Obstetrics & Gynaecology (Scholarly Publications)
http://hdl.handle.net/2262/216
Obstetrics & Gynaecology (Scholarly Publications)2024-03-29T07:06:18ZCirculating tumour cells: The Good, the Bad and the Ugly.
http://hdl.handle.net/2262/104059
Circulating tumour cells: The Good, the Bad and the Ugly.
Ward, Mark; O'Toole, Sharon; O'Leary, John; Malone, Victoria; O'Connor, R?is?n
This review is an overview of the current knowledge regarding circulating tumour cells (CTCs), which are potentially the most lethal type of cancer cell, and may be a key component of the metastatic cascade. The clinical utility of CTCs (the "Good"), includes their diagnostic, prognostic, and therapeutic potential. Conversely, their complex biology (the "Bad"), including the existence of CD45+/EpCAM+ CTCs, adds insult to injury regarding their isolation and identification, which in turn hampers their clinical translation. CTCs are capable of forming microemboli composed of both non-discrete phenotypic populations such as mesenchymal CTCs and homotypic and heterotypic clusters which are poised to interact with other cells in the circulation, including immune cells and platelets, which may increase their malignant potential. These microemboli (the "Ugly") represent a prognostically important CTC subset, however, phenotypic EMT/MET gradients bring additional complexities to an already challenging situation.
PUBLISHED
2023-01-01T00:00:00ZInstrumental delivery and ultrasound : a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.
http://hdl.handle.net/2262/75510
Instrumental delivery and ultrasound : a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.
MURPHY, DEIRDRE
OBJECTIVE:
To determine whether the use of ultrasound can reduce the incidence of incorrect diagnosis of the fetal head position at instrumental delivery and subsequent morbidity.
DESIGN:
Two-arm, parallel, randomised trial, conducted from June 2011 to December 2012.
SETTING:
Two maternity hospitals in the Republic of Ireland.
SAMPLE:
A cohort of 514 nulliparous women at term (≥37 weeks of gestation) with singleton cephalic pregnancies, aiming to deliver vaginally, were recruited prior to an induction of labour or in early labour.
METHODS:
If instrumental delivery was required, women who had provided written consent were randomised to receive clinical assessment (standard care) or ultrasound scan and clinical assessment (ultrasound). [Correction added on 17 April 2014, after first online publication: Sentence was amended.]
MAIN OUTCOME MEASURE:
Incorrect diagnosis of the fetal head position.
RESULTS:
The incidence of incorrect diagnosis was significantly lower in the ultrasound group than the standard care group (4/257, 1.6%, versus 52/257, 20.2%; odds ratio 0.06; 95% confidence interval 0.02-0.19; P < 0.001). The decision to delivery interval was similar in both groups (ultrasound mean 13.8 minutes, SD 8.7 minutes, versus standard care mean 14.6 minutes, SD 10.1 minutes, P = 0.35). The incidence of maternal and neonatal complications, failed instrumental delivery, and caesarean section was not significantly different between the two groups.
CONCLUSIONS:
An ultrasound assessment prior to instrumental delivery reduced the incidence of incorrect diagnosis of the fetal head position without delaying delivery, but did not prevent morbidity. A more integrated clinical skills-based approach is likely to be required to prevent adverse outcomes at instrumental delivery.
PUBLISHED
2014-01-01T00:00:00ZAuthors' reply: Does ultrasound determination of fetal occiput position improve labour outcome?
http://hdl.handle.net/2262/74902
Authors' reply: Does ultrasound determination of fetal occiput position improve labour outcome?
MURPHY, DEIRDRE
PUBLISHED
2014-01-01T00:00:00ZPoor glycated haemoglobin and adverse pregnancy outcomes in Type 1 and Type 2 Diabetes mellitus - Systematic review of observational studies.
http://hdl.handle.net/2262/73195
Poor glycated haemoglobin and adverse pregnancy outcomes in Type 1 and Type 2 Diabetes mellitus - Systematic review of observational studies.
MURPHY, DEIRDRE
PUBLISHED
2006-01-01T00:00:00Z