Connolly Hospital Blanchardstown

About: Connolly Hospital Blanchardstown is a healthcare organization based out in Dublin, Ireland. It is known for research contribution in the topics: Population & Ambulatory blood pressure. The organization has 302 authors who have published 213 publications receiving 3858 citations. The organization is also known as: James Connolly Memorial Hospital.

A protocol for a qualitative synthesis exploring people with stroke, family members, caregivers and healthcare professionals experiences of early supported discharge (ESD) after stroke.

Abstract: Early supported discharge (ESD) facilitates a person with a stroke to be discharged from the acute hospital environment earlier than conventional care to continue their rehabilitation within the home with members of the multi-disciplinary team. A number of quantitative studies have highlighted benefits of ESD including a reduction in the length of inpatient stay, cost savings, as well as reducing long term dependency. This systematic review and qualitative synthesis explores the perspectives and experiences of those involved in ESD including people with stroke, family members, caregivers as well as the healthcare professionals involved in the delivery of the service. A comprehensive literature search will be completed in the following databases CINAHL, PubMed Central, Embase, Medline, PsycINFO, Sage, Academic Search Complete, Directory of Open Access Journals, The Cochrane Library, PsycARTICLES and Scopus. Qualitative or mixed methods studies that include qualitative data on the perspectives and experiences of people with stroke, family members, caregivers and healthcare professionals of an ESD service will be included. Methodological quality will be appraised using the ten-item Critical Appraisal Skills Programme checklist for qualitative research by two independent reviewers with a third reviewer involved should differences of opinion arise. Findings will be synthesised using thematic synthesis. It is anticipated that the qualitative synthesis will provide a deeper understanding of the experiences of ESD which may serve to inform practice as well as assist in the development of new ESD services. PROSPERO registration: CRD42020135197 – 28/04/2020

Beware of Non-Traumatic Chylothorax.

Abstract: A chylothorax occurs when lymph fluid accumulates in the pleural space due to disruption or obstruction of the thoracic duct. The following illustrates such a case. A 34 year old lady, current smoker presented with a 3-day history of worsening shortness of breath on exertion. She had no past medical history and was on no medication. There was no significant family history and she was unemployed. All her vitals were normal. Positive clinical findings on examination revealed reduced breath sound at the base of her left lung which was dull on percussion. CXR confirmed a moderate left sided pleural effusion. Her FBC, U&E, LFT and CRP were all normal. 1.5L of the pleural fluid were drained under ultrasound guidance. The fluid was milky white in appearance and the sample was sent to the lab for analysis. The fluid triglyceride came back as 17 mmol/L, fluid pH was 7.5, fluid LDH was 704 U/L, fluid glucose was 4.2 mmol/L and fluid protein 64 g/L. Cytology came back as predominantly lymphocytic in content. CT Thorax,Abdomen and Pelvis revealed a pericardial effusion with prominent thoracic mediastinal lymph node. After discussion at the Lung multidisciplinary meeting, the patient was then referred to the cardiothoracic team for a mediastinoscopy for lymph node sampling which eventually turned out to be a lymphoma.

Marked hyperandrogenicity in a 60-year-old woman

Abstract: Markedly elevated androgen levels can lead to clinical virilization in females. Clinical features of virilization in a female patient, in association with biochemical hyperandrogenism, should prompt a search for an androgen-producing tumor, especially of ovarian or adrenal origin. We herein report the case of a 60-year-old woman of Pakistani origin who presented with the incidental finding of male pattern baldness and hirsutism. Her serum testosterone level was markedly elevated at 21 nmol/L (normal range: 0.4-1.7 nmol/L), while her DHEAS level was normal, indicating a likely ovarian source of her elevated testosterone. Subsequently, a CT abdomen-pelvis was performed, which revealed a bulky right ovary, confirmed on MRI of the pelvis as an enlarged right ovary, measuring 2.9 × 2.2 cm transaxially. A laparoscopic bilateral salpingo-oophorectomy was performed, and histopathological examination and immunohistochemistry confirmed the diagnosis of a Leydig cell tumor, a rare tumor accounting for 0.1% of ovarian tumors. Surgical resection led to normalization of testosterone levels. Learning points Hirsutism in postmenopausal women should trigger suspicion of androgen-secreting tumorExtremely elevated testosterone level plus normal DHEAS level point toward ovarian sourceLeydig cell tumor is extremely rare cause of hyperandrogenicity.

Mycoplasma Pneumonia: Late Treatment Leading to Acute Respiratory Distress Syndrome and Renal Failure.

Abstract: Introduction Mycoplasma pneumonia is one of the most common types of pneumonia, although it is often not diagnosed due to mild clinical course. Aims In this case study we aim to describe the importance of considering mycoplasma pneumonia in high-risk groups. Methods We present the case of a 27-year-old woman admitted with pneumonia, progressing to acute respiratory distress syndrome and acute kidney injury. She had a prolonged stay in the ICU, requiring intubation and continuous veno-venous haemofiltration (CVVH). After 1 month in hospital, she was discharged with full recovery. Discussion Mycoplasma pneumonia is a common type of pneumonia in the community, but only a small percentage of patients require hospitalization. Delayed treatment can result in multi-organ failure, which requires intensive care and long hospital stays. LEARNING POINTS Delayed initiation of proper treatment allowed our patient's mycoplasma pneumonia to progress to acute respiratory distress syndrome and acute kidney injury.The British Thoracic Society does not recommend blanket empiric treatment of mycoplasma pneumonia, although other European and American guidelines do, and so it is important to consider this organism in high-risk groups to prevent severe complications.