1,454 Works

The Development of Cell-Mediated Tissue Engineered Collagen-Based Strategies for Osteochondral Defect Repair

Conor Moran
Smooth articular cartilage is vital for the pain free movement of the joint, therefore the formation of osteochondral defects remains a challenge for orthopaedic surgeons. The hyaline cartilage, however is avascular and is poorly supplied with cells roughly 1.7% cell volume density in the medial femoral condyle (Hunziker, 1999). Therefore, any injury to the joint surface does not heal easily. The latest focus is on tissue engineering techniques to design scaffolds that can be implanted...

Improving the Recognition and Management of Common Mental Disorders in Government-Operated Primary Care Settings in Penang, Malaysia: Feasibility of a Pilot Primary Care Consultation-Liaison Psychiatry Service and Impact on Undergraduate Medical Education

Vincent Russell
International evidence suggests that the implementation of evidence-based interventions for common mental disorders (CMDs) in primary care settings is challenging, especially in low and middle-income countries. This thesis is based on a clinical and medical educational research initiative carried out by the author at Penang Medical College, Malaysia in collaboration with local academic colleagues and clinicians and support from academics in his home institution in RCSI, Dublin. The aims of the study were to explore...

The role of AIB-1 and PEA-3 in a signalling pathway mediating breast cancer invasion

Zahra Al-Hilli
Tumour invasion and metastasis is mediated in part through the action of Cyclooxygenase-2 (COX-2) and Matrix Metalloproteinases (MMP). COX-2 mediated production of prostaglandins drives tumour growth through cell proliferation and angiogenesis, while MMPs have a role in degrading the extracellular membrane, which in turn promotes cell motility and invasiveness. The over-expression of these genes has been shown to be a marker of cancer cells with a higher metastatic potential. Unfortunately, the exact mechanism involved in...

Diabetes Mellitus and Pregnancy: Influence of Maternal and Fetal Factors on Pregnancy Outcomes

Pregnancy in women with pre-gestational type 1 diabetes mellitus (TI DM) is associated with increased rates of fetal morbidity and mortality. Little data exists on pregnancy outcomes in patients with TI DM pregnancy in Ireland. In this thesis I present the results of one large audit and 9 smaller studies of 600 women with T1 DM attending at the combined diabetes-obstetric antenatal clinics from 1995-2006 in Dublin. Outcomes of pregnancy in patients with TlDM are...

Pre-operative quadriceps femoris neuromuscular electrical stimulation in total knee arthroplasty : a clinical and molecular analysis.

Raymond John Walls
Patients with knee osteoarthritis (OA) have asymmetrical muscle weakness due to neuromuscular activation deficits and muscle atrophy. Quadriceps muscle (QFM) strength declines after total knee arthroplasty (TKA) with associated functional impairment. The ultimate purpose of this investigation was to determine the effects of preoperative neuromuscular electrical stimulation (NMES) on quadriceps muscle strength and functional recovery after TKA. Patients undergoing TKA for advanced knee OA were randomised into control or intervention (NMES) groups. NMES was applied...

Platelet Reactivity and Pregnancy Loss

Karen Flood
Although many advances in reproductive medicine have been made during the past quarter century, miscarriage remains the most common complication of pregnancy. Recurrent Miscarriage (RM) is traditionally defined as three or more consecutive losses before 20 weeks post menstruation. A causal factor can be identified in less than half of affected couples, leading to the term idiopathic RM in the remainder. The empiric use of the antiplatelet agent aspirin is widespread in this population as...

Hypothalamic disease in craniopharyngioma patients.

Rachel K. Crowley
Craniopharyngioma (CP) patients suffer from high rates of morbidity and mortality. The aim of this study was to describe hypothalamic morbidityand establish the standardised mortality ratio for CP patients attendingthe national neurosurgical unit in Ireland; to investigate abnormalities ofthirst, sleep disorders and somnolence, glucose tolerance and abnormalhormonal responses to food intake, in CP patients. The standardised mortality ratio for craniopharyngioma patients in this study was 8.75, with a predominance of deaths due to cardiovascular andrespiratory...

Transoesophageal Echocardiographic - Defined Valvular Strands in Acute Ischaemic Stroke: A Prospective Study

Albi J. Chalissery
Background: Transoesophageal echocardiographic (TOE)-defined mobile, thread-like valvular strands (VS) have been associated with acute ischaemic stroke (AIS). The relationship between VS as a possible embolic substrate and the risk of recurrent stroke remains unclear. Our primary aims were to measure the prevalence of VS and explore their association with AIS in a case-control study and then, compare the risk of subsequent poor vascular outcome (vascular events and vascular death) in the stroke cohort patients with...

An MRI and H1-MRS study of dementia in down's syndrome and alzheimer's disease in the general population.

Diane Mullins
Introduction Dementia is a progressive and largely irreversible clinical syndrome which is characterised by a disturbance of higher cortical functioning, occurring in clear consciousness. Alzheimer’s disease is the most common form of dementia. People with Down’s syndrome, the most common genetic cause for intellectual disability, have a significantly increased risk for developing Alzheimer’s disease in later life. Neuroimaging is an important tool in the preclinical detection and monitoring of Alzheimer’s disease. Much attention has focused...

Proficiency-based simulation training in open and endovascular surgery.

Hazem Hseino
The traditional form of surgical skills training and recent changes in health care have created challenges in keeping up the standards in skills training of future surgeons. The structured development of simulation training might help tackle these challenges. The main aim of this thesis was to explore whether basic surgical skills acquired using proficiency-based simulation training in superficial femoral artery (SFA) angioplasty and saphenofemoral junction (SFJ) dissection translate to real-world performance. Four studies were performed....

Neoadjuvant chemoradiotherapy in oesophageal cancer : response, outcome and the role of surgery

Heidi Furlong
Neoadjuvant chemoradiotherapy in oesophageal cancer : response, outcome and the role of surgery

Endothelial progenitor cells in mothers of low birthweight infants : a link between defective placentation and increased cardiovascular risk.

Thomas FJ King
Aims: This study tested the hypothesis that endothelial progenitor cell (EPC) pathology provides a unifying explanation for the tendency to carry low birthweight babies and subsequent increased maternal cardiovascular risk. Methods: We measured maternal EPC number and function, conventional cardiovascular risk markers, and cord blood adiponectin in 23 small for gestational age (SGA; birthweightcentile) and 23 appropriate for gestational age (AGA; birthweight >10th centile) pregnancies. Results: Median EPC count was lower (294 vs. 367, p=0.005),...

Endothelial progenitor cells in mothers of low birthweight infants : a link between defective placentation and increased cardiovascular risk.

Thomas FJ King
Aims: This study tested the hypothesis that endothelial progenitor cell (EPC) pathology provides a unifying explanation for the tendency to carry low birthweight babies and subsequent increased maternal cardiovascular risk. Methods: We measured maternal EPC number and function, conventional cardiovascular risk markers, and cord blood adiponectin in 23 small for gestational age (SGA; birthweightcentile) and 23 appropriate for gestational age (AGA; birthweight >10th centile) pregnancies. Results: Median EPC count was lower (294 vs. 367, p=0.005),...

Anti tumour necrosis factor - alpha : does it rescue bone loss in inflammatory bowel disease patients?

Sundaram G. Veerappan
I. I inflammatory Bowe1 Disease I. I. I General Overview Inflammatory bowel disease (IBD) is a group of disorders of the gastrointestinal tract characterized by intestinal inflammation and a chronic relapsing course. IBD has traditionally been categorized as either ulcerative colitis (UC) or Crohn's disease (CD) on the basis of clinical, radiological, endoscopic and histological criteria [I], (Figure 1.1 and Figure 1.2). About 10 % of colitis cases show overlapping features of the two major...

Genetic risk profiling to predict surgical outcome in inflammatory bowel disease patients.

BACKGROUND: Severe pouchitis (SP) and Crohn's disease (CD)-like complications confound the success o f the ileal pouch anal anastomosis (IPAA) in patients with ulcerative colitis. Furthermore, there are no clear criteria for judging the severity of disease in patients with CD. Yet classification of patients into low- and high-risk severity groups would benefit both medical and surgical management. To date, approximately 83 single nucleotide polymorphisms (SNPs) within 55 genes have been associated with IBD. OBJECTIVE:...

The Effects of Prehabilitation on the Outcome of Anterior Cruciate Ligament Reconstruction

Introduction: Anterior cruciate ligament injury results in quadriceps femoris atrophy. The effects of atrophy can persist after 5 years post anterior cruciate ligament reconstruction (ACLR) and can prolong rehabilitation [4]. Prehabilitation has been defined as preparing an individual to withstand a stressful event through enhancement of functional capacity before surgery [5]. We hypothesise that a preoperative exercise programme would enhance postoperative recovery. Aims: To determine the effects of a 6-week lower limb strengthening and proprioceptive...

The Sodium Potassium ATPase, Caveolin 1 and their Interaction as Potential Anti-Breast Cancer Therapeutic Targets

Mark Owens
Breast cancer pathogenesis is modulated by complex signalling pathways centred on cholesterol-enriched membrane domains termed lipid rafts. Caveolae, a subtype of rafts, express the protein caveolin-1, which has been suggested as both as a tumour suppressor and promoter. One protein that interacts with caveolin-1 is the sodium potassium ATPase (Na+ K+ ATPase) ion channel. Na+ K+ ATPase has recently been implicated in cell signalling via interaction with its natural inhibitors, cardiac glycosides (CGs). Although predominantly...

The 'totality' of psychosis: systematic comparison of the major psychotic diagnoses in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS)

Major psychotic disorders such as schizophrenia (SZ), bipolar disorder (BD) and major depressive disorder with psychotic features (MDDP) are global leading causes of disability-adjusted life years. Considerable advances in research into these disorders over the last few decades have resulted in more reliable operational diagnoses, improved treatment approaches and better outcomes. However, absence of neurobiological markers and high rates of cormorbidity mean that differentiating various psychotic disorders within the totality of psychosis and identifying boundaries...

Quantitative Proteomic Analysis and Gene Expression Profiling Microarray Re-analysis of Uveal Melanoma

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults and 40% develop fatal metastatic disease. Compared to tumours with chromosome 3 disomy, monosomy 3 tumours will nearly exclusively develop metastasis. To identify differentially expressed proteins, quantitative label-free LC-MS proteomic profiling of 8 primary UM tissues from patients with metastasis (M) and 8 from patients without metastasis (NM) was performed. Fifty proteins with ≥ 3 peptides matched and p < 0.05 between the...

A study to find novel genetic abnormalities associated with epilepsy in affected Irish families.

Gerard O'Connor
Background; Epilepsy is one of the commonest neurological illnesses. There is considerable evidence that, in many cases, epilepsy is partly or completely genetic in aetiology. However, in spite of progress in certain Mendelian epilepsy syndromes, the genetic cause of epilepsy within families often remains unclear. With the advent of techniques such as whole exome sequencing, it may now be possible to identify the novel genetic variations underlying epilepsy in affected families. The aim of this...

Pre-clinical investigation of the effect of combining the cytotoxic agent Temozolomide with a dual mTORC2 inhibitor for the treatment of glioblastoma and establishment of an imageable surgical resection model of glioblastoma

Kieron J. Sweeney
Glioblastoma is the most common primary brain tumour. It is an incurable disease and is commonly referred to as the worst of the “incurable cancers” by neurosurgeons and neuro-oncologists. It is heterogeneous on a cellular and genetic level. The genetic mutations that occur in glioblastoma lead to dysregulation of several principal pathways, the most commonly dysregulated pathways involve mTOR. mTOR is involved in the control of several cellular processes including autophagy and apoptosis. Despite maximal...

Profile of cardiovascular risk factors at six months post ischaemic stroke in Dublin: the ASPIRE-S study

Linda M. Brewer
Stroke is a leading cause o f death and disability in all countries and results in substantial personal and healthcare costs. Approximately one third of strokes occur in individuals with a previous transient ischaemic attack and one half occur in individuals with previous vascular events of any kind. The significant disease burden and the high recurrence rates of stroke emphasize the importance of both primary and secondary preventive strategies amongst all patients at high risk...

Regeneration of Ablated Motor Nerves Using Olfactory Neuroepithelial Derived Stem Cells In a Pre-Clinical Model

Phoebe E. Roche
Peripheral nerve injury is a life-changing problem, which presents significant therapeutic challenges to clinicians and patients. A number of different approaches to dealing with the issue exist but to date there is no consensus on the most effective method of treatment. With large gap nerve transection or central to peripheral nervous system intersection injury, spontaneous meaningful axonal recovery seldom occurs. Despite surgical intervention with autografts, the functional outcomes are often unfavorable. Tissue engineered strategies utilising...

The frequency and nature of adverse events in acute Irish hospitals: the Irish National Adverse Events Study

Natasha Rafter
Irish healthcare has undergone extensive change with spending cuts and a focus on quality initiatives. However, little is known about adverse event occurrence. This thesis assesses the frequency and nature of adverse events in Irish hospitals and compares the results to international adverse events data, using a systematic review methodology and conducting the Irish National Adverse Events Study (INAES). Retrospective patient chart review based on the Harvard Medical Practice Study methodology was undertaken. A random...

Improving student learning through virtual means

Michelle Mary McEvoy
Virtual Patients are used in medical education but research evidence to guide their use is still modest. This research was designed to test the hypothesis that the use of Virtual Patients does not significantly improve the development of clinical knowledge, professional identity and reflective skills in undergraduate medical students. The research questions addressed were: (i) Based on an evaluation of current undergraduate training, is there a need to supplement the traditional paediatric curriculum to ensure...

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