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Papers by David Waldron

Research paper thumbnail of Strategic Leadership towards Sustainability

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Research paper thumbnail of Fulminant small bowel enteritis: A rare complication of Clostridium difficile‐associated disease

Inflammatory Bowel Diseases, Jun 1, 2009

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Research paper thumbnail of The solution to a big hole: dermal collagen graft

Irish Journal of Medical Science, Mar 1, 2005

... Large incisional hernias are a common complication of abdominal surgery and can be very diffi... more ... Large incisional hernias are a common complication of abdominal surgery and can be very difficult to manage. ... S Tawfik, A Fahy, N Hynes, B Mahendran, A Lowery, J Asad, E Andrews, A !shtiaq, S Sultan Western Vascular Institute, Dept. ...

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Research paper thumbnail of Structured Comprehension For Systems Thinking, Learning And Leadership Towards Sustainability

The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's pro... more The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's programme focusing on sustainable development in September 2004. The programme is intended to contribute to a growing international network of sustainability practitioners, including early and mid-...

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Research paper thumbnail of Respiratory Syncytial Virus Preterm (32-36 Completed Weeks Gestation) Risk Estimation Measure for RSV Hospitalization in Ireland: A Prospective Study

The Pediatric infectious disease journal, Jan 16, 2015

In several countries RSV prophylaxis is offered to late preterm infants who are at escalated risk... more In several countries RSV prophylaxis is offered to late preterm infants who are at escalated risk of respiratory syncytial virus hospitalization (RSVH). However, targeted prophylaxis should be informed by country specific data. This study, which uniquely includes 36 weeks gestational age (GA) infants, aims to establish the risk factors for RSVH in 32-36 weeks GA infants in Ireland. A 13 hospital prospective observational study of laboratory confirmed RSVH in non-prophylaxed 32-36 weeks GA infants was conducted from July 2011- February 2014. Baseline and first year clinical data were analyzed using IBM SPSSV22. Significant (P<0.05) variables were entered into multiple logistic regression to determine independent risk factors for RSVH. Sixty-three percent of eligible infants (1,825/2,877) were recruited. The RSVH rate was 3.6 % (65/1807 analyzed infant records).There was no RSV attributable mortality. Twelve infants required intensive care. Of fifteen variables correlating to RSVH,...

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Research paper thumbnail of What Services Are Being Offered by Whom?

Alcoholism Treatment Quarterly, 1997

A survey of how services are being provided was completed with 91 substance abuse programs in 30 ... more A survey of how services are being provided was completed with 91 substance abuse programs in 30 New Mexico communities. Dominant program philosophies were divided about evenly among disease model, cognitive-behavioral, twelve-step, and other approaches, although eclecticism was evident in the range of views endorsed by individual programs. With the exception of detoxification, services were primarily offered on an outpatient

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Research paper thumbnail of Laparoscopic-assisted sigmoid colectomy for diverticular colovesical fistula

The American surgeon, 2013

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Research paper thumbnail of Metastatic breast cancer presenting as a gallstone ileus

Journal of surgical case reports, 2013

Metastatic breast cancer to the small bowel (SB) presenting as gallstone ileus and resulting in S... more Metastatic breast cancer to the small bowel (SB) presenting as gallstone ileus and resulting in SB obstruction has not been described previously. A 76-year-old woman with previous metastatic breast cancer to the axial spine and hips presented with abdominal pain and bilious vomiting. CT scanning revealed SB obstruction consistent with gallstone ileus. The patient underwent two segmental SB resections for distal ileal strictures mimicking what appeared to be macroscopic Crohn's disease. The entero-biliary fistula was undisturbed. Pathological analysis revealed the dual pathologies of gallstone ileus and metastatic carcinoma from a breast primary causing luminal SB obstruction. Improvements in staging and treatment modalities have contributed to the increased overall long-term survival for breast cancer, compelling clinicians to consider metastatic breast cancer as a differential diagnosis in women presenting with new onset of gastrointestinal symptoms in order that appropriate tr...

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Research paper thumbnail of Emergency presenting colon cancer is an independent predictor of adverse disease-free survival

International surgery, 2015

Twenty percent of colon cancers present as an emergency. However, the association between emergen... more Twenty percent of colon cancers present as an emergency. However, the association between emergency presentation and disease-free survival (DFS) remains uncertain. Consecutive patients who underwent elective (CC) and emergent (eCC) resection for colon cancer were included in the analysis. Survival outcomes were compared between the 2 groups in univariate/multivariate analyses. A total of 439 patients underwent colonic resection for colon cancer during the interval 2000-2010; 97 (22.1%) presented as an emergency. eCC tumors were more often located at the splenic flexure (P = 0.017) and descending colon (P = 0.004). The eCC group displayed features of more advanced disease with a higher proportion of T4 (P = 0.009), N2 tumors (P < 0.01) and lymphovascular invasion (P< 0.01). eCC was associated with adverse locoregional recurrence (P = 0.02) and adverse DFS (P < 0.01 ) on univariate analysis. eCC remained an independent predictor of adverse locoregional recurrence (HR 1.86, 95...

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Research paper thumbnail of Strategic leadership towards sustainability

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Research paper thumbnail of Experience with Porcine Acellular Dermal Collagen Implant in One-stage Tension-free Reconstruction of Acute and Chronic Abdominal Wall Defects

World Journal of Surgery, 2007

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Research paper thumbnail of Atypical midcycle pain

The American Journal of Surgery, 2009

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Research paper thumbnail of Vertical rectus abdominis myocutaneous flap and quality of life following abdominoperineal excision for rectal cancer: a multi-institutional study

Techniques in Coloproctology, 2014

To obtain a clear surgical margin, abdominoperineal excision (APE) for rectal cancer frequently l... more To obtain a clear surgical margin, abdominoperineal excision (APE) for rectal cancer frequently leaves a large perineal defect surrounded by irradiated tissue. A vertical rectus abdominis myocutaneous (VRAM) flap may facilitate healing of this wound. The current study aims to determine the effect of VRAM flap perineal reconstruction following APE on patient quality of life (QOL). This is a retrospective cohort study from a prospectively collected database. Data on QOL were assessed via telephone questionnaire using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30, EORTC QLQ-C29 and the Cleveland Clinic QOL questionnaires. Twenty-seven patients underwent primary perineal closure, and 12 patients underwent a VRAM flap perineal reconstruction. The mean duration of follow-up was 16.8 months. Overall, there was no significant difference in the Cleveland Clinic QOL score between groups (VRAM vs. no VRAM: 0.7 ± 0.2 vs. 0.7 ± 0.2, p 0.735). Patients in the VRAM group had lower levels of fatigue (5.5 ± 9.9 vs. 23.6 ± 19.2, p 0.004). Patients in the VRAM group had reduced sore skin scores around the stoma site (11.0 ± 16.2 vs. 31.8 ± 31.1, p 0.036). VRAM flap was associated with an increased incidence of abdominal wall hernia (VRAM vs. no VRAM: 25 % vs. 0 %, p 0.024). This study is limited by its non-randomized retrospective design and relatively small sample size. A significant difference in patient QOL was not demonstrated between VRAM flap and primary perineal closure after APE for rectal cancer. Further studies in this area are warranted.

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Research paper thumbnail of Fulminant small bowel enteritis: A rare complication of Clostridium difficile-associated disease

Inflammatory Bowel Diseases, 2009

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Research paper thumbnail of Prolonged ambulant assessment of anorectal function in patients with prolapsing hemorrhoids

Diseases of the Colon & Rectum, 1989

Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pres... more Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pressure and external sphincter electromyography performed over a prolonged period under ambulant conditions. Patients with prolapsing hemorrhoids demonstrated greater degrees of sampling responses, 12.9 +/- 1.9/hour, vs. 7.4 +/- 2.0/hour (mean +/- SEM) in controls (P less than .05). Ultraslow wave and giant ultraslow wave activity were seen frequently in the patient group occupying more than 30 percent of recording. The external sphincter demonstrated much greater electrical activity (spike potentials) in patients with hemorrhoids than in controls both by day, 24.9 +/- 11.0/10 min vs. 12.8 +/- 3.2/10 min (P less than .02), and by night, 7.4 +/- 2.6 min vs. 1.6 +/- 1.3/10 min (P less than .03). Sleep electrical activity in the presence of hemorrhoids did not differ significantly from that of controls during waking, 7.4 +/- 2.6/10 min vs. 12.8 +/- 3.2/10 min (P less than .1). No difference in phasic and periodic rectal motor activity was noted between patient and control groups. This demonstrates the application of prolonged assessment of anorectal motility and external sphincter activity in a patient group. Abnormalities previously documented in patients with hemorrhoids using conventional manometric tests were confirmed. In addition, evidence of increased external sphincter function during waking and sleep may have implications in the pathophysiology of this disorder.

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Research paper thumbnail of Pressure response of human colon to intraluminal distension

Digestive Diseases and Sciences, 1989

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Research paper thumbnail of Small bowel obstruction secondary to migration of a fragment of lithobezoar: a case report

Cases Journal, 2009

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Research paper thumbnail of Rectum-conserving surgery in the era of chemoradiotherapy

British Journal of Surgery, 2010

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Research paper thumbnail of Structured comprehension for systems thinking, learning and leadership towards sustainability

… (EMSU). Tecnológico de …, 2004

The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's pro... more The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's programme focusing on sustainable development in September 2004. The programme is intended to contribute to a growing international network of sustainability practitioners, including early and mid-...

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Research paper thumbnail of Early quality of life outcomes following Doppler guided transanal haemorrhoidal dearterialisation: a prospective observational study

Acta gastro-enterologica Belgica, 2013

There are few studies examining the quality of life (QOL) of patients with haemorrhoidal disease.... more There are few studies examining the quality of life (QOL) of patients with haemorrhoidal disease. Transanal heamorrhoidal dearterialization (THD) is a treatment modality for heamorrhoidal disease in which a Doppler transducer is used to locate the supplying arteries that are subsequently ligated. The aim of this study was to assess symptoms and QOL changes following THD. This was a prospective evaluation of QOL and symptom changes following THD. Patient symptoms, demographics and QOL were recorded preoperatively and 1-month post-operatively following THD using the medical outcomes study short-form-36 (SF-36). Thirteen patients undergoing THD were evaluated. One month following THD symptoms of haemorrhoid protrusion, bleeding, anal pain, painful defaecation, constipation and tenesmus, had all significantly reduced (P <0.05). Limitations in usual role activities because of physical health problems (53.8 +/- 10.5 Vs 90.4 +/-4.5, P = 0.004), vitality, energy and fatigue (45 +/- 6.9 V...

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Research paper thumbnail of Strategic Leadership towards Sustainability

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Fulminant small bowel enteritis: A rare complication of Clostridium difficile‐associated disease

Inflammatory Bowel Diseases, Jun 1, 2009

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The solution to a big hole: dermal collagen graft

Irish Journal of Medical Science, Mar 1, 2005

... Large incisional hernias are a common complication of abdominal surgery and can be very diffi... more ... Large incisional hernias are a common complication of abdominal surgery and can be very difficult to manage. ... S Tawfik, A Fahy, N Hynes, B Mahendran, A Lowery, J Asad, E Andrews, A !shtiaq, S Sultan Western Vascular Institute, Dept. ...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Structured Comprehension For Systems Thinking, Learning And Leadership Towards Sustainability

The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's pro... more The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's programme focusing on sustainable development in September 2004. The programme is intended to contribute to a growing international network of sustainability practitioners, including early and mid-...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Respiratory Syncytial Virus Preterm (32-36 Completed Weeks Gestation) Risk Estimation Measure for RSV Hospitalization in Ireland: A Prospective Study

The Pediatric infectious disease journal, Jan 16, 2015

In several countries RSV prophylaxis is offered to late preterm infants who are at escalated risk... more In several countries RSV prophylaxis is offered to late preterm infants who are at escalated risk of respiratory syncytial virus hospitalization (RSVH). However, targeted prophylaxis should be informed by country specific data. This study, which uniquely includes 36 weeks gestational age (GA) infants, aims to establish the risk factors for RSVH in 32-36 weeks GA infants in Ireland. A 13 hospital prospective observational study of laboratory confirmed RSVH in non-prophylaxed 32-36 weeks GA infants was conducted from July 2011- February 2014. Baseline and first year clinical data were analyzed using IBM SPSSV22. Significant (P<0.05) variables were entered into multiple logistic regression to determine independent risk factors for RSVH. Sixty-three percent of eligible infants (1,825/2,877) were recruited. The RSVH rate was 3.6 % (65/1807 analyzed infant records).There was no RSV attributable mortality. Twelve infants required intensive care. Of fifteen variables correlating to RSVH,...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of What Services Are Being Offered by Whom?

Alcoholism Treatment Quarterly, 1997

A survey of how services are being provided was completed with 91 substance abuse programs in 30 ... more A survey of how services are being provided was completed with 91 substance abuse programs in 30 New Mexico communities. Dominant program philosophies were divided about evenly among disease model, cognitive-behavioral, twelve-step, and other approaches, although eclecticism was evident in the range of views endorsed by individual programs. With the exception of detoxification, services were primarily offered on an outpatient

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Laparoscopic-assisted sigmoid colectomy for diverticular colovesical fistula

The American surgeon, 2013

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Research paper thumbnail of Metastatic breast cancer presenting as a gallstone ileus

Journal of surgical case reports, 2013

Metastatic breast cancer to the small bowel (SB) presenting as gallstone ileus and resulting in S... more Metastatic breast cancer to the small bowel (SB) presenting as gallstone ileus and resulting in SB obstruction has not been described previously. A 76-year-old woman with previous metastatic breast cancer to the axial spine and hips presented with abdominal pain and bilious vomiting. CT scanning revealed SB obstruction consistent with gallstone ileus. The patient underwent two segmental SB resections for distal ileal strictures mimicking what appeared to be macroscopic Crohn's disease. The entero-biliary fistula was undisturbed. Pathological analysis revealed the dual pathologies of gallstone ileus and metastatic carcinoma from a breast primary causing luminal SB obstruction. Improvements in staging and treatment modalities have contributed to the increased overall long-term survival for breast cancer, compelling clinicians to consider metastatic breast cancer as a differential diagnosis in women presenting with new onset of gastrointestinal symptoms in order that appropriate tr...

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Research paper thumbnail of Emergency presenting colon cancer is an independent predictor of adverse disease-free survival

International surgery, 2015

Twenty percent of colon cancers present as an emergency. However, the association between emergen... more Twenty percent of colon cancers present as an emergency. However, the association between emergency presentation and disease-free survival (DFS) remains uncertain. Consecutive patients who underwent elective (CC) and emergent (eCC) resection for colon cancer were included in the analysis. Survival outcomes were compared between the 2 groups in univariate/multivariate analyses. A total of 439 patients underwent colonic resection for colon cancer during the interval 2000-2010; 97 (22.1%) presented as an emergency. eCC tumors were more often located at the splenic flexure (P = 0.017) and descending colon (P = 0.004). The eCC group displayed features of more advanced disease with a higher proportion of T4 (P = 0.009), N2 tumors (P < 0.01) and lymphovascular invasion (P< 0.01). eCC was associated with adverse locoregional recurrence (P = 0.02) and adverse DFS (P < 0.01 ) on univariate analysis. eCC remained an independent predictor of adverse locoregional recurrence (HR 1.86, 95...

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Research paper thumbnail of Strategic leadership towards sustainability

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Experience with Porcine Acellular Dermal Collagen Implant in One-stage Tension-free Reconstruction of Acute and Chronic Abdominal Wall Defects

World Journal of Surgery, 2007

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Atypical midcycle pain

The American Journal of Surgery, 2009

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Vertical rectus abdominis myocutaneous flap and quality of life following abdominoperineal excision for rectal cancer: a multi-institutional study

Techniques in Coloproctology, 2014

To obtain a clear surgical margin, abdominoperineal excision (APE) for rectal cancer frequently l... more To obtain a clear surgical margin, abdominoperineal excision (APE) for rectal cancer frequently leaves a large perineal defect surrounded by irradiated tissue. A vertical rectus abdominis myocutaneous (VRAM) flap may facilitate healing of this wound. The current study aims to determine the effect of VRAM flap perineal reconstruction following APE on patient quality of life (QOL). This is a retrospective cohort study from a prospectively collected database. Data on QOL were assessed via telephone questionnaire using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30, EORTC QLQ-C29 and the Cleveland Clinic QOL questionnaires. Twenty-seven patients underwent primary perineal closure, and 12 patients underwent a VRAM flap perineal reconstruction. The mean duration of follow-up was 16.8 months. Overall, there was no significant difference in the Cleveland Clinic QOL score between groups (VRAM vs. no VRAM: 0.7 ± 0.2 vs. 0.7 ± 0.2, p 0.735). Patients in the VRAM group had lower levels of fatigue (5.5 ± 9.9 vs. 23.6 ± 19.2, p 0.004). Patients in the VRAM group had reduced sore skin scores around the stoma site (11.0 ± 16.2 vs. 31.8 ± 31.1, p 0.036). VRAM flap was associated with an increased incidence of abdominal wall hernia (VRAM vs. no VRAM: 25 % vs. 0 %, p 0.024). This study is limited by its non-randomized retrospective design and relatively small sample size. A significant difference in patient QOL was not demonstrated between VRAM flap and primary perineal closure after APE for rectal cancer. Further studies in this area are warranted.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Fulminant small bowel enteritis: A rare complication of Clostridium difficile-associated disease

Inflammatory Bowel Diseases, 2009

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Prolonged ambulant assessment of anorectal function in patients with prolapsing hemorrhoids

Diseases of the Colon & Rectum, 1989

Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pres... more Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pressure and external sphincter electromyography performed over a prolonged period under ambulant conditions. Patients with prolapsing hemorrhoids demonstrated greater degrees of sampling responses, 12.9 +/- 1.9/hour, vs. 7.4 +/- 2.0/hour (mean +/- SEM) in controls (P less than .05). Ultraslow wave and giant ultraslow wave activity were seen frequently in the patient group occupying more than 30 percent of recording. The external sphincter demonstrated much greater electrical activity (spike potentials) in patients with hemorrhoids than in controls both by day, 24.9 +/- 11.0/10 min vs. 12.8 +/- 3.2/10 min (P less than .02), and by night, 7.4 +/- 2.6 min vs. 1.6 +/- 1.3/10 min (P less than .03). Sleep electrical activity in the presence of hemorrhoids did not differ significantly from that of controls during waking, 7.4 +/- 2.6/10 min vs. 12.8 +/- 3.2/10 min (P less than .1). No difference in phasic and periodic rectal motor activity was noted between patient and control groups. This demonstrates the application of prolonged assessment of anorectal motility and external sphincter activity in a patient group. Abnormalities previously documented in patients with hemorrhoids using conventional manometric tests were confirmed. In addition, evidence of increased external sphincter function during waking and sleep may have implications in the pathophysiology of this disorder.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Pressure response of human colon to intraluminal distension

Digestive Diseases and Sciences, 1989

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Small bowel obstruction secondary to migration of a fragment of lithobezoar: a case report

Cases Journal, 2009

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Rectum-conserving surgery in the era of chemoradiotherapy

British Journal of Surgery, 2010

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Structured comprehension for systems thinking, learning and leadership towards sustainability

… (EMSU). Tecnológico de …, 2004

The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's pro... more The Blekinge Institute of Technology (BTH) Karlskrona, Sweden, will begin a new Master's programme focusing on sustainable development in September 2004. The programme is intended to contribute to a growing international network of sustainability practitioners, including early and mid-...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early quality of life outcomes following Doppler guided transanal haemorrhoidal dearterialisation: a prospective observational study

Acta gastro-enterologica Belgica, 2013

There are few studies examining the quality of life (QOL) of patients with haemorrhoidal disease.... more There are few studies examining the quality of life (QOL) of patients with haemorrhoidal disease. Transanal heamorrhoidal dearterialization (THD) is a treatment modality for heamorrhoidal disease in which a Doppler transducer is used to locate the supplying arteries that are subsequently ligated. The aim of this study was to assess symptoms and QOL changes following THD. This was a prospective evaluation of QOL and symptom changes following THD. Patient symptoms, demographics and QOL were recorded preoperatively and 1-month post-operatively following THD using the medical outcomes study short-form-36 (SF-36). Thirteen patients undergoing THD were evaluated. One month following THD symptoms of haemorrhoid protrusion, bleeding, anal pain, painful defaecation, constipation and tenesmus, had all significantly reduced (P <0.05). Limitations in usual role activities because of physical health problems (53.8 +/- 10.5 Vs 90.4 +/-4.5, P = 0.004), vitality, energy and fatigue (45 +/- 6.9 V...

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