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1. Royal Academy of Medicine in Ireland Section of Biomedical Sciences

Author

Kathy M. O'Boyle, Andrew Harkin, B. F. Leek, Peter McLoughlin, R. A. Padua, M. Leek, M. Garrett, A. Watson, C. G. Lyons, C. S. Downes, D. Cantillon, B. A. O. McCormack, P. Quinn, Alan Carr, Margaret Griffin, Thomas F. Gorey, T. Ruane, John J. O'Connor, D. J. Wilcox, T. M. Dineen, P. N. Convery, G. O’Cuinn, Damian P. O’Connell, C-A. Frazer, S. Thornton, Jmcc Anderson, D. M. P. Morrow, K. Scott, D. M. Walsh, O. P. Friery, W. Quinlan, D. M. Burns, J. R. Docherty, C. P. Halligan, Jacqueline M. O'Connor, R. Moran, Edward R. Perl, J. P. Ryan, D. Harvey, F. S. Fay, C. Higgins, T. J. Connor, E. Arendt, R. M. Drummond, Brian E. Leonard, D. Fitzpatrick, L. A. J. O’Neill, P. R. O'Connell, E. S. Galligan, P. M. Murchan, A. Rizvi, R. J. Delicata, K. Søballe, Momna Hejmadi, D. G. Hirst, A. S. Lowe, D. P. Campion, S. Dudeney, T. Robson, John F. Cryan, C. L. Brady, D. S. Soppitt, Brian J. Harvey, B. Schreiber, G. J. Dempsey, Valerie J. McKelvey-Martin, Deborah A. Brown, C. Lally, J. C. McGrath, I. Hill, C. M. G. Thompson, S. Mehdi, P. D. Carey, C. J. O’Boyle, A. Greer, M. H. Esfandiary, T. Quinn, J. R. Bailie, T. P. J. Hennessy, K. R. Milligan, T. Dineen, M. M. Murray, F. Lynch, M. Dumbleton, K. A. Fitzgerald, M. McCarthy, Anthony William Sharpe Watson, John P. Kelly, James Allen, J. Carson, Noel G. McHale, A. M. Redmond, A. Dunne, Austin Leahy, K. Abdullah, Timothy M. McGloughlin, M. C. Mukunda, D. E. Beverland, A. K. Keenan, A. O’Farrell, A. Nolan, G. B. Nevin, Alex Lennon, John Orr, James A. Robinson, J. B. Macmillan, T. N. Walsh, Kevin M. Joyce, J. P. Mulville, S. Maher, K. T. Gavin, Stephanie R. McKeown, R. Powell, J. O’Byrne, David Bouchier-Hayes, S. T. O’Sullivan, L. Brennan, Nicholas Dunne, S. K. Smith, M MacDermott, C. Simms, M. Cashman, K. O’Rourke, Ken D. O'Halloran, C. Thompson, B. M. Flavin, Dervla O'Malley, D. Lloyds, G. Wilson, T. P. F. O’Connor, A. Devitt, S. Ní Aodha, M. G. O. Riordain, N. O’Connor, M. O’Shaughnessy, Patrick J. Prendergast, G. R. Wasson, A. Jenkinson, Bernadette M. Hannigan, B. Higgins, J. J. Strain, E. V. Davies, K. J. Brady, R. G. O’Regan, J. T. Dingle, J. Panchal, J. Rice, J. Rothwell, Michael Carey, Michelle K. McGuire, L. Noelke, Aidan Bradford, A. J. McShane, J. M. O’Donoghue, A. K. Curran, L. Doherty, P. A. Kelly, R. Dwyer, James A. Houghton, G. D. Kennovin, Deirdre M O'Leary, William S. Gilmore, Tim O'Brien, B. Van Hemelrijk, Brian Caulfield, P. Fanning, M. Sweeney, B. Lew, T. Mubarak Abujaffom, J. G. McCarron, K. D. Cotton, S McGrath, J. G. McGeown, J. C. W. Brown, A. P. Moran, K. U. O’Kelly, E. Healy, Keith D. Thornbury, G. D. Baxter, D. McCormack, C. Galvin, L. Gilmartin, Maxine P. Bonham, M. Harbinson, C. Connolly, Y. Ikadi, C. S. Regan, G. Noble, J. Shine, C. J. Kelly, S. Z. Imam, H-C. McKillen, J. Macfie, M. C. Regan, E. J. Petitt, A. A. J. Adgey, Andrew N. Coogan, R. G. K. Watson, Mark A. Hollywood, J. L. Leckey, W. J. Hatton, T. Barry, M. Browne, C. J. Mitchell, S. Atkinson, M. P. Ryan, J. Monaghan, G. T. McMahon, M. A. Cox, G. P. Love, C. A. Higgins, A. H. Baker, N. Cregg, G. McKerr, A. McElligott, Laurence H. Patterson, Ciaran MacDonncha, F. Markos, W. Ruddock, R. Huiskes, A. Bird, J. P. H. Fee, W. J. Hall, J. Kilbride, Hugh McGlynn, C. W. Taylor, David Taylor, D. J. Buckley, J. Flaherty, T. Prenderville, Robert G. Hill, T. C. Lee, Jennifer M. Walsh, K. M. Smith, J. Lewis, A. D. Martin, and John M. Fitzpatrick

Subjects
medicine.medical_specialty, business.industry, Duchenne muscular dystrophy, Section (typography), General Medicine, medicine.disease, Transcutaneous electrical nerve stimulation, Epsp amplitude, law.invention, law, Ophthalmology, medicine, Optometry, business, Biomedical sciences
Published
1997
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2. Abstracts

Author

Brian P. Kavanagh, Cuong Ngo, Karen Raymer, Homer Yang, Jamal A. Alhashemi, Anne C. P. Lui, Dennis Reid, Nicholas Cicutti, Barbra Krepski, Gordon Wood, Daren K. Heyland, Neal H. Badner, John M. Murkin, Jim Mohr, F. Neil McKenzie, Peter J. A. van der Starre, W. T. van Rooyen-Butijn, Kristine Wilson-Yang, Kevin Teoh, R. M. K. W. Lee, Imtiaz Hossain, Davy Cheng, Jacek Karski, Buvanendran Asokumar, Alan Sandier, Marc A. St-Amand, Alan H. Menkis, Donal B. Downey, William Nantau, Sandy Adams, Noreen Dowd, David Wong, Jo Carroll-Munro, Clare Trachuk, N. Cregg, D. C. H. Cheng, W. G. Williams, J. M. Karski, S. Siu, G. Webb, Davy C. H. Cheng, David T. Wong, Rafal Kustra, Robert J. Tibshirani, Dany L. Côté, David E. Lacey, Kenneth M. LeDez, Julia A. Smith, Edward T. Crosby, Fredrick K. Orkin, A. Fisher, G. Volgyesi, J. Silverman, S. Edelstein, J. Rucker, L. Sommer, S. Dunington, L. Roy, C. Crochetière, M. -Y. Arsenault, E. Villeneuve, L. Lortie, Caroline S. Grange, M. Joanne Douglas, Timothy J. Adams, Pamela M. Merrick, S. Brian Lucas, Pamela J. Morgan, Stephen Halpern, Jason Lo, Carolyn L. Giesinger, Stephen H. Halpern, Terrance W. Breen, Srigowri Vishnubala, Geeta R. Shetty, M. De Kock, A. Lagmiche, J. L. Scholtes, Wlodzimierz Grodecki, Peter J. Duffy, Kathryn A. Hull, Geoffrey S. Hawboldt, Alexander J. Clark, J. Bruce Smith, Richard W. Norman, W. Scott Beattie, A. Sandier, M. Jewett, L. Valiquette, J. Katz, Y. Fradet, D. Redelmeier, H. Sampson, Jeff Cole, Todd Chedore, Walter Snedden, Robert G. Green, Mitchel B. Sosis, Philip I. Robles, Edward R. Lazar, Donald T. Jolly, Yun K. Tarn, Soheir R. Tawfik, Alexander S. Clanachan, Avaleigh Milne, Travis Beamish, D. J. Cuillerier, M. D. Sharpe, J. K. Lee, M. Basta, A. D. Krahn, G. J. Klein, R. Yee, Narendra Vakharia, Heather Francis, Louis Scheepers, Himat Vaghadia, Joanne Carrier, René Martin, Marline Pirlet, Yves Claprood, Jean-Pierre Tétrault, T. D. Wong, L. Ryner, P. Kozlowski, G. Scarth, R. K. Warrian, G. Lefevre, D. Thiessen, L. Girling, L. Doiron, C. McCudden, J. Saunders, W. A. C. Mutch, Stéphan Langevin, Martin R. Lessard, Claude A. Trépanier, Gregory M. T. Hare, Johnson C. S. Ngan, Dan Viskari, A. Berrill, Christian Jodoin, Jacques Couture, François Bellemare, Stephen Farmer, Holly Muir, Phyllis Money, Brian Milne, Joel Parlow, Jennifer Raymond, Julie M. Williams, Rosemary A. Craen, Teresa Novick, Wendy Komar, Luc Frenette, Jerry Cox, B. Lockhart, P. McArdle, D. Eckhoff, S. Bynon, Wojciech B. Dobkowski, David R. Grant, William J. Wall, Edgar G. Chedrawy, Richard I. Hall, Vivian Nedelcu, Jean-Paul Viale, Gérard Bégou, Pierre Sagnard, Richard Hughson, Luc Quintin, Éric Troncy, Jean-Paul Collet, Stan Shapiro, Jean-Gilles Guimond, Louis Blair, Thiérry Ducruet, Martin Francœur, Marc Charbonneau, Gilbert Blaise, W. Snedden, E. Bernadska, H. I. Manson, Juditli L. Kutt, Beruie Y. Mezon, Osamu Nishida, Ramiro Arellano, Patty Boylen, Wilfred DeMajo, David P. Archer, Sheldon H. Roth, Sitaram Raman, Pirjo Manninen, Kevin Boyle, Aleksa Cenic, Ting-Yim Lee, Adrian W. Gelb, F. X. Reinders, J. I. M. Brown, A. J. Baker, R. J. Moulton, L. Schlichtert, Stephan K. W. Schwarz, Ernest Puil, Barry A. Finegan, Brendan T. Finucane, Matt M. Kurrek, J. Hugh Devitt, Doreen Cleave-Hogg, John Bradley, Robert Byrick, Salvatore M. Spadafora, John G. Fuller, Mark H. Gelula, Kelly Mayson, Bruce Forster, R. J. Byrick, D. J. McKnight, M. Kurrek, M. Kolton, D. Cleave-Hogg, J. Haughton, S. Halpern, J. Kronberg, Sandy Shysh, Chris Eagle, A. Joel Dagnone, Joel L. Parlow, G. Blaise, F. Yang, H. Nguyen, E. Troncy, G. Czaika, Ireneusz Wachowski, Hervé Deladrière, Chantal Cambier, Philippe Pendeville, O. R. Hung, E. Coonan, S. C. Whynot, M. Mezei, Anthony M. -H. Ho, Ingrid S. Luchsinger, Elizabeth Ling, Doreen Mashava, Herbert M. Chinyanga, Marsha M. Cohen, Melissa Shaw, J. A. Robblee, R. S. Labow, F. D. Rubens, A. M. Diemunsch, R. Gervais, D. K. Rose, M. M. Cohen, L. O’Brien-Pallas, C. Copplestone, K. Karkouti, K. Sykora, Shirley L. W. Cheung, Peter D. Booker, Roger Franks, Marco Pozzi, Beverley Guard, Nancy Sikich, Jerrold Lerman, Mark Levine, Hilton Swan, Peter Cox, Carolyne Montgomery, Gillian Dunn, Russell Bourne, Anna Kinahan, James McCormack, Gillian S. Dunn, Eleanor J. Reimer, Peter Sanderson, Peter M. Sanderson, Carolyne J. Montgomery, Terri A. Betts, Guy R. Orlay, David H. Wong, Marsha Cohen, A. A. Al-Kaisy, V. Chan, P. Peng, A. Perlas, A. Miniad, Edward V. Cushing, Keith R. Mills, Hossam El-Beheiry, Shokrollah S. Jahromi, John Weaver, Mary Morris, Peter L. Carien, Robert McTaggart Cowan, Jonathan Richards, Blair T. Henderson, Robert J. Hudson, Ian R. Thomson, Michael Moon, Mark D. Peterson, Morley Rosenbloom, Patrick J. Davison, Mohamed Ali, Naheed S. Ali, Norman R. Searle, Ian Thomson, Micheline Roy, Line Gagnon, A. Lye, F. Walsh, W. Middleton, D. Wong, A. Langer, L. Errett, C. D. Mazer, Karin M. Williamson, Graham Smith, Kandiah P. Gnanendran, S. J. Bignell, S. Jones, J. Sleigh, M. Arnell, Jan-Ake I. Schultz, David W. Fear, S. Ganapathy, C. Moote, R. Wassermann, J. Watson, K. Armstrong, Aznif Ozsolak Calikyan, Oya Yilmaz, Yildiz Kose, Philip Peng, Vincent Chan, Frances Chung, Andrew R. Claxton, Ananthan Krishnathas, Gabor Mezei, Terri L. Paul, Jacqueline A. Doyle, Mahesh Mehta, Luiz G. R. DeLima, Lucia E. O. Silva, Warren L. May, Roy J. Maliakkal, Richard Kolesar, Sara Rafuse, Mary Fletcher, Geoffrey Dunn, Michael Curran, Paul Bragg, Wayne Chamberlain, MaryLou Crossan, H. Sandhu, S. Spadafora, R. Mian, B. Evans, L. Hurst, and S. Katsiris

Subjects
Anesthesiology and Pain Medicine, General Medicine
Published
1997
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3. Severe ovarian hyperstimulation syndrome following the GIFT procedure

Author

J Moriarty, E McGUINNESS, and N Cregg

Subjects
Gynecology, medicine.medical_specialty, In vitro fertilisation, business.industry, medicine.medical_treatment, Intensivist, Ovarian hyperstimulation syndrome, Critical Care and Intensive Care Medicine, medicine.disease, Intensive care unit, law.invention, Vascular space, law, medicine, Ovulation induction, Complication, business, Ovarian enlargement
Abstract

Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of ovulation induction. With the increasing popularity of assisted reproductive techniques, OHSS will be encountered more frequently by the intensivist. The first case of severe OHSS following in vitro fertilisation (IVF) was reported by Friedman et al in 1984. Although rare, severe OHSS is a life-threatening condition requiring admission to the intensive care unit (ICU). We report a case of severe OHSS following the GIFT (gamete intrafallopian tube transfer) procedure.The characteristic features of OHSS, namely ovarian enlargement with passage of fluid and protein from the vascular space into peritoneal and pleural cavities, is well illustrated by this case report.

Published
1996
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4. National scientific medical meeting 1995 abstracts

Author

S. Norris, C. Collins, J. Hegarty, C. O’Farrelly, J. Carton, L. Madrigal, D. P. O’Donoghue, H. Holloway, J. F. Fielding, W. Mullins, S. W. Hone, M. Donnelly, F. Powell, A. W. Blayney, E. A. Cahill, S. F. Daly, M. J. Turner, P. A. Sullivan, M. McLoughlin, M. M. Skelly, H. E. Mulcahy, T. Connell, C. Duggan, M. J. Duffy, A. Troy, K. Sheahan, A. Whelan, C. M. Herra, C. T. Keane, H. Johnson, B. Lee, E. Doherty, T. McDonnell, D. Mulherin, O. FitzGerald, B. Bresnihan, H. M. Hassett, A. Boyce, V. Greig, C. O’Herlihy, P. P. A. Smyth, E. F. Roche, I. McCormack, E. Tempany, M. J. Cullen, D. F. Smith, Y. McBrinn, B. Murray, R. Freaney, D. Keating, M. J. McKenna, J. A. O’Hare, H. Alam, Q. Raza, M. Geoghegan, S. Killalea, M. Hall, J. Feely, L. Kyne, B. O’Hara, M. Cullen, I. M. Rea, J. P. Donnelly, R. W. Stout, P. Lacey, M. J. Donnelly, J. McGrath, T. P. Hennessy, C. V. I. Timon, D. Hyde, H. X. Xia, M. Buckley, C. O’Morain, S. Keating, H. Xia, J. P. McGrath, R. C. Stuart, P. Lawlor, P. J. Byrne, T. N. Walsh, T. P. J. Hennessy, M. Duffy, M. Tubridy, J. Redmond, K. Monahan, R. P. Murphy, D. R. Headon, T. O’Gorman, F. M. O’Reilly, C. Darby, G. M. Murphy, A. Murphy, M. Codd, P. Dervan, D. Lawlor, S. O. Loughlin, N. Flanagan, R. Watson, L. Barnes, C. Kilgallen, E. Sweeney, A. Mynes, D. Mooney, I. Donoghue, O. Browne, J. A. Kirrane, D. McKenna, M. Young, E. O’Toole, S. O’Briain, U. Srinivasan, C. Feighery, N. Leonard, E. Jones, M. A. Moloney, D. G. Weir, M. Lawler, A. O’Neill, H. Gowing, D. Pamphilon, S. R. McCann, G. O’Toole, A. Orren, C. M. Seifer, D. C. Crowley, G. J. Sheehan, T. Deignan, J. Kelly, V. J. Tormey, J. Faul, C. Leonard, C. M. Burke, L. W. Poulter, S. Lynch, G. McEntee, O. Traynor, E. Barry, P. Costello, A. Keavney, R. Willoughby, C. O’Donnell, M. Cahill, A. Earley, P. Eustace, R. Osborne, C. Saidlear, B. Holmes, A. Early, A. P. Moran, A. Neisser, R. J. Polt, H. Bernheimer, M. Kainz, B. Schwerer, L. Gallagher, R. Firth, N. Kennedy, E. McGilloway, N. Tubridy, K. Shields, W. K. Cullen, M. J. Rowan, A. R. Moore, M. Rowan, D. Coakley, B. Lawlor, G. Swanwick, R. Al-Naeemi, R. Murphy, N. M. Codd, M. Goggins, N. P. Kennedy, B. L. Mallon, H. Mulcahy, M. Skelly, D. O. Donoghue, D. McCarthy, A. Saunders, D. J. Veale, J. J. F. Belch, D. Breathnach, E. Murphy, G. Kernohan, K. Gibson, A. G. Wilson, G. W. Duff, N. de Vries, L. B. A. van de Putte, J. Donoghue, F. O’Kelly, Z. Johnson, T. Maher, A. Moran, C. Keane, D. O’Neill, N. Horgan, J. M. Barragry, D. M. Campbell, M. Behan, P. R. O’Connell, V. S. Donnelly, D. Crowley, M. Geary, P. Boylan, M. Fanagan, K. Hickey, T. Teoh, M. Doyle, R. Harrison, D. Lyons, Y. Shenouda, M. Coughlan, P. McKenna, P. Lenehan, M. Foley, P. Kelehan, P. Ravichandran, M. Kelly, A. Conroy, C. Fitzpatrick, D. Egan, C. L. Regan, B. V. McAdam, P. McParland, G. A. FitzGerald, D. J. Fitzgerald, S. C. Sharma, K. Foran, C. Barry-Kinsella, R. F. Harrison, F. J. Gillespie, P. O’Mahony, M. Boyle, M. J. White, F. Donohoe, Y. Birrane, M. Naughton, R. B. Fitzsimons, M. Piracha, S. McConkey, E. Griffin, E. Hayes, T. Clarke, N. Parfrey, K. Butler, A. J. Malone, P. J. Kearney, P. F. Duggan, A. Lane, R. Keville, M. Turner, S. Barry, D. Sloan, S. Gallagher, M. Darby, P. Galligan, J. Stack, N. Walsh, M. O’Sullivan, M. Fitzgerald, D. Meagher, S. Browne, C. Larkin, P. Casey, E. O’Callaghan, S. Rooney, E. Walsh, M. Morris, T. Burke, M. Roe, C. Maher, M. Wrigley, M. Gill, M. Burgess, E. Corcoran, D. Walsh, B. Gilmer, C. B. Hayes, L. Thornton, J. Fogarty, R. Lyons, M. O’Connor, V. Delaney, K. Buckley, D. Lillis, V. Delany, C. Hayes, P. Dack, D. Igoe, H. J. O’Neill, P. Kelly, D. McKeown, L. Clancy, G. Varghese, S. Hennessy, J. J. Gilmartin, K. Birthistle, D. Carrington, H. Maguire, P. Atkinson, C. Foley-Nolan, M. Lynch, B. Cryan, D. Whyte, C. Conlon, V. Kucinskas, U. Usinskiene, I. Sakalyte, E. Dawson, K. Molloy, N. Goulden, J. Doyle, E. Lawlor, M. G. Harrington, N. El-Nageh, M. -L. Nolan, J. O’Riordan, G. Judge, G. Crotty, T. Finch, M. Borton, T. Barnes, O. Gilligan, G. Lee, R. Limmer, M. Madden, C. Bergin, A. O’Leary, F. Mulcahy, F. Wallis, M. Glennon, M. Cormican, U. NiRiain, M. Heiginbothom, F. Gannon, T. Smith, C. O’Sullivan, R. Hone, D. A. Caugant, C. A. P. Fijen, E. J. Van Schalkwyk, G. J. Coetzee, U. Ni Riain, M. G. Cormican, L. Park, J. Flynn, V. Regazzoli, M. Hayes, G. Nicholson, P. Higgins, N. Flynn, G. Corbett-Feeney, D. J. Conway, N. J. O’Higgins, S. Rajendiran, J. Byrne, E. Kilfeather, P. Dingle, M. Hunter, S. K. Al-Ghazal, P. Stanley, J. Palmer, A. Hong, P. Saxby, D. Sheehan, I. Regan, J. O’Mullane, M. Ni Chaoimh, M. Leahy, J. J. Heffron, M. Lehane, C. Keohane, N. O’Leary, M. Sheehan, E. Renny-Walsh, M. J. Whelton, C. T. Doyle, J. Webster, N. Benjamin, S. FitzGerald, J. S. Chadha, M. G. FitzGerald, G. R. FitzGerald, L. Hemeryck, P. McGettigan, J. Golden, N. Arthur, S. Y. Wen, P. Deegan, T. Cooke, G. I. Adebayo, P. Gaffney, M. Sinnot, D. O’Riordan, T. Hayes, C. M. O’Connor, M. X. FitzGerald, C. Costello, G. Finlay, J. Hayes, C. O’Connor, K. McMahon, S. Hone, J. Robertson, R. Coakley, S. O’Neill, M. Walsh, J. McCarthy, D. Lannon, A. E. Wood, R. Sharkey, E. Mulloy, M. Long, I. Kilgallen, V. Tormey, S. Horne, T. Feeney, Ó. Ó Muiré, M. J. Griffin, D. Hughes, A. Knaggs, D. Magee, C. McCrory, B. March, D. Phelan, M. White, J. Fabry, D. Buggy, C. Cooney, E. Aziz, D. O’Keefe, A. J. McShane, J. Boylan, E. Tobin, C. Motherway, F. Colreavy, N. Denish, R. Dwyer, A. Bergin, K. O’Brien, R. MacSullivan, K. D. Carson, W. P. Blunnie, D. C. Moriarty, B. Kinirons, B. Lyons, N. Cregg, W. Casey, K. P. Moore, S. A. Colbert, C. Ecoffey, D. O’Gorman, J. Fitzgerald, P. Diamond, M. B. Codd, D. D. Sugrue, J. Kellett, M. Tighe, C. J. McKenna, J. Galvin, H. A. McCann, A. Scallon, A. Fraser, M. Norton, G. Tomkin, I. Graham, A. Byrne, M. Maher, N. Moran, D. Fitzgerald, D. O’Callaghan, D. Coyle, A. G. Nugent, C. McGurk, G. D. Johnston, A. Nugent, B. Silke, N. Murphy, L. Jennings, D. Pratico, C. Doyle, T. Hennessy, H. McCann, D. Sugrue, S. Donnelly, A. Hennessy, C. Hartigan, D. MacDonald, S. Blake, D. McDonald, D. Dominque, S. R. McMechan, G. MacKenzie, J. Allen, G. T. Wright, G. J. Dempsey, M. Crawley, J. Anderson, A. A. J. Adgey, M. T. Harbinson, N. P. S. Campbell, C. M. Wilson, P. K. Ellis, E. M. McIlrath, A. McShane, T. V. Keaveny, K. Rabenstein, F. Scheller, D. Pfeiffer, C. Urban, I. Moser, G. Jobst, A. Manz, S. Verpoorte, F. Dempsey, D. Diamond, M. Smyth, E. Dempsey, V. Hamilton, J. Twomey, R. Crowley, L. Fenelon, F. Walsh, J. McCann, P. McDonagh, E. McGovern, D. Luke, K. Crowley, D. Mannion, D. Murphy, K. Clarkson, E. Carton, I. Leonard, D. O’Toole, M. Staunton, M. Griffin, D. Owens, P. Collins, A. Johnson, G. H. Tomkin, N. A. Herity, J. D. Allen, R. O’Moore, G. M. Crotty, M. DeArce, K. Nikookam, P. Keenan, D. Cregan, N. O’Meara, S. Forman, D. A. Cusack, and B. Farrell

Subjects
medicine.medical_specialty, business.industry, Family medicine, medicine, MEDLINE, General Medicine, business
Published
1995
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5. Oliguria during corrective spinal surgery for idiopathic scoliosis: the role of antidiuretic hormone

Author

N, Cregg, D, Mannion, and W, Casey

Subjects
Male, Adolescent, Central Venous Pressure, Vasopressins, Dopamine, Osmolar Concentration, Sodium, Oliguria, Spine, Diuresis, Scoliosis, Humans, Female, Postoperative Period, Cardiac Output, Anesthesia, Inhalation, Child, Intraoperative Complications
Abstract

Patients undergoing surgery for idiopathic scoliosis were studied to determine the incidence and aetiology of oliguria during the perioperative period and to evaluate the efficacy of low dose dopamine in preventing its occurrence. Thirty patients, aged 6-18 years undergoing elective surgery were studied. Anaesthesia was standardized. Patients were randomized to receive either dopamine infusion (3 micrograms.kg-1.min-1) (Group A) (n = 15) or dextrose infusion (control) (Group B) (n = 15). Serum and urinary electrolytes and osmolalities and serum antidiuretic hormone (ADH) concentrations were measured. Urine output and haemodynamic parameters were recorded. Intraoperative oliguria occurred in 7% of patients in Group A and 47% in Group B (P0.05). Postoperative oliguria occurred in 20% of patients in Group A and 47% in Group B (P0.05). Urine and serum biochemical analysis revealed a statistically significant decrease in serum sodium and osmolality (P0.005) and an increase in urinary sodium and osmolality in both groups. Serum ADH concentrations were increased in both groups (P0.05), returning to baseline 18 h postoperatively. We conclude that oliguria during corrective spinal surgery occurs in association with excess ADH secretion as opposed to perioperative hypovolaemia. Dopamine increases urine output in the perioperative period but does not prevent the release of ADH and its subsequent biochemical effects.

Published
1999

6. Ecstasy intoxication - an unusual presentation

Author

J Moriarty, M White, and N Cregg

Subjects
medicine.medical_specialty, Presentation, business.industry, media_common.quotation_subject, Ecstasy, medicine, Critical Care and Intensive Care Medicine, Psychiatry, business, media_common
Published
1996
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8. Adverse ventilatory strategy causes pulmonary-to-systemic translocation of endotoxin.

Author

Murphy DB, Cregg N, Tremblay L, Engelberts D, Laffey JG, Slutsky AS, Romaschin A, and Kavanagh BP

Subjects
Animals, Blood Gas Analysis, Lung microbiology, Male, Rabbits, Random Allocation, Bacterial Translocation, Endotoxins blood, Positive-Pressure Respiration adverse effects
Abstract

Accumulating evidence strongly suggests that ventilatory strategy has an important impact on development of lung injury and patient outcome. Adverse ventilatory strategies have been shown to cause release of pulmonary-derived cytokines and may permit bacterial translocation from the lung to the systemic circulation. Because endotoxin is a potent and clinically important stimulant of cytokine-mediated systemic inflammatory responses that can lead to multiorgan failure, we investigated the effects of ventilatory strategy on lung-to-systemic translocation of endotoxin. We studied the effects of protective (tidal volume [VT] 5 ml. kg(-)(1), positive end-expiratory pressure [PEEP] 10 to 12.5 cm H(2)O) versus nonprotective (VT 12 ml. kg(-)(1), PEEP zero) ventilatory strategy on translocation of endotracheally instilled endotoxin. Anesthetized New Zealand White rabbits were subjected to saline lung lavage, and 32 were randomized to one of four groups: PS (protective ventilation + instilled saline); PE (protective ventilation + instilled endotoxin); NS (nonprotective ventilation + instilled saline); NE (nonprotective ventilation + instilled endotoxin), and ventilated for 3 h. Plasma endotoxin levels increased significantly in the NE group, and remained low and unchanged in the other groups. Peak levels of plasma tumor necrosis factor-alpha (TNF-alpha) were higher in NE versus other groups. Pa(O(2)) and mean arterial pressure (Pa) were lowest, and requirement for pressor and bicarbonate support greatest, in the NE group. Finally, plasma endotoxin levels were significantly greater in eventual nonsurvivors than survivors. These data provide convincing evidence for pulmonary translocation of lung-derived endotoxin. This translocation depends on ventilatory strategy, and suggests a pathophysiologic link between ventilatory strategy and outcome.

Published
2000
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9. Morbidity outcome in patients with hypertrophic obstructive cardiomyopathy undergoing cardiac septal myectomy: early-extubation anesthesia versus high-dose opioid anesthesia technique.

Author

Cregg N, Cheng DC, Karski JM, Williams WG, Webb G, and Wigle ED

Subjects
Adjuvants, Anesthesia administration & dosage, Analgesics, Opioid administration & dosage, Anesthesia adverse effects, Anesthetics, Combined administration & dosage, Anesthetics, Intravenous, Benzodiazepines administration & dosage, Female, Fentanyl administration & dosage, Humans, Intubation, Intratracheal, Male, Midazolam administration & dosage, Middle Aged, Propofol administration & dosage, Retrospective Studies, Time Factors, Anesthesia methods, Cardiomyopathy, Hypertrophic surgery, Heart Septum surgery, Postoperative Complications
Abstract

Objective: Anesthetic management of patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing septal myectomy is challenging. The morbidity outcome of early-extubation anesthesia (EEA), or fast tracking, versus high-dose opioid (HDO) anesthesia was studied., Design: Retrospective study., Setting: University teaching hospital., Participants: One hundred seventy-five cardiac septal myectomy patients (EEA, n = 53; HDO, n = 122)., Interventions: EEA technique consisted of low-dose fentanyl, 10 to 15 microg/kg; propofol infusion; midazolam; and inhalation agent. HDO technique consisted of fentanyl, 50 to 100 microg/kg, and benzodiazepines, with or without an inhalation agent. Demographic data, preoperative symptoms, and data on anesthesia management and postoperative complications were recorded., Measurements and Main Results: There were no differences between the groups (EEA v HDO, respectively) regarding age, sex, preoperative symptoms (dyspnea, 89% v 79%; palpitations, 28% v 26%; angina, 47% v 61%; syncope, 47% v 41%), redo surgery, or combined surgery. Mean +/- standard deviation time to tracheal extubation was 7.2 +/- 5.3 hours in EEA versus 19.4 +/- 10.5 hours in HDO patients (p < 0.0001). Intensive care unit (ICU) stay was significantly shorter in EEA versus HDO patients (2.2 v 3.0 days; p < 0.005), with the trend toward earlier hospital discharge (9.7 v 11.3 days; p = 0.09). There was a high requirement for temporary pacing in both groups immediately postoperatively (EEA, 60% v HDO, 48%; p > 0.08). Permanent pacemaker insertion postoperatively was required in 7 of 53 patients (13%) in the EEA group and 11 of 122 patients (9%) in the HDO group (p > 0.25). Atrial arrhythmias occurred postoperatively in 25% of EEA patients versus 34% of HDO patients (p > 0.08)., Conclusion: EEA facilitates earlier tracheal extubation by 12 hours in patients with HOCM undergoing septal myectomy, significantly shortening ICU stay by 1 day without increasing perioperative cardiac morbidity or mortality.

Published
1999
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10. Oliguria during corrective spinal surgery for idiopathic scoliosis: the role of antidiuretic hormone.

Author

Cregg N, Mannion D, and Casey W

Subjects
Adolescent, Anesthesia, Inhalation, Cardiac Output drug effects, Central Venous Pressure physiology, Child, Diuresis drug effects, Dopamine therapeutic use, Female, Humans, Intraoperative Complications blood, Intraoperative Complications physiopathology, Intraoperative Complications prevention & control, Male, Oliguria blood, Oliguria physiopathology, Oliguria prevention & control, Osmolar Concentration, Postoperative Period, Sodium blood, Sodium urine, Vasopressins blood, Intraoperative Complications etiology, Oliguria etiology, Scoliosis surgery, Spine surgery, Vasopressins physiology
Abstract

Patients undergoing surgery for idiopathic scoliosis were studied to determine the incidence and aetiology of oliguria during the perioperative period and to evaluate the efficacy of low dose dopamine in preventing its occurrence. Thirty patients, aged 6-18 years undergoing elective surgery were studied. Anaesthesia was standardized. Patients were randomized to receive either dopamine infusion (3 micrograms.kg-1.min-1) (Group A) (n = 15) or dextrose infusion (control) (Group B) (n = 15). Serum and urinary electrolytes and osmolalities and serum antidiuretic hormone (ADH) concentrations were measured. Urine output and haemodynamic parameters were recorded. Intraoperative oliguria occurred in 7% of patients in Group A and 47% in Group B (P < 0.05). Postoperative oliguria occurred in 20% of patients in Group A and 47% in Group B (P > 0.05). Urine and serum biochemical analysis revealed a statistically significant decrease in serum sodium and osmolality (P < 0.005) and an increase in urinary sodium and osmolality in both groups. Serum ADH concentrations were increased in both groups (P < 0.05), returning to baseline 18 h postoperatively. We conclude that oliguria during corrective spinal surgery occurs in association with excess ADH secretion as opposed to perioperative hypovolaemia. Dopamine increases urine output in the perioperative period but does not prevent the release of ADH and its subsequent biochemical effects.

Published
1999
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11. Hypercapnic acidosis may attenuate acute lung injury by inhibition of endogenous xanthine oxidase.

Author

Shibata K, Cregg N, Engelberts D, Takeuchi A, Fedorko L, and Kavanagh BP

Subjects
Acidosis enzymology, Analysis of Variance, Animals, Blood Pressure physiology, Capillaries physiopathology, Capillary Permeability physiology, Carbon Dioxide administration & dosage, Free Radicals antagonists & inhibitors, Hydrostatic Pressure, Hypercapnia enzymology, Lung blood supply, Male, Microcirculation physiology, Nitric Oxide Synthase antagonists & inhibitors, Pulmonary Artery physiopathology, Purines adverse effects, Rabbits, Reperfusion Injury enzymology, Reperfusion Injury physiopathology, Respiration, Artificial adverse effects, Respiratory Distress Syndrome chemically induced, Respiratory Distress Syndrome prevention & control, Uric Acid antagonists & inhibitors, Vascular Resistance physiology, Xanthine Oxidase adverse effects, Acidosis physiopathology, Hypercapnia physiopathology, Respiratory Distress Syndrome physiopathology, Xanthine Oxidase antagonists & inhibitors
Abstract

Relative hypoventilation, involving passively-or "permissively"-generated hypercapnic acidosis (HCA), may improve outcome by reducing ventilator-induced lung injury. However, the effects of HCA per se on pulmonary microvascular permeability (Kf,c) in noninjured or injured lungs are unknown. We investigated the effects of HCA in the isolated buffer-perfused rabbit lung, under conditions of: (1) no injury; (2) injury induced by warm ischemia-reperfusion; and (3) injury induced by addition of purine and xanthine oxidase. HCA (fraction of inspired carbon dioxide [FICO2] 12%, 25% versus 5%) had no adverse microvascular effects in uninjured lungs, and prevented (FICO2 25% versus 5%) the increase in Kf,c following warm ischemia-reperfusion. HCA (FICO2 25% versus 5%) reduced the elevation in Kf,c, capillary (Pcap), and pulmonary artery (Ppa) pressures in lung injury induced by exogenous purine/xanthine oxidase; inhibition of endogenous NO synthase in the presence of 25% FICO2 had no effect on Kf,c, but attenuated the reduction of Pcap and Ppa. HCA inhibited the in vitro generation of uric acid from addition of xanthine oxidase to purine. We conclude that in the current models, HCA is not harmful in uninjured lungs, and attenuates injury in free-radical-mediated lung injury, possibly via inhibition of endogenous xanthine oxidase.

Published
1998
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12. Repair of ventricular septal defect in a child with severe pulmonary hypertension-response to inhaled nitric oxide.

Author

Cregg N and Casey W

Abstract

Nitric oxide (NO), was administered successfully, to a child with severe pulmonary hypertension, following surgical repair of a large ventricular septal defect. Inhalation of NO, 20-25 parts per million (ppm) was continued for 24 h, resulting in mean pulmonary artery pressure (PAP) of 25 mmHg and permitting a reduction in both ventilatory and inotropic support. Weaning of NO was commenced. At 5 ppm, administration was discontinued. An immediate and dramatic increase in PAP occurred. A similar pattern resulted on further attempts, demonstrating the extreme sensitivity of the pulmonary vasculature to the effects of inhaled low dose NO and the selectivity of the response., (1997 Blackwell Science Ltd.)

Published
1997
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13. Primary congenital pulmonary hypoplasia--genetic component to aetiology.

Author

Cregg N and Casey W

Subjects
Consanguinity, Cyanosis congenital, Disease Progression, Dyspnea congenital, Fatal Outcome, Female, Fetal Organ Maturity, Genetics, Humans, Infant, Newborn, Lung embryology, Mediastinal Emphysema congenital, Pneumothorax congenital, Respiratory Distress Syndrome, Newborn etiology, Lung abnormalities
Abstract

Primary congenital pulmonary hypoplasia, defined as congenital pulmonary hypoplasia occurring in the absence of other congenital anomalies, is an exceedingly rare condition of unknown aetiology. We report on two cases that presented as severe progressive respiratory failure immediately after birth in siblings of a consanguinous marriage, and we postulate that a genetic aetiology may be responsible for the arrest of lung maturation in utero. The possibility of a genetic component to the aetiology has not been previously documented in the literature.

Published
1997
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14. Humidification reduces coughing and breath-holding during inhalation induction with isoflurane in children.

Author

Cregg N, Wall C, Green D, Mannion D, and Casey W

Subjects
Child, Child, Preschool, Female, Humans, Humidity, Infant, Male, Anesthetics, Inhalation adverse effects, Cough prevention & control, Isoflurane adverse effects, Respiration drug effects
Abstract

Purpose: Inhalation induction using isoflurane is associated with airway irritability, coughing, breath-holding and laryngospasm. These complications are more common in children. This study was designed to determine if humidification of isoflurane in oxygen/nitrous oxide would reduce respiratory complications and hypoxic episodes at induction., Methods: Fifty-nine unpremedicated children, aged three months to 12 yr, were enrolled in the study and randomised to receive either humidified isoflurane (n = 27, Group A), or non-humidified isoflurane (n = 32, Group B). All inductions of anaesthesia were with isoflurane 4% in 50% oxygen/nitrous oxide. Subjects were observed for the occurrence of breath-holding, coughing, laryngospasm, bronchospasm, secretions, and hiccoughs. The severity of each complication was graded on a scale of 0-3. The need to administer 100% oxygen and/or succinylcholine was also identified., Results: Coughing (33% vs 53%) was more frequent in Group B (P < 0.05). Coughing severity scores (13 vs 36) and breath-holding severity scores (8 vs 19) were also greater in Group B (P < 0.05). A change in FIO2 was required more frequently in Group B (4% vs 16%). Although there was a high incidence of laryngospasm in both groups (52% vs 59%), no other differences were identified, breath-holding (26% vs 31%), secretions (30% vs 31%), hiccough (11% vs 12.5%) (P > 0.05)., Conclusion: Humidification of inspired isoflurane reduces the frequency and severity of coughing, the severity of breath-holding, and the need to increase supplemental inspired oxygen concentration, when isoflurane is used for inhalation induction of anaesthesia in children. Humidification has no effect, however, on the frequency and severity of laryngospasm, or on the frequency of occurrence of arterial oxygen desaturation.

Published
1996
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15. Analgesia after otoplasty: regional nerve blockade vs local anaesthetic infiltration of the ear.

Author

Cregg N, Conway F, and Casey W

Subjects
Adolescent, Child, Child, Preschool, Female, Humans, Lidocaine administration & dosage, Male, Nausea prevention & control, Vomiting prevention & control, Analgesia, Anesthetics, Local administration & dosage, Ear, External surgery, Nerve Block, Pain, Postoperative therapy
Abstract

Purpose: Children scheduled to undergo otoplasty experience severe pain postoperatively. Nausea and vomiting is also a problem. This study was designed to compare two analgesic techniques (i) regional nerve blockade (ii) local anaesthetic infiltration, with respect to quality and duration of analgesia, opioid requirements and the incidence of postoperative nausea and vomiting (PONV)., Methods: Forty three children, ASA I-II, aged 3-15 yr, were studied and followed for 24 hr postoperatively. Patients were randomised into two groups. Patients in Group A received local infiltration with lidocaine 1% with adrenaline 1:200,000 0.4 ml.kg-1 (n = 21). Patients in Group B (n = 22) received nerve blockade, bupivacaine 0.5%, 0.4 ml.kg-1. No other form of analgesia was used intraoperatively. Quality and duration of analgesia were assessed using pain and sedation scores recorded by a blinded observer at 0, 5, 10, 15, 30, 45 min with Recovery Room, and at 0, 30, 60, 90, 120, 180, 240, 360, 480 min on the ward. Pain score > 6 was treated with fentanyl 1 microgram.kg-1 iv (recovery) and morphine 0.2 mg.kg-1 im or mefenamic acid 8 mg.kg-1 po on the ward. Time to first supplemental analgesia was noted. Mean duration of analgesia was 8.6 (1.1-24) hr, Group A and 10.5 (1.3-24) hr, Group B (P > 0.7). 24% per cent of children (Group A) and 27% (Group B) required no supplemental analgesia (P > 0.6). The degree of pain control resulted in a low requirement for opioids, Group A: 24%, Group B: 14% (P:NS). The overall incidence of PONV was 43% (Group A) and 36% (Group B) (P:NS): PONV correlated with opioid use. There were no differences between the groups with regard to pain/sedation scores, quality/duration of analgesia, opioid requirements and incidence of PONV., Conclusion: Both techniques provided excellent postoperative analgesia. Lidocaine 1% infiltration (adrenaline 1:200,000) has the added advantage of improving surgical field and haemostasis. Thus, we advocate use of the simpler technique.

Published
1996
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16. Premedication for ambulatory surgery in preschool children: a comparison of oral midazolam and rectal thiopentone.

Author

Lyons B, Cregg N, Conway F, Casey W, Doherty P, and Moore KP

Subjects
Administration, Oral, Administration, Rectal, Ambulatory Surgical Procedures, Child, Preschool, Female, Humans, Infant, Male, Masks, Midazolam administration & dosage, Preanesthetic Medication, Thiopental administration & dosage
Abstract

Seventy five ASA 1 and 2 children, aged between six months and five years were randomized to receive oral midazolam 0.5 mg.kg-1, rectal thiopentone 35 mg.kg-1 or no premedication to compare the safety and efficacy of, and parental attitudes to, both premedicants. Cardio-respiratory variables were from the time of premedication to awakening from anaesthesia. In addition, anxiety and sedation scores and patients' acceptance of both premedicant and mask at induction, were all recorded using four-point rating scales. Times to recovery and discharge, and parental satisfaction with the premedication their child had received were also recorded. Children receiving rectal thiopentone had higher sedation scores and were more accepting of the mask than were the other two groups (P < 0.001). Their acceptance of the premedication was similar to that of the midazolam group. Times to spontaneous eye opening and discharge were longer in the thiopentone group (P < 0.005). Parental preoperative satisfaction rating was higher for thiopentone, but not midazolam, than no premedication (P < 0.05). When asked their premedication preferences for subsequent general anaesthetics, a higher proportion of parents whose children were not premedicated requested an alternative regimen (P < 0.01). In conclusion the study found that premedication with rectal thiopentone provided superior induction characteristics to oral midazolam, but with a longer recovery period.

Published
1995
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