The Role of Transoral Robotic Palatine and Lingual Tonsillectomy in the Diagnosis of Carcinoma of Unknown Primary in the Head and Neck Region.

Background: The use of transoral robotic surgery (TORS) lingual tonsillectomy in the diagnostic algorithm for head and neck carcinoma of unknown primary (CUP) has gained recent popularity. The primary aim of our study was to determine the identification rate of primary tumors in our cohort undergoing lingual ± palatine tonsillectomy for the workup of head and neck CUP.

Methods: This was a retrospective study of all patients undergoing diagnostic TORS for head and neck CUP over an eight-year period, across four centers in two countries.

Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations.

Major head and neck surgery poses a threat to perioperative airway patency. Adverse airway events are associated with significant morbidity, potentially leading to hypoxic brain injury and even death. Following a review of the literature, recommendations regarding airway management in head and neck surgery were developed with multicenter, multidisciplinary agreement among all Irish head and neck units.

Retrospective analysis of radiological investigation of surgically excised head and neck lipomas.

Purpose: Differentiating benign lipomas from malignant causes is challenging and preoperative investigative guidelines are not well-defined. The purpose of this study was to retrospectively identify cases of head and neck lipomas that were surgically resected over a 5-year period and to identify the radiological modality chosen and features discussed in the final report. Multidisciplinary outcomes and pathology reports were examined with a view to identifying high risk features of a lipoma to aid in future risk stratification.

Ocular lymphoma: overcoming a diagnostic challenge with an endoscopic sinus approach.

Background: Ocular lymphomas are rare, indolent tumours that pose a diagnostic challenge. Patients may be asymptomatic or present with symptoms of increased orbital mass. An index of suspicion is required alongside an understanding of the diagnostics and staging required to facilitate expedited multi-disciplinary work-up and management.

Parathyroid carcinoma: Current management and outcomes - A systematic review.

Objective: Parathyroid carcinoma is rarely encountered in clinical practice. When faced with this clinical challenge, there is currently a paucity of evidence available for the optimal management of patients with parathyroid carcinoma. This systematic review synthesizes the available literature to evaluate the optimal management approach, thus providing guidance for future management.

A curious case of metastatic parotid adenoid cystic carcinoma to kidney.

A woman in her 60s presented with a 2-week history of non-specific left-sided abdominal pain. She previously underwent a total parotidectomy and adjuvant radiotherapy for left parotid adenoid cystic carcinoma 13 years prior, with a local recurrence 4 years after. Investigations revealed a large left-sided renal mass with appearances of renal carcinoma and no signs of metastatic disease.

Multispecialty surgical management of large clavicular tumor: A case report.

Introduction: Primary and metastatic malignancies of the clavicle are extremely uncommon and difficult to treat. It carries a high morbidity rate. Total or partial claviculectomy is the recommended treatment option.

Metastatic medullary thyroid carcinoma presenting as ectopic Cushing's syndrome.

Summary: A 41-year-old male presented to the Emergency Department with a 6-month history of back and hip pain. Skeletal survey revealed bilateral pubic rami fractures and MRI of the spine demonstrated multiple thoracic and lumbar fractures. Secondary work up for osteoporosis was undertaken.

Transoral robotic surgery in Ireland: the beginning.

Background: Transoral robotic surgery (TORS) has shown promising results in the treatment of myriad head and neck pathologies but is now most commonly used in the investigation and management of oropharyngeal squamous cell carcinoma.

Aims: The aim of this study was to report our cases of the newly introduced TORS, particularly its role in identifying primary of unknown origin and the potential implications for patients. A literature review and our early experience should begin to debunk some of the criticisms of TORS including setup times and cost.

Twin pathologies: synchronous leiomyosarcoma and squamous cell carcinoma of the larynx.

The synchronous discovery of leiomyosarcoma (LMS) and squamous cell carcinoma (SCC) of the larynx is extremely rare. We describe our experience of managing a patient with this unusual presentation. A 35-year-old man was initially diagnosed with advanced stage (TNM) laryngeal LMS.

Sexual Behaviour and Human Papillomavirus-Positive Oral Cavity and Oropharyngeal Cancer: An Irish Perspective.

Background Characterization of the sexual behaviours and lifestyle factors associated with human papillomavirus (HPV)-positive oral cavity and oropharyngeal squamous cell carcinoma (OPSCC) is crucial to optimal counselling. Our study aims to investigate the relationship between sexual behaviours, lifestyle factors and HPV-positive OPSCC in an Irish population. Methods We performed a case-control study of 60 patients with newly diagnosed HPV-positive and HPV-negative oral cavity and OPSCC.

Is Bismuth Really the "Green" Metal? Exploring the Antimicrobial Activity and Cytotoxicity of Organobismuth Thiolate Complexes.

Antimicrobial resistance is becoming an ever-increasing threat for human health. Metal complexes and, in particular, those that incorporate bismuth offer an attractive alternative to the typically used organic compounds to which bacteria are often able to develop resistance determinants. Herein we report the synthesis, characterization, and biological evaluation of a series of homo- and heteroleptic bismuth(III) thiolates incorporating either one (BiPhL), two (BiPhL), or three (BiL) sulfur-containing azole ligands where LH = tetrazolethiols or triazolethiols (thiones).

High-Affinity Low-Capacity and Low-Affinity High-Capacity N-Acetyl-2-Aminofluorene (AAF) Macromolecular Binding Sites Are Revealed During the Growth Cycle of Adult Rat Hepatocytes in Primary Culture.

Long-term cultures of primary adult rat hepatocytes were used to study the effects of N-acetyl-2-aminofluorene (AAF) on hepatocyte proliferation during the growth cycle; on the initiation of hepatocyte DNA synthesis in quiescent cultures; and, on hepatocyte DNA replication following the initiation of DNA synthesis. Scatchard analyses were used to identify the pharmacologic properties of radiolabeled AAF metabolite binding to hepatocyte macromolecules. Two classes of growth cycle-dependent AAF metabolite binding sites-a high-affinity low-capacity site (designated Site I) and a low-affinity high-capacity site (designated Site II)-associated with two spatially distinct classes of macromolecular targets, were revealed.

N-Acetyl-2-Aminofluorene (AAF) Processing in Adult Rat Hepatocytes in Primary Culture Occurs by High-Affinity Low-Velocity and Low-Affinity High-Velocity AAF Metabolite-Forming Systems.

N-acetyl-2-aminofluorene (AAF) is a procarcinogen used widely in physiological investigations of chemical hepatocarcinogenesis. Its metabolic pathways have been described extensively, yet little is known about its biochemical processing, growth cycle expression, and pharmacological properties inside living hepatocytes-the principal cellular targets of this hepatocarcinogen. In this report, primary monolayer adult rat hepatocyte cultures and high specific-activity [ring G-3 H]-N-acetyl-2-aminofluorene were used to extend previous observations of metabolic activation of AAF by highly differentiated, proliferation-competent hepatocytes in long-term cultures.

Transient auditory hallucinations in an adolescent.

In adolescents, hallucinations can be a transient illness or can be associated with non-psychotic psychopathology, psychosocial adversity, or a physical illness. We present the case of a 15-year-old secondary-school student who presented with a 1-month history of first onset auditory hallucinations, which had been increasing in frequency and severity, and mild paranoid ideation. Over a 10-week period, there was a gradual diminution, followed by a complete resolution, of symptoms.

Non-attendance at new appointments at St James's Child Guidance Clinic.

Objective: This study aimed to examine non-attendance rates at new appointments at St James's Child Guidance Clinic.

Method: The sample consisted of all new referrals to St. James's Child Guidance Clinic in one calendar year (2004).

Routine investigations in paediatric psychopharmacology.

Objectives: This study examines (1) what are the minimum accepted baseline investigations recommended in the literature prior to prescribing in child psychiatry and (2) whether these investigations are routinely performed.

Method: Medical literature on prescribing in child and adolescent psychiatry was reviewed, and a list of minimum baseline investigations recommended in the literature was established. A postal survey was performed to establish what current clinical practice is among child and adolescent psychiatrists.