Irish Journal of Medical Science

Publisher: Springer Verlag

Current impact factor: 0.83

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 0.827
2013 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
Year

Additional details

5-year impact 0.67
Cited half-life 5.40
Immediacy index 0.28
Eigenfactor 0.00
Article influence 0.19
ISSN 1863-4362
OCLC 180074721
Material type Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Author's pre-print on pre-print servers such as arXiv.org
    • Author's post-print on author's personal website immediately
    • Author's post-print on any open access repository after 12 months after publication
    • Publisher's version/PDF cannot be used
    • 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


  • No preview · Article · Feb 2016 · Irish Journal of Medical Science
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    ABSTRACT: Background Low bone mineral density (BMD) is common in older people with stroke, particularly in the paretic limb. Younger people with acquired brain injury (ABI), of all causes, are at increased risk of low BMD. Aims To examine prevalence of low BMD, based on World Health Organisation diagnostic criteria, in patients with ABI. Methods This is a cross-sectional study of 112 ABI patients. All completed a questionnaire, had laboratory investigations and DXA assessment of lumbar spine and one or both hips. Results Mean age ± SD of participants was 45.7 ± 13.7 years. Risk of vitamin D deficiency (25-OHD < 30 nmol/L) occurred in 27.7 %, 34.3 % had adequate levels (30–50 nmol/L) and 36.6 % had levels in excess of this. Based on T-scores, 41.1 % had osteopenia and 21.4 % had osteoporosis. A Z score of −1 or less but greater than −2 occurred in 25 %; a further 21.4 % had a Z score of −2 or less. Patients who could walk outdoors had significantly higher BMD at the neck of femur than those who walked indoors only and those who could not walk at all (p < 0.001). On multiple linear regression analysis, ambulatory ability and duration of disability were independent predictors of BMD at sound neck of femur and total proximal femur. Conclusions Osteopenia and osteoporosis are common in young adults with ABI compared with the general population. Bone heath monitoring should form part of the long-term follow-up of this patient group.
    No preview · Article · Jan 2016 · Irish Journal of Medical Science
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    ABSTRACT: Background This study investigates the use of fibre tractography to facilitate visualisation of the medial longitudinal fasciculus (MLF) and the impact of internuclear ophthalmoplegia (INO) causing lesions on these reconstructions of the tract. Improved visualisation of such tracts may improve knowledge, understanding and confidence related to neurological conditions. Aims To explore the use of fibre tractography for the visualisation of the MLF in patients with INO. Methods Twelve MS subjects with clinical evidence of INO and 12 matched controls underwent magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI), of the brain. Fibre tractography reconstructions were then evaluated and validated by an experienced neuroanatomist. Results The evaluating neuroanatomist confirmed that the MLF had been reproduced in all of the reconstructed cases (fibre tractography was unsuccessful in five cases). The sensitivity of fibre tractography to MLF pathology was 58.3 % while the specificity was much higher at 85.7 % with a positive predictive value of 87.5 % and a negative predictive value of 54.6 %, with excellent intra-reader reliability. Conclusion This study demonstrates that fibre tractography of the MLF can potentially be performed with a view to facilitating improved visualisation of the tract and associated pathology in cases of INO. This may help explain the association between lesion type and location with clinical symptomatology and may assist in monitoring disease progression. These reconstructions may provide a valuable addition to the teaching and understanding of clinical signs related to subtle pathology.
    No preview · Article · Jan 2016 · Irish Journal of Medical Science
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    ABSTRACT: Background Nystagmus in patients with multiple sclerosis (MS) is generally attributed to brainstem disease. Lesions in other regions may result in nystagmus. The identification of these other sites is enhanced by using 3-Tesla magnetic resonance imaging (3TMRI) due to increased signal-to-noise ratio. Objective We sought to evaluate the distribution of structural lesions and disruption of tracts in patients with horizontal nystagmus secondary to MS using 3TMRI. Methods Twenty-four patients (20 women, 4 men; age range 26–55 years) with horizontal nystagmus secondary to MS underwent 3TMRI brain scans; and 18 patients had diffusion tensor imaging (DTI) for tractography. Results Nystagmus was bidirectional in 11, right-sided in 6 and left-sided in 7. We identified 194 lesions in 20 regions within the neural integrator circuit in 24 patients; 140 were within the cortex and 54 were within the brainstem. Only two patients had no lesions in the cortex, and 9 had no lesions in the brainstem. There was no relationship between side of lesion and direction of nystagmus. Thirteen of 18 (72 %) had tract disruption with fractional anisotropy (FA) values below 0.2. FA was significantly lower in bidirectional compared to unidirectional nystagmus (p = 0.006). Conclusion In MS patients with horizontal nystagmus, lesions in all cortical eye fields and their descending connections were evident. Technical improvements in tractography may help identify the specific site(s) resulting in nystagmus in MS.
    No preview · Article · Dec 2015 · Irish Journal of Medical Science
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    ABSTRACT: Introduction: Pheochromocytomas are rare neuroendocrine tumors of the adrenal medulla that may present with protean manifestations. Surgical resection is the mainstay of therapy and patients are at risk of significant hemodynamic and circulatory complications mainly attributable to catecholamine excess. The mainstay of medical therapy in order to optimize patients for surgery includes: alpha-blockers, beta-blockers, calcium channel blocker and other agents to achieve normal blood pressure, heart rate, as well as normal volume status. Understanding the pathophysiology of pheochromocytoma, the pharmacology of medications used, and recognizing postoperative complications will impact patient outcomes. Conclusion: A multidisciplinary team approach is best throughout the perioperative period to prevent potential complications that arise. The hospital physician, intensivist, anesthetist and cardiovascular specialist play a pivotal role in the management of patients with pheochromocytoma. In addition to the pharmacologic and volume recommendations, a multidisciplinary discussion allows for seamless implementation of an organized plan of care.
    No preview · Article · Dec 2015 · Irish Journal of Medical Science
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    ABSTRACT: Introduction: Nutritional risk impacts outcome in developmental delay. The main objectives were to identify the incidence and factors contributing to growth faltering. Methods: Clinical data review was completed for 500 patients with developmental delay accepted to an Early Intervention service. Data was collected using the standardised parent nutrition screening checklist prior to and at time of initial dietary assessment. Data was compared to nutritional assessment data, GOSH and FSAI dietary guidelines. Weight category was determined using RCPCH growth and BMI charts. Statistical analysis was conducted using Statistical Package for the Social Sciences version 20 (IBM Statistics 20.0). Results: Nutritional risk was identified in 48.6 %. Weight categories were growth faltering (13.5 %), underweight (7.7 %), overweight (8.4 %) and obesity (4.3 %) at initial assessment. Growth faltering was correlated with age <1 year (p = 0.000) and with gestational age (p = 0.017) with highest rates identified in those born 32-36 weeks (3.6 %). Weight category was associated with introduction of solids pre 17 weeks recommendation (10.1 %), ANOVA demonstrating significance (P = 0.013). There was poor parental recognition of nutritional risk in 22.7 % of those assessed. Nutritional difficulties were common: 4.2 % were enterally fed, 7.7 % were on prescribed nutritional supplements, 29.1 % (n = 121) had feeding difficulties and 13.9 % (n = 58) had behavioural feeding difficulties. Iron intake did not meet the recommended intake in 20.9 % (n = 87), calcium in 4.5 % (n = 19). The prevalence of constipation was 21.6, 11.8 % of whom required medical management. Conclusions: Developmental delay predisposes to nutritional deficits which influence outcome. Screening, assessment and timely interventions are warranted to prevent poorer developmental outcomes.
    No preview · Article · Nov 2015 · Irish Journal of Medical Science
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    ABSTRACT: Introduction: Surgical site infection (SSI) is one of the main causes of postoperative morbidity and mortality. Appendectomy for acute appendicitis is one of the most commonly performed surgical interventions worldwide. The use of ring retractors to protect the wound edge from contaminated intra-abdominal contents may be an effective method to reduce SSI. Aim: The aim of this systematic review and meta-analysis is to determine whether the use of wound ring retractors reduces SSI rates after open appendectomy. Methods: A systematic review of randomized controlled trials (RCTs) and meta-analysis of ring retractors was undertaken using the PRISMA guidelines. PubMed, Cochrane RCTs Central Register, CINAHL, and ISRCTN registry were searched for eligible studies. Only studies in which open appendectomy was undertaken were included. The Cochrane Collaboration's RevMan 5.3 was used for analysis. A subgroup analysis by degree of appendiceal inflammation was performed. Results: Four RCTs inclusive of 939 patients met eligibility requirements. One trial used single ring while three used double ring protectors. Differences in the definition of SSI, skin preparation, and type and duration of prophylactic antibiotic were found between the 4 studies. The use of ring retractors show some evidence of SSI reduction risk ratio 0.44 [95 % CI (0.21, 0.90)]. On sub-analysis, ring retractor was more effective in more severe degrees of appendiceal inflammation i.e., the contaminated group. Conclusion: Our review suggests some benefit in using ring retractors to reduce SSI post appendectomy; however the small number and variable quality of the studies suggest the need for more RCTs to confirm these results.
    No preview · Article · Nov 2015 · Irish Journal of Medical Science
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    ABSTRACT: Background: Pelvic and acetabular fractures are rare, complex injuries associated with significant morbidity. Fixation of these injuries requires major orthopaedic surgery which in itself is associated with substantial blood loss owing to the extensile operative approach and prolonged operating time required to address the complex fracture anatomy. In order to reduce morbidity, a multifactor approach to blood conservation must be adopted. Current role of antifibrinolytics in orthopaedic surgery: The use of antifibrinolytics to reduce operative blood loss is well documented in many surgical specialties, including orthopaedic surgery. Elective spinal surgery and joint arthroplasty have benefited from the introduction of antifibrinolytics; however, their role in trauma and fracture surgery is not fully defined. Pelvic and acetabular fracture surgery would benefit from further investigation on the benefit and safety of these agents. Conclusion: Routine use cannot be recommended at this time but agents may be considered on a case-specific basis.
    No preview · Article · Nov 2015 · Irish Journal of Medical Science
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    ABSTRACT: Introduction: Long-term daily azithromycin therapy reduces the frequency of exacerbations in chronic obstructive pulmonary disease (COPD) in a randomized controlled clinical trial setting. Concerns exist regarding arrhythmic and auditory toxicities from chronic use in the real-world setting. We hypothesized that risk factors for adverse drug reactions to azithromycin would be more frequent than previously reported, that certain specific subgroups would have different frequencies of these risk factors and that the whispered voice test would be a useful test with which to test for hearing deficits. Methods: Following ethical approval, 47 consecutive hospital-based patients with a mean age 69 years ± 8.2, and with physician-diagnosed COPD (mean FEV1 45.1 ± 18 % predicted), were screened for subjective hearing impairment (screening questions and whispered voice test) and by electrocardiogram for prolonged QTc. Other potential risk factors and contraindications to long-term daily azithromycin were sought. Results: In total, 38 patients (80.9 %) had at least one risk factor or contraindication to azithromycin treatment. 19 patients (40.4 % of total) had subjective hearing impairment. 17 (36.1 %) had prolonged QTc intervals. 4 patients (8.51 %) had contraindicating co-morbidities. Those on long-term oxygen therapy were significantly more likely to have at least one risk factors or contraindications to azithromycin (p = 0.0025). Conclusion: In a COPD population who would otherwise potentially be candidates for long-term daily azithromycin therapy, over 80 % had risk factors for complications from long-term daily azithromycin. Preventative treatment with long-term daily azithromycin may be appropriate for fewer COPD patients than previously thought, especially in those on long-term oxygen therapy.
    No preview · Article · Oct 2015 · Irish Journal of Medical Science
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    ABSTRACT: Introduction: Over half of marriages are consanguineous in some countries, and about 10 % of children worldwide have consanguineous parents. Perceived benefits of consanguineous marriage (CM) include preservation of tradition, stronger family ties, financial advantages, and bride protection. Potential harms include autosomal recessive disorders, complex congenital malformations, stillbirths, postnatal mortality. There have been no population-based data published on frequency of CM in Ireland since 1970. Methods: International prevalence figures and published estimates of CM were applied to 2011 Irish Census data to calculate the frequency of CM in at-risk groups. Searches of the published and grey literature were conducted to review evidence-based approaches to mitigate risks of CM and apply findings to the Irish context. Results: The estimated number of consanguineous couples has grown in subpopulations in Ireland in the past decade, particularly among Pakistanis (>967 couples), Nigerians (418-794 couples) and Indians (54-2099 couples). There are up to 3000 consanguineous couples in the Traveller community. Evidence for approaches to mitigate associated risks supports a three-stranded approach: family-centred genetics services, training and education of healthcare professionals (HCPs), community education programmes. Discussion: Consanguineous couples desire accurate information for reproductive decisions, but may avoid hospital-based services due to language barriers, poor understanding, stigma. Uptake of genetic counselling and carrier testing is higher if a family-centred approach is provided, ideally through home visits in the couple's preferred language. Targeted education programmes enhance community awareness and have led to declines in CM elsewhere. Education of HCPs is necessary to clarify referral pathways, as many have exaggerated impressions of the genetic risks.
    No preview · Article · Oct 2015 · Irish Journal of Medical Science
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    ABSTRACT: Background The Conway Review Lecture is held annually by the Royal Academy of Medicine in Ireland Biomedical Sciences Section, to remember the life and scientific work of a world class Irish scientist, Professor Edward J Conway. Aims This years lecture will focus on large conductance Ca2+ activated K+ (BK) channels and aims to describe how a combination of techniques can be used to unravel drug effects on ion channels at a molecular level. Methods Experiments were performed using a range of techniques including patch clamp electrophysiology, mutagenesis, structural biology and mathematical modeling. Results Our data suggest that the novel BK channel opener GoSlo-SR-5-6 mediates its effects via an interaction with 2 residues on S6 (S317 and I326) and a residue on the S4/S5 linker (L227). Conclusions We hypothesize that this novel opener activates BK channels by altering an interaction between the S4/S5 linker and the pore-forming S6 transmembrane helix.
    No preview · Article · Oct 2015 · Irish Journal of Medical Science
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    ABSTRACT: Background: This is a literature review of outcomes for patients with Guillain-Barré Syndrome (GBS) who require admission to the intensive care unit for mechanical ventilation. Respiratory distress is the leading cause of death in the acute phase, and occurs in about 25 % of patients. Aims: The aim of this review is to compile, analyse, and summarise the most relevant literature looking at outcomes for Guillain-Barré (GB) patients requiring admission to the intensive care unit and mechanical ventilation. Methods: A PubMed and Google-Scholar literature search was performed using the key words 'Guillain-Barré, Outcomes, Mechanical Ventilation, Prognosis, Mortality, ICU. All 7 papers from the years 2000-2014 which assessed outcomes for GBS patients requiring mechanical ventilation were included, and critically analysed. Results: The parameters recorded by these studies looked at mortality, disability, length of hospitalisation, and complications. The mortality of GB patients requiring mechanical ventilation varied from 8.3 to 20 %, Disability was primarily measured by the GBS disability scale. One study deemed that a score of 0-1 was a positive outcome, and found that slightly over half 53.8 % of the patients fulfilled that criteria. Over half of the mechanically ventilated patients were required to be admitted for over 3 weeks. Complications during ICU admission are common, with bed-sores (40 %), pneumonia (30.2 %) and sepsis (17.4) being the most frequently encountered in one study. Conclusion: Accurate data are limited by the fact that these studies are retrospective, often covering long periods in the past. Larger, more recent, prospective, multi-centre studies will be required.
    No preview · Article · Oct 2015 · Irish Journal of Medical Science
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    ABSTRACT: Purpose: The goal of this study was to compare the coronary atherosclerotic burden in patients with and without type-2 diabetes by using CT coronary angiography (CTCA). Methods: A total of 206 diabetic (mean age 67 ± 11 years; male: 136) and 523 non-diabetic patients (mean age 62 ± 13 years; male: 323) without history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined, and each diseased segment was classified as showing obstructive lesion (luminal narrowing >50 %) or not. Coronary angiography was then performed to confirm diagnosis. Results: Diabetics showed a higher rate of abnormal CAD (76 vs. 53 % of patients; p < 0.0001) and fewer normal coronary arteries (24 vs. 47 %; p < 0.0001) compared with non-diabetics. Multi-vessel disease was seen more frequently in patients with diabetes than in patients without diabetes [15 % (n = 22) vs. 7 % (n = 62), respectively; p = 0.0004]. The per-patient number of segments with plaque (4.5 vs. 2.0, respectively; p < 0.0001) and the number of segments with obstructive disease (0.9 vs. 0.5, respectively; p = 0.0001) were higher for diabetic patients than for non-diabetic patients. Conclusion: Diabetes was associated with higher coronary plaque burden.
    No preview · Article · Oct 2015 · Irish Journal of Medical Science
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    ABSTRACT: Evarts Graham performed the first successful pneumonectomy in 1933. Evarts Ambrose Graham, the son of a Scotch Irish surgeon, was born on 19 March 1883. After early schooling in Chicago, he graduated at Princeton and returned to Chicago to study Medicine, taking his MD at Rush Medical College in 1907. The chemical aspects of pathological changes then occupied him fully until 1919, when he was appointed full-time professor of surgery at the Washington School of Medicine in St Louis. Visualisation of gallstones temporarily took his attention, but bronchogenic carcinoma was seldom far from his thoughts, and he recognised (too late to save himself) the causative association with cigarette smoking by 1950. He died on 4 March 1957.
    No preview · Article · Sep 2015 · Irish Journal of Medical Science