Awareness of diabetes complications in an Irish population

Background  

Patients’ awareness of the increased cardiovascular risk associated with their diabetes is poorly documented.     

Prevalence of left-sided melanomas in an Irish population

Background

A predominance of melanomas on the left side of the body has recently been described. No associations between tumour laterality and gender, age or anatomical site have been identified.

Aim

The aim of this study was to investigate the prevalence of left-sided melanomas in an Irish population and to examine potential associations with various patient and tumour characteristics.

Methods

A retrospective chart review of patients with cutaneous melanoma who were treated over a 10-year period was carried out. Lateral distribution of melanoma on either side of the body was compared using χ² analysis and evaluated by gender, age group, anatomic location, histologic subtype and Breslow depth.

Results

More melanomas occurred on the left side (57%, P = 0.015), and this finding was particularly significant in females. For both genders combined, there were no statistically significant differences in laterality by age group, anatomic location, type of melanoma and Breslow depth. There were significantly more superficial spreading melanomas on the left side in both men and women.

Conclusions

This study demonstrates a predominance of left-sided melanomas in Irish patients. While a number of demographic and molecular associations have been proposed, further research is required to fully explain this phenomenon.     

Hepatitis C infection in an Irish antenatal population

Background  

Hepatitis C infection (HCV) has an estimated seroprevalence of 1–2% in women of child-bearing age and vertical transmission rate of 5–15%.     

Isotretinoin therapy for acne vulgaris: Results in an Irish population

The results of treatment of cystic and antibiotic-resistant acne vulgaris in 96 consecutive patients with the oral retinoid isotretinoin (13-cis-retinoic acid; Roacentane) are reported retrospectively. The results show that the drug, while toxic in the short term, is highly effective in clearing acne.     

Validation of serological tests forHelicobacter pylori infection in an Irish population

Background Serological tests forHeilcobacter pylori using laboratory and ‘office’ formats are commonly used, easy to perform, inexpensive and widely available. Local validation of test performance is required.

Aims  

This study examined the performance of a laboratory and ‘office’ ELISA in a population of Irish dyspeptics presenting for endoscopy.     

Meningitis in an Irish community

A series of 26 cases of meningitis occurring in one year in a defined area is presented. The clinical features, and complications are reviewed. Neisseria meningitidis occurred twice as commonly as Haemophilus influenzae, suggesting that the pattern of infection differs from that reported in England and Wales. An incidence of 4·6/100,000 for N. meningitidis is reported exceeding rates of infection in previous UK “epidemics”.     

Colonoscopic polypectomy and management of malignant colorectal polyps — A review in an Irish population

A RETROSPECTIVE analysis of 2124 colonoscopies was carried out. Most were performed as day cases under sedation. Abnormalities were detected in 59% of the colons examined; polyps were detected in 24% and almost half of these had more than one polyp. The detection rate was higher in males than females. Most polyps were left sided. Increasing size of polyp was associated with a higher proportion of villous elements and more frequent malignant change. The pattern of histological types was comparable to other large published series. Carcinoma was detected in 5% of adenomatous polyps, mainly in larger villous lesions. Twenty-nine polyps were malignant; these were also predominantly left sided. Applying the St. Mark’s criteria, no polyp with malignant change which was considered completely excised by endoscopic polypectomy has recurred or metastasized at follow up. In contrast, those polyps considered incompletely excised had a high (80%) incidence of residual tumour. The current controversies in the management of malignant colorectal polyps are discussed.     

An examination of the prevalence of IDF- and ATPIII-defined metabolic syndrome in an Irish screening population

Objectives  To investigate the prevalence of ATPIII- and IDF-defined metabolic syndrome (MetS) in an Irish screening population and to determine the calculated cardiovascular risk for each group. Design  A total of 1,716 subjects were enrolled over a 12-month period. Main outcomes  The ATPIII-defined prevalence of MetS in this population was 13.2%. Using IDF criteria, 21.4% of subjects were identified as having the MetS. Correlation between the two definitions was high; however, IDF criteria identified an additional 9.5% (n = 164) of the population as having MetS, which ATPIII criteria failed to recognise. Conclusion  We noted a higher prevalence of MetS in the studied population when defined by IDF criteria. However, those identified by IDF and not by ATPIII definition did not have a higher cardiovascular risk score by either Framingham or European Score than those without MetS. Thus, application of the ATPIII definition of MetS, may be the more practical.     

Haemochromatosis gene frequency in a control and diabetic Irish population

Background  Hereditary haemochromatosis is inherited in an autosomal recessive manner. Two major mutations have been identified and the condition is emerging as one of the most common recessive mutations among subjects of Northern European descendants. Aim  This study investigated the prevalence of C282Y, H63D and S65C (three mutations of clinical significance for haemochromatosis), in a diabetic and control population from the North West of Ireland. Methods  DNA was extracted from whole blood samples of 249 known diabetics and 249 controls and assayed for the three genetic variants (C282Y, H63D and S65C). Results  The incidence for C282Y homozygosity is higher in the control population (1 in 83) when compared to the diabetic group (1 in 249). However, this is not statistically significant. S65C heterozygosity occurs with an incidence of 1 in 32 in control individuals and 1 in 124 in the diabetic population. The prevalence of the H63D mutation was similar in both populations. Conclusion  For the three haemochromatosis mutations, there was no significant difference between the control group and the diabetic populations.     

Obesity and disability in the symptomatic Irish knee osteoarthritis population

Background  

Osteoarthritis (OA) of the knee is a common disorder with significant social and financial implications. Obesity is the strongest modifiable risk factor of knee OA. There is little data on obesity in Irish knee OA populations and its relationship to other measures of disease severity.     

HpSA: Assessment of a new non-invasive diagnostic assay for helicobacter pylori infection in an Irish population

Background  The diagnosis of Helicobacter pylori is an essential element in the management of many common gastrointestinal pathologies. Previously diagnosis was dependent on the availability of endoscopic biopsy samples. The advent of non invasive assays such as the C13Urea breath test and Elisa serology have enabled diagnosis, and treatment to be undertaken in the primary care setting. The isolation of Helicobacter pylori antigen from stool has led to the development of a new non-invasive test. Aim  A prospective study was designed to assess and compare the performance of Premier Platinum HpSA with current gold standard tests. Methods  Consecutive patients undergoing a gastroscopy for investigation of dyspepsia at the Meath and Adelaide hospitals were enrolled. At endoscopy gastric biopsies were taken for histology, microbiology and rapid urease testing. In addition all subjects had C13UBT, serology and stool tests performed. Individuals who were H. pylori positive received standard proton pump inhibitor based triple therapy. Following treatment all tests, apart from serology were repeated. Results  54 patients were enrolled, 46 per cent were H. pylori positive. HpSA had a sensitivity and specificity and positive and negative predicted values of 96 per cent, 75 per cent and 80.6 per cent, 75.8 per cent respectively and compared favourably with all other tests. The sensitivity and specificities of the other tests were, histology 79.2 per cent and 100 per cent, culture 68 per cent and 100 per cent, rapid urease test 75 per cent and 100 per cent, serology 75 per cent and 96 per cent and C13 urea breath test 100 per cent and 96.6 per cent. Conclusion  The detection of H. pylori antigen in stool by means of a HpSA assay is a new and effective non-invasive means of diagnosis which can be performed in a routine laboratory setting. It is simple to perform and has possible advantages over other non-invasive tests, detecting actual antigen indicating current active infection.