Title: Enhanced surveillance of initial cases of pandemic H1N1 2009 influenza in Ireland, April-July 2009.

Authors: Martin, J; O'Donnell, J; Igoe, D; O'Hora, A; Thornton, L; Murphy, N; Cullen, G; Fitzgerald, M; Cotter, S; McKeown, P; O'Flanagan, D

Abstract: From 28 April to 18 July 2009 there were 156 cases of pandemic H1N1 2009 influenza confirmed in Ireland. During this time, Ireland was in containment phase, and detailed case-based epidemiological information was gathered on all cases presenting in the community and acute health care setting. Active case finding was performed among contacts of cases. Eighty percent of cases were in people less than 35 years of age and 86% were imported. The most frequent symptoms were fever, sore throat, myalgia and dry cough. Nine people were hospitalized, no fatalities occurred.

Title: High DNA melting temperature predicts transcription start site location in human and mouse.

Authors: Dineen, David G; Wilm, Andreas; Cunningham, Pádraig; Higgins, Desmond G

Abstract: The accurate computational prediction of transcription start sites (TSS) in vertebrate genomes is a difficult problem. The physicochemical properties of DNA can be computed in various ways and a many combinations of DNA features have been tested in the past for use as predictors of transcription. We looked in detail at melting temperature, which measures the temperature, at which two strands of DNA separate, considering the cooperative nature of this process. We find that peaks in melting temperature correspond closely to experimentally determined transcription start sites in human and mouse chromosomes. Using melting temperature alone, and with simple thresholding, we can predict TSS with accuracy that is competitive with the most accurate state-of-the-art TSS prediction methods. Accuracy is measured using both experimentally and manually determined TSS. The method works especially well with CpG island containing promoters, but also works when CpG islands are absent. This result is clear evidence of the important role of the physical properties of DNA in the process of transcription. It also points to the importance for TSS prediction methods to include melting temperature as prior information.

Title: Alterations in integrin expression modulates invasion of pancreatic cancer cells.

Authors: Walsh, Naomi; Clynes, Martin; Crown, John; O'Donovan, Norma

Abstract: BACKGROUND: Factors mediating the invasion of pancreatic cancer cells through the extracellular matrix (ECM) are not fully understood. METHODS: In this study, sub-populations of the human pancreatic cancer cell line, MiaPaCa-2 were established which displayed differences in invasion, adhesion, anoikis, anchorage-independent growth and integrin expression. RESULTS: Clone #3 displayed higher invasion with less adhesion, while Clone #8 was less invasive with increased adhesion to ECM proteins compared to MiaPaCa-2. Clone #8 was more sensitive to anoikis than Clone #3 and MiaPaCa-2, and displayed low colony-forming efficiency in an anchorage-independent growth assay. Integrins beta 1, alpha 5 and alpha 6 were over-expressed in Clone #8. Using small interfering RNA (siRNA), integrin beta1 knockdown in Clone #8 cells increased invasion through matrigel and fibronectin, increased motility, decreased adhesion and anoikis. Integrin alpha 5 and alpha 6 knockdown also resulted in increased motility, invasion through matrigel and decreased adhesion. CONCLUSION: Our results suggest that altered expression of integrins interacting with different extracellular matrixes may play a significant role in suppressing the aggressive invasive phenotype. Analysis of these clonal populations of MiaPaCa-2 provides a model for investigations into the invasive properties of pancreatic carcinoma.

Title: An experimental platform for systemic drug delivery to the retina.

Authors: Campbell, Matthew; Nguyen, Anh T H; Kiang, Anna-Sophia; Tam, Lawrence C S; Gobbo, Oliviero L; Kerskens, Christian; Ni Dhubhghaill, Sorcha; Humphries, Marian M; Farrar, G-Jane; Kenna, Paul F; Humphries, Peter

Abstract: Degenerative retinopathies, including age-related macular degeneration, diabetic retinopathy, and hereditary retinal disorders--major causes of world blindness--are potentially treatable by using low-molecular weight neuroprotective, antiapoptotic, or antineovascular drugs. These agents are, however, not in current systemic use owing to, among other factors, their inability to passively diffuse across the microvasculature of the retina because of the presence of the inner blood-retina barrier (iBRB). Moreover, preclinical assessment of the efficacies of new formulations in the treatment of such conditions is similarly compromised. We describe here an experimental process for RNAi-mediated, size-selective, transient, and reversible modulation of the iBRB in mice to molecules up to 800 Da by suppression of transcripts encoding claudin-5, a protein component of the tight junctions of the inner retinal vasculature. MRI produced no evidence indicative of brain or retinal edema, and the process resulted in minimal disturbance of global transcriptional patterns analyzed in neuronal tissue. We show that visual function can be improved in IMPDH1(-/-) mice, a model of autosomal recessive retinitis pigmentosa, and that the rate of photoreceptor cell death can be reduced in a model of light-induced retinal degeneration by systemic drug delivery after reversible barrier opening. These findings provide a platform for high-throughput drug screening in models of retinal degeneration, and they ultimately could result in the development of a novel "humanized" approach to therapy for conditions with little or no current forms of treatment.

Title: How do patients with inflammatory bowel disease want their biological therapy administered?

Authors: Allen, Patrick B; Lindsay, Hannah; Tham, Tony C K

Abstract: BACKGROUND: Infliximab is usually administered by two monthly intravenous (iv) infusions, therefore requiring visits to hospital. Adalimumab is administered by self subcutaneous (sc) injections every other week. Both of these anti-TNF drugs appear to be equally efficacious in the treatment of Crohn's Disease and therefore the decision regarding which drug to choose will depend to some extent on patient choice, which may be based on the mode of administration.The aims of this study were to compare preferences in Inflammatory Bowel Disease (IBD) patients for two currently available anti-TNF agents and the reasons for their choices. METHODS: An anonymous questionnaire was distributed to IBD patients who had attended the Gastroenterology service (Ulster Hospital, Dundonald, Belfast, N. Ireland. UK) between January 2007 and December 2007. The patients were asked in a hypothetical situation if the following administering methods of anti-TNF drugs (intravenous or subcutaneous) were available, which drug route of administration would they choose. RESULTS: One hundred and twenty-five patients fulfilled the inclusion criteria and were issued questionnaires, of these 78 questionnaires were returned (62 percent response). The mean age of respondent was 44 years. Of the total number of respondents, 33 patients (42 percent) preferred infliximab and 19 patients (24 percent) preferred adalimumab (p = 0.07). Twenty-six patients (33 percent) did not indicate a preference for either biological therapy and were not included in the final analysis. The commonest reason cited for those who chose infliximab (iv) was: "I do not like the idea of self-injecting," (67 percent). For those patients who preferred adalimumab (sc) the commonest reason cited was: "I prefer the convenience of injecting at home," (79 percent). Of those patients who had previously been treated with an anti-TNF therapy (n = 10, all infliximab) six patients stated that they would prefer infliximab if given the choice in the future (p = 0.75). CONCLUSIONS: There was a trend towards patient preference for infliximab (iv) treatment as opposed to adalimumab (sc) in patients with IBD. This difference may be due to the frequency of administration, mode of administration or differing 'times in the market-place', as infliximab had been approved for a longer period of time in Crohn's disease. Further studies are required in IBD patients to investigate whether patient choice will affect compliance, patient satisfaction and efficacy of treatment with anti-TNF therapies.

Title: Urachal endometrioma: a case report.

Authors: Browne, Katherine M; Connolly, Stephen S; Daly, Niamh; Crotty, Tom; Flynn, Robert J

Abstract: INTRODUCTION: We discuss a rare presentation of an unusual case of endometrioma. CASE PRESENTATION: A 40-year-old Caucasian woman presented with subacute abdominal pain and a suprapubic mass. A final diagnosis was made after the mass was resected and histopathology confirmed an endometrioma originating from an urachal remnant. Select imaging studies and histopathology are presented in this case report. CONCLUSION: While endometriomata are well known to arise from abdominal scars, the condition described in this case report is a rare example of an endometrioma arising from the urachus. A review of the pathological complications of the urachus is also included.

Title: Management of anterior triangle swellings in a tertiary vascular centre with emphasis on the roles of duplex ultrasound, computed tomography angiogram and magnetic resonance angiogram: a case series.

Authors: Colleran, Gabrielle C; Cronin, Kevin C; Browne, Ann M; Hynes, Niamh; Sultan, Sherif

Abstract: BACKGROUND: Anterior triangle masses pose an important clinical dilemma. It is very difficult to distinguish the potential pathologies pre operatively by clinical and radiological assessment. CASE REPORT: The first case highlights the management of a bilateral chemodectoma, the second case is a presentation of castleman's disease and the third is that of metastatic tonsillar adenocarcinoma. All three cases had a similar presentation and radiological appearance pre-operatively. CONCLUSION: Anterior triangle masses span the clinical spectrum of pathologies from chemodectoma to castleman's disease to carcinoma. Expert vascular and radiological management is required for optimum patient care and should take place in a tertiary referral centre. Duplex US, CTA and MRA are important pre operative assessment tools to ensure that adequate information regarding the relationship of the lesion to the carotid artery is available to the operating surgeon who should have vascular expertise as deliberate practice volume has been repeatedly shown to result in improved patient outcome.

Title: Saltwater nectotizing fasciitis following coral reef laceration possibly exacerbated by a long-haul flight: a case report.

Authors: Byrne, Ann-Maria; Sullivan, Paul; Keogh, Peter

Abstract: INTRODUCTION: Necrotising fasciits is a rapidly progressive disease characterised by extensive necrosis of the fascia, skin, and subcutaneous tissue, with relative sparing of the underlying muscle. CASE PRESENTATION: We present the case of a 24-year old Irish male student who sustained a laceration to his right shin from contact with a coral reef while swimming in the Phuket region, off the west coast of Thailand. The following day, he returned to Ireland and presented with an aggressive and destructive variant of group A beta-hemolytic streptococcal necrotising fasciitis originating at the site of the coral reef injury, and exacerbated by the long-haul flight. He was successfully treated with aggressive surgical debridement, vacuum-assisted dressings, split skin grafting and broad spectrum antibiotics. CONCLUSION: Necrotising fasciitis can progress rapidly to systemic toxicity and even death without expedient diagnosis and aggressive treatment. Long-haul flights induce significant fluid accumulation in the lower extremity. These physiological fluid shifts may have contributed to the severity of our patient's necrotizing condition following his flight from Thailand.

Title: Small bowel obstruction secondary to migration of a fragment of lithobezoar: a case report.

Authors: Medani, Mekki; Myers, Eddie; Kenny, Bryan; Waldron, David

Abstract: INTRODUCTION: Small bowel obstruction is a common world-wide condition that has a range of etiological factors. The management is largely dependent on the cause of the obstruction. Small bowel obstruction caused by foreign body ingestion is rare; many items have been reported as responsible, but there are no reports implicating polyurethane foam. CASE PRESENTATION: We report the case of a 44-year-old Irish male who presented following ingestion of polyurethane foam. He was asymptomatic on presentation but developed a small bowel obstruction shortly thereafter. CONCLUSION: Patients presenting following ingestion of polyurethane foam should be scheduled for elective laparotomy, gastrotomy, and retrieval of the cast on the next available theatre list - given that they are suitable for surgery.

Title: Safety of trastuzumab (Herceptin) during pregnancy: two case reports.

Authors: Goodyer, Matthew J; Ismail, Jeffri Rm; O'Reilly, Seamus P; Moylan, Eugene J; Ryan, C Anthony M; Hughes, Paul Af; O'Connor, Alan

Abstract: We report on two cases of women on trastuzumab therapy for breast cancer who became pregnant and delivered healthy live infants. At the time of reporting the children are growing and developing normally (ages 3 and 2).

Title: Food Safety Authority of Ireland Annual Report 2008

Authors: Food Safety Authority of Ireland (FSAI)

Title: A children's residential centre in the HSE Western Area: follow-up inspection

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Western Area: follow-up inspection

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE South Area: final report

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Southern Area: follow-up inspection

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Dublin North East

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Dublin North East Area: follow-up inspection

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Dublin North East Area

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Dublin North East Area

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)

Title: A children's residential centre in the HSE Dublin Mid-Leinster Area

Authors: Health Information and Quality Authority (HIQA), Social Services Inspectorate (SSI)