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J Geraghty

Publications and source records attributed to J Geraghty.

18 recordsLinked to original sources
PubMed2004

The clinical significance of axillary lymph node micrometastases in breast cancer.

OBJECTIVE: To evaluate the clinical significancer of axillary lymph-node micrometastases, in the era of sentinel lymph node (SLN) biopsy. DATA SOURCES: Searches of MEDLINE (1966-2003) and an extensive manual review of journals were performed using the key search terms breast cancer, axillary lymph-node micrometastases, micrometastatic disease, and SLN biopsy. STUDY SELECTION: All articles identified from the data sources were evaluated and all information deemed relevant was included for this review. CONCLUSIONS: Axillary lymph-node micrometastases can be detected by serial sectioning, immunohistochemistry, or reverse transcriptase-polymerase chain reaction (RT-PCR). The presence of axillary SLN micrometastases is generally associated with a worse prognosis and is an indication for axillary lymph node dissection (ALND) and adjuvant therapy. The clinical significance of micrometastases identified by RT-PCR remains unknown and further research with longer follow-up is needed to ascertain the clinical implications of a positive result.

Axilla↗
PubMed2002

Homeopathic treatment of Chronic Fatigue Syndrome: three case studies using Jan Scholten's methodology.

This paper explores the treatment of Chronic Fatigue Syndrome following a viral infection in young people. The methodology is based on that of Dr Jan Scholten, Holland, who has systematically described the homeopathic themes of all elements in the periodic table. Three case studies are presented, Cobaltum Phosphoricum, Calcium Phosphoricum and Cadmium Phosphoricum were prescribed. The common themes and the differentiating features of these Phosphate salts are described in detail to show how the homeopathic similimum is found and cure achieved.

Adult↗
PubMed2001

Evolving structures in surgical oncology and the role of the Federation of European Cancer Societies in continuing medical education.

This article describes the evolution of a European system of accreditation of educational events in oncology and the establishment by the Federation of European Cancer Societies of the Accreditation Council of Oncology in Europe. It draws attention to the need for a coordinated system which is acceptable in the different European countries so that an international system of "Eurocredits" can be devised. Through the official Union Europeénne des Médecins Specialistes (UEMS), reciprocity with the accrediting bodies in the United States and other countries is planned.

Accreditation↗
PubMed1996

Continuing medical education in oncology in Europe.

A European Conference on Continuing Medical Education (CME) in Oncology was designed and organised in Dublin (Ireland), on 12th and 13th October 1995 by the European School of Oncology in collaboration with University College Dublin and with the financial support of the European Commission (Europe Against Cancer Programme). Two experts were invited from each Member State and all attended the Conference with the sole exception of the representatives of Luxembourg, who did not attend due to unexpected important commitments. Observers were invited to contribute to the discussion as representatives of organisations that were involved either directly or indirectly in CME. The Conference took the format of a plenary session coupled with the identification of five discussion groups formed to debate key areas in CME at a European level in oncology (Table 1). As a result of these discussions and subsequent consultations, an agreement was reached on the following statements: (a) Continuing Medical Education (CME) is an ethical duty and an individual responsibility for each doctor. Although CME should remain voluntary at the present time, it is nevertheless a professional obligation since almost 50% of medical knowledge becomes obsolete after ten years. It should be organised with clear guidelines for medical personnel working in hospitals, in primary health care and in private practice. (b) The CME system within the European Union (EU) should remain self-directed without the necessity for interval examinations: it should be interdisciplinary and must be driven and controlled by the profession itself. (c) A common concept and system within a CME framework may have a considerable impact on EU integration. It should certainly be developed, maintained and monitored at national level but on the basis of a common European model to ensure scientific and cultural interchange among Member States. (d) It was agree that a credit system is needed to help doctors keep track of their CME activities: the system should be based on the accumulation of credit points (one credit equalling one hour of continuing medical education) and monitored at a national level. Credit transfer among Member States is vital to facilitate exchange between Member States. (e) Oncology provides a very useful model of CME within which guidelines can be proposed and tested. Harmonisation of CME systems among the different European cancer organisations and scientific societies within this model system may represent a useful basis that other specialities can follow.

Education, Medical, Continuing↗
PubMed1996

Radioimmunoguided surgery and colorectal cancer.

Radioimmunoguided surgery is a technique that aims to delineate the extent of epithelial neoplasms (primary/recurrent) and their spread (local, regional, and distant) which are not adequately visualized by conventional imaging techniques. The target lesion binds radiolabelled, tumour-associated monoclonal antibodies which are administered in the days before surgery and which bind to the target lesion. The radiotracer is detected intraoperatively using a hand-held gamma detecting probe. This identifies the extent of the tumour, involvement of lymph nodes or other organs and may allow a more complete surgical clearance of the tumour. This article provides a basic understanding of the RIGS (radioimmunoguided surgery) technique, the monoclonal antibodies which are used and outlines the advantages and limitations of this technique.

Antibodies, Monoclonal↗
PubMed1995

Inhibition of intimal hyperplasia in rat aortic allografts with cyclosporine.

The rat aortic transplant model of chronic rejection was used to study the effect of cyclosporine (CsA) on the development of intimal hyperplasia. ACI and Lewis rat strains were used to create isograft and allograft CsA nontreated and treated groups. After orthotopic abdominal aortic transplantation, recipients received either no treatment, CsA 2.5 mg/kg/day, CsA 5 mg/kg/day, or CsA 10 mg/kg/day by gavage. Treated grafts were harvested at 3 and 6 months after transplantation, and computer image digital analysis was used to measure intimal and medial areas of graft cross-sections. At 3 months, the reduction in percent intima was 62% (P = 0.005), 74% (P = 0.002), and 97% (P < 0.0001) for the 2.5-, 5-, and 10-mg/kg allograft groups, respectively. There was a 93% (P < 0.0001) reduction in percent intima at 6 months in the 10-mg/kg allograft group. CsA treatment also preserved the aortic media. In comparison to nontreated isografts, medial area in nontreated allografts was decreased by 37% at 3 months after transplantation. In contrast, medial area was not significantly changed in CsA-treated recipients (10 mg/kg/day) in comparison to nontreated isografts. More importantly, medial nuclear density was preserved in the CsA-treated recipients in comparison to nontreated allografts and was similar to treated or nontreated isografts. In conclusion, daily high dose CsA treatment was found to markedly inhibit intimal hyperplasia in rat aortic allografts up to 6 months after transplantation, which suggests that CsA at an adequate dosage can suppress chronic rejection.

Animals↗
PubMed1995

Regional renal blood flow in normal and disease states.

Renal function is intimately dependent on renal blood flow. Alterations in either total or regional renal blood flow have major consequences for renal function. Through homeostatic mechanisms the kidneys are able to maintain relatively stable rates of flow over a wide range of perfusion pressures. A combination of neural, endocrine, exocrine and autocrine signals serve to regulate renal blood flow at both local and systemic levels. Alterations in the balance of these systems occur in the presence of certain pathophysiological conditions and an understanding of the subsequent changes in regional renal blood flow distribution aids in the understanding of the associated changes in renal function. The regulation and distribution of regional blood flow and the effects of surgical and pathophysiological conditions on these factors are reviewed.

Diabetes Mellitus↗
PubMed1995

Effects of portal hypertension on responsiveness of rat mesenteric artery and aorta.

1. We have examined the effects of pre-hepatic portal hypertension on the responsiveness of rat small mesenteric arteries and aorta. Rats were made portal hypertensive by creating a calibrated portal vein stenosis, or sham-operated. 2. In rat mesenteric arteries, there was no significant difference between portal hypertensive and sham-operated animals in the contractile potency of noradrenaline (NA), but the maximum contractile responses to NA, U46619 and KCl were significantly increased in vessels from portal hypertensive animals. This altered maximum contractile response was not due to alterations in smooth muscle mass. 3. In rat mesenteric arteries, there were no significant differences between portal hypertensive and sham-operated animals in endothelium-dependent relaxations to acetylcholine (ACh). The difference between portal hypertensive and sham-operated rats in the maximum response to U46619 was maintained following a combination of methylene blue (1 microM) and NG-monomethyl-L-arginine (100 microM), suggesting that any differences in endothelial function do not explain differences in the response to vasoconstrictors. 4. In rat aorta, there were no significant differences between portal hypertensive and sham-operated animals in the contractile response to NA or KCl or in the endothelium-dependent relaxations to ACh. 5. In pithed rats, there was no difference between portal hypertensive and sham-operated animals in the pressor potency of NA. 6. It is concluded that portal hypertension produces an increase in the contractile response to the vasoconstrictors NA, U46619 and KCl in rat mesenteric arteries but not in the aorta. This suggests that the diminished responsiveness to vasoconstrictors reported in portal hypertensive rats in vivo is not due to a diminished responsiveness at the level of the vascular smooth muscle.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1995

Investigations of the function of the vascular endothelium in portal hypertensive rats.

There were no differences between mesenteric arteries from sham or 14-day portal hypertensive (PH) rats in the potency of or maximum endothelium-dependent relaxations (EDR) to acetylcholine. There were no differences between sham-operated and PH rats in the effects of the combination of the nitric oxide synthase inhibitor NG-monomethyl-L-arginine (100 mumol/l) and methylene blue (10 mumol/l) in causing a significant reduction in the EDR to acetylcholine. The degree of portal-systemic shunting, as measured by 57Co-labeled microspheres, was unaffected by acute administration of NG-monomethyl-L-arginine (50 mg/kg) or methylene blue (5 mg/kg). In conclusion, nitric oxide is the main mediator of EDR in rat mesenteric artery, and no evidence was found for an increased role for endothelial-derived nitric oxide in PH rats.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1986

Intestinal perforation in Wegener's granulomatosis.

Wegener's granulomatosis is a disease characterised by a necrotising vasculitis and granulomatous inflammation. The localised form involves the upper and/or lower respiratory tracts while in the commoner generalised form there is a widespread necrotising vasculitis and renal involvement. Intestinal involvement, which may be severe, has been detected at necropsy in 24% of cases. Gastrointestinal symptoms are uncommon, however, none being mentioned in a recent series of 87 cases. There has been only one reported case of intestinal perforation secondary to Wegener's granulomatosis. We report a case of small and large bowel perforations in a patient with Wegener's granulomatosis.

Colonic Diseases↗
PubMed1984

Antibiotic prophylaxis in neurosurgery. A randomized controlled trial.

A randomized trial was performed to support the contention that prophylactic antibiotics can reduce the incidence of postoperative neurosurgical wound infections. The regime outlined by Malis was followed. Vancomycin and gentamicin were administered systemically just prior to surgery and streptomycin was added to the irrigating solution. Patients were randomly assigned to two groups: control and treated. The infection rate in the control group was 3.5% and in the treated group 0.5%.

Adult↗
PubMedDate not supplied

Small bowel obstruction secondary to a giant enterolith complicating Crohn's disease.

BACKGROUND: Enterolith formation associated with Crohn's disease is a very uncommon clinical entity. AIM: To describe a case of sub-acute small bowel obstruction secondary to a giant enterolith in a patient with Crohn's disease. RESULTS: A 54-year-old male with a history of Crohn's disease presented with sub-acute small bowel obstruction secondary to a giant enterolith. The diagnosis was confirmed utilising plain film radiography and computed tomography CONCLUSION: Plain film radiography and computed tomography play a central role in establishing the diagnosis of this rare complication of Crohn's disease and assist in planning surgical intervention.

Calculi↗
PubMedDate not supplied

Radiation enteropathy.

Radiation enteritis is a functional disorder of the intestine that occurs during or after a course of radiotherapy to the abdomen, pelvis or rectum. It presents in both an acute and chronic form and has sequelae that can be life threatening. As radiotherapy is now being used more than ever before in the treatment of solid organ malignancies in the abdomen and pelvis, the incidence of radiation enteropathy is likely to increase in the future. We present two patients with severe forms of this condition in order to clarify the salient issues regarding its diagnosis and, in particular, its distinction from mechanical bowel obstruction. We also review its pathophysiology, management and current preventative strategies.

Adenocarcinoma↗