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Article ; Online: Timing of surgery following SARS-CoV-2 infection: an ever-changing landscape.

Reynolds, I S / Ryan, É J / Martin, S T

2022 Volume 77, Issue 7, Page(s) 832–833

MeSH term(s)	COVID-19 ; Humans ; SARS-CoV-2
Language	English
Publishing date	2022-02-15
Publishing country	England
Document type	Letter
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.15673
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Article: Optimising the Use of Procedural Beds: Time for an Intervention.

Healy, O / McStay, M / Mannion, H / Reynolds, I S / Ryan, J / Winter, D C

Irish medical journal

2022 Volume 115, Issue No.9, Page(s) 675

Language	English
Publishing date	2022-10-20
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	193134-9
ISSN	0332-3102 ; 0021-129X
ISSN	0332-3102 ; 0021-129X
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Article: Management of Cylindrical Battery Ingestion.

O'Mahony, C J / Reynolds, I S / Arya, S / Ryan, E R / Martin, S T

Irish medical journal

2022 Volume 115, Issue 8, Page(s) 657

Abstract: Presentation A female presented to the Emergency Department following ingestion of an unknown number of cylindrical batteries. Diagnosis Abdominal X-ray confirmed the presence of multiple batteries located throughout the abdomen. Treatment A trial of ... ...

Abstract	Presentation A female presented to the Emergency Department following ingestion of an unknown number of cylindrical batteries. Diagnosis Abdominal X-ray confirmed the presence of multiple batteries located throughout the abdomen. Treatment A trial of conservative management was pursued, and five AA batteries were successfully passed per rectum. Serial X-rays over three weeks revealed that the majority of batteries failed to pass. A decision was made to perform a laparotomy, and 46 cylindrical batteries were removed from the stomach through a small gastrotomy. Four batteries located in the colon were milked into the rectum and removed via the transanal route. Discussion Using daily clinical exams and weekly plain films of the abdomen, conservative management is possible if a small number of batteries are ingested and make it to the stomach. However, the potential of cylindrical batteries to result in acute surgical emergencies should not be underestimated.
MeSH term(s)	Humans ; Female ; Foreign Bodies/diagnostic imaging ; Foreign Bodies/surgery ; Electric Power Supplies ; Radiography ; Laparotomy ; Eating
Language	English
Publishing date	2022-09-15
Publishing country	Ireland
Document type	Case Reports
ZDB-ID	193134-9
ISSN	0332-3102 ; 0021-129X
ISSN	0332-3102 ; 0021-129X
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Article ; Online: Mucinous and non-mucinous colorectal cancers show differential expression of chemotherapy metabolism and resistance genes.

O'Connell, E / Reynolds, I S / Salvucci, M / McNamara, D A / Burke, J P / Prehn, J H M

The pharmacogenomics journal

2021 Volume 21, Issue 4, Page(s) 510–519

Abstract: Previous research has identified differences in mutation frequency in genes implicated in chemotherapy resistance between mucinous and non-mucinous colorectal cancers (CRC). We hypothesized that outcomes in mucinous and non-mucinous CRC may be influenced ...

Abstract	Previous research has identified differences in mutation frequency in genes implicated in chemotherapy resistance between mucinous and non-mucinous colorectal cancers (CRC). We hypothesized that outcomes in mucinous and non-mucinous CRC may be influenced by expression of genes responsible for chemotherapy resistance. Gene expression data from primary tumor samples were extracted from The Cancer Genome Atlas PanCancer Atlas. The distribution of clinical, pathological, and gene expression variables was compared between 74 mucinous and 521 non-mucinous CRCs. Predictors of overall survival (OS) were assessed in a multivariate analysis. Kaplan-Meier curves were constructed to compare survival according to gene expression using the log rank test. The median expression of 5-FU-related genes TYMS, TYMP, and DYPD was significantly higher in mucinous CRC compared to non-mucinous CRC (p < 0.001, p = 0.003, p < 0.001, respectively). The median expression of oxaliplatin-related genes ATP7B and SRPK1 was significantly reduced in mucinous versus non-mucinous CRC (p = 0.004, p = 0.007, respectively). At multivariate analysis, age (odds ratio (OR) = 0.96, p < 0.001), node positive disease (OR = 0.49, p = 0.005), and metastatic disease (OR = 0.32, p < 0.001) remained significant negative predictors of OS, while high SRPK1 remained a significant positive predictor of OS (OR = 1.59, p = 0.037). Subgroup analysis of rectal cancers demonstrated high SRPK1 expression was associated with significantly longer OS compared to low SRPK1 expression (p = 0.011). This study highlights that the molecular differences in mucinous CRC and non-mucinous CRC extend to chemotherapy resistance gene expression. SRPK1 gene expression was associated with OS, with a prognostic role identified in rectal cancers.
MeSH term(s)	Aged ; Colorectal Neoplasms/genetics ; Copper-Transporting ATPases/genetics ; Drug Resistance, Neoplasm/genetics ; Female ; Gene Expression/genetics ; Humans ; Inactivation, Metabolic/genetics ; Male ; Prognosis ; Protein Serine-Threonine Kinases/genetics
Chemical Substances	Protein Serine-Threonine Kinases (EC 2.7.11.1) ; Copper-Transporting ATPases (EC 7.2.2.8)
Language	English
Publishing date	2021-03-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2106831-8
ISSN	1473-1150 ; 1470-269X
ISSN (online)	1473-1150
ISSN	1470-269X
DOI	10.1038/s41397-021-00229-5
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Zs.A 5806: Show issues

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Article ; Online: Microsatellite instability and response to neoadjuvant chemoradiotherapy in rectal cancer: A systematic review and meta-analysis.

O'Connell, E / Reynolds, I S / McNamara, D A / Prehn, J H M / Burke, J P

Surgical oncology

2020 Volume 34, Page(s) 57–62

Abstract: Background: Response to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer is variable. Identification of biomarkers to predict response is desirable in order to provide prognostic information and targeted therapy. Several studies ... ...

Abstract	Background: Response to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer is variable. Identification of biomarkers to predict response is desirable in order to provide prognostic information and targeted therapy. Several studies have investigated microsatellite instability (MSI) as a predictor of response to CRT with contradictory results. This study aims to clarify the effect of MSI status on response to CRT in locally advanced rectal cancer through systematic review and meta-analysis. Methods: A systematic search of PubMed, Embase and Cochrane databases was performed for all studies relating to MSI and response to CRT in rectal cancer using the search algorithm (Microsatellite Instability) AND (Chemoradiotherapy) AND (Rectal Cancer). From each included study the number of patients with MSI tumors and Microsatellite Stable (MSS) tumors and the numbers achieving pathological complete response (pCR) were recorded. Pooled outcome measures were determined using a random effects model and the odds ratio estimated with variance and 95% confidence interval. Results: Nine published studies were identified reporting data on MSI and its effect on outcome after CRT for locally advanced rectal cancer. Five studies describing 5,877 patients included data on MSI and the number of patients achieving pCR. There was no significant association between MSI and pCR (MSI Vs MSS: 10.1% Vs 6.6%, OR 1.38, 95% CI: 0.7-2.72, p = 0.35). Conclusion: This meta-analysis concludes that there appears to be no significant difference in pCR rate following CRT in patients with MSI versus MSS rectal tumors.
MeSH term(s)	Chemoradiotherapy, Adjuvant/methods ; Humans ; Microsatellite Instability ; Neoadjuvant Therapy/methods ; Prognosis ; Rectal Neoplasms/genetics ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy
Language	English
Publishing date	2020-04-02
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1107810-8
ISSN	1879-3320 ; 0960-7404
ISSN (online)	1879-3320
ISSN	0960-7404
DOI	10.1016/j.suronc.2020.03.009
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Article ; Online: Meta-analysis of the molecular associations of mucinous colorectal cancer.

Reynolds, I S / Furney, S J / Kay, E W / McNamara, D A / Prehn, J H M / Burke, J P

The British journal of surgery

2019 Volume 106, Issue 6, Page(s) 682–691

Abstract: Background: Mucinous differentiation occurs in 5-15 per cent of colorectal adenocarcinomas. This subtype of colorectal cancer responds poorly to chemoradiotherapy and has a worse prognosis. The genetic aetiology underpinning this cancer subtype lacks ... ...

Abstract	Background: Mucinous differentiation occurs in 5-15 per cent of colorectal adenocarcinomas. This subtype of colorectal cancer responds poorly to chemoradiotherapy and has a worse prognosis. The genetic aetiology underpinning this cancer subtype lacks consensus. The aim of this study was to use meta-analytical techniques to clarify the molecular associations of mucinous colorectal cancer. Methods: This study adhered to MOOSE guidelines. Databases were searched for studies comparing KRAS, BRAF, microsatellite instability (MSI), CpG island methylator phenotype (CIMP), p53 and p27 status between patients with mucinous and non-mucinous colorectal adenocarcinoma. A random-effects model was used for analysis. Results: Data from 46 studies describing 17 746 patients were included. Mucinous colorectal adenocarcinoma was associated positively with KRAS (odds ratio (OR) 1·46, 95 per cent c.i. 1·08 to 2·00, P = 0·014) and BRAF (OR 3·49, 2·50 to 4·87; P < 0·001) mutation, MSI (OR 3·98, 3·30 to 4·79; P < 0·001) and CIMP (OR 3·56, 2·85 to 4·43; P < 0·001), and negatively with altered p53 expression (OR 0·46, 0·31 to 0·67; P < 0·001). Conclusion: The genetic origins of mucinous colorectal adenocarcinoma are predominantly associated with BRAF, MSI and CIMP pathways. This pattern of molecular alterations may in part explain the resistance to standard chemotherapy regimens seen in mucinous adenocarcinoma.
MeSH term(s)	Adenocarcinoma, Mucinous/genetics ; Adenocarcinoma, Mucinous/pathology ; Biomarkers, Tumor/genetics ; Colorectal Neoplasms/genetics ; Colorectal Neoplasms/pathology ; CpG Islands/genetics ; DNA Methylation ; Gene Expression Regulation, Neoplastic ; Humans ; Microsatellite Instability ; Models, Statistical ; Mutation ; Phenotype ; Proliferating Cell Nuclear Antigen/genetics ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins p21(ras)/genetics ; Tumor Suppressor Protein p53/genetics
Chemical Substances	Biomarkers, Tumor ; KRAS protein, human ; Proliferating Cell Nuclear Antigen ; Tumor Suppressor Protein p53 ; p27 antigen ; BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2019-04-04
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11142
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Uk I Zs.66: Show issues

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Article ; Online: Response to: shift in paradigm of clinical management of anastomotic leak.

Reynolds, I S / Deasy, J / Burke, J P / McNamara, D A

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2017 Volume 19, Issue 10, Page(s) 943–944

MeSH term(s)	Anastomosis, Surgical ; Anastomotic Leak/surgery ; Humans
Language	English
Publishing date	2017
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.13825
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Article ; Online: Endoscopic tattooing to aid tumour localisation in colon cancer: the need for standardisation.

Reynolds, I S / Majeed, M H / Soric, I / Whelan, M / Deasy, J / McNamara, D A

Irish journal of medical science

2017 Volume 186, Issue 1, Page(s) 75–80

Abstract: Background/aims: An increasing number of colon and rectal tumours are being resected using laparoscopic techniques. Identifying these tumours intraoperatively can be difficult. The use of tattooing can facilitate an easier resection; however, the lack ... ...

Abstract	Background/aims: An increasing number of colon and rectal tumours are being resected using laparoscopic techniques. Identifying these tumours intraoperatively can be difficult. The use of tattooing can facilitate an easier resection; however, the lack of standardised guidelines can potentially lead to errors intraoperatively and potentially result in worse outcomes for patients. The aim of this study was to identify the most reliable method of preoperative tumour localisation from the available literature to date. Methods: A literature review was undertaken to identify any articles related to endoscopic tattooing and tumour localisation during colorectal surgery. Results: To date there is still mixed evidence regarding tattooing techniques and the choice of ink that should be used. There are numerous studies demonstrating safe tattooing techniques and highlighting the risks and benefits of different types of ink available. Conclusion: Based on the available studies we have recommended a standardised approach to endoscopic tattooing of colorectal tumours prior to laparoscopic resection.
MeSH term(s)	Colonoscopy/methods ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Humans ; Laparoscopy/methods ; Tattooing/standards
Language	English
Publishing date	2017-02
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-016-1502-y
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Zs.B 323: Show issues

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Article ; Online: Adherence to clinical guidelines and the potential economic benefits of admission avoidance for acute uncomplicated diverticulitis.

Reynolds, I S / O'Connell, E / Heaney, R M / Khan, W / Khan, I Z / Waldron, R / Barry, K

Irish journal of medical science

2017

Abstract: Background: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community.: Aims: The aim of this study was to analyse how acute diverticulitis ... ...

Abstract	Background: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community. Aims: The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis. Methods: A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained. Severity of disease, treatment received and average length of stay (LOS) were analysed for all patients. Contemporaneous hospital inpatient enquiry (HIPE) data was interrogated to analyse current management for acute diverticulitis at a national level. Results: One hundred twenty-six patients were admitted to our institution with acute diverticulitis during the study period (inpatient stay = €1277/night). Of patients, 59.5% had uncomplicated diverticulitis while 40.5% had complicated disease. The median LOS was 4 (range 1-34) days and 8 (range 2-51) days in the uncomplicated and complicated group, respectively. Based on HIPE data, there were 11,357 patients with uncomplicated diverticulitis and 526 patients with complicated diverticulitis admitted to Irish hospitals in the year 2015. Nationally, the median LOS for those with uncomplicated diverticulitis was 3 (range 1-142) days and for those with complicated diverticulitis the median LOS was 7 (range 1-308) days. Projected total cost for hospital stay nationally for uncomplicated diverticulitis amounted to €43.5 million for the year 2015. Conclusions: At present, uncomplicated diverticulitis in Ireland is not being managed as per evidence-based guidelines. Changing practice could result in significant cost savings for surgical departments.
Language	English
Publishing date	2017-05-25
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-017-1632-x
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Article ; Online: C-reactive protein as a predictor of anastomotic leak in the first week after anterior resection for rectal cancer.

Reynolds, I S / Boland, M R / Reilly, F / Deasy, A / Majeed, M H / Deasy, J / Burke, J P / McNamara, D A

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2017 Volume 19, Issue 9, Page(s) 812–818

Abstract: Aim: Anastomotic leak (AL) after anterior resection results in increased morbidity, mortality and local recurrence. The aim of this study was to assess the ability of C-reactive protein (CRP) to predict AL in the first week after anterior resection for ... ...

Abstract	Aim: Anastomotic leak (AL) after anterior resection results in increased morbidity, mortality and local recurrence. The aim of this study was to assess the ability of C-reactive protein (CRP) to predict AL in the first week after anterior resection for rectal cancer. Method: A retrospective review of a prospectively maintained database that included all patients undergoing anterior resection between January 2008 and December 2013 was performed. The ability of CRP to predict AL was assessed using area under the receiver-operating characteristics (AUC) curves. The severity of AL was defined using the International Study Group of Rectal Cancer (ISREC) grading system. Results: Two-hundred and eleven patients were included in the study. Statistically significant differences in mean CRP values were found between those with and without an AL on postoperative days 5, 6 and 7. A CRP value of 132 mg/l on postoperative day 5 had an AUC of 0.75, corresponding to a sensitivity of 70%, a specificity of 76.6%, a positive predictive value of 16.3% and a negative predictive value of 97.5%. Multivariable analysis found that a CRP of > 132 mg/l on postoperative day 5 was the only statistically significant patient factor that was linked to an increased risk of AL (HR = 8.023, 95% CI: 1.936-33.238, P = 0.004). Conclusion: Early detection of AL may minimize postoperative complications. CRP is a useful negative predictive test for the development of AL following anterior resection.
Language	English
Publishing date	2017-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.13649
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