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Blessington, Ireland

Grimes T.,Trinity College Dublin | Fitzsimons M.,Tallaght Hospital | Galvin M.,Naas General Hospital | Delaney T.,Quality and Patient Safety Directorate
Journal of Clinical Pharmacy and Therapeutics | Year: 2013

What is known and Objective The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. Methods For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. Results Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. What is new and conclusion The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation. © 2013 Blackwell Publishing Ltd.

Nason G.J.,University of Limerick | O'Kelly F.,Tallaght Hospital | Kelly M.E.,University of Limerick | Phelan N.,University of Limerick | And 7 more authors.
BJU International | Year: 2015

Objective To assess the emerging use of Twitter by urological journals. Methods A search of the Journal of Citation Reports 2012 was performed to identify urological journals. These journals were then searched on Twitter.com. Each journal website was accessed for links to social media (SoMe). The number of 'tweets', followers and age of profile was determined. To evaluate the content, over a 6-month period (November 2013 to April 2014), all tweets were scrutinised on the journals Twitter profiles. To assess SoMe influence, the Klout score of each journal was also calculated. Results In all, 33 urological journals were identified. Eight (24.2%) had Twitter profiles. The mean (range) number of tweets and followers was 557 (19-1809) and 1845 (82-3692), respectively. The mean (range) age of the twitter profiles was 952 (314-1758) days with an average 0.88 tweets/day. A Twitter profile was associated with a higher mean impact factor of the journal (mean [sd] 3.588 [3.05] vs 1.78 [0.99], P = 0.013). Over a 6-month period, November 2013 to April 2014, the median (range) number of tweets per profile was 82 (2-415) and the median (range) number of articles linked to tweets was 73 (0-336). Of these 710 articles, 152 were Level 1 evidence-based articles, 101 Level 2, 278 Level 3 and 179 Level 4. The median (range) Klout score was 47 (19-58). The Klout scores of major journals did not exactly mirror their impact factors. Conclusion SoMe is increasingly becoming an adjunct to traditional teaching methods, due to its convenient and user-friendly platform. Recently, many of the leading urological journals have used Twitter to highlight significant articles of interest to readers. © 2014 The Authors. BJU International © 2014 BJU International.

Kooblall M.,Tallaght Hospital
BMJ case reports | Year: 2014

A 70-year-old man, ex-smoker with a 3-pack-year smoking history, presented with a 5-week history of persistent cough. There were no positive findings on clinical examination. The patient's chest X-ray showed a nodular density in the right lung, initially thought to be malignant. After an extensive workup which included CT-guided lung biopsies, bronchoscopies, positron emission tomography scanning, among many other investigations, discussion at the respiratory multidisciplinary team meeting, and a right upper lobe lung resection, a diagnosis of histoplasmosis was performed.

Dunne M.,Tallaght Hospital
Irish journal of medical science | Year: 2013

Optimal risk factor control is integral to managing patients with proven coronary heart disease (CHD+) and for those at risk of coronary heart disease (CHD-). The primary aim of the study was to assess the success rate of reaching lipid risk factor targets in a multiple risk factor clinic. A retrospective audit was conducted in 488 patients (CHD+, n = 112; CHD-, n = 376) who attended the Cardiovascular Risk Factor Clinic at Tallaght Hospital, Dublin in 2009 and 2010. Risk factor targets achieved in CHD+ and CHD- patients were LDLc (54/62 %), HDLc (67/67 %), systolic blood pressure (35/38 %), diastolic blood pressure (82/75 %), smoking cessation (27/26 %), BMI ≤ 30 (39/50 %) and normal waist circumference (27/39 %). Patients not reaching LDLc targets were found to be receiving fewer lipid-lowering drugs and having higher LDL levels at the initial clinic visit than those reaching targets. This retrospective audit highlights gaps in achieving target lipid levels at a multiple risk factor clinic level. High initial LDLc levels and lack of drug titration are evident. Guideline changes, staff rotation, clinic visit frequency and multiplicity of targets may be contributory. More emphasis needs to be placed on education and algorithm-based strategies to achieve better risk factor control.

Graham I.,Charlemont Clinic | Cooney M.-T.,Dun Laoghaire Co. | Bradley D.,St Jamess Hospital | Dudina A.,Tallaght Hospital | Reiner Z.,University of Zagreb
Current Cardiology Reports | Year: 2012

Atherosclerotic cardiovascular disease is now the major global cause of death, despite reductions in CVD deaths in developed societies. Dyslipidemias are a major contributor, but the mass occurrence of CVD relates to the combined effects of hyperlipidemia, hypertension, and smoking. Total blood cholesterol and LDL-cholesterol relate to CVD risk in an independent and graded manner and fulfill the criteria for causality. Therapeutic reduction of these lipid fractions is associated with improved outcomes. There is good evidence that HDL-cholesterol, triglycerides, and Lp(a) relate to CVD although the evidence for a causal relationship is weaker. The HDL association with CVD is largely independent of other risk factors whereas triglycerides may be more important as signaling a need to look intensively for other measures of risk such as central obesity, hypertension, low HDL-cholesterol, and glucose intolerance. Lp(a) is an inherited risk marker. The benefit of lowering it is uncertain, but it may be that its impact on risk is attenuated if LDL-cholesterol is low. © Springer Science+Business Media, LLC 2012.

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