The Tallaght University Hospital (Irish: Ospidéal Ollscoile Thamhlachta) is a teaching hospital in County Dublin, Ireland. Its academic partner is the Trinity College Dublin. It is managed by Dublin Midlands Hospital Group.
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased risk of stroke and mortality. Effective management requires both patient engagement and clear understanding of treatment goals yet evidence suggests persistent gaps in knowledge and involvement in care. Pharmacists are increasingly involved in AF clinics, yet little is known about how patients perceive their role, particularly in the context of potential pharmacist prescribing. To explore patients’ perspectives on the management of AF and the role of pharmacists in an Irish outpatient AF clinic, including attitudes toward potential pharmacist prescribing. A qualitative study was conducted using 15 one-to-one semi-structured interviews with adults aged ≥ 65 years attending a specialist AF clinic at Tallaght University Hospital, Dublin, Ireland. Interviews took place between March and May 2025. Participants were purposively sampled to capture a range of clinical and demographic characteristics. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke’s six-step reflexive thematic analysis. An inductive approach was adopted. Coding and theme development were conducted iteratively, with a subset of transcripts independently reviewed by supervisors to enhance analytical rigour and consistency. Five overarching themes were identified relating to understanding of AF, pharmacotherapy, satisfaction with care, perceptions of the pharmacist’s role, and views on pharmacist prescribing. Participants demonstrated variable understanding of AF, with limited awareness of stroke risk despite consistent recognition of anticoagulant therapy. Knowledge of anticoagulant safety, particularly bleeding risk, was strong and well retained, whereas understanding of rate-control medicines was limited. Satisfaction with care was high; however, most participants adopted a passive role in decision-making, expressing trust in healthcare professionals. Pharmacists were frequently misidentified as doctors or nurses, reflecting limited role visibility. Once recognised, pharmacist input, particularly in anticoagulant counselling and medication advice, was highly valued. Views on pharmacist prescribing were mixed: while participants acknowledged pharmacists’ expertise in medicines, many preferred doctors to retain prescribing responsibility due to established trust. While patients spoke positively about pharmacists’ input, many struggled to identify the pharmacist within the clinic and were unclear about the scope of their role. Gaps in understanding of stroke risk and broader treatment goals highlight the need for structured patient education. As Ireland considers expanding pharmacist prescribing beyond the current common conditions scheme in community pharmacy, strengthening patient education and fostering trust will be essential to optimise pharmacist-led AF services.
Older adults represent an increasingly significant proportion of Emergency Department (ED) attendances in Ireland, often presenting with complex geriatric syndromes including frailty, cognitive impairment, and multi-morbidity. Tallaght University Hospital (TUH) introduced the Gerontological Emergency Department Intervention (GEDI) team in 2018 to address the needs of this vulnerable cohort through comprehensive geriatric assessment (CGA). To characterise the demographics, clinical features, and outcomes of older patients assessed by the GEDI team in TUH ED over a five-year period, and to identify factors independently associated with hospital admission. A retrospective observational study was conducted using routinely collected data on all patients assessed by the GEDI team from January 1, 2020 to December 31, 2024. Patient demographics, presenting complaints, CGA components (Rockwood Frailty Score, Barthel Index, 4AT, Mini Nutritional Assessment, SARC-F), ED length of stay, and disposition outcomes were analysed. Multivariate logistic regression identified independent predictors of hospital admission. Over the study period, 11,256 ED presentations pertaining to 7,055 older patients were assessed by the GEDI team. The mean age was 81.1 years (SD 6.6); 55
The RSNA Lumbar Degenerative Imaging Spine Classification dataset is the largest publicly available adult MRI lumbar spine dataset for degenerative disease. The dataset includes multisequence, multiplanar MRIs from 2,697 patients through contributions from 8 institutions across 6 countries and 5 continents. ©RSNA, 2026.
BACKGROUND:Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments. METHODS:The ARIA-EAACI 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs. RESULTS:Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication. They also discuss the role of oral antihistamines (OAH), leukotriene receptor antagonists (LTRA), ocular antihistamines (OcAH) and ocular mast cell stabilisers. Four questions had not been previously evaluated in ARIA guidelines, while, for the other four, there was a change in the strength or directionality of the recommendations. Overall, these guidelines recommend using intranasal corticosteroids over OAH and using OAH over LTRA. Moreover, they suggest using OAH over OcAH and suggest being against adding LTRA to OAH. Finally, considerations for choosing between different individual OAHs are presented. CONCLUSION:This ARIA-EAACI 2024-2025 article supports patients, their caregivers and healthcare professionals in choosing oral and ocular treatments for AR. Decisions on treatment should consider the clinical variability of the disease, patients' values and the affordability of medications.
Background: Oligometastatic bladder cancer (OMBC) is increasingly recognised as an intermediate state between localised and widespread metastatic disease, although its definition and optimal management remain uncertain. Patients with OMBC have a generally more favourable prognosis compared to patients with metastatic disease. However, its definition, diagnostic criteria, and optimal management remain poorly standardised. Methods: This narrative review summarises current evidence on the definitions, diagnostic approaches, and treatment strategies for OMBC, with an emphasis on emerging biological and molecular insights that may refine disease classification and guide therapy. Results: Existing definitions of OMBC rely on lesion count and anatomical distribution, overlooking molecular and clinicopathological heterogeneity that influences prognosis and treatment response. Advances in Positron Emission Tomography (PET)/Computed Tomography (CT) and magnetic resonance imaging (MRI) have improved detection of small-volume disease, while liquid biopsy and circulating tumour DNA show promise for assessing micrometastatic burden. Therapeutic approaches, including metastasis-directed and consolidative therapies, are under investigation. Nonetheless, most data are derived from small, retrospective series, and evidence from prospective studies remains limited. Conclusions: Prospective, biomarker-integrated, and randomised trials are essential to refine definitions, optimise patient selection for therapy, and define the role of precision-based multimodal therapy in OMBC management.
