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 review of the diagnosis and management of hyponatremia in connolly hospital: an audit of current practice and the construction of a clinical aid for the diagnosis and treatment of Hyponatremia

Abstract: Background Hyponatraemia is the most common example of body fluid and electrolyte imbalance encountered in clinical practice, and is associated with increased mortality, morbidity and length of hospital stay in patients [1]. In spite of this, the diagnosis and management of hyponatremia remains inconsistent as clinicians adopt a broad range of hospitaland specialty-specific approaches [1, 2]. In light of this observed inconsistency, the objectives of the present project were: (i) To audit all patients admitted to Connolly Hospital Blanchardstown (CHB) Emergency Department (ED) with hyponatremia (<135 mmol/L) over a 14 day period. (ii) Record the diagnostic and management methods employed, comparing them with recent guidelines published by the European Society of Endocrinology (ESE). (iii) To construct a clinical aid for the diagnosis and treatment of hyponatremia, specific to CHB.

FRI0612-HPR The Development of Physiotherapy-Led Musculoskeletal Triage Services in Ireland

Abstract: Background In 2012, funding was approved for twenty-four Advanced Practice Physiotherapy (APP) posts in Ireland through the Clinical Strategy and Programmes Directorate of the HSE. These posts were to provide orthopaedic and rheumatology triage clinics across 16 hospitals throughout the country. Objectives The aims of these clinics were to reduce the waiting time for outpatient consultation for orthopaedic and rheumatology patients; to establish a diagnosis and triage patients along the most appropriate care pathway according to their diagnosis. Methods Initially 18 APPs were recruited in 2012 and currently there are 22.5 in post nationally. Guidelines regarding inclusion for attendance at these clinics were disseminated to APPs recruited to posts. Clinical governance for APP clinics is provided by either a consultant orthopaedic surgeon or a consultant rheumatologist who provide support with clinical diagnosis; with the ordering of investigations and with management of patients as appropriate. Results From January 2012 to May 2015 48,279 patients have been removed from orthopaedic and rheumatology waiting lists nationally. In orthopaedic clinics APPs reviewed 33,092 new patients and discharged 25,917 (78%); in rheumatology clinics APP9s reviewed 7,550 new patients and of this 5,417 (72%) were discharged following their review. Conclusions Advanced Practice Physiotherapist9s can assist in the management of orthopaedic and rheumatology waiting lists. These services provide patients with early access for a specialist opinion and management and therefore prevent chronicity of symptoms. It can be hypothesized that prevention of chronicity would result in a reduction in the use of health care resources by this subgroup of patients. Disclosure of Interest None declared

A Less Known Stroke Mimic: Posterior Reversible Encephalopathy Syndrome

Abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuro-radiological diagnosis, which can complicate a wide range of conditions. Clinical features include generalised and/or focal neurological deficits. These features are also present in neurovascular disorders, such as stroke. Currently, emphasis in the management of hyperacute stroke is thrombolysis, and it is important to bear in mind stroke mimics as a possible cause of clinical features. The Authors present the case of a 66-year-old man, who presented with acute focal neurological deficit. His brain imaging and history were consistent with PRES.

57 Novel roles for dietary nitrate in non ischaemic dilated cardiomyopathy and resistant hypertension

Abstract: Introduction Non ischaemic dilated cardiomyopathy (NIDCM) and resistant hypertension (HTN) are common, chronic diseases. Blood nitrate/nitrite indicate nitric oxide (NO) bioavailability and levels are typically lower in NIDCM and HTN compared to controls indicating perturbed nitric oxide (NO) metabolism. In addition to the well-characterised L-arginine-NO synthase pathway, a second independent pathway for NO synthesis in vivo has been recently discovered whereby dietary nitrate is reduced to nitrite and consequently NO. Exploitation of this pathway represents a promising strategy for increasing NO bioavailability, with possible physiological benefits. Methods To assess effects in HTN, 19 eligible subjects wore an ambulatory blood pressure (BP) monitor (ABPM) for 24 h and fasting blood was taken before and after 14 d of nitrate-rich beetroot juice (BRJ). To assess effects in NIDCM, we recorded exercise capacity (incremental shuttle walk test) and BP before and 3 h after both BRJ and placebo in a randomised, double-blind, crossover trial among 11 subjects. There was 7 d between testing days with the alternate beverage. Results In the HTN study, 11 subjects had controlled blood pressure while 8 had uncontrolled blood pressure. There were similar increases in serum nitrate (p = 0.01) and nitrite (p = 0.001) in both controlled and uncontrolled hypertension. Further, there were no differences in either group regarding serum lipids (triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol). We observed very little chance in BP variables among the controlled hypertensives. In contrast, there were reductions in 24 h, daytime, and nighttime BP as well an increase in nocturnal BP dipping. The decreases in mean nighttime DBP and ambulatory arterial stiffness index (AASI) reached significance (p = 0.03 and p = 0.05 respectively). In the NIDCM trial, there were no significant differences in heart rate, arterial oxygen concentrations, breathlessness, leg fatigue or blood pressure at any time point with either beverage. However, NIDCM subjects walked significantly when took BRJ (+65 m) than when they took PL (-5 m) (p = 0.006). Conclusions Dietary nitrate has potential as a novel therapeutic, adjunct strategy to increase NO bioavailability in cardiovascular disease with potential physiological benefits. Our preliminary results require confirmation in larger trials. However, considering the low cost and safety profile of dietary nitrate containing foods and supplements, this concept appears promising as an adjunct therapeutic strategy for cardiovascular diseases.