Irish Journal of Medical Science

Publisher: Springer Verlag

Journal description

Current impact factor: 0.57

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 0.573
2012 Impact Factor 0.506
2011 Impact Factor 0.581
2010 Impact Factor 0.661
2009 Impact Factor 0.696
2008 Impact Factor 0.352
2007 Impact Factor 0.29
2006 Impact Factor 0.4
2005 Impact Factor 0.276
2004 Impact Factor 0.185
2003 Impact Factor 0.224
2002 Impact Factor 0.246
2001 Impact Factor 0.336
2000 Impact Factor 0.353
1999 Impact Factor 0.269
1998 Impact Factor 0.307
1997 Impact Factor 0.304
1996 Impact Factor 0.403
1995 Impact Factor 0.178
1994 Impact Factor 0.206
1993 Impact Factor 0.167
1992 Impact Factor 0.078

Impact factor over time

Impact factor

Additional details

5-year impact 0.62
Cited half-life 6.20
Immediacy index 0.08
Eigenfactor 0.00
Article influence 0.18
ISSN 1863-4362
OCLC 180074721
Material type Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

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    • Author's post-print on any open access repository after 12 months after publication
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    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (see policy)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Melanotic neuroectodermal tumour of infancy (MNTI) is a rare pigmented neoplasm of neural crest origin. It usually presents in the first year of life in the maxilla as a fast growing lesion. We describe the case of a 3-month-old boy who presented with an enlarging swelling of left maxillary alveolus. He was treated with combined surgical and chemotherapy modalities. MNTI is complicated by high recurrence rate, local invasion and malignancy has been reported. This report describes the diagnosis, treatment and follow-up of recurrent MNTI.
    Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1323-4
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    ABSTRACT: To observe the preventive and therapeutic effects of diosgenin on retinoic acid-induced osteoporosis in rats. A total 50 Sprague-Dawley rats were randomly divided into 5 groups: control group, model group (osteoporosis rats), low (10 mg kg(-1)), middle (30 mg kg(-1)), and high-dose diosgenin (90 mg kg(-1))-treated groups. The osteoporosis rats model was induced by retinoic acid. The BMD and physical parameters of femoral including length, wet weight, and dry weight in each group were measured. The hematoxylin-eosin staining was used for bone histomorphology analysis. Besides, the bone calcium (Ca) and phosphorus (P) contents were measured. In order to detect the biochemical index in different treatment groups, the serum tartrate-resistant acid phosphatase (TRAP), alkaline phosphatase (ALP), estradiol, and osteocalcin were compared among different groups. The osteoporosis rat model was successfully induced by retinoic acid. Compared with the model group, the lessening of femoral length and weight and the loss of BMD were significantly improved in diosgenin groups. Both contents of Ca and P were much more increased when induced by retinoic acid (p < 0.05). The estradiol and osteocalcin levels in the middle and high-dose treatment groups were significantly higher than that of the model group, while the ALP and TRAP levels were much lower than the model group (p < 0.05). Diosgenin can prevent the loss of bone in experimental rats. The mechanism may be that it improves the level of estrogenic hormone of estradiol and inhibits the high bone turnover.
    Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1309-2
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    ABSTRACT: Renal sympathetic denervation (RSD) is an emerging device based treatment for patients with resistant hypertension. Nocturnal dipping (ND) is defined as a decrease in BP of 10-20 % during sleep, and has been shown to be protective against cardiovascular disease. This study examined the effect of RSD on the 24 h BP profile of patients with resistant hypertension. The first 23 consecutive patients with resistant hypertension scheduled for renal denervation in a single centre were included. 24 h ambulatory blood pressure monitors (ABPM) were given to patients pre-procedure and 9 months post-procedure. RSD led to a statistically non-significant reduction in overall 24 h ABPM BP (150/85 ± 12/9 vs. 143/84 ± 15/11 mmHg; P > 0.05) despite a reduction in the number of antihypertensive medications (4.9 ± 1.2 vs. 4.3 ± 1.2; P = 0.001). There were improvements in systolic ND 1.7 ± 8 vs. 5.2 ± 8 %; P < 0.05), diastolic ND (5.2 ± 8 vs. 10.2 ± 9 %; P < 0.05) and mean arterial pressure (MAP) ND (4.2 ± 8 vs. 8.0 ± 8 %; P < 0.05). Non-significant changes in ND status were observed in systolic (17 vs. 43 % of participants; P > 0.05), diastolic (30 vs. 43 % of participants; P > 0.05) and MAP (22 vs. 39 % of participants; P > 0.05) measurements. These data suggest that RSD may lead to an improvement in nocturnal dipping in selected patients with resistant hypertension. This may have cardiovascular benefits even if reduction in BP is not achieved with RSD.
    Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1324-3
  • Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1322-5
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    ABSTRACT: Nephronophthisis (NPHP) is an autosomal recessive cystic disease of the kidney with main characteristic features of polyuria/polydipsia, mild or absent proteinuria, interstitial fibrosis, and tubular cysts. NPHP is responsible for 5-10 % of inheritable end-stage renal disease (ESRD) cases. We investigated the clinical features and genetic cause of NPHP in a Persian family with three siblings affected by tubulointerstitial nephropathy reaching ESRD in adulthood. Uromodulin (UMOD), known to be involved in adult medullary cystic kidney disease, and nephronophthisis 1 (NPHP1) were investigated in the genomic DNA of the probands using DNA sequencing, multiplex ligation-dependent probe amplification (MLPA) analysis and molecular karyotyping. No mutation was detected in UMOD. Copy number variation analysis of the NPHP1 gene using the commercially available MLPA kit identified a recurrent large homozygous deletion encompassing all NPHP1 exons. The parents were heterozygous for this deletion. Whole genome array-CGH analysis confirmed a homozygous deletion on chromosome 2q13, NPHP1 site, and revealed that the size of the copy number loss was approximately 102 Kbp. This is the first report of determination of an NPHP1 deletion size using routine diagnostic methods. The results of this study expand the knowledge about the genotype-phenotype correlations in NPHP1, and have implications for genetic counseling and family planning advice for other affected families. This is the first molecular analysis of NPHP1 in an Iranian kindred.
    Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1312-7
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    ABSTRACT: St Vincent's University Hospital has an established neurology consultation service. Referral volumes have been growing. The Department regularly reviews its service to monitor changes and seek improvements. We sought to determine the impact of the growing service on patient care, on the department itself in delivering the service, and on inpatient admission trends. We reviewed the electronic referral forms of all consults seen over a 9-week period in 2014 (n = 213). We recorded the source of each consult, demographic information, clinical presentation, time from referral to consult, and outcome. We compared the consult list to inpatient admissions list to determine the proportion admitted from consults. We compared our results to previous reviews by this and other neurology departments in Ireland. Three quarters of neurology consults relate to acute admissions. Patients are all seen within one working day of referral. A significant change in management (83.6 %) resulted from the majority of consults. Consultants see an average of 4.8 (range 0-10) consults per day, needing up to 7.5 h per day to deliver the service. One-third of the department's inpatients come from consults. The service significantly benefits patient care. The increasing number of consults will require increased resources and/or service reorganisation to maintain the current level of service.
    Irish Journal of Medical Science 06/2015; DOI:10.1007/s11845-015-1317-2
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    ABSTRACT: HIV-positive substance dependent patients contribute disproportionally to HIV morbidity and mortality as a result of poor compliance with their HIV treatment. For HIV-positive opiate-dependent patients integrating HIV and addiction care improves HIV morbidity but the effect on addiction morbidity is not known. This study aims to establish if integrating HIV and addiction care has a significant effect on addiction and HIV morbidity for non-engaging HIV-positive opiate-dependent patients. Patients attending the National Drug Treatment Centre who had disengaged from their HIV treatment in St James's Hospital were recruited to receive HIV care integrated into their methadone maintenance programme. Outcome was investigated in terms of urine toxicology (opiates, cocaine, cannabis and amphetamines); adherence to methadone; proportion receiving directly observed antiretroviral therapy; proportion HIV virally suppressed; and the CD4 cell count. No significant change in substance use or methadone adherence was demonstrated in the 19 recruited participants. There was a significant increase in the proportion receiving directly observed antiretroviral therapy, and in the CD4 cell count. Integration of HIV and addiction care optimises the physical health of non-engaging HIV-positive opiate-dependent patients with no substantial effect on their methadone maintenance programme.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1319-0
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    ABSTRACT: Retention in Methadone Maintenance Treatment (MMT) is superior to that of other therapies for opioid addiction, but with international retention rates around 50 % after 1 year of treatment, there remains a need for improved retention rates. This study aimed to explore the demographic and clinical factors predicting retention in MMT. Face-to-face surveys with MMT patients in a Dublin methadone clinic were conducted. Retention was assessed by the presence and duration of breaks in treatment at any stage. 189 patients participated in the study. 46 % (n = 87) reported having at least one break in treatment, and the median duration of a break was 3 months. Age, current methadone dose and prescription of antipsychotic medication were significant predictors of retention. Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment. Males tended to have significantly longer breaks. Patients reported that the main reasons for breaks were relapse into drug use (21.8 %, n = 19), incarceration (11.4 %, n = 10), weary of MMT (13.7 %, n = 12) or problems at the clinic (10.3 %, n = 9). Factors enabling regular attendance included wanting to get or stay clean (37.5 %, n = 51), avoidance of withdrawal symptoms (16.1 %, n = 22), methadone dependence (13.9 %, n = 19) and services provided (10.2 %, n = 14). Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1314-5
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    ABSTRACT: Adequate bowel preparation is necessary for a complete colonoscopy. Polyethylene glycol-electrolyte oral solution (PEG-EOS), sodium picosulphate (SS) and sodium biphosphonate (SP) are the three most commonly used purgative agents. We aimed to determine their efficacy and tolerability compared to each other in a randomised study. 313 patients were randomly assigned to receive either PEG-EOS, SS or SP. Patients completed a tolerability score pre-colonoscopy. A cleanliness score was used to document adequacy of bowel preparation. A separate group of patients completed taste scores for the three cathartic agents before and after addition of flavour. PEG-EOS was the worst-tolerated regimen but achieved the highest rates of right colonic cleansing and the lowest rate of incomplete colonoscopies. There were no statistical differences in the rates of rectosigmoid and mid-gut cleansing among the three agents. SS was by far the preferred purgative in the taste assessment study. Addition of flavour increased significantly taste scores for PEG-EOS. For adequate bowel cleansing PEG-EOS is the most effective but is the least tolerated and least preferred among patients. Addition of flavour increases significantly patients' acceptance of PEG-EOS.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1320-7
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    ABSTRACT: Sarcoidosis is a multi-systemic granulomatous disease of unknown etiology. The present study has been designed to evaluate the importance of diastolic dysfunction with left atrial volume index (LAVi) and left ventricular mass index (LVMi) in determining subclinical cardiac involvement in subjects with stage I-II pulmonary sarcoidosis. A total of 54 patients under follow-up for sarcoidosis without cardiac involvement and 56 healthy subjects were included in the study. The echocardiographic assessment of the patients revealed no significant difference between the two groups regarding left ventricular end-systolic and end-diastolic diameters, ejection fraction (LVEF) and annular velocity determined by tissue Doppler evaluation. The LVEF calculated was 61.8 ± 7.8 % in the sarcoidosis group versus 64.1 ± 2.7 % in the control group (p = 0.04). Left ventricular interventricular septum thickness, posterior wall thickness, and relative wall thickness were significantly higher in the sarcoidosis group compared to the control group (p < 0.001). The sarcoidosis group had higher LVM and LVMi values compared to the control group (145 ± 18.1 and 79 ± 14 g/m(2), 135 ± 27.7 and 74 ± 14.2 g/m(2); p = 0.020 and p = 0.021, respectively). Left atrial end-systolic volume and LAVi were higher in the sarcoidosis group (28.7 ± 18.5; 15.6 ± 10.2) compared to the control group (16.6 ± 10.9; 8.9 ± 5.5) with a statistically significant difference (p < 0.001). The present study indicates diastolic dysfunction and increased LVMi despite normal systolic function in patients with early-stage sarcoidosis without cardiac involvement. Also, the diastolic parameters were normal without showing any significant difference compared to the control group while there was a statistically significant increase in LAVi. This finding suggests that LAVi may be the earliest marker of diastolic dysfunction in patients with early-stage sarcoidosis without cardiac involvement.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1318-1
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    ABSTRACT: Franciscus Cornelis Donders was educated at Duizel and Boxmeer before entering the Military Medical School and the medical faculty at Utrecht University in 1835. In 1840, he received his MD from Leiden and spent 2 years in practice at Vlissingen before returning to Utrecht, where he was appointed as an extraordinary professor to lecture on forensic medicine, anthropology, general biology and ophthalmology. Refraction by the eye is complex, since the ray of light passes through many changes of refractive index in its path, and Donders simplified the account of the process by establishing an equivalent refractive system: the reduced eye. When Donders opened an Eye Hospital in 1858, he devoted himself to clinical ophthalmology, making fundamental advances in providing spectacles to correct errors of refraction-which he separated from errors of accommodation. In 1862, Donders was promoted as an ordinary professor at Utrecht and he handed over the greater part of his practice to his pupil Hermann Snellen. From narrow specialisation, Donders was freed to return to the broader physiology; subatmospheric pressure in the pleura was for a while referred to as 'Donders' pressure'; he also devised a method of measuring the mental reaction time taken in making discrimination, rather than the simple reaction time in which no choice is involved. He was widely honoured, presiding at international congresses, and elected as a foreign member of the Royal Society. He died suddenly on 14 March 1889, but his work lives on.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1311-8
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    ABSTRACT: Adjuvant endocrine therapy for at least 5 years improves oncological outcomes in oestrogen receptor-positive breast cancer. Adherence rates to prescribed endocrine therapy are low and the search for modifiable causes of this continues. The aim of this study was to assess adherence rates in an Irish cohort of breast cancer patients prescribed adjuvant endocrine therapy and to assess modifiable factors associated with suboptimal adherence. A cross-sectional anonymous survey was performed on 261 patients currently prescribed endocrine therapy. Data were collected regarding demographics, treatment, social and emotional factors and medication side effects. Each patient completed a medication adherence score and provided information about discontinuation of therapy and reasons for same. Only 67.8 % of patients assessed demonstrated complete medication adherence on the medication adherence scale. Twenty-nine patients (10.9 %) permanently stopped taking their prescribed endocrine therapy. Suboptimal adherence was more likely in younger patients (p < 0.001), those in employment (p = 0.005), those who experienced side effects (p = 0.006), those who perceived themselves to have low levels of emotional support (p < 0.001) and those who use the internet to read about their illness (p = 0.003). Endocrine therapy adherence is suboptimal in almost one-third of patients in our cohort. Appropriate assessment and management of side effects and negative emotions, combined with direction of patients to accurate internet sources of information, could help improve endocrine therapy adherence in women with early-stage breast cancer.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1307-4
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    ABSTRACT: Opioids can mimic the effects of remote cardiac preconditioning and mediate a subsequent reduction in myocardial infarct size. This study investigated the role of beta-endorphin (β-EP) in intracerebroventricular morphine cardioprotection. Anesthetized, open-chest, male Sprague-Dawley rats were assigned to 1 of 9 treatment groups 3 days after intracerebroventricular catheter placement. Remote preconditioning was induced with 3 μg/kg of morphine. The β-EP antagonist was administered via intracerebroventricular or intravenous routes either 10 min before or immediately after morphine or saline administration. Ischemia-reperfusion injury was caused by 30 min of left coronary artery occlusion followed by 120 min of reperfusion. The infarct size, as a percentage of the area at risk, was determined by 2,3,5-triphenyltetrazolium staining. Radioimmunoassay and immunoreactivity were used to determine the β-EP levels in the serum and brain. Intracerebroventricular administration of β-EP antiserum (AEP) after morphine administration attenuated the cardioprotective effects of remote preconditioning. The addition of intravenous AEP either before or after morphine did not affect infarct size. After morphine preconditioning, the β-EP level decreased in the hypothalamic arcuate nucleus and increased significantly in the serum, pituitary gland, ventrolateral periaqueductal gray and rostral ventrolateral medulla. Central but not peripheral β-EP is involved in morphine remote preconditioning and plays a role in the ongoing mediation of cardioprotective effects.
    Irish Journal of Medical Science 05/2015; DOI:10.1007/s11845-015-1308-3
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    ABSTRACT: A positive learning environment in which postgraduate doctors are supported, supervised and nurtured, is likely to lead to enhanced professional satisfaction and improved patient care. The aims of the current study were to use the PHEEM inventory to determine the aspects of their current learning environment which junior doctors rate most and least positively. The PHEEM questionnaire was administered to all junior doctors working in medical subspecialties at Galway University Hospitals in Ireland. A response rate of 60 % (n = 61) was obtained. The mean total PHEEM score was 82.88 ± 18.99, corresponding to an educational environment with more positive than negative aspects but with room for improvement. The mean total PHEEM score (±standard deviation) of registrars (89.65 ± 20.92) exceeded that of Interns (84.00 ± 15.26) and SHOs (75.12 ± 18.09). Over half (55 %) of the individual items were rated by the junior doctors as more positive than negative. Nineteen items (48 %) pointed to areas in need of enhancement, whilst 3 items were rated as satisfactory or better. Analysis of qualitative data confirmed that deficiencies exist in various aspects of the educational climate, including protected educational time, access to suitable learning opportunities, the nature of tasks performed by junior doctors, the hospital bleep protocol, implementation of the European Working Time Directive, feedback and career guidance. Recommendations stemming from this study should lead to improvements in the quality of the educational environment of junior doctors and may stimulate similar evaluations in other teaching hospitals.
    Irish Journal of Medical Science 04/2015; DOI:10.1007/s11845-015-1303-8
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    ABSTRACT: Alcohol withdrawal syndrome (AWS) is a frequent cause of admission to acute care hospitals and many of these patients have a history of depression. Our objective was to determine if antidepressant use in patients with a history of depression is associated with lower rates of hospital readmission for AWS. A retrospective study was performed of patients admitted with AWS between January 1, 2006 and December 31, 2008 to an academic tertiary referral hospital. Three hundred and twenty-two patients were admitted with AWS during the study period. One hundred and sixty-one patients (50 %) had no history of depression, 111 patients (34 %) had a history of depression and antidepressant use, and 50 patients (16 %) had a history of depression and no antidepressant use. There was no significant difference in the number of hospitalizations for AWS between these three groups. Patients with a history of depression on antidepressant medication were more likely to be retired or work disabled compared to the other two groups (p < 0.05). The antidepressant class most commonly used was SSRI (63 %). Our study highlights the high frequency of depression and antidepressant use in patients admitted with AWS to an acute care hospital. As alcohol withdrawal is associated with increased morbidity and mortality and depression is common in those with alcohol use disorder, further research is necessary to clarify the optimal treatment of comorbid depression and alcohol use disorder in reducing these revolving door admissions.
    Irish Journal of Medical Science 04/2015; DOI:10.1007/s11845-015-1304-7
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    ABSTRACT: The pain of cryosurgery for hand warts can lead to poor patient satisfaction and inadequate response to treatment. To determine if local anaesthetic infiltration using a 30-gauge needle prior to cryosurgery is acceptable to patients. 20 consecutive patients were recruited over a 14-month period who attended a cryosurgery clinic and who had at least two warts between 5 and 10 mm in diameter on different parts of the hands. In each patient, two warts of approximately equal size were treated using standard cryosurgery techniques, one under local anaesthetic (LA) and the other without. The average pain score of cryosurgery without LA was more than twice the pain score of administering the LA with a 30-gauge needle (p < 0.0005). One out of 20 warts failed to clear in the LA-treated group and 2 out of 20 warts failed to clear in the non-LA-treated group. This research suggests that for the majority of patients with warts between five and ten millimetres in diameter, cryosurgery is significantly less painful when carried out under LA.
    Irish Journal of Medical Science 04/2015; DOI:10.1007/s11845-015-1301-x
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    ABSTRACT: Transurethral resection of bladder tumors close to these areas may stimulate the obturator nerve, causing violent adductor contraction and possible inadvertent bladder perforation. To avoid this reaction, local anesthetic blockade of the obturator nerve as it passes through the obturator canal is effective in stopping adductor spasm during spinal anesthesia. Forty-one patients undergoing (transurethral resection of bladder tumor) TUR-BT with spinal anesthesia who required (obturator nerve block) ONB were included in the study. After spinal anesthesia, ONB was performed with an inguinal approach (group 1) (n = 21) or an intravesical approach (group 2) (n = 20). In this study, we used 10 ml of 2 % lidocaine to perform the ONB. The mean age of patients was 60.8 ± 7.5 years. The groups were not different with regards to age, tumor localization and tumor size. There were two bladder perforations in group 1 and six perforations in group 2 (p = 0.130). However, the efficacy of ONB was significantly higher in inguinal approach group compared to intravesical approach group (p = 0.032). Obturator nerve block plays an additive role on the quality of analgesia for bladder surgery. Our data suggests that identification of the obturator nerve with ultrasound is easy and the block can be assessed by observing avoidance of bladder spasm.
    Irish Journal of Medical Science 04/2015; DOI:10.1007/s11845-015-1300-y