, and time from diagnosis of AIDS to treatment of less than 60 days. By proportional hazards analysis, development of serious anemia was the most significant factor associated with early death. Receiving zidovudine for a high proportion of time significantly improved chances of survival even if anemia developed. Serious leukopenia occurring in 37% and serious anemia occurring in 32% of patients. Nonhematologic adverse events were uncommon and no previously unreported adverse events were seen.

Published
1991

27. National AIDS incidence trends and the extent of zidovudine therapy in selected demographic and transmission groups

Author

P S, Rosenberg, M H, Gail, L K, Schrager, S H, Vermund, T, Creagh-Kirk, E B, Andrews, W, Winkelstein, M, Marmor, D C, Des Jarlais, and R J, Biggar

Subjects
Male, Acquired Immunodeficiency Syndrome, Urban Population, Incidence, Sexual Behavior, New York, Hispanic or Latino, Homosexuality, Hemophilia A, Los Angeles, United States, White People, Black or African American, Cohort Studies, Humans, Blood Transfusion, Female, San Francisco, Substance Abuse, Intravenous, Zidovudine
Abstract

After mid-1987 fewer than the expected number of cases of AIDS were reported in the United States in some demographic and transmission groups but not in others. Gay men (regardless of intravenous drug use), adults with hemophilia, and transfusion recipients exhibited fewer cases than expected based on previously reliable models. These favorable trends could not be explained by assuming earlier cessation of human immunodeficiency virus (HIV) infection. Favorable AIDS incidence trends were not found in heterosexual intravenous drug users or in persons infected through heterosexual contact. White gay men from New York City, Los Angeles, and San Francisco experienced markedly favorable trends, whereas little changes was observed for nonwhite gay men from nonurban areas. AIDS incidence trends were quantitatively consistent with the fraction of AIDS-free persons with severe immunodeficiency who received zidovudine in three cohorts. Gay men in San Francisco used zidovudine more frequently than did adults with hemophilia, while little was used by intravenous drug users in New York City. Data describing the initial national distribution of zidovudine (March 31-September 18, 1987) indicated relatively high use by patients with severe immunodeficiency in those groups, such as urban white gay men, that subsequently experienced fewer cases of AIDS than expected. Available data suggest that zidovudine, perhaps in combination with other therapies, has been one factor contributing to favorable AIDS incidence trends in some groups. Broader application of therapy might further retard the incidence of AIDS, especially in intravenous drug users, persons infected through heterosexual contact, minorities, women, and persons diagnosed outside major metropolitan areas.

Published
1991

28. Pathologist variation in reporting cervical borderline epithelial abnormalities and cervical intraepithelial neoplasia

Author

E Martin-Bates, T Creagh, D E Fish, Emil Kupek, J E Bridger, and M J Wilkins

Subjects
Pathology, medicine.medical_specialty, Biopsy, Uterine Cervical Neoplasms, Cervix Uteri, Cervical intraepithelial neoplasia, Pathology and Forensic Medicine, Histological diagnosis, medicine, Humans, Medical diagnosis, Papillomaviridae, Uncertain significance, Observer Variation, biology, medicine.diagnostic_test, business.industry, Papillomavirus Infections, General Medicine, Uterine Cervical Dysplasia, medicine.disease, biology.organism_classification, Tumor Virus Infections, Interobserver Variation, Female, business, Kappa, Research Article
Abstract

AIMS--To evaluate the interobserver variation in the diagnosis of cervical intraepithelial lesions, including the new category "borderline abnormalities of uncertain significance" (BAUS) which has not been tested before. METHODS--Biopsy specimens of 122 patients were reviewed by five histopathologists and the diagnoses subjected to kappa statistical analysis. RESULTS--There was poor interobserver agreement in all categories, particularly between BAUS and normal tissue. CONCLUSIONS--The current guidelines for the histological diagnosis of cervical intraepithelial neoplasia and BAUS are poorly reproducible.

Published
1995
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29. Experience with peyronies disease

Author

O. Fulena, M. Butler, and T. Creagh

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Penile deformity, Penile angulation, Penile prosthesis, General Medicine, Disease, Surgery, Sexual intercourse, medicine.anatomical_structure, Fibrous plaque, Deformity, Medicine, medicine.symptom, business, Penis
Abstract

Peyronies disease of the penis is characterised by pain and deformity on erection with a palpable fibrous plaque. The penile deformity may prevent normal sexual intercourse requiring surgical intervention. A review of 16 patients treated over an 8 year period shows that 11 of 12 patients treated surgically had a satisfactory outcome. The Nesbit procedure is the treatment of choice for marked lateral penile angulation due to Peyronies disease.

Published
1994
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30. Haemospermia: How to proceed?

Author

M. R. Butler, R. Grainger, A. McNamara, Ted McDermott, and T. Creagh

Subjects
Adult, Male, Urologic Neoplasms, medicine.medical_specialty, Retrospective review, medicine.diagnostic_test, business.industry, General surgery, Prostatic secretions, General Medicine, Urine, Cystoscopy, Middle Aged, Malignancy, medicine.disease, Surgery, Blood, Semen, Urinary Tract Infections, Intravenous Pyelogram, medicine, Humans, business, Retrospective Studies
Abstract

Haemospermia is an alarming symptom but does it signify serious disease and how should it be investigated? A retrospective review of 44 men showed no evidence of malignancy and infection as the commonest cause. Standard investigation with midstream specimen of urine, intravenous pyelogram and cystoscopy is unhelpful. Microscopy and culture of a first stream specimen of urine or expressed prostatic secretions is the investigation of choice. Cystoscopy should be reserved for patients with recurrent haemospermia.

Published
1993
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34. Selective doping of mbba to optimize display performance

Author

Linda T. Creagh and Allan R. Kmetz

Subjects
Materials science, Solid-state physics, business.industry, Scattering, Transition temperature, Doping, Condensed Matter Physics, Light scattering, Electronic, Optical and Magnetic Materials, Condensed Matter::Soft Condensed Matter, MBBA, chemistry.chemical_compound, Optics, chemistry, Liquid crystal, Materials Chemistry, Optoelectronics, Electrical and Electronic Engineering, business, Refractive index
Abstract

Several researchers have reported that intrinsic material parameters of 4′-methoxybenzyl idene-4-butylaniline (MBBA), such as transition temperature and refractive indices, are sensitive to impurities. Electrooptic behavior also depends strongly on purity. Selective doping of MBBA to optimize characteristics important for display applications will be described. Emphasis will be on dc operation. For example, doping to raise conductivity above a critical level is essential for fast response and to achieve an abrupt threshold for light scattering. These effects are understood in terms of recent theory of the scattering mechanism in nematic liquid crystals.

Published
1972
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35. Spectra and photolysis of the 1-oxides of the pyridinecarboxylic acids and pyridinecarboxamides

Author

Linda T. Creagh, Lyman R. Caswell, and Florence C. Lee

Subjects
Aqueous solution, Chemistry, Organic Chemistry, Photodissociation, Ultraviolet absorption, Photochemistry, Deoxygenation, Spectral line, Vicinal
Abstract

The ultraviolet absorption spectra of aqueous and alcoholic solutions of the pyridinemono-carboxylic acids and amides, of the vicinal pyridinedicarboxylic acids, and of the 1-oxides of these compounds, were measured and qualitatively interpreted. The photolysis of the 1-oxides in aqueous solution resulted principally in their deoxygenation. Photolysis of picolinamide 1-oxide also gave a rearrangement product, 1-formyl-2-pyrrolecarboxamide. The photolyses of the 2- and 4-monosubstituted 1-oxides were somewhat faster than those of the 3-substituted 1-oxides. The experimental results are discussed in terms of possible hydrogen-bonding effects.

Published
1972
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37. Phylogeny of substance P

Author

D. Powell, A. Balfe, Petr Skrabanek, D. Cannon, and T. Creagh

Subjects
Central Nervous System, Rana temporaria, Radioimmunoassay, Zoology, Substance P, Sea anemone, chemistry.chemical_compound, Cnidaria, Endocrinology, Elasmobranchii, Bioassay, Animals, Skate, Columbidae, Lung, Phylogeny, Skin, biology, Helix, Snails, Rana pipiens, Fishes, Lizards, Anatomy, biology.organism_classification, Intestines, Sea Anemones, chemistry, Animal Science and Zoology, Anura, Coelenterata, Frog Skin
Abstract

Immunoreactive substance P (ISP) was measured by radioimmunoassay in acid-acetone tissue extracts in representative species of invertebrates (phyla Coelenterata and Mollusca) and of non-mammalian vertebrates (Elasmobranchii, Teleostei, Amphibia, Reptilia, Aves). Extracts from the nervous system of the lizard, frog, and pigeon, and from the frog skin and lung, caused a displacement of substance P (SP) tracer parallel to the SP standard curve, suggesting the presence of SP itself or of a related tachykinin sharing the C-terminal pentapeptide Phe-X-Gly-Leu-Met-NH 2 against which the SP antibody was directed. In extracts from the whole sea anemone and from the tentacles of the snail, from the nervous system of the skate and mackerel, from the gastroitestinal tract of the frog and pigeon, and in unextracted frog serum, material caused a displacement of SP tracer which was nonparallel with the SP standard curve. While previous bioassays suggested that SP may be present in invertebrates, our radioimmunoassay results show that SP or closely related tachykinins occurred in the vertebrates, but not in the invertebrates tested.

Published
1980

38. Suppression of recurrent genital herpes with oral acyclovir

Author

S E, Straus, M, Seidlin, H E, Takiff, S, Bachrach, J J, DiGiovanna, K A, Western, T, Creagh-Kirk, L, Lininger, and D W, Alling

Subjects
Adult, Male, Clinical Trials as Topic, Herpes Genitalis, Time Factors, Double-Blind Method, Recurrence, Acyclovir, Humans, Female
Published
1983

39. Nasogastric warnings

Author

T, Creagh

Subjects
Oxygen, Enteral Nutrition, Partial Pressure, Humans, Carbon Dioxide, Hydrogen-Ion Concentration, Intubation
Published
1988

40. Just a little jab?

Author

T, Creagh

Subjects
Muscles, Humans, Injections, Intramuscular
Published
1986

43. Treatment of First Episodes of Genital Herpes Simplex Virus Infection with Oral Acyclovir

Author

B L Johnson, Yvonne J. Bryson, S Taylor, G Acuna, M Dillon, Whitfield B. Growdon, Ronald E. Keeney, T Creagh-Kirk, E Wiesmeier, M Lovett, and James D. Cherry

Subjects
Adult, Male, medicine.medical_specialty, Genital herpes simplex, viruses, Acyclovir, Administration, Oral, Placebo, Virus, Malaise, law.invention, Double blind, Random Allocation, Double-Blind Method, Randomized controlled trial, Recurrence, law, Internal medicine, Virus latency, Humans, Dysuria, Medicine, Viral shedding, Clinical Trials as Topic, Herpes Genitalis, business.industry, Obstetrics and Gynecology, General Medicine, medicine.disease, Virology, Dermatology, Surgery, Clinical trial, Female, medicine.symptom, business
Abstract

We performed a double-blind placebo-controlled trial of oral acyclovir in the treatment of first episodes of genital herpes simplex virus infections in 48 young adults (31 women and 17 men). Subjects were randomized to receive either placebo or acyclovir (200 mg per dose) five times daily for 10 days; they were examined on at least eight visits until healed and at monthly visits thereafter. Acyclovir treatment, as compared with placebo, significantly reduced virus shedding, new lesion formation after 48 hours, and the duration of genital lesions in both men and women. The total duration and severity of clinical symptoms (such as pain, adenopathy, dysuria, and malaise) were significantly reduced by acyclovir in both men and women by the third and fourth day, respectively (P less than or equal to 0.025), as compared with placebo. No toxicity was observed. Recurrence rates have so far been similar in placebo and acyclovir recipients. Oral acyclovir treatment of first-episode genital herpes simplex virus infections is clinically effective, but it does not seem to prevent virus latency or associated recurrent disease.

Published
1983
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46. When things go wrong

Author

K Gatter, Ian D. Buley, B McDonald, C Mason, C Lawson, P Kelly, T Creagh, C Wells, B Crossley, and M Gillett

Subjects
Risk, Pathology, Clinical, Letter, business.industry, Internet privacy, General Engineering, General Medicine, Liability insurance, Insurance, Liability, World Wide Web, Humans, General Earth and Planetary Sciences, Business, General Environmental Science
Published
1986
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47. Kikuchi's disease simulating acute appendicitis

Author

A Taylor, I Lampert, T Creagh, and J McLoughlin

Subjects
Adult, Mesenteric Lymphadenitis, medicine.medical_specialty, Pathology, business.industry, Diagnostico diferencial, Mesenteric lymphadenitis, Disease, Appendicitis, medicine.disease, Diagnosis, Differential, Necrosis, medicine.anatomical_structure, Acute Disease, Acute appendicitis, medicine, Humans, Female, Surgery, Radiology, Differential diagnosis, business, Mesentery
Published
1988
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48. Abdominal and perineal hernia rates following vertical rectus abdominis myocutaneous (VRAM) flap reconstruction - a supraregional experience.

Author

Kim E, Fernando C, McCombie A, Bailey W, Frizelle F, Glyn T, Porter C, Wakeman C, and Creagh T

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Perineum surgery, Rectus Abdominis transplantation, Retrospective Studies, Hernia, Abdominal etiology, Hernia, Abdominal surgery, Myocutaneous Flap, Plastic Surgery Procedures adverse effects, Plastic Surgery Procedures methods
Abstract

Background: Vertical rectus abdominis myocutaneous (VRAM) flap has proven to be a robust reconstruction method following radical pelvic surgery. Radical pelvic surgery is associated with high morbidity due to pelvic complications and non-healing perineal wounds, as a result of non-collapsible pelvic dead space and pre-operative adjuvant radiotherapy insult. VRAM flap reconstruction addresses both issues by obliterating the dead space and introducing healthy non-radiated tissue. However, flap reconstruction complications can include donor site hernias (abdominal wall), perineal hernias, and flap-specific complications. This study aimed to evaluate the abdominal and perineal hernia rates as well as radiological evidence of flap vascularity post-operatively., Methods: We conducted a retrospective analysis of patients who underwent a VRAM flap reconstruction following radical pelvic surgery at Christchurch hospital over a 10-year period. We identified the presence of donor site hernias (abdominal wall hernias), perineal hernias, and flap vascularity on post-operative radiological imaging performed within 48 months., Results: Seventy-seven patients underwent a VRAM flap reconstruction of which 60 patients met the inclusion requirements for the study (mean age was 60.3 years [range 26-89]; 31 were male and 29 were female). Eighteen patients underwent an APR and 42 underwent a partial or a complete pelvic exenteration and the majority of them (75.0%) were for rectal cancers. Available imaging was on average 21.6 months post-operatively (IQR 11.8-31.3 months). The donor site hernia rate was 16.7%, and the perineal hernia rate was 3.3%. VRAM flap appeared to have DIEA flow in 98.3% of the patients., Conclusion: VRAM flap reconstruction of complex pelvic defects remains a robust method of choice in complex pelvic reconstruction with little morbidity., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare., (Copyright © 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Published
2022
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49. Morbidity associated with the immediate vertical rectus abdominus myocutaneous flap reconstruction after radical pelvic surgery.

Author

Proctor MJ, Westwood DA, Donahoe S, Chauhan A, Lynch AC, Heriot AG, Sent-Doux K, Creagh T, Frizelle FA, and Wakeman CJ

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Morbidity, Perineum surgery, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Rectus Abdominis transplantation, Retrospective Studies, Myocutaneous Flap transplantation, Plastic Surgery Procedures adverse effects, Plastic Surgery Procedures methods
Abstract

Aim: Patients who undergo radical pelvic surgery often have problems with perineal wound healing and pelvic collections. While there is recognition of the perineal morbidity, there also remains uncertainty around the benefit of vertical rectus abdominus myocutaneous (VRAM) flaps due to the balance between primary healing and the complications associated with this form of reconstruction. This study aimed to evaluate factors associated with significant flap and donor site related complications following VRAM flap reconstruction for radical pelvic surgery., Method: A retrospective analysis of VRAM flap related complications was undertaken from prospectively maintained databases for all patients undergoing radical pelvic surgery (2001- 2017) in two cancer centres., Results: In all, 154 patients were identified [median age 62 years (range 26-89 years), 80 (52%) men]. Thirty-three (21%) patients experienced significant donor or flap related complications. Major complications (Clavien-Dindo ≥ 3) related to the abdominal donor site occurred in nine (6%) patients, while those related to the flap or perineal site occurred in 28 (18%) patients. Only smoking (P = 0.003) and neoadjuvant radiotherapy (P = 0.047) were associated with the development of significant flap related complications on univariate analysis. Flap related complications resulted in a significantly longer hospital stay (P < 0.001)., Conclusion: Careful patient selection is required to balance the risks vs the benefits of VRAM flap reconstruction. Immediate VRAM reconstruction in patients undergoing radical pelvic surgery can achieve early healing and stable perineal closure; it has a low but significant morbidity. Major flap related complications are significantly associated with smoking status and neoadjuvant radiotherapy and result in a prolonged length of hospital stay., (Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.)

Published
2020
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50. The double loop mattress suture.

Author

Biddlestone J, Samuel M, Creagh T, and Ahmad T

Subjects
Animals, Cartilage, Microscopy, Muscles, Skin, Swine, Tensile Strength, Dermatologic Surgical Procedures, Suture Techniques, Sutures, Wound Healing, Wounds and Injuries pathology
Abstract

An interrupted stitch type with favorable tissue characteristics will reduce local wound complications. We describe a novel high-strength, low-tension repair for the interrupted closure of skin, cartilage, and muscle, the double loop mattress stitch, and compare it experimentally with other interrupted closure methods. The performance of the double loop mattress technique in porcine cartilage and skeletal muscle is compared with the simple, mattress, and loop mattress interrupted sutures in both a novel porcine loading chamber and mechanical model. Wound apposition is assessed by electron microscopy. The performance of the double loop mattress in vivo was confirmed using a series of 805 pediatric laparotomies/laparoscopies. The double loop mattress suture is 3.5 times stronger than the loop mattress in muscle and 1.6 times stronger in cartilage (p ≤ 0.001). Additionally, the double loop mattress reduces tissue tension by 66% compared with just 53% for the loop mattress (p ≤ 0.001). Wound gapping is equal, and wound eversion appears significantly improved (p ≤ 0.001) compared with the loop mattress in vitro. In vivo, the double loop mattress performs as well as the loop mattress and significantly better than the mattress stitch in assessments of wound eversion and dehiscence. There were no episodes of stitch extrusion in our series of patients. The mechanical advantage of its intrinsic pulley arrangement gives the double loop mattress its favorable properties. Wound dehiscence is reduced because this stitch type is stronger and exerts less tension on the tissue than the mattress stitch. We advocate the use of this novel stitch wherever a high-strength, low-tension repair is required. These properties will enhance wound repair, and its application will be useful to surgeons of all disciplines., (© 2014 The Authors. Wound Repair and Regeneration published by Wiley Periodicals, Inc. on behalf of The Wound Healing Society.)

Published
2014
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