Time filter

Source Type

Gaillimh, Ireland

Burke A.J.,National University of Ireland | Sullivan F.J.,National University of Ireland | Sullivan F.J.,Galway University Hospitals | Giles F.J.,National University of Ireland | And 2 more authors.

Nitric oxide (NO) is a short-lived, pleiotropic molecule that affects numerous critical functions in the body. Presently, there are markedly conflicting findings in the literature regarding NO and its role in carcinogenesis and tumor progression. NO has been shown to have dichotomous effects on cellular proliferation, apoptosis, migration, invasion, angiogenesis and many other important processes in cancer biology. It has been shown to be both pro- and antitumorigenic, depending on the concentration and the tumor microenvironment in question. NO is generated by three isoforms of NO synthase (NOS) that are widely expressed and sometimes upregulated in human tumors. Due to its vast array of physiological functions, it presents a huge challenge to researchers to discover its true potential in cancer biology and consequently, its use in anticancer therapies. In this study, we review the current knowledge in this area, with an emphasis placed on NO modulation as an anticancer therapy, focusing on NO-donating drugs and NOS inhibitors. © The Author 2013. Published by Oxford University Press. All rights reserved. Source

Neligan P.J.,Galway University Hospitals
Anesthesiology Clinics

General anesthesia and surgery are associated with changes in the shape of the chest that result in atelectasis, a major factor in the development of postoperative respiratory failure. Postoperative noninvasive positive pressure ventilation (NIPPV) has been shown to improve oxygenation and ventilation for high-risk patients. NIPPV has been used as rescue therapy for patients developing acute respiratory distress postoperatively, and appears to be most frequently successful in patients whose problem is atelectasis or obesity. Failure to respond to NIPPV after 20 minutes is usually an indication of intubation, mechanical ventilation, and transfer to the intensive care unit. © 2012 Elsevier Inc. Source

Neligan P.J.,Galway University Hospitals | Baranov D.,University of Pennsylvania
Anesthesiology Clinics

Homeostasis refers to the capacity of the human body to maintain a stable constant state by means of continuous dynamic equilibrium adjustments controlled by a medley of interconnected regulatory mechanisms. Patients who sustain tissue injury, such as trauma or surgery, undergo a well-understood reproducible metabolic and neuroendocrine stress response. This review discusses 3 issues that concern homeostasis in the acute care of trauma patients directly related to the stress response: hyperglycemia, lactic acidosis, and hypothermia. There is significant reason to question the " conventional wisdom" relating to current approaches to restoring homeostasis in critically ill and trauma patients. © 2013 Elsevier Inc. Source

Byrne D.,Galway University Hospitals
Irish medical journal

A consistent finding in the literature is that newly graduated medical students often do not prossess the basic skills required to perform their jobs. Training designed to prepare newly graduated medical students for intermship was developed and delivered to 106 newly graduated medical students. Feedback on the course was obtained using anonymous pre-and post-course questionaires. A total of 32 students (52.5% of the recourse respondents) felt that they were prepared prior to the training, compared wit 51students (79.7% of the post-course respondents) who felt prepared for intership after the training. The largest effect size of the training was for the administration of medication (Cohen's d = 0.93). Futher development to the training programme is required. Nevertheless, it is suggested that this course serve as a model to address the unsatisfactory levels of preparedness for the work of a junior reported by medical students from many countries. Source

Emergency cricothyroidotomy is a potentially life-saving procedure in the 'cannot intubate cannot ventilate (CICV)' scenario. Although surgical cricothyroidotomy remains the technique recommended in many 'CICV' algorithms, the insertion of a tracheostomy as a cannula over a trocar, or using the Seldinger method, may have advantages as they are more familiar to the anaesthetist. We compared the utility of three cuffed cricothyroidotomy devices: cuffed Melker®, Quicktrach 2®, and PCK® devices, with surgical cricothyroidotomy. After ethical committee approval and written informed consent, 20 anaesthetists performed cricothyroidotomy with all four devices in random order, in a pig larynx and trachea model covered in cured pelt. The primary endpoints were the rate of successful placement of the cricothyroidotomy device into the trachea and the duration of the insertion attempt. The Melker® and Quicktrach 2® devices possessed advantages over the surgical approach, in contrast to the PCK® device, which performed less well. All 20 participants inserted the Melker®, with 19 being successful using the surgical approach and the Quicktrach 2®, whereas only 12 successfully inserted the PCK® device (PCK® vs surgical, P=0.02). The Quicktrach 2® had the fastest insertion times and caused least trauma to the posterior tracheal wall. The Melker® was rated highest by the participants and was the only device rated higher than the surgical technique. The Melker® and Quicktrach 2® devices appear to hold particular promise as alternatives to surgical cricothyroidotomy. Further studies, in more clinically relevant models, are required to confirm these initial positive findings. Source

Discover hidden collaborations