IntroductionAlthough PSA (prostate specific antigen) based screening for prostate cancer (PCa) is controversial, an increasing number of men are undergoing Transrectal Ultrasound Guided prostate biopsy (TRUSPB) through primary care-based PSA testing and referral to hospitals. The aim of our study was to investigate presenting risk profiles of PCa over the last decade in a cohort of men in Ireland and to examine any change in the same over this time period.Material and methodsThe hospital patient administration system was analysed for patients who underwent TRUSPB from January 2005 to December 2015. Clinically significant PCa was defined as Gleason score of 7 or above.ResultsComplete data was available on 2391 TRUSPB patients: number of biopsies increased by 53%, median age decreased by 0.9%, median PSA decreased by 6% (p = 0.001, ANOVA) and abnormal DRE increased by 9% (p = 0.001, chi square). Overall positive biopsy was 44% and significant cancer rate was 21%. There was a significant change in trend of detection (p = 0.02) with average annual increase in significant cancer of 3%. The median age of the significant cancer cohort reduced by 1% and the PSA at diagnosis reduced by 9%. In younger men (<50 years), the rate of significant cancer detection increased by 18%.ConclusionsSignificant PCa detection increased across all age groups but recently, a younger patient profile was diagnosed with high-grade disease. This paves the way for future research on early-onset PCa. Younger patients with significant disease would result in increasing number of patients being eligible for radical treatment with implications on health resource planning and provision.

Background: Admission to an acute orthopaedic ward within 4 hours of presentation is one of the six blue book standards for the management of acute hip fractures. This is consistently amongst the poorest performing of the standards with a nationwide achievement rate of 14% in Ireland in 2016. Delays in the time-to-XR of these patients may contribute to this poor performance and impact on patient care. Methods: A retrospective review of all acute hip fractures presenting to the emergency department (ED) of University Hospital Limerick over a 3-month period was performed using local Irish hip fracture database (IHFD) and national integrated medical imaging service (NIMIS) data. The time-to-XR interval, time-to-XR request interval and time from XR request to completion of XR were all calculated. Results: Mean time-to-XR was 159 minutes (range, 35-808 minutes) with only 4 of the 59 cases included for analysis having had an XR within 1 hour of presentation to ED. Over half of cases (33/59) had a time-to-XR of more than 2 hours. Mean time-to-XR request (79 minutes) and mean time from XR request to completion (80 minutes) were similar. Admission to an orthopaedic ward within 4 hours occurred in only 9 of 59 cases, of which 7 had their XR performed in less than 2 hours from presentation. Conclusions: Time-to-XR in acute hip fractures is a measurable and modifiable factor in the pursuit of improved care for hip fracture patients and warrants further attention at a local and national level.