Deirdre McGrath

Is there a role for microorganisms in the pathogenesis of sarcoidosis

 du Bois RM, Goh N, McGrath D, Cullinan P (Royal Brompton Hospital and Imperial College, London, UK). Is there a role for microorganisms in the pathogenesis of sarcoidosis (Minisymposium)? J Intern Med 2003; 253: 4–17.

Optical Fibre Pressure Sensors in Medical Applications

This article is focused on reviewing the current state-of-the-art of optical fibre pressure sensors for medical applications. Optical fibres have inherent advantages due to their small size, immunity to electromagnetic interferences and their suitability for remote monitoring and multiplexing. The small dimensions of optical fibre-based pressure sensors, together with being lightweight and flexible, mean that they are minimally invasive for many medical applications and, thus, particularly suited to in vivo measurement. This means that the sensor can be placed directly inside a patient, e.g., for urodynamic and cardiovascular assessment. This paper presents an overview of the recent developments in optical fibre-based pressure measurements with particular reference to these application areas.

Terminology and nomenclature in colonic surgery: universal application of a rule-based approach derived from updates on mesenteric anatomy

Recent developments in colonic surgery generate exciting opportunities for surgeons and trainees. In the first instance, the anatomy of the entire mesenteric organ has been clarified and greatly simplified. No longer is it regarded as fragmented and complex. Rather it is continuous from duodenojejunal flexure to mesorectum, spanning the gastrointestinal tract between. Recent histologic findings have demonstrated that although apposed to the retroperitoneum, the mesenteric organ is separated from this via Toldt’s fascia. These fundamentally important observations underpin the principles of complete mesocolic excision, where the mesocolic package is maintained intact, following extensive mesenterectomy. More importantly, they provide the first opportunity to apply a canonical approach to the development of nomenclature in resectional colonic surgery. In this review, we demonstrate how the resultant nomenclature is entirely anatomic based, and for illustrative purposes, we apply it to the procedure conventionally referred to as right hemicolectomy, or ileocolic resection.

The financial costs of delivering problem-based learning in a new, graduate-entry medical programme

Context  In discussions of the merits and limitations of problem‐based learning (PBL) as an educational methodology, the cost of its delivery is often cited as a significant issue. Although there appears to be no shortage of opinion as to the perceived cost of PBL, we know of no institution that has accurately measured its cost, even in financial terms. Where factual information is lacking, opinion and misconception tend to proliferate. In setting up a new, graduate‐entry medical programme on a greenfield site at the University of Limerick, we took the opportunity to calculate both the initial and recurring costs of our particular approach to the delivery of PBL.

Attitudes towards statistics of graduate entry medical students: the role of prior learning experiences.

BackgroundWhile statistics is increasingly taught as part of the medical curriculum, it can be an unpopular subject and feedback from students indicates that some find it more difficult than other subjects. Understanding attitudes towards statistics on entry to graduate entry medical programmes is particularly important, given that many students may have been exposed to quantitative courses in their previous degree and hence bring preconceptions of their ability and interest to their medical education programme. The aim of this study therefore is to explore, for the first time, attitudes towards statistics of graduate entry medical students from a variety of backgrounds and focus on understanding the role of prior learning experiences.Methods121 first year graduate entry medical students completed the Survey of Attitudes toward Statistics instrument together with information on demographics and prior learning experiences.ResultsStudents tended to appreciate the relevance of statistics in their professional life and be prepared to put effort into learning statistics. They had neutral to positive attitudes about their interest in statistics and their intellectual knowledge and skills when applied to it. Their feelings towards statistics were slightly less positive e.g. feelings of insecurity, stress, fear and frustration and they tended to view statistics as difficult. Even though 85% of students had taken a quantitative course in the past, only 24% of students described it as likely that they would take any course in statistics if the choice was theirs. How well students felt they had performed in mathematics in the past was a strong predictor of many of the components of attitudes.ConclusionThe teaching of statistics to medical students should start with addressing the association between students’ past experiences in mathematics and their attitudes towards statistics and encouraging students to recognise the difference between the two disciplines. Addressing these issues may reduce students’ anxiety and perception of difficulty at the start of their learning experience and encourage students to engage with statistics in their future careers.

Differential in vivo urodynamic measurement in a single thin catheter based on two optical fiber pressure sensors

Abstract. Urodynamic analysis is the predominant method for evaluating dysfunctions in the lower urinary tract. The exam measures the pressure during the filling and voiding process of the bladder and is mainly interested in the contraction of the bladder muscles. The data arising out of these pressure measurements enables the urologist to arrive at a precise diagnosis and prescribe an adequate treatment. A technique based on two optical fiber pressure and temperature sensors with a resolution of better than 0.1  cm H2O (∼10  Pa), a stability better than 1  cm H2O/hour, and a diameter of 0.2 mm in a miniature catheter with a diameter of only 5 Fr (1.67 mm), was used. This technique was tested in vivo on four patients with a real-time urodynamic measurement system. The optical system presented showed a very good correlation to two commercially available medical reference sensors. Furthermore, the optical urodynamic system demonstrated a higher dynamic and better sensitivity to detect small obstructions than both pre-existing medical systems currently in use in the urodynamic field.

Non-invasive continuous online hemoglobin monitoring system

The Hemoglobin (Hb) concentration in human blood is an important parameter to evaluate the physiological condition. A hemoglobin test reveals how much hemoglobin is to be found in the blood. With this information anemia (a low hemoglobin level) and polycythemia vera (a high hemoglobin level) can be a diagnosed and monitored. It is also possible to observe postoperative bleedings and autologous retransfusions. Currently, invasive methods are used to measure the Hb concentration. For this purpose blood is taken and analyzed. The disadvantage of this method is the delay between the blood collection and its analysis, which does not allow real-time monitoring of patients in critical situations. The non-invasive method, discussed in this paper, allows pain free online monitoring of patients with minimum risk of infection. Real-time data monitoring facilitates immediate clinical reaction to the measured data.

Farmer’s Lung in Ireland (1983–1996) remains at a constant level

A prospective study was undertaken by the Departments of Respiratory Medicine and Medical Microbiology at the Cork University Hospital, a. to investigate the epidemiology of Farmer’s Lung (F.L.) in the Republic of Ireland (pop. 3.5 million), with special reference to the South Western Region of this country (pop. 536,000) and b. to assess any relationship between the prevalence/incidence of F.L. with climatic factors in South West Ireland, between 1983 and 1996. F.L. incidence remained constant throughout the 13 yrs studied both on a national and a regional basis. A significant relationship was also found between total rainfall each summer and F.L. incidence and prevalence over the following yr (p<0.005) in South-West Ireland. The persistence of F.L. in Ireland at a constant level suggests that farmers’ working environment and farm practices need to be improved.

Sensor system for non-invasive optical hemoglobin determination

The Hemoglobin (Hb) concentration in human blood is an important parameter to evaluate the physiological condition. A hemoglobin test reveals how much hemoglobin can be found in the blood. With this information anemia (a low hemoglobin level) and polycythemia vera (a high hemoglobin level) can be a diagnosed and monitored. It is also possible to observe imminent postoperative bleedings and autologous retransfusions. Currently, invasive methods are used to measure the Hb concentration. For this purpose blood is taken and analyzed. The disadvantage of this method is the delay between the blood collection and its analysis, which does not allow a real-time patient monitoring in critical situations. A non-invasive method allows pain free online patient monitoring with minimum risk of infection and facilitates real time data monitoring allowing immediate clinical reaction to the measured data.

Demographic attributes and knowledge acquisition among graduate-entry medical students

Background: Recent changes to undergraduate (basic) medical education in Ireland have linked an expansion of student numbers with wide-ranging reforms. Medical schools have broadened access by admitting more mature students from diverse backgrounds and have increased their international student numbers. This has resulted in major changes to the demographic profile of students at Irish medical schools. Aim: To determine whether the demographic characteristics of students impact on their academic performance and specifically on their rate of knowledge acquisition. Methods: As a formative assessment exercise, we administered a progress test to all students twice each year during a 4 year graduate-entry medical programme. We compared scores over time between students from different age cohorts, of different gender, of different nationalities and from different academic backgrounds. Results: In the 1143 tests taken by 285 students to date, there were no significant differences in the rate of knowledge acquisition between the various groups. Early in the course, students from a non-biological science background performed less well than others but outperformed their peers by the time of graduation. Conclusion: Neither age, gender, nationality nor academic background impacts on the rate of knowledge acquisition among graduate-entry medical students.