Abstract：
INTRODUCTION:Rapid Access Prostate Clinics (RAPC) were introduced in Ireland by the National Cancer Control Programme bringing about expedited referral pathways and increased detection rates of prostate cancer. Lower Gleason (G) grade at diagnosis due to RAPC has been previously reported but grade at prostatectomy has not been assessed. The aim of this study was to assess the impact of RAPC on the outcomes of patients with G7 disease on radical prostatectomy (RP). METHODS:A retrospective analysis was carried out of all RPs performed over a 9-year period (2006-2014). Outcomes for G7 prostatectomies were compared before and after the introduction of the RAPC, with a further sub-analysis of G4 + 3 versus G3 + 4. The primary outcome was biochemical recurrence (BCR). Other outcomes were adjuvant/salvage radiotherapy, extra prostatic extension, positive surgical margins, seminal vesicle involvement and tumour stage. RESULTS:In total, 240 RPs were performed with 167 cases graded G7 (70 graded G4 + 3 and 97 graded G3 + 4). Since the introduction of RAPC the proportion of G4 + 3 compared to G3 + 4 has increased from 37.9 to 42%. There was no statistical difference in outcomes for G4 + 3 treated before and after the introduction of RAPC. G4 + 3 was associated with higher rates of BCR (24.4 vs. 0%, p < 0.0001, radiotherapy (41.1 vs. 4.8%, p < 0.0001) and worse histological features than G3 + 4. CONCLUSION:Despite the benefits in diagnosis of prostate cancer brought about by RAPC in Ireland, this has not translated to a lower grade for surgically treated patients. There has been no improvement in outcomes especially for higher grade G4 + 3 disease.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Broe MP,Forde JC,Inder MS,Galvin DJ,Mulvin DW,Quinlan DMdoi
10.1007/s11845-017-1583-2subject
Has Abstractpub_date
2017-08-01 00:00:00pages
583-588issue
3eissn
0021-1265issn
1863-4362pii
10.1007/s11845-017-1583-2journal_volume
186pub_type
杂志文章abstract：:1. Constrictor responses of the isolated perfused rabbit ear artery to electrical stimulation and to intraluminally applied noradrenaline and histamine have been studied before and after addition to the perfusate of the anticholinesterases neostigmine and physostigmine. 2. Both neostigmine (6×10(-5)-2.4×10(-4) mol/l) ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02939056
更新日期：1975-12-01 00:00:00
abstract：OBJECTIVES:This study is designed to explore the effect of paricalcitol (vitamin D receptor agonist) on pancreatic oxidative stress, inflammatory markers, and adiponectin and glycemic status in diabetic rats. MATERIALS AND METHODS:Forty Sprague-Dawley male rats aged 10-12 weeks (150-250 g) were used in this study. Typ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-017-1635-7
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:In patients presenting with rapidly progressive dementia, prion disease may enter the differential diagnosis. The commonest malignancies masquerading as prion disease are primary CNS lymphoma and intravascular large B-cell lymphoma, both rare and difficult to diagnose without brain biopsy. CASE PRESENTATION...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/s11845-017-1653-5
更新日期：2018-05-01 00:00:00
abstract：:A study is presented of the skin manifestations of 30 patients, 25 females and 5 males, with systemic lupus erythematosus (S.L.E.) admitted to this hospital over a two year period. Their ages ranged from 20 years to 75 years. The diagnosis of S.L.E. was made according to the criteria laid down for the diagnosis of S.L...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02938956
更新日期：1976-12-01 00:00:00
abstract：BACKGROUND:Gallbladder stone with symptom is an indication of cholecystectomy according to the current guideline. However, about 80% of gallstone patients are asymptomatic. The identification of gallbladder stone patients likely to develop symptomatic complications would be of benefit in clinical practice. AIMS:The ai...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-019-02161-x
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Circumcision is one of the world's most common operations. Series describing a new technique involving the use of fibrin-based glue have become more apparent in the literature. Here we outline the first 100 such cases for 62 children and 38 adults in our practice describing complications and learning curve. ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-010-0545-8
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Solitary adenomas have been shown to be responsible for almost 90% of cases of primary hyperparathyroidism. AIM:The purpose of this study was to determine the utility of sestamibi scanning pre-operatively to guide minimally invasive video-assisted (MIVA) parathyroidectomy. METHODS:We reviewed 40 patients w...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-007-0075-1
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:Of over 20 different scoring systems to evaluate outcome following calcaneal fracture, the Maryland Foot Score has broad current acceptance. A general health survey, the Short Form 36 (SF 36) has also been used. AIMS:The study compared two scoring systems for assessing the outcome of open reduction and inte...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF03166916
更新日期：2000-04-01 00:00:00
abstract：INTRODUCTION:Pituitary tuberculosis is an uncommon cause of sellar mass [1]; the estimated prevalence worldwide is not known, and there have been no reports of the condition occurring in Ireland. Tuberculosis of the pituitary gland may present as a sellar mass or with symptoms of hypopituitarism. CASE PRESENTATION:A 4...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/s11845-017-1654-4
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Anal ulceration is uncommon. Patients are typically referred because of severe anal pain, bleeding, discharge, and ulceration. It is important to exclude anal carcinoma, and to consider more unusual causes. METHODS:A 74-year-old lady presented with severe anal pain and ulceration. This was subsequently note...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF03169175
更新日期：2006-07-01 00:00:00
abstract：:Serum antibodies to Epstein-Barr virus (EBV) were measured in members of twenty-nine families in which two or more first degree relatives had rheumatoid arthritis (RA). These patients were assessed clinically for activity of disease and their treatment recorded. A higher proportion of seropositive individuals was foun...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02943612
更新日期：1989-08-01 00:00:00
abstract：BACKGROUND:Secondary prevention therapies, such as angiotension converting enzyme (ACE) inhibitors, beta-blockers and statins, are known to reduce cardiovascular morbidity and mortality. OBJECTIVE:The aim of the study was to examine the prevalence of coronary heart disease (CHD) and the prescribing of secondary preven...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF03169139
更新日期：2005-07-01 00:00:00
abstract：:We report a rare case of iatrogenic tracheal tear during a three-stage oesophagectomy in a 76-year-old woman and review current literature. The tear occurred due to trauma from a double lumen endotracheal tube. We used a novel technique of repairing the tear, which extended to the carina, avoiding a second thoracotomy...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-008-0169-4
更新日期：2009-09-01 00:00:00
abstract：:A case of cervical pregnancy resulting in intra abdominal rupture in the first trimester is reported. The clinical features of this rare cause of uterine rupture are outlined. Pathological examination of the uterus showed placenta percreta. ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02942011
更新日期：1989-01-01 00:00:00
abstract：:Percutaneous tracheostomy (PCT) facilitates easy, bedside insertion of a tracheostomy tube. The percutaneous approach to tracheostomy is used in some parts of the world. This is the first report of a PCT method, in Ireland. The percutaneous technique appears to have advantages over conventional, surgical tracheostomy....
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02996321
更新日期：1993-10-01 00:00:00
abstract：:We report experiences in 3 patients with acromegaly while using the somatostatin analogue octreotide. In case 1, a 44 year old male developed pneumococcal meningitis 3 months after having transphenoidal surgery for a pituitary tumour. This occurred with the re-emergence of communication between the surgical tract and ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02942899
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:In recent decades the management of acute appendicitis has evolved significantly. Improved access to early imaging and better clinical scoring algorithms have resulted in less negative appendicectomy rates. In addition, non-operative management has become increasingly utilized. The aim of this study was to a...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-020-02349-6
更新日期：2020-08-27 00:00:00
abstract：BACKGROUND:Attitudes have been shown to be important determinants of the quality and efficacy of medical care. There is little research on the education about, and assessment of, attitudes in undergraduate medical education. AIM:To describe the design and delivery of an attitude awareness workshop, and the associated ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF03170282
更新日期：2002-10-01 00:00:00
abstract：INTRODUCTION:Optimisation of patient comfort during flexible bronchoscopy is achieved with the use of intravenous sedation and vocal anaesthesia. METHODS:The effect of transcricoid lignocaine injection was investigated with regards to ease of procedure and frequency of cough. A single-blinded study was carried out and...
journal_title：Irish journal of medical science
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11845-014-1099-y
更新日期：2015-06-01 00:00:00
abstract：:Menorrhagia affects 20-30% of healthy women, many of whom undergo hysterectomy. In recent years, transcervical resection of the endometrium (TCRE) has become an alternative surgical option. This observational study assesses patient satisfaction following TCRE. The case notes of 55 patients who had a TCRE in the Coombe...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02940244
更新日期：1996-07-01 00:00:00
abstract：OBJECTIVE:To describe the relationship between parents with gender identity disorder (GID) and their child(ren) as described by the parent and to understand how being a parent affects transitioning from one gender to the other. METHODS:Fourteen parents with GID underwent a semi-structured interview and completed the I...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-013-1003-1
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:The introduction of treat and referral by ambulance practitioners is under active consideration in Ireland. The Irish ambulance services have traditionally transported all patients following an emergency (112/999) call to an emergency department. The introduction of treat and referral will present a signific...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-020-02224-4
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:It has been recognised for some time that mortality rates vary across social class groups, with lower rates in the higher social classes. Internationally, but particularly in Ireland, many studies on the topic of inequalities in mortality have been confined to men, partly because the most frequently used soc...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-014-1189-x
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:A 32-year-old HIV-positive man required ventilation for seizures secondary to viral encephalitis. He had a prolonged care unit stay and had percutaneous tracheostomy performed on day 14 of his admission. He subsequently developed persistent right basal infiltrates and atelectasis on chest radiographs that we...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-008-0182-7
更新日期：2010-03-01 00:00:00
abstract：BACKGROUND:The incidence and prevalence of childhood chronic disease is increasing worldwide. Obesity, poor diet and lifestyle may be more prevalent in children with a chronic disease than in their healthier contemporaries. The Growing Up in Ireland (GUI) study is a nationally representative cohort study of children li...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-018-1814-1
更新日期：2019-02-01 00:00:00
abstract：:It has been suggested in the literature that an eight hour period of distal oesophageal monitoring is adequate for the diagnosis of reflux in symptomatic patients. The aim of this study was to investigate whether 3 hour intra-oesophageal pH-metry could be substituted for the eight hour test period without loss of sens...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02947641
更新日期：1991-02-01 00:00:00
abstract：OBJECTIVE:Evaluate condylar, ramal, and condylar plus ramal vertical mandibular asymmetry in patients with unilateral posterior crossbite (UPCB) and in patients with unilateral cleft lip and palate (UCLP) compared with subjects having normal occlusion. DESIGN:This cross-sectional study evaluated panoramic radiographs ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-013-1020-0
更新日期：2014-09-01 00:00:00
abstract：:Due to the difficulties in the diagnosis of ruptured splenic artery aneurysm in pregnancy both maternal and fetal mortality continue to be high. A case is presented of a 37 year old woman who ruptured a splenic artery aneurysm at 29 weeks gestation. The presentation of the disease, its risk factors and treatment, as w...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/BF02945175
更新日期：1993-05-01 00:00:00
abstract：:A bioassay method for measuring parathyroid hormone (PTH) and other substances that influence bone metabolism is described. Monolayers of bone cells are culturedin vitro, then treated with the test material. Biological activity is determined by measuring the resulting rise in bone-cell adenosine 3',5'-monophosphate (c...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02938966
更新日期：1976-12-01 00:00:00
abstract：BACKGROUND:The weight of the delivered placenta gives a useful representation of placental function in utero. In the absence of Irish data, many pathologists rely on data from other populations, many of which are now 15 to 30 years old. The development of a population-specific nomogram would aid in the examination of p...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-019-02102-8
更新日期：2020-05-01 00:00:00
