2013 Projects (61-85)

62. Investigating links between emotional intelligence and observer performance by radiologists in mammography

Keane K1, Brennan P2, Mello-Thoms C2, Cumming S2, McEntee M2, and Mackay S3 Lewis SJ2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield Dublin 4.

2Medical Imaging Optimisation and Perception Group, Faculty of Health Sciences, The University of Sydney, Australia.

3School of Health Sciences, University of Liverpool, United Kingdom.

A novel direction of mammography/radiology research is better understanding the links between cognitive factors and radiologists' accuracy and performance.  This study examines relationships between EI scores and observer performance by radiologists in breast cancer detection.

Three separate samples were collected with Australian and US breast imaging radiologists.  The radiologists were asked to undertake a mammographic interpretation task to identify malignant breast lesions and localise the lesions using a confidence rating scale.  Following this activity, the radiologists were administered the EI Trait (TEIQue) questionnaire.  The Trait EI test gives a Global EI score and 4 sub-scores in Well-being, Self-Control, Emotionality and Sociability.

Sample 1 (Darling Harbour 2012) radiologists were divided into 2 experience bands; radiologists <13 years as “less” experience and >13 years as “more”.  There was a significant Pearsons correlation (r = 0.849, p =0.012) between Self control and Location Sensitivity in the “less” experience band however there was little correlation (r = 0.09) between this EI trait in “more” experience. In the second sample (Darwin 2013) radiologists were divided into 3 groups: high, medium, low experience; however there were no statistically significant correlation between EI and performance.  Analysis of the US radiologists (Sample 3: Louisville) scores is ongoing; however there is a significant difference between the EI scores of US and Australian radiologists in terms of the EI traits Well-being (5.86, 5.50, p<0.03) and Self-Control (4.89, 4.70, p<0.04).

EI is correlated to observer performance in lesser experienced radiologists. It is suggested that tasks perceived as more difficult by less experienced radiologists may evoke more emotion (uncertainty, frustration, pressure).  As experience increases radiologists may develop an ability to control their emotions or emotional intelligence becomes less important in decision making.                                                                                                               

  • Presenting Author: Mr Kevin Keane
  • Supervisor: Dr Sarah Lewis
  • Co-Supervisor: Prof Patrick Brennan

63. To determine the effect of the brd4 inhibitor jq1 on small cell lung cancer cell lines

Berney M1, Brodie S2, Brandes J2

1UCD School of Medicine and Medical Science University College Dublin, Belfield, Dublin 4.

2 Winship Cancer Institute 1365-C Clifton Road, NE Atlanta, GA 30322

Bromodomain-containing protein 4 (BRD4) facilitates transcription of target genes via epigenetic signalling. JQ1, an inhibitor of BRD4 has shown potent anti-proliferative effects in a number of haematological cancers by suppressing c-MYC. Lung adenocarcinoma cells have also been inhibited by JQ1, through a mechanism independent of c-MYC down-regulation (1). The purpose of this study is to determine the effect of JQ1 on a number of small cell lung cancer (SCLC) cell lines.

Human cell lines (H69, H82, H146) were cultured under standard conditions and treated with JQ1 (dose range 0.5µM – 8µM) for 72 hours followed by dose-response analysis using XTT. All cell lines underwent RT-PCR analysis for c-MYC following treatment with vehicle, 1µM and 5 µM of JQ1 for 24 hours.  Cell line H82 was assessed by RT-PCR for c-MYC following treatment with vehicle and 5 µM JQ1 for 16, 24, 40 hrs. Western blot analysis for p53 protein was performed on cell line H146 following treatment with vehicle, 1µM and 5 µM of JQ1 for 16 hours.

Cell lines H82 and H146 showed sensitivity to JQ1 in a dose-dependent manner. c-MYC was down-regulated in these cell lines in the RT-PCR analysis. Cell line H69 was found to be resistant to JQ1 treatment with no change in c-MYC levels on RT-PCR analysis following treatment.   

These findings suggest that certain SCLC cell lines are sensitive to JQ1 treatment due to down-regulation of c-MYC transcription within these cells. Therefore, JQ1 may be a promising therapeutic agent in SCLC.

Reference:

1. Lockwood WW, Zejnullaha K, Bradner JE, Varmus H. Sensitivity of human lung adenocarcinoma cell lines to targeted inhibition of BET epigenetic signalling proteins. PNAS 2012;109(47):19408-19413.

  • Presenting Author: Mr Mark Berney
  • Supervisor: Dr Johann Brandes
  • Co-Supervisor: Dr Seth Brodie

64. Prevalence of hereditary metabolic diseases in the irish traveller population

Lam O1, Crushell E2, Knerr I2, O’Reilly E 2, Hughes J 2, Monavari A2, Treacy EP 2

1UCD School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4.

2 National Centre for Inherited Metabolic Disorders (NCIMD), Children’s University Hospital, Temple St, Dublin, Ireland

Autosomal recessive rare diseases are common in the Irish Traveller population (a nomadic highly consanguineous population constituting approximately 0.6% of the Irish population: ww.cso.ie), with at least 20 hereditary metabolic diseases (HMDs) described.

Aim:-To perform a retrospective review of the prevalence of HMDs in Irish Traveller children (< age 16) attending the NCIMD from 2000 to July 2013.

Analysis was performed of all listed traveller and non-traveller confirmed HMD cases (<age 16) captured in the NCIMD Apex database as documented in July 2013, (since January 2000). Categorisation was performed for ethnicity, age and diagnosis. The number of confirmed deceased cases was also noted. The point (July 2013) and period prevalence (Jan 2000- July 2013) for HMD confirmed cases was determined using the average of 3 population censuses during this time. Statistical analysis (chi squared and Fischer exact test) was applied.

The point prevalence (July 2013) was determined to be 98.89/10,000 for traveller children vs 6.58/10,000 for non-traveller children (15 fold increased prevalence, p< 0.0001). For the period prevalence, the respective numbers are 136.59/10,000 and 7.97/10,000 (17 fold increased prevalence, p<0.0001). The most common HMD diagnoses in traveller children were noted to be Classical Galactosaemia, Hurler syndrome, Mitochondrial disease, PKU and Glutaric Aciduria Type 1 with highly significant increases in the prevalence of all of these conditions vs. non-traveller children (p<0.005).

This study confirms a markedly increased prevalence of HMDs in the Irish traveller paediatric population and allows for further epidemiological and genetic screening studies.

  • Presenting Author: Ms Odelia Lam
  • Supervisor: Prof Eileen Tracey
  • Co-Supervisor: Dr Ellen Crushell

65. Review: radiation therapy in brain tumour patients

Vinnakota K1, D’Arcy R1, Karvat A2, Ghosh-Hajra S1

1 Simon Fraser University, 250-13450 102nd Avenue Surrey, B.C. Canada V3T 0A3

2 Surrey Memorial Hospital, British Columbia Cancer Agency, 13750 96 Ave, Surrey, BC, Canada

Much has been published regarding the treatment of primary cerebral tumours with radiation but relatively little is known about the response that radiation therapy has on the shrinking tumour, and with that, the changes that occur to the functionally surrounding eloquent cortices. A review of the available literature suggests the following conclusions:

Brain tumours are most commonly diagnosed and treated with surgery, chemotherapy, and mainly, radiation. Recent improvements, such as Stereotactic Radiosurgery (SRS), allow for the delivery of large doses to the lesion while limiting the effects of the radiation to the surrounding eloquent areas of the brain (1).

Currently, SRS is used to treat small size (<3.5-4.0 cm diam.) cerebral metastases. It’s accessibility to the deep structures; a comparable median survival and minimal interference with the patients’ quality of life make it the optimal treatment option. However, radiation induced complications are not avoided. 30% of patients with AVMs treated by SRS developed long-term radiation induced complications (2).

With there not being significant advancement in SRS technology in the past ten years, it is evident there hasn’t been sufficient improvement in administering radiation, and thereby patient quality of life (2). In order to improve SRS therapy, first, there must be adequate knowledge of the functional and structural changes, post radiation therapy (1). Ideally, integration of Magnetic Resonance Imaging and Functional Magnetic Resonance Imaging (fMRI) would provide clear, pronounced information of functional and structural changes. With this knowledge, the dosage can be altered using structural MR and fMRI technologies. 

References:

1. W.C. Liu, M. Schulder, V. Narra, et al. Functional Magnetic Resonance Imaging Aided Radiation Treatment Planning. Med. Phys. 2000; 27(7): 1563-1572.

2. J. C. Flickinger, L. D. Lunsford, D. Kondziolka, A. H. Maitz, et al. Radiosurgery and Brain Tolerance: An Analysis of Neurodiagnostic Imaging Changes After Gamma Knife Radiosurgery for Arteriovenous Malformations. IJRO. 1992; 23:19-26.

  • Presenting Author: Ms Krishna Vinnakota
  • Supervisor: Dr Ryan D’Arcy
  • Co-Supervisor: Dr Anand Karvat

 

66. A study into the role of bmp antagonist noggin in pulmonary fibrosis

Hewitt K, Murphy N, Howell K1,2, McLoughlin P1,2

1UCD School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4.

2UCD Conway Institute of Biomedical and Biomolecular Research, University College Dublin, Belfield, Dublin 4.

Chronic lung diseases are among the leading cause of death and disability worldwide. The pathogenic mechanisms underlying such diseases are poorly understood. Gremlin is a bone morphogenic protein (BMP) antagonist whose expression is highly upregulated in hypoxic and fibrotic lung diseases. It plays a key role in their pathogenesis.1Recently it has been identified that noggin, another member of the BMP antagonist family, has increased mRNA expression in bleomycin injured lungs. (Murphy, Noelle. Unpublished  results.) The aim of this study was to investigate the expression of noggin in the bleomycin model of lung injury.

Immunostaining was carried out on previously prepared mouse lung tissue that had been exposed to intratracheal bleomycin (N=7) or control (N=7) conditions. (approved by UCD Animal Research Ethics Committee and carried out under license). The tissue was stained using anti-noggin and anti-phosphosmad-1,5,8 antibodies, the latter as an index of BMP signaling.

Noggin protein expression was increased in bleomycin injured lungs. Increased staining was particularly notable in large airway epithelium, alveolar epithelium, macrophages and the smooth muscle of large vessels. Phosphosmad-1,5,8 expression was decreased in the large airway epithelium and the smooth muscle of large vessels.

These results show that noggin expression is increased in the bleomycin model of lung fibrosis. Compatible with reduced BMP signalling, Phosphosmad-1, 5, 8 expression was decreased. The exact pathogenic role of noggin in bleomycin injured lungs requires further investigation.

Acknowledgement:

Funded by the Physiological society of Great Britain and Ireland's vacation studentship award

Reference:

Costello CM, Cahill E, Martin F,  Gaine S,  McLoughlin P. Role of Gremlin in the Lung Development and Disease. Am J Respir Cell Mol Biol 2010 May;42(5):517-23

  • Presenting Author: Ms Katie Hewitt
  • Supervisor: Prof Paul McLoughlin
  • Co-Supervisor: Dr Katherine Howell

67. External validation of the 2013 partin tables in a cohort of irish men

Boyd Lyons A1, Boyce S1,2, Watson RWG1,2

1UCD School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4.

2UCD Conway Institute of Biomedical and Biomolecular Research, University College Dublin, Belfield, Dublin 4.

Prostate Cancer (PCa) is the second most common cancer in Irish men (1).Many nomograms and predictive tools have been developed to aid the clinician and patient in treatment decision-making (2). The Partin Tables are the most well known predictive model for pre surgical PCa staging (2).

The aim of this study was to externally validate the 2013 Partin tables in an Irish cohort.

A retrospective review of the Irish Prostate Cancer Research Consortium (PCRC) was carried out, resulting in a final cohort of N=414. The 2013 Partin table was applied to the Irish cohort of men and predicted and actual probabilities compared by means of receiver operating characteristic (ROC) curves and area under the curve (AUC) values.

The 2013 updated Partin tables have been shown to inadequately predict the majority of PCa stages in a cohort of Irish men (organ confined disease AUC = 65.8%, extra capsular extension AUC = 57.8%, seminal vesicle involvement AUC = 63%). However, the tables were able to accurately predict patients with the most advanced PCa stage, lymph node involvement (AUC = 85.5%).

We have performed the first international external validation of the 2013 updated Partin tables. They do not accurately predict the most common PCa stages in Irish men. This finding will impact on the clinical management of Irish PCa patients. We propose the development of an Irish Partin table using clinical data of Irish men. More accurate biomarkers to predict PCa stage are urgently required.

References:

1.  Irish Cancer Society. About Prostate Cancer [internet]. Ireland: Irish Cancer Society; undated [cited 2013 July 29]. Available from: http://www.cancer.ie/cancer-information/prostate-cancer/about.

2. Capitano U, Briganti  A, Gallina A, et al. Predictive Models Before and After Radical Prostatectomy. The Prostate. 2010: 70:1371-1378.

  • Presenting Author: Ms Amy Boyd Lyons
  • Supervisor: Ms Susie Boyce
  • Co-Supervisor: Prof R William G Watson

68. The potential of digital media to improve fetal and maternal outcomes

Murphy OC1, O’Higgins AC2, Egan AF1, Kennelly MM2, Sheehan SR2, Turner MJ2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2UCD Centre for Human Reproduction, Coombe Women and Infants Hospital,  Dublin 8.

Despite free maternity, adverse fetal and maternal outcomes remain closely linked to social disadvantage.  Traditional media and information leaflets remain the main media of communication to pregnant women.  It is likely that many of these messages are not adequately communicated to those most at risk. The aim of this study was to assess the use of digital media in women attending for maternity care.

A standardised questionnaire was distributed to antenatal and postnatal maternity patients attending a large Dublin maternity hospital. Results: A total of 522 women responded, comprising 42% antenatal patients and 58%  postnatal patients.  There were 71% attending public clinics and 29% attending semi-private and private clinics, 62% lived in Dublin, 19% were unemployed.  The majority of women were aged between 25-34 years.  Most women (55%) already had at least one child. 

Overall 95% used the internet to access pregnancy information. Overall 73% of women had a smartphone. Newspapers were read by only 29% of women. All women wanted some form of online/digital support during their pregnancy, including weekly text messages about pregnancy stage-specific issues (cited by 45%), a maternity smartphone app (44%) and a hospital Facebook page (31%).  Usage of digital media was similar across all age-groups. 

Digital media use in pregnant women is widespread across all socioeconomic groups, age-groups and parities. Digital communication channels are more commonly used than traditional channels. Health communications about pregnancy should use contemporary digital media.

Reference:

HLS-EU Consortium (2012): Comparative report on health literacy in eight EU member states. The European Health Literacy Survey HLS-EU, online publication: http://www.health-literacy.eu

  • Presenting Author: Ms Olivia Murphy
  • Supervisor: Prof Michael J Turner
  • Co-Supervisor: Dr Amy O’Higgins

69. Spirasi and survivors of torture: a demographic analysis

Singleton BN1, Duffy2 R, Kelly B2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2Adult Psychiatry Department,  Mater Misericordiae University Hospital, Eccles Street, Dublin 7.

The aim of this project was to measure the demographics and characteristics of the population of torture survivors visiting the Spiritan Asylum Seeker Initiative (SPIRASI), a non-governmental organisation that provides therapeutic, medical and psychosocial support to survivors of torture, the vast majority of whom are either asylum seekers or refugees.

All visitors to SPRASI from January 2001 to December 2012 were included in the dataset, a total of 2590. Recorded variables for those attending SPIRASI included: gender, date of birth, country of origin, first or preferred language, interpreter required (y/n), residency status and date of first visit.

Cross tabulation analysis revealed a number of noteworthy facts or trends, including: increasing numbers from the Middle East, lower number of females from Asia and the Middle East, underrepresentation of females relative to the asylum seeking population in Ireland as a whole, and an apparent stabilisation in recent years in the percentage of asylum seekers arriving in Ireland who also go on to attend SPIRASI.

The increasing numbers of the Middle East may be expected in continue in tandem with the Arab Spring, and this change in the make up of the population attending SPIRASI may have operational implications for the organisation. The gender-regional differences and underrepresentation of females warrant further investigation, to see whether these differences are the result of female gender discrimination or disadvantages. And lastly, the population trend mentioned above may be predictive of the number of asylum seekers attending SPIRASI in the future.

  • Presenting Author: Mr Barry Singleton
  • Supervisor: Dr Richard Duffy
  • Co-Supervisor: Dr Brendan Kelly

70. Custody, care and country of origin: demographic and diagnostic admission statistics at an inner-city adult psychiatry unit

Rock, C1, Kelly BD1, Emechebe A1, Anamdi C1, Duffy R1, Murphy N2

1 Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7.

2 School of Medicine, Clinical Sciences Institute, National University of Ireland Galway, Newcastle Road, Galway.

Individuals with mental disorders can, under specific circumstances, be detained and treated against their wishes. Ng & Kelly(1) previously examined all admissions to St. Aloysius adult psychiatry unit in Dublin's north inner-city (served by the Mater Misericordiae University Hospital) over a three-year period (2008-2010). It was found that there were a greater proportion of involuntary admissions of non-Irish patients compared to admissions for people born in Ireland. However, this effect was mediated by diagnosis (higher rates of schizophrenia among non-Irish) with this being the only independent predictor of admission status.  

The present study examined admission statistics for St. Aloysius Ward between January 2011 and June 2013 and compared them with national statistics and data from the Irish National Census 2011 in order to further explore involuntary admission rates among individuals from outside Ireland.

It was again found that the proportion of admissions that was involuntary among individuals from outside Ireland (32.5%) was higher than that among individuals from Ireland (9.9%) (p<0.001).  35.0% of individuals resident in the catchment area were born outside Ireland and accounted for 36.6% of involuntary admissions but only 12.5% of voluntary admissions. So rather than an especially high rate of involuntary admissions among the non-Irish, this excess of involuntary admission is quite small in magnitude, but the rates of voluntary admission among those born outside Ireland are very low indeed, compared to those born in Ireland.

Further study is needed to explain the relatively low rate of voluntary admission among individuals born outside Ireland (possibly attributable to different patterns of help-seeking).

Reference:

1. Ng XT & Kelly BD. Voluntary and involuntary care: three-year study of demographic and diagnostic admission statistics at an inner-city adult psychiatry unit. Int J Law Psychiat. 2012; 35: 317-326.

  • Presenting Author: Ms Catherine Rock
  • Supervisor: Dr Brendan Kelly
  • Co-Supervisor: Dr John Sheehan

71. Formal thought disorder and neurocognitive functioning in first episode psychosis

MacMahon D1, Roche E2, Gaynor K3, Clarke M2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4. 

2DETECT Early Intervention in Psychosis, Avila House, Blackrock, Co. Dublin

3St John of God Hospital, Stillorgan, Co Dublin

Formal Thought Disorder (FTD) describes the language disturbance seen in schizophrenia and other mental illnesses.(1) Deficits in the areas of inhibition, context memory, processing of semantic information and working memory have all been associated with the presence of FTD in psychosis.(2) We sought to investigate the neurocognitive and psychopathological correlates of FTD in a mixed sample of patients experiencing First Episode Psychosis.

50 subjects aged 17-56 with first episode psychosis presenting to the Cluain Mhuire Mental Health Service were assessed, diagnosed and examined with a comprehensive set of tests. Statistics were compiled using SPSS 20.

FTD correlations with various neurocognitive areas: Executive functioning, P = 0.04; Attention, P = 0.02, Working Memory, P = -0.09; Verbal Memory, P = -0.09; Processing Speed, P = 0.23; Premorbid IQ, P = -0.32.

FTD does not have a significant correlation to neurocognitive deficits in this sample of FEP patients, nor within a subgroup of those with schizophrenia-spectrum diagnoses

References:

1. Andreasen NC. Thought, language, and communication disorders. II. Diagnostic significance. Arch Gen Psychiatry. 1979; Nov;36(12):1325-30.

2. Kerns JG, Berenbaum H. Cognitive impairments associated with formal thought disorder in people with schizophrenia. J Abnorm Psychol. 2002; May;111(2):211-24.

  • Presenting Author: Mr Donagh McMahon
  • Supervisor: Dr Eric Roche
  • Co-Supervisor: Dr Mary Clarke

72. Predictors of long term health service use in people with a first episode of psychosis

Moloney D1, Behan C2, Hill M3, Kinsella A2, Clarke M1,2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2DETECT, Avila House, Block 5, Blackrock Business Park, Carysfort Ave, Blackrock, Co Dublin.

3Schizophrenia Program, Massachusetts  General Hospital and Harvard Medical School, USA.

Identification of individuals at first presentation who may have a poorer outcome means we can plan their care more effectively. The aim of this project is to evaluate potential predictors of future contact with community mental health services and health service use (HSU) in a cohort of people with first episode psychosis (FEP) at twelve years.

The cohort consisted of an epidemiological sample of individuals with FEP who first presented to Community mental health services (CMHT) between 1995-1999 (n=171). 68.4% were followed up and had information on health service use collected using Client Socio-Demographic and Service Receipt Inventory (CSSRI).1

At 12 year follow up; 41% were in contact with CMHT and 27% were in contact with both their GP and CMHT. 19% were only in contact with their GP and 15% weren’t in contact with any service. χ2, Mann-Whitney and independent t tests were used to examine relationships between variables. There was no relationship between DUP (p = 0.3), or having a diagnosis of schizophrenia (p = 0.06) and being in contact with health services at 12 years. Those in contact with health services at 12 years had significantly more suicide attempts than those who weren’t (p = 0.01), and lower GAF scores indicating a lower level of functioning (p = 0.002).

The main implication of this project is that risk assessment and management of suicidal ideation by both the CMHT services and GPs is very important considering the relationship between suicide attempts and long-term HSU.

Reference:

1. Hill M, Crumlish N, Clarke M et al. Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years. Schizophr Res. 2012; 141(2-3): 215-221.

  • Presenting Author: Mr David Moloney
  • Supervisor: Dr Caragh Behan

74. The anaesthetic gases, sevoflurane & xenon, have opposing effects on cell migration in breast cancer cells in vitro

Ní Mhathúna AN, Valchev G, Ash S, Buggy DJ1,   Gallagher HC1,2

1UCD School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4.

2UCD Conway Institute of Biomedical and Biomolecular Research, University College Dublin, Belfield, Dublin 4.

Anaesthetic technique and anaesthetic drug choice can affect the clinical outcome of breast cancer. The anaesthetic xenon has advantages over other inhalational agents, however, compared to the standard clinical agent, sevoflurane, xenon is not in widespread clinical use (1). Here, the aims were to compare the effects of sevoflurane and xenon on migration and invasion of two breast adenocarcinoma cell lines.

Two cell lines, MDA-MB-231 (ER-negative) and MCF-7 (ER-positive) were maintained according to standard cell culture protocols. Three gases were used, control gas (70% N2, 25% O2 , 5% CO2), sevoflurane mix ( 59% O2, 38% N2, 2.5% sevoflurane) and xenon mix (70% Xe, 25% O2,  5% CO2). The OrisTM Cell Migration and Cell Invasion assays, based on the formation of an exclusion zone into which cells can subsequently migrate or invade, were employed. Cells were exposed to control gas, sevoflurane or xenon for a period of 3 hours. Following 24 hours migration they were stained using calcein-AM. Cell density in the exclusion zone was quantified using a fluorescent plate reader.

In the MDA-MB-231 cell line, sevoflurane increased cell migration (P=0.04) and there was a significant difference between the sevoflurane and xenon-exposed cells in the degree of migration (P=0.04). In the MCF-7 cell line, there was a significant decrease in migration in xenon-exposed cells (P=0.03).

Xenon and sevoflurane have opposing effects on breast cancer cell migration in vitro. This effect appears to be more pronounced for the ER-negative cell line, MDA-MB-231, suggesting that oestrogen receptor status may be a contributory factor.

Acknowledgment:

This work was funded by Air Liquide and was supported by The Pathological Society of Great Britain and Ireland.

  • Presenting Author: Ms Avril Ní Mhathúna
  • Supervisor: Dr Helen Gallagher
  • Co-Supervisor: Dr Georgi Valchev/ Dr Simon Ash/Prof Donal Buggy

75. Prevalence of minor depressive disorder in non-affective first episode psychosis

MacMahon D1, Renwick L2, Clarke M2,  Roche E2

1UCD School of Medicine and Medical Science,  University College Dublin, Belfield, Dublin 4.

2DETECT Early Intervention in Psychosis, Avila House, Blackrock, Co. Dublin

Depression is a distinct clinical feature of first episode psychosis (FEP). It is reported in up to 83% of patients during the early phase.(1) Currently the DSM-IV does not consider Minor Depressive Episodes to be a component of schizophrenia and other non-affective disorders. There is a paucity of research looking at depression as a syndrome in schizophrenia and other non-affective psychoses

We sought to examine the prevalence of minor depressive episodes in non-affective FEP, evaluate the severity of the disorders and examine the symptoms that are prevalent in MDEs determining if there is any overlap with the negative symptoms of schizophrenia.

581 patients aged 16 to 64 with FEP were referred to the DETECT Mental Health Service assessed between February 2005 and June 2013. They were assessed using the Structured Clinical Interview for DSM-IV disorders (SCID).

444 patients had a non-affective psychoses. Of these 54 (12.2%) met the criteria for a minor depressive episode.  Severity was equally split, with one third having two, one third having three and one third having four symptoms. The most common symptoms were depressed mood (55.5%) and diminished interest (44.5%). All other symptoms were relatively similarly prevalent.

The prevalence of Minor Depressive Episode (MDE) in this population of non-affective FEP patients was not significant. Severity was uniform in those with a MDE. The most common symptoms of depressed mood and diminished interest reflect results in a normal population. There was no significant overlap with the negative symptoms of schizophrenia.

References:

1.  Sonmez N. Depressive Symptoms in first episode psychosis: a one year  follow up study. (2013) BMC Psychiatry, 13, 106

2. Birchwood M. Cognitive approach to depression and suicidal thinking in psychosis: I. Otogeny of post-psychotic depression (2000) BJ Psych, 177:516-528

  • Presenting Author: Mr Donagh McMahon
  • Supervisor: Dr Laoise Renwick
  • Co-Supervisor: Dr Mary Clarke

76. The evaluation of experience of ports in neurologically impaired children

Wong P, Connolly B, Mahant S1

1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto

Implanted vascular access devices (PORTs) are traditionally used for administration of chemotherapy in oncology patients. PORTs have mainly been used for patients requiring specific medications to treat a certain disease.1 However, the trend of PORTs in non-oncology, neurologically impaired children with medical complexity has evolved. These children with poor venous access who require intermittent vascular access for repeated intercurrent illness has never been characterized and evaluated from a healthcare perspective.

A retrospective case series review was undertaken using the Hospital for Sick Children’s electronic patient charts for those who have had PORT insertions based on disease, age, uses and frequency of access, complications and outcomes.

Before the PORT insertion, all patients had implanted devices, ninety percent of them having G-tubes and seventy percent with previous IV access devices. In the year prior to the PORT insertion, patients had an average of fourteen IV starts and thirty-one IV attempts, demonstrating difficult intravenous access. The duration of PORT access was thirty-four days on average. Fourty-five percent of patients had late complications and twenty-seven percent of patients had acute complications. Twenty-seven percent of patients had their device removed due to PORT associated complications.

By identifying and characterising this medically complex patient population with difficult venous access, a subsequent prospective study may be performed using a descriptive statistics analysis to evaluate their experience of PORTs. Furthermore, ethical issues for inserting PORTs in these patients may be discussed due to the many issues that may arise from their medical complexity.2

References:

1. Alder A., Yaniv I., Steinberg R.. Infectious complications of implantable ports and Hickman catheters in pediatric heamotology-oncology patients. 2006;62(3):358-65.

2. Cohen E., Dennis Z.K., Agrawal R.. Children with Medical Complexity: An Emerging Population for Clinical Research Initiatives. 2011; 127(3):529-538.

  • Presenting Author: Mr Paul Wong
  • Supervisor: Dr Bairbre Connolly

 

77. Ezh-2 expression is inhibited in prostate cancer cell lines by microrna mir-124 overexpression

Gaffney B1, Ma AH2, Shi XB2, Xue L2, Devere White RW2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA.

Prostate cancer (CaP) continues as the second leading cause of cancer deaths in males in the western world . The mechanism of the switch from androgen dependent CaP to castration-resistant prostate cancer (CRPC) remains unclear and has been further complicated by the involvement of microRNA (miRNA) [1]. These small non-coding RNAs are able to regulate gene expression by binding to the 3‘UTR of target genes [1].

The aim of this study is to confirm that the miRNA miR-124 binds to the enhancer of zeste homolog 2 (EZH2) gene through a suggested binding site on the 3’UTR and downregulate its transcriptional level in prostate cancer cell lines. Recent work in the lab found adding a miR-124 mimic in animal and cell models was found to inhibit tumor cell growth, while additional evidence shows miR-124 is downregulated in clinical CaP samples [2].  EZH2 was identified as a target of miR-124. The expression of EZH2 has been correlated with CaP progression, especially CRPC [3]. It is thought that miR-124 is downregulated in CRPC allowing the EZH-2 to negatively regulate the apoptotic pathway as well as increasing invasion and proliferation pathways of cancer cells.

The EZH2 3’UTR fragments with and without the predicted binding site for miR-124 were cloned into a reporter plasmid. A luciferase reporter assay was used to quantify experimental and control reporters. The results of this study show that miR-124 appears to be binding to the suggested binding site on the 3‘UTR of the EZH-2 gene and downregulating its expression. This downregulation is significant in both PC3 and C4-2B cell lines. Further work needs to identify the functional significance of this finding but treatment of CRPC with miR-124 continues to represent a possible therapeutic approach.

References:

1. Yu, J.J. and S.J. Xia, Novel role of microRNAs in prostate cancer. Chin Med J (Engl), 2013.

126(15): p. 2960-4.

2. Shi, X.B., et al., Tumor suppressive miR-124 targets androgen receptor and inhibits proliferation

of prostate cancer cells. Oncogene, 2012.

3. Xu, K., et al., EZH2 oncogenic activity in castration-resistant prostate cancer cells is Polycomb-

independent. Science, 2012. 338(6113): p. 1465-9.

  • Presenting Author: Mr Brian Gaffney
  • Supervisor: Dr Ai-Hong Ma
  • Co-Supervisor: Mr Ralph W deVere White

79. The study of the sympathetic nervous system activity during urination in children with non-neuropathic voiding disorders

Fan EF1, Fazeli MS2, Afshar K3, Collet JP2

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2Department of Pediatrics, BC Children’s Hospital, Vancouver, BC, Canada.

3Department of Urology, BC Children’s Hospital, Vancouver, BC, Canada.

Non-neuropathic voiding disorders (NVD) is a group of disorders with no anatomic and/or neurologic lesions identified (1). Normally, the activity of the parasympathetic nervous system (PNS) increases while the sympathetic nervous system (SNS) decreases during voiding (2). However, the role of Autonomic Nervous System (ANS) dysfunction in pathogenesis of NVD has not yet been fully investigated.

Main objective: to compare the changes in the SNS activity (measured by Pre-ejection period (PEP)) during voiding in patients with NVD and healthy children (controls). We expected a smaller change in PEP in children with NVD compared to controls.

A cross-sectional study was conducted with a goal sample size of 40 children between the ages of 5 to 18 diagnosed with NVD (cases) and 20 otherwise healthy controls. This preliminary analysis consisted of 7 cases and 5 controls. We assessed the SNS function through impedance cardiography techniques to measure PEP, which is the time interval from beginning of the electrical stimulation of the ventricles to the opening of the aortic valve (electrical systole). SNS is inversely correlated to PEP.

At baseline, there was no significant difference between cases and controls in PEP values. However; during voiding among the cases, the percentage change of PEP varied from 2.6% to 31.0% (mean=13.0) while in the controls, this ranged from 13.6% to 73.9% (mean= 40.8). This difference was significant (p=0.048). This finding shows that the SNS function during voiding is deeply affected in children with NVD. However, more data is needed to confirm this observation.

References:

1. Gearhart JP, Rink R.C, Mouriquand PD, editor. Pediatric urology. 2nd ed. Saunders; 2010.

2. Susan Standring. Gray's anatomy: The anatomical basis of clinical practice. 40th ed. Churchill Livingstone; 2008.

  • Presenting Author: Ms Eileen Fan
  • Supervisor: Dr Jean Paul Collet
  • Co-Supervisor: Dr Mir Sohail Fazeli

80. The perfect count: multidisciplinary strategy for the prevention of retained surgical items

Bhatti A1, Ferguson K2, Duffy D2, Afshar K2

1UCDSchool of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2BC Children’s Hospital, Surgical Services Quality & Safety, Vancouver, British Columbia2

Current studies indicate a 0.3-1% rate of retained surgical items per 1000 cases in the United States1. This type of adverse event is considered a “never” event; a medical error that should never occur because it is serious and usually preventable.  The purpose of this project is twofold; first, to identify risk factors for retained surgical items at BC Children’s Hospital and second, to engage front line clinicians in improving current processes for counting and handling incorrect counts. 

Retrospective chart reviews of the last 50 patients with reported incorrect surgical counts (2012-2013) at BCCH in Vancouver, Canada were conducted to identify common trends.  Operating room observations were performed in order to identify themes in team communication and interaction during the count process.

Preliminary results from the chart reviews demonstrate trends in the occurrence of incorrect counts and inconsistency in follow-up documentation of investigative measures performed to resolve count discrepancies.  Operating theatre observation has enabled the identification of common distractions (e.g.: loud conversations, pagers) and interruptions that can lead to avoidable count discrepancies.  Preliminary findings indicate distractions and/or interruptions occurred during the count of 69% of randomly audited cases. 

Results indicate that in order to reduce the risk for retained surgical items, we must focus on culture change within the operating theatre that will enhance team communication and aid in the incorporation of evidence-based best practices.  Results have also indicated opportunities to improve our current count policy, count process and documentation of the resolution of incorrect counts. 

Acknowledgement:

Funding through the Surgical Quality Action Network 

Reference:

Stawicki et al. Retained Surgical Items: A Problem Yet to be Solved.  American  College of Surgeons. 2013

  • Presenting Author: Ms Annam Bhatti
  • Supervisors: Mrs Kimberly Ferguson/ Dr. Koroush Afshar
  • Co-Supervisor: Mr Nathan O’Hara

81. A clinical review of maternal bacteraemia

Egan AF1, Higgins AC2,  Murphy OC1,  Fitzpatrick C2, Sheehan SR2, Turner MJ2

1 UCD School of Medicine and Medical Sciences, University College Dublin, Belfield,  Dublin 4.

2UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork St, Dublin 8.

This study reviewed all cases of bacteraemia which occurred in obstetric patients from 2009-2012.

Cases of maternal bacteraemia were identified from the laboratory database and clinical records of each case were reviewed.

A total of 37,700 obstetric patients attended the hospital over the study period.  There were 58 cases of bacteraemia;19 were diagnosed antepartum, 20 intrapartum and 19 postpartum. There were no maternal deaths.  Two cases resulted in septic shock. Four cases occurred in the 2,366 women who experienced a miscarriage (0.15%).  Fifty-four of the cases occurred in 34,956 women who delivered a baby weighing 500g or more(0.15%). The organism most frequently causing antepartum and postpartum bacteraemia was Escherichia coli. The organism most frequently causing intrapartum bacteraemia was Streptococcus agalactiae (β-haemolytic, Lancefield group B).  An equal number of cases of gram-negative and gram-positive organisms occurred.  The majority of organisms cultured were sensitive to first-line antibiotics, with no cases of bacteraemia involving multi-drug resistant organisms.

No association was found between the development of bacteraemia and maternal risk factors, including socio-economic group, obesity, parity, smoking status or maternal age.  It was notable that 53% of the cohort were born outside Ireland compared with 30% in the reference obstetric population(p< 0.05). Of the 58 women, four needed an interpreter to communicate with hospital staff.  The incidence of maternal bacteraemia in our population was low and usually associated with a good outcome for the woman and her baby.

  • Presenting Author: Ms Aileen Egan
  • Supervisor: Prof M J Turner
  • Co-Supervisor: Dr Amy O’Higgins

84. Gender and ethnic variations in teenage suicide: a global review

McLoughlin AB1, Gould MS2, Kelleher C3, Malone KM1

1Department of Psychiatry, Psychotherapy, and Mental Health Research, St. Vincent's University Hospital and School of Medicine & Medical Science , University College Dublin, Elm Park, Dublin 4.  

2Psychiatry and Public Health (Epidemiology), Columbia University – New York State Psychiatric Institute, New York, NY, USA. 

3UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin 4. 

The objective is to review the past ten years of research on teenage suicide with a particular emphasis on gender and ethnic epidemiological trends. 

A review of research literature from 2003-2013 was conducted via a systematic search of relevant Psychological and Medical databases. 

In terms of results, the gender paradox of elevated suicidality in females and higher completed suicide rates in males is observed in teenage populations worldwide, with the notable exceptions of China and India.  In addition, Native and Indigenous ethnic minority teen populations are found to be at significantly increased risk of completed suicide. 

In conclusion, gender and ethnic variations in suicidality are embedded within cultural, historical, psychological, sociological, relational, and socio-economic domains. It is essential that clinicians working with teenagers vulnerable to suicide adopt a holistic approach to intervention that incorporates an awareness of gender and ethnic-specific risk factors.  As such, it is imperative that cultural competency informs a component of tailored suicide intervention programmes for at-risk teenagers.

Acknowledgement: 

Review conducted with the assistance of The Professor Muiris X. Fitzgerald Scholarship  

References:

1. Clifford AC, Doran CM, & Tsey K. A  systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand. BMC Public Health. 2013 May 13; 13:463. Epub 2013 May 13.

2.  Gracey M & King M.  Indigenous health part 1: determinants and disease patterns. Lancet 2009, 374(9683):65-75.

  • Presenting Author: Ms Aoibheann McLoughlin
  • Supervisor: Prof Kevin Malone
  • Co-Supervisor: Prof Cecily Kelleher

85. Development of a novel experimental approach for examining the impact of extracellular environment on neural cell growth

Walsh MN1,2, Murphy KJ2, Pickering M1

1UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4.

2UCD School of Biomolecular & Biomedical Science, University College Dublin, Belfield, Dublin 4.

The structure of the extracellular environment surrounding a tissue regulates cell migration and differentiation through chemical and mechanical factors. In the nervous system, many cell types interact with this environment during both development and repair, although this process is poorly understood. We attempted to examine the impact of both chemical and mechanical factors on nervous system cells.

The effect of a physiological matrix was examined by decellularising CNS tissue containing both white and grey matter (rat cerebellar slices) and seeding this with oligodendrocyte precursor cells. To examine the effect of purely mechanical influences on nervous tissue growth, dorsal root ganglion (DRG) cells were grown on 3-D printed plastic substrates with complex textured surfaces.

In the CNS tissue, when detergent exposure was sufficient to produce decellularisation, structural integrity of the tissue was lost; and in the tissues where structure was maintained, nuclei of the original cells remained, indicating incomplete decellularisation. For the DRGs grown on the plastic substrate, 71.92% of 146 axons (95%CI; 63.78% - 78.88%) were in alignment with substrate surface texture, suggesting mechanical regulation of axon growth. This alignment is not evident in neurons grown on flat coverslips.

While we were unable to generate structurally stable physiological scaffolds, the synthetic 3-D printed substrates did allow us to examine the effect of mechanical forces on neuronal growth. This technology may be further developed to allow the development of novel systems for studying neuronal growth.

  • Presenting Author: Mr Michael Walsh
  • Supervisor: Dr Mark Pickering
  • Co-Supervisor: Dr Keith Murphy