Showing papers by "Connolly Hospital Blanchardstown published in 2008"

Insulin detemir improves glycaemic control without weight gain in insulin-naïve patients with type 2 diabetes: subgroup analysis from the PREDICTIVE study.

Abstract: ()3.7 mmol ⁄ l; p < 0.0001), and within-patient fasting glucose variability ()0.5 mmol ⁄ l; p < 0.0001). In the majority of patients (82%), these improvements in glycaemic control were achieved with once daily administration of insulin detemir. There was a small reduction in mean body weight ()0.7 kg; p < 0.0001), which was most apparent in patients with a higher body mass index (BMI) at baseline. A significant negative relationship between weight change and baseline BMI was observed (greater the BMI, greater the weight reduction). Multiple regression analysis showed that BMI and HbA1c at baseline, and change in HbA1c, were all predictors for weight change (p < 0.0001 for all), with BMI being the strongest predictor. Conclusions: Patients with type 2 diabetes nao¨ve to insulin can be effectively treated with once-daily insulin detemir (± OADs) to achieve improved glycaemic control with no adverse effect on weight and a low risk of hypoglycaemia. These short-term results are consistent with the findings of clinical trials. What’s known It has been well documented that insulin therapy can result in significant weight gain. Furthermore, this insulin-associated weight gain can act as a barrier to effective treatment of diabetes. This is due to a number of factors such as increased insulin resistance, cardiovascular risks, poor compliance and reluctance to start insulin treatment (in patients with type 2 diabetes).

Cement-in-cement revision hip arthroplasty: an analysis of clinical and biomechanical literature.

Abstract: Introduction The number of revision hip arthroplasties is increasing but several aspects of this procedure could be improved. One method of reducing intra-operative complications is the cement-in-cement technique. This procedure entails cementing a smaller femoral prosthesis into the existing stable cement mantle. The aim of this systematic review is to provide a concise overview of the existing historical, operative, biomechanical and clinical literature on the cement-in-cement construct.

Lack of awareness of oesophageal carcinoma among the public in Ireland

Abstract: Oesophageal cancer is advanced in the majority at presentation and its symptoms are usually present for many months suggesting poor awareness of its symptoms. Few studies have examined awareness of oesophageal cancer amongst the public. This study aimed to identify the level of awareness among the general public of oesophageal cancer, of its symptoms, of its awareness campaigns and to compare it with other common cancers. Face-to-face interviews were conducted with 279 members of the public. People were asked about their awareness of a range of cancers, and their knowledge of cancer symptoms and cancer awareness campaigns. Awareness of oesophageal cancer was low and knowledge of its symptoms was even lower. Despite the efforts of awareness campaigns, knowledge of these campaigns was poor amongst the public. Awareness of oesophageal cancer and its symptoms is low amongst the public. This needs to be addressed if disease is to be detected at an earlier and curable stage.

The nutritional status of older adults on admission to hospital

Abstract: mechanical effects of overnutrition, in combination with the increased prevalence of chronic disease with increasing age, may cause more overnourished older patients to be admitted to hospital than in previous years. A cross-sectional study was performed that aimed to assess the nutritional status and dietary intake of older patients admitted to an acute geriatric ward of a Dublin hospital. A secondary aim was to identify characteristics associated with under- and overnutrition among the patient sample. Thirty patients aged ‡ 65 years who were not on artificial nutritional support, not actively under the care of a clinical nutritionist and not terminally ill were recruited within 72 h of admission. Patients were profiled by the collection of anthropometric, biochemical and clinical data. Dietary assessment commenced within this time and continued for three subsequent consecutive days. When Malnutrition Universal Screening Tool (MUST) (5) classifications of BMI were applied it was found that a greater number of older patients admitted were overweight (n 12) or obese (n 9) than underweight (n 2) or of healthy weight (n 7). When data were analysed by tertiles of BMI, characteristics found to be associated with undernutrition were more frequently seen in the lowest tertile; three of nine patients in the lowest tertile were found to be depressed compared with one of eleven in the highest tertile, while three of nine patients in the lowest tertile were found to be cognitively impaired compared with two of eleven patients in the highest tertile. No correlation was found between BMI and serum albumin (r 0.264, P = 0.166); however, a correlation was found between serum albumin and midupper-arm circumference (r 0.392, P = 0.032) and serum albumin and mid-arm muscle circumference (r 0.506, P = 0.005). Mean energy intake (4092 (SD 1396) kJ/d) did not meet individual energy requirements for the entire sample, while ten patients had intakes of < 50 % of requirements. A greater number of older patients were classified as overnourished than undernourished on admission to hospital. Despite the observation of a well-nourished older patient group, nutritional status may have deteriorated before admission or deteriorated rapidly on admission as a result of poor dietary intake and increased energy requirements, leaving the patient at risk of significant weight loss, undernutrition and ultimately a poorer outcome. This finding is an indicator of the need for nutritional services and nutritional screening for all acute medical services for older adults.