Pope K.,University of Toronto |
Pope K.,Peter MacCallum Cancer Center |
Fitzpatrick D.,University of Toronto |
Fitzpatrick D.,St Lukes Hospital |
And 10 more authors.
Supportive Care in Cancer | Year: 2013
Purpose: The incorporation of three-dimensional (3D) planning for the treatment of bone metastases has been embraced in many North American practices with assumed superior tumor targeting, sparing of normal structures, and improvement in patient outcomes. The goal of our project was to evaluate the dosimetric and clinical impact of 3D vs. two-dimensional (2D) planning for patients who require simple palliative radiotherapy techniques (≤2 beams) for bone metastases. Methods: Patients undergoing palliative radiation therapy for bone metastases were eligible. The study oncologists first documented the intended treatment target, defined the treatment target/field using digital radiographs (2D), followed by using full 3D planning computerized tomography volumetric datasets. Treatment plans were compared dosimetrically, and patient-reported outcomes (pain, fatigue, anorexia, and nausea) were compared against a historical cohort treated with 2D plans. Results: Eighty-five patients were enrolled in the study group. Review of the 3D datasets led to changes in the target area of interest in 44/85 (52 %) of cases, of which 21/85 (25 %) were clinically significant. 3D plans resulted in superior target coverage and normal tissue sparing. There was no significant difference in patient-reported outcomes however. Conclusion: 3D radiotherapy planning resulted in superior treatment plans but we were unable to demonstrate a significant benefit in clinical outcomes. Prospective study designs are needed to describe the contemporary expectation of palliative radiotherapy for bone metastases in the modern era of 3D planning. © 2013 Springer-Verlag Berlin Heidelberg.
Keogan D.M.,Stephens College |
Twamley B.,Trinity College Dublin |
Fitzgerald-Hughes D.,Beaumont Hospital Beaumont |
Griffith D.M.,Stephens College
Dalton Transactions | Year: 2016
Reaction of Bi(NO3)3 with benzohydroxamic acid (Bha) and salicylhydroxamic acid (Sha) gives the novel Bi(iii) complexes [Bi2(Bha-1H)2(μ-Bha-1H)2(η2-NO3)2] (1) and [Bi6(CH3OH)2(η1-NO3)2(η2-NO3)(OH2)2(Sha-1H)12](NO3)2 (2). X-ray crystal structure of 1 reveals two hydroxamato coordination modes; bidentate bridging (O, O′) and bidentate non-bridging (O, O′) and of 2 reveals one coordination mode; bidentate bridging (O, O′). 1, specifically designed to and demonstrated to inhibit the activity of urease, exhibits excellent antibacterial activity against three strains of Helicobacter pylori with MIC ≥ 16 μg mL-1. This journal is © 2016 The Royal Society of Chemistry.
Ni Chroinin D.,Beaumont Hospital Beaumont |
Glavin P.,Charleville Family Practice Charleville Co. |
Power D.,St Marys Hospital |
Power D.,Materials Misericordiae University Hospital
Archives of Osteoporosis | Year: 2013
We conducted a cross-sectional study of the understanding on osteoporosis amongst community-dwelling geriatric patients. Patient understanding on the pathology, risk factors and its complications was suboptimal, but better amongst women and persons with diagnosed osteoporosis. Improving patient osteoporosis education may lead to improved compliance with preventive and therapeutic measures. Purpose: Osteoporosis is often preventable and treatable. Establishing levels of understanding in an Irish population will help inform future public and patient education. Methods: We conducted a cross-sectional survey of 126 randomly selected geriatric day hospital patients, interviewing next of kin where abbreviated mental test score was <6. Questions assessed awareness of (1) basic pathology, (2) predisposing and protective factors, (3) complications and (4) personal osteoporosis status and treatment. Results: Participants included 103 patients and 23 carers; 78.6 % were female; patients' mean age was 81.6 years. Of the patients surveyed, 87.3 % had heard of osteoporosis; 56.1 % knew affected bone; and 30.2 % were cognisant of architectural change. About 65.9 % reported that a doctor had never discussed the condition; 92.9 % correctly identified whether diagnosed with osteoporosis, and >96 % correctly identified their treatment status. Rates of risk factor identification were as follows: 88.9 % for ageing, 83.8 % female gender, 65.1 % smoking, 62.4 % low BMI and 51.6 % alcohol excess; <10 % identified other risk factors. Awareness of complications ranged from 91.3 % for fractures to 44.4 % for height loss. Awareness of protective factors (calcium/vitamin D-rich food, medication and exercise) was >85 % for each. More women had heard of osteoporosis (p = 0.02), knew affected bone (p = 0.005) and recognised gender as a risk factor (p = 0.015) and pain (p = 0.05) or kyphosis (p = 0.014) as complications. Osteoporotic patients (N = 38) were more likely to know it as affected bone (p = 0.006). Amongst patients surveyed [abbreviated mental test score (AMTS) 6-10], AMTS score did not predict understanding. Age did not predict understanding, nor were next of kin more likely to understand osteoporosis than patients. Conclusion: There is scope for enhancing patient osteoporosis education, which may improve compliance with preventive and therapeutic measures. © 2012 International Osteoporosis Foundation and National Osteoporosis Foundation.
Lydon S.,Trinity College Dublin |
O'Connor P.,National University of Ireland |
McVeigh T.,Galway University Hospital |
Offiah G.,Beaumont Hospital Beaumont |
Byrne D.,Galway University Hospital
Irish Medical Journal | Year: 2015
There has been increasing interest in the personalities of doctors. This study examined whether personality differed based upon gender, level of training or medical speciality among 200 physicians and 134 medical students. Post-internship doctors scored significantly higher on conscientiousness (p=.001) than those pursuing basic medical training. Among those pursuing basic medical training, females scored significantly higher than males on agreeableness (p<.001) and conscientiousness (p=.001). Among post-internship respondents, females scored significantly higher on agreeableness (p=.004). There were no personality differences between post-internship doctors working in different specialities. However, among those pursuing basic medical training, those interested in person-focused medical specialities scored significantly higher on extraversion (p<.001), conscientiousness (p=.001), and lower on neuroticism (p=.01) than those who had no strong preference. These results suggest that there is no unique personality profile associated with medical practice, or medical speciality. Instead, it appears that medical school may shape personality. © 2015 Irish Medical Association. All rights reserved.