ANNUAL REVIEW 2004 - St Vincent's University Hospital

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Department of Endocrinology and Diabetes Mellitus operation of the Radiology Department and the Endocrine Laboratory, investigation of hypoglycaemia, and particularly the search for insulin-secreting pancreatic tumours, has been developed. This essentially involves arterial catherisation of blood vessels feeding the various sections of the pancreas with infusion of calcium and simultaneous sampling of blood from the portal venous system insulin secreting tumours too small for detection by conventional imaging may be localised when calcium stimulates the insulinoma to secrete insulin. This investigation has attracted national attention. The Endocrine Laboratory experienced an overall 9% growth rate. The Endocrine Laboratory continues to provide HbA1c measurement for diabetes patients, in addition to a full array of steroid and glycoprotein measurements. Research Projects 1. Control of Adrenal Steroidogenesis: (Ms Sinead Kelly) Sinead Kelly is currently investigating the role of these orphan nuclear receptors and their co-activator proteins in regulating key steroidogenic enzymes and subsequent production of cortisol and adrenal androgens. 2. Characterisation of Macroprolactin: (Ms Lucille Kavanagh) (a) Findings suggest an autoimmune susceptibility in macroprolactinaemic patients. (b) The much reduced bioactivity apparent in vivo may be due to nonbioavailability rather than intrinsic inactivity of prolactin in macroprolactin. 3. Androgen-secreting Tumours: (Dr D Smith) The importance of the findings in this study is that it supports the policy of restricting comprehensive evaluation of patients presenting with signs of androgen excess to a relatively small percentage of patients with a high likelihood of identifying a disorder other than polycystic ovary syndrome. 4. Bone Disease:Thyroid Disorders: (Dr D Smith, Ms Barbara Murray, Metabolic Laboratory) The usefulness of indices developed in the Metabolic Laboratory for the assessment of bone turnover and bone remodelling balance have also been assessed and applied to patients with Paget’s Disease, hyperparathyroidism and eating disorders. 5. Bone Biomarkers in the Assessment of Breast Cancer Patients: (Dr J Gibney, Ms Barbara Murray, Metabolic Laboratory, Dr D Smith) Over 100 patients have entered in a study, whereby the sensitivity of bone biomarkers for the detection of bone metastases in breast cancer patients with normal bone scan is ongoing. This study will take several years to yield a result. 6. Thyroid Eye Disease: (Dr T Cawood) Dr Cawood will examine the inflammatory cytokines that mediate the early stages of this condition in the hope that more targeted treatments can be developed to interrupt the process. 7. Diabetes Clinical trials are currently being conducted to assess the efficacy of newly introduced long-acting anologue insulins which have reported the value in reducing the frequency of hypoglycaemia, particularly through the night, reduced weight gain, improved metabolic control with more reproducible glycaemic profiles. A study is also ongoing to assess the impact of analogue insulin in combination with fish oils, or fish oils alone or neither treatment in-patients with mild diabetes and evidence of vascular risk. Achievements and Distinctions Professor T J McKenna is President of the Royal College of Physicians of Ireland. Professor McKenna is a member of The National Taskforce on Medical Manpower and a member of its Medical Education and Training Group. He is also on the Editorial Boards for the journals, Clinical Endocrinology (Oxford) and The Endocrinologist (U.S.). He is a member of the Students Affairs Committee of the Endocrine Society (U.S.). Professor McKenna was invited assessor of quality for the Department of Medicine, University College Galway. Dr Donal O’Shea is a member of the Eastern Regional Health Authority Diabetes Review Committee. Dr O’Shea is Secretary of The Irish Endocrine Society. He is also a member of the National Taskforce on Obesity and Chairman of the Detection and Treatment Subgroup. Dr O’Shea is Chairman of the Nutrition Council of the Irish Heart Foundation and Chairman of the St Vincent’s Healthcare Group Drugs and Therapeutics Committee. He received an under-graduate-nominated Premier Award for Teaching Excellence from the Faculty of Medicine, UCD. Dr Tom Smith is Chairman of the Association of Clinical Biochemists, Republic of Ireland Region. Dr James Gibney was appointed Consultant Endocrinologist, Adelaide & Meath Hospital incorporating the National Childrens Hospital,Tallaght. Ms Maire Culliton was appointed Chief Medical Scientist, National Maternity Hospital, Holles Street. Martina Cassidy was awarded MSc in Biomedical Science by the University of Ulster, Coleraine, Co Derry. Sinead Kelly submitted a Thesis entitled "Transcriptional regulation of key steroidogenic enzymes in the human adrenal gland" for consideration for the PhD degree to The Department of Pharmacology, UCD. Tom Cawood was awarded the Ritchie Research Scholarship by the Royal 116 St Vincent’s Healthcare Group
Collegeof Physicians and Surgeons of Glasgow to study "The roles of new therapies for thyroid eye disease". Dr Abdulwahab Suliman received the Irish Journal of Medical Science Doctor Award for excellence in Clinical Research for the best paper published in the field of Endocrinology during 2003. The paper was entitled "Frequent misdiagnosis and mismanagement of hyperprolactinemic patients before the introduction of macroprolactin screening: Application of a new strict laboratory definition of macroprolactinemia". Suliman AM, Smith TP, Gibney J and McKenna TJ. Clin. Chem. 2003; 49(9) 1504-9. (The research reported was undertaken when Dr Suliman was Lecturer in Medicine, U.C.D., attached to this department). Conferences/Courses/Meetings Attended DPC Immulite Training Course, Wales: 2nd- 4th March 2004. Tosoh HPLC Training Course, Brussels: 10th March 2004. The 23rd Joint Meeting of British Endocrine Societies, Brighton, England: 22nd-24th March 2004. Association of Physicians of Great Britain and Ireland,Trinity College Dublin: 25th-26th March 2004. Diabetes Federation of Ireland Study Day for Health Professionals: Dublin 26th March 2004. American College of Physicians Annual Meeting: New Orleans, 22nd - 25th April 2004. Designing and Conducting an Audit for Clinical Practice: Monaghan, 7th May 2004; Run by Professional Development Centre Irish Nurses Organisation The Irish Endocrine Society/British Thyroid Association Study Day: Dublin, 13th-14th May 2004. Public Health Nurses Education Day: Vergemount Hospital, Dublin, 10th June 2004. Diabetes Federation of Ireland Kids Camp:Tain Adventure Centre, Co Louth, 16th-18th July 2004. 12th International Conference on Intelligent Systems for Molecular Biology (ISMB 2004) and 3rd European Conference on Computational Biology (ECCB 2004); 31st July - 4th August 2004, Glasgow, Scotland. The 12th International Congress of Endocrinology: Lisbon, 31st August – 4th September 2004. Professor T J McKenna - Invited speaker: Meet-the-Professor: "Polycystic ovary syndrome". Medisense Annual Diabetes Meeting: Kildare, 17th September 2004. Diabetes Nurse Specialists Association A.G.M.: Cavan, 7th - 8th October 2004. Irish External Quality Assurance Conference: Dublin: 14th October 2004 Mater Misericordiae Hospital, Dublin Annual Study on Contemporary Issues: 14th October 2004. Professor T J McKenna - Invited speaker: "The impact on training of the European Working Time Directive". Medical Representative Institute of Ireland Education Evening: St Vincent’s University Hospital, Dublin, 2nd November 2004. Immulite 2000 Users Group Meeting: Kilkenny, 4th - 5th November 2004 Irish Endocrine Society 29th Annual Meeting: Malahide, Dublin, 5th - 6th November ‘04 Group Facilitation (Irish Management Institute): Dublin, 10th November 2004. European Federation of Endocrine Societies: Postgraduate Course in Clinical Endocrinology, Sitges, Spain: 11 - 13th November 2004; Professor T J McKenna, invited speaker "Macroprolactin". Academy of Medical Laboratory Science Conference: Killarney, Co Kerry: 12 th November 2004 National Diabetes Awareness Day: Dublin, 14th November 2004. Nutrition and Dietetic Institute of Ireland Meeting: Dublin, 19th November 2004. Publications Suliman AM, Freaney R, McBrinn Y, Gibney J, Murray B, Smith TP, McKenna TJ. Insulin-Induced Hypoglycemia Suppresses Plasma Parathyroid Hormone Levels in Patients with Adrenal Insufficiency. Metabolism 2004 53: 1251-1254. Kelly SN, McKenna TJ,Young LS. Modulation of steroidogenic enzymes by orphan nuclear transcriptional regulation may control diverse production of cortisol and androgens in the human adrenal. J Endocrinol.;181:355-65. O’Connell J, Green A, Crotty T, O’Shea D, McKenna TJ. Li-Fraumeni Syndrome with Adrenocortical Tumors Producing Estrogens in a Young Man and Testosterone in his 18 Month-Old Daughter. Endocrinologist 2004; 14:133-137. Cawood TJ, O’Shea D. et al. Update on insulin analogues. Drug Ther. Bull. 2004; 42:77-80. Cawood TJ, Moriarty P, O’Shea D. Recent developments in thyroid eye disease. British Medical Journal 2004; 329:385-90. Departmental Review 117
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Annual Review St. Vincent’s Healt
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Dr. Risteárd Ó Laoide Professor M
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Governance I should report that the
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Group Executive Executive Review Ni
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Minor capital equipment grants tota
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DEPARTMENT 2002 2003 2004 GENERAL M
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DEPARTMENT 2002 2003 2004 PAIN RELI
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St. Michael’s Hospital
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Organisation Structure St. Michael
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ANNUAL REVIEW 2004 - St Vincent's University Hospital

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