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.

Day surgery in a teaching hospital: identifying barriers to productivity

Abstract: Introduction: Ambulatory surgery is a standard of care for many surgical procedures due to cost-effectiveness and benefits to patients including the reduced risk of contracting hospital infection by reducing the hospital stay. However, late cancellations can be costly. We examined the utilisation of the surgical day ward in our institution over a four-year period. Methods: A retrospective study of surgical day ward records from September 2007 to September 2011 in one institution. Parameters investigated included the number of planned admissions. Reasons for cancellations were also collected. Results: A total of 17,461 procedures were intended as a day ward admission during the study interval. There were 3,539 procedures that were cancelled (20.3%). The prevalent proportion of cancellations (n = 1,367) (38.6%) were due to patients not showing up for their procedures (7.8% of planned admissions); 1,188 (33.6%) patients were cancelled by the admissions office due to bed shortages, accounting for 6.8 % of planned admissions and 650 (18.4%) of cases were due to last minute cancellations by patients, accounting for 3.7% of all planned admission. The remaining 334 (9.4%) of cases were cancelled on medical grounds including patients who were considered unfit for the intended procedure, or anti-coagulations not appropriately ceased prior to surgery, accounting for 1.9% of all planned admissions. Conclusion: The cancellation rate in this study was high, mainly due to failure of patients to attend or signal their intentions, inadequate bed capacity and bed closure strategies. The ring fencing and protection of day beds and a more active patient management interaction would have had the greatest impact on increased efficiency.

Non-operative management of acute cholecystitis in the elderly (Br J Surg 2012; 99: 1254-1261).

Abstract: The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

PWE-025 Botulinum toxin injection versus topical nitrates for chronic anal fissure- an updated meta-analysis of randomised controlled trials

Abstract: Introduction Chronic anal fissures (CAF) are frequently encountered in coloproctology clinics. Chemical sphincterotomy with pharmacological agents is recommended as first-line therapy. Topical nitrates (TN) are effective at healing CAF but recurrences are common. An alternative treatment modality is injection of botulinum toxin (BT) into the anal sphincter. We aimed to perform a systematic review and meta-analysis to compare the effectiveness of BT and TN in the management of CAF. Method The online published literature was searched for relevant articles from inception till January 2017. All published randomised trials (RCTs) that reported direct comparisons of BT and TN were included. Two independent reviewers performed methodological assessment and data extraction. Random effects models were used to calculate pooled effect size estimates. Results Five RCTs describing 313 patients (154 in BT, 159 in TN) were included. There was significant heterogeneity among the trials. On random effects analysis, there were no significant differences in incomplete fissure healing (OR=0.47, 95% CI=0.13 to 1.67, p=0.24) or recurrence (OR=0.61, 95% CI=0.26 to 1.43, p=0.26) between BT and TN, respectively. BT was associated with a higher rate of transcient anal incontinence (pooled OR=2.53, 95% CI=0.98 to 6.57, p=0.06) but significantly fewer side effects (OR=0.09, 95% CI=0.01 to 0.72, p=0.02) and headache (OR=0.10, 95% CI=0.01 to 0.77, p=0.03)) compared to TN. Conclusion BT is associated with fewer side effects when compared to TN but there is no difference in fissure healing. However, well-designed RCTs with adequate follow-up are needed to definitively answer this important clinical question. Disclosure of Interest None Declared

A multi-site review of second hip fractures across 6 Dublin teaching hospitals.

Abstract: Fragility hip fractures are common and costly. Secondary fracture prevention is a treatment goal following hip fracture; however, the number of those that proceed to fracture their contralateral hip in Ireland is unknown. There are plans to introduce a Fracture Liaison Service Database in Ireland which will aim to prevent secondary fractures. To establish a baseline figure for secondary hip fractures, the injury radiographs of 1284 patients from 6 teaching hospitals over a 1-year period were reviewed. Irish Hip Fracture Datasheets and corresponding injury radiographs were reviewed locally for all hip fractures within each respective teaching hospital for a 1-year period (2019). A total of 8.7% of all fragility hip fractures across the 6 hospitals were secondary hip fractures (range 4.9–11.5%). 46% occurred within years 1 to 3 following index hip fracture. Forty-eight per cent of patients were started on bone protection medications following their second hip fracture. Approximately 1 in 11 hip fractures treated across the 6 teaching hospitals assessed in 2019 was a patient’s second hip fracture. We advocate for the widespread availability of Fracture Liaison Services to patients throughout Ireland to assist secondary fracture prevention.

The opioid epidemic and headache: Experience of a general neurology consult service:

Abstract: Background:Headaches represent a significant proportion of referrals to any neurology consult service, of which many are migrainous. Regular use of opioids can lead to medication overuse headache i...