Publications by authors named "Tormey W"
Article Synopsis
- Vaccination against SARS-CoV-2 improves outcomes for COVID-19 pneumonia patients, particularly older individuals at high risk for severe disease.
- In a study of hospitalized patients over and under 70 years, low serum vitamin D levels (D30) were linked to significantly higher rates of ICU admission and mortality in unvaccinated patients.
- While older patients generally showed higher mortality rates, those over 70 with low vitamin D levels experienced a reduction in mortality when vaccinated or with higher vitamin D levels, indicating that both factors can help lessen the risk, though age remains a significant risk factor.
Central serous chorioretinopathy secondary to intramuscular testosterone therapy.
Endocrinol Diabetes Metab Case Rep
May 2023
Summary: A patient treated with intramuscular testosterone replacement therapy for primary hypogonadism developed blurred vision shortly after receiving his testosterone injection. The symptom resolved over subsequent weeks and recurred after his next injection. A diagnosis of central serous chorioretinopathy (CSR) was confirmed following ophthalmology review.
View Article and Find Full Text PDFBackground: Lipid disorders are now considered causal for atherosclerotic cardiovascular disease (ASCVD) which remains one of the most important contributors to morbidity and mortality in the developed world. Identification and early treatment of lipid disarrays remains the cornerstone of good clinical practice to prevent, halt and even reverse ASCVD. Guidelines for lipid management are imperative to help promote good clinical practice.
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- - The study investigates the link between low vitamin D levels and higher mortality rates in unvaccinated patients with COVID-19, considering common risk factors like age and obesity.
- - Researchers analyzed 232 patients, finding that age (especially over 70) and lower vitamin D levels significantly increased mortality risk, independent of other factors like gender and diabetes.
- - Results indicate that low vitamin D is associated with higher COVID-19 mortality, but not due to systemic inflammation as measured by CRP, suggesting the need for further research into vitamin D's role in COVID-19 outcomes.
Aims: Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM). Epidemiological studies suggest serum Osteoprotegrin (OPG)/Tumour-necrosis-factor-related-apoptosis-inducing- ligand (TRAIL) ratio may be a useful marker of cardiovascular risk. This study aimed to compare serum levels of TRAIL, OPG and OPG/TRAIL ratio in people with T2DM, with and without a history of CVD, and controls; and to determine which of these indices, if any, predict cardiovascular risk.
View Article and Find Full Text PDFHbA1c is the established test for monitoring glycaemic control in diabetes, and intervention trials studying the impact of treatment on glycaemic control and risk of complications focus predominantly on this parameter in terms of evaluating the glycaemic outcomes. It is also the main parameter used when targets for control are being individualised, and more recently, it has been used for the diagnosis of type 2 diabetes. For laboratories performing this test and clinicians utilising it in their decision-making process, a thorough understanding of factors that can impact on the accuracy, and appropriate interpretation of the test is essential.
View Article and Find Full Text PDFWe audited use of acute hospital beds in Connolly Hospital over a 3-month period (January-March 2020) which coincided with increased provision of step-down (nursing home) beds. Our results show both ineffective and inefficient baseline uses of these acute beds. Increased step-down beds improve patient care by reducing the trolley count, shortening average length of stay and reducing waiting lists.
View Article and Find Full Text PDFObjective: Growth hormone (GH) replacement alters the peripheral interconversion of thyroxine (T4) and triiodothyronine (T3). However, little is known about the clinical impact of these alterations. We aimed to compare changes observed in the serum T3:T4 ratio with known biological markers of thyroid hormone action derived from different peripheral tissues.
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- - Hyponatraemia, a condition characterized by low sodium levels in the blood, significantly affects older patients, increasing their risk of complications and mortality, especially since the factors and outcomes related to it haven't been thoroughly studied in this demographic.
- - A 9-month study analyzed 1,321 cases of hyponatraemia in patients aged 65 and older compared to younger patients and healthy controls, revealing that common causes were similar across ages but older patients received more treatment yet fared worse.
- - Despite higher treatment rates in older hyponatraemic patients, they were more likely to face in-hospital death compared to both younger patients and healthy controls, highlighting the urgent need to understand and address hyponatraemia's risks
Context: Animal data and cross-sectional human studies have established that chronic hyponatraemia predisposes to osteoporosis; the effects of acute hyponatraemia on bone turnover have not been determined. Our objective was to test the hypothesis that acute hyponatraemia leads to dynamic effects on bone turnover.
Design: A prospective observational pilot study.
Objective: Severe hyponatraemia (plasma sodium concentration, pNa <120 mmol/L) is reported to be associated with mortality rates as high as 50%. Although there are several international guidelines for the management of severe hyponatraemia, there are few data on the impact of treatment.
Design And Methods: We have longitudinally reviewed rates of specialist input, active management of hyponatraemia, treatment outcomes and mortality rates in patients with severe hyponatraemia (pNa <120 mmol/L) in 2005, 2010 and 2015, and compared the recent mortality rate with that of patients with pNa 120-125 mmol/L.
Background: Glucocorticoid therapy is the most common cause of iatrogenic osteoporosis. Less is known regarding the effect of glucocorticoids when used as replacement therapy on bone remodelling in patients with adrenal insufficiency. Enhanced intracellular conversion of inactive cortisone to active cortisol, by 11 beta-hydroxysteroid dehydrogenase type 1(11β-HSD1) and other enzymes leading to alterations in glucocorticoid metabolism, may contribute to a deleterious effect on bone health in this patient group.
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- Fluid restriction (FR) was tested as a treatment for chronic syndrome of inappropriate antidiuresis (SIAD) in a study involving 46 patients, comparing its effects to no treatment over one month.
- The study found that FR led to a greater initial increase in plasma sodium concentration (pNa) after 3 days compared to no treatment, although the rise was modest and limited at 30 days.
- The results indicate that while FR is somewhat effective and well-tolerated, about one-third of patients did not reach the target sodium level, highlighting the need for additional treatment options for some patients with SIAD.
Background: Measurement of late night salivary cortisol (LNSF) is useful in the identification of cyclical Cushing's syndrome (CS); the usefulness of its metabolite cortisone (late night salivary cortisone, LNSE) is less well described.
Aim: The aim of this study was to determine the utility of measuring LNSE in patients with confirmed CS compared with other diagnostic tests and to analyse serial LNSF measurements for evidence of variable hormonogenesis.
Methods: This was a retrospective observational study including patients with confirmed CS in whom LNSF and LNSE were measured.
Introduction: Coronavirus disease 2019 (COVID-19), is a respiratory illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Clinical Blood Sciences Laboratory (CBSL) plays a key role in supporting the monitoring and management of patients with COVID-19 disease.
Objective: To provide a comprehensive CBSL testing protocol to support the medical management of SARS-CoV-2 infection.
Background: Thyroid dysfunction (TD) occurs in 13.4% of diabetic patients, which has prompted recommendations for annual thyroid screening in patients with diabetes. However, recommendations for annual screening should be based on disease incidence rather than prevalence.
View Article and Find Full Text PDFBackground: Acute hyponatremia is a medical emergency that confers high mortality, attributed primarily to cerebral edema. Expert guidelines advocate the use of intravenous boluses of hypertonic saline rather than traditional continuous infusion to achieve a faster initial rise in plasma sodium (pNa) concentration. However, there is a limited evidence base for this recommended policy change.
View Article and Find Full Text PDFObjective: Hyponatraemia is common in community-acquired pneumonia (CAP) and is associated with increased mortality. The mechanism of hyponatraemia in CAP is not completely understood and treatment is therefore ill-defined. We aimed to define the causation of hyponatraemia in CAP.
View Article and Find Full Text PDFObjective: Alterations in the thyroid axis are frequently observed following growth hormone (GH) replacement, but uncertainty exists regarding their clinical significance. We aimed to compare fluctuations in circulating thyroid hormone levels, induced by GH, to changes in sensitive biological markers of thyroid hormone action.
Methods: This was a prospective observational clinical study.