Anaesthesia, Intensive Care and Pain Medicine - St Vincent's ...

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Department of Metabolism St.Vincent’s Healthcare Group Department of Medical Oncology Departmental Review 108 compliance with Clinical Pathology Accreditation (CPA ) requirements. Representative Functions Barbara Murray is a member of the Executive Committee of Eurachem Ireland. Meetings attended by Department Personnel Roche 2nd Ireland User Group Forum Dublin,27th – 29th May 2003 Nutrition Society Meeting ( Optimal Nutrition for Osteoporosis Prevention ) Cork,18th – 20th June 2003 Irish Endocrine Society Armagh, 7th – 8th November 2003 Annual Conference of the Association of Clinical Biochemists Malahide, 14th – 15th November 2003 Publications Suliman AM, Freaney R,Smith TP, McBrinn Y, Murray B, McKenna TJ. The Impact of Different Glucocorticoid Replacement schedules on Bone Turnover and Insulin Sensitivity in Patients with Adrenal Insufficiency. Clin Endocrinol (Oxf) 2003 59(3): 380-87 Murphy E,Freaney R,Bresnihan B, McKenna M, Fitzgerald O. Increased Bone Resorption and Failure to Respond to Antiresorptive Therapy in Progressive Dystrophic Calcification. Calcif Tissue Int.2003 Nov;73(5) :433-40 Abstract Smith D, Murray B, Gibney J, McKenna TJ. Application of new Indices of Bone activity for evaluation of the response to treatment of Hyperthyroidism and Paget’s Disease. Ir. J.Med. Sci.2003;172(4):17 2003 was a highly successful period of growth for the Medical Oncology Department of St.Vincent’s Healthcare Group. As before, patient activities were concentrated in the St.Anne’s Ward complex.As is the case throughout the medical oncology world,increasing the focus of acute cancer therapeutics in the ambulatory setting,and the oncology day ward / outpatients area,continued to provide a high quality service, to increasing numbers of cancer patients. Research protocols resumed in the division in the Summer of 2003. The flagship clinical trials from the breast programme remained the BCIRG 006 and 007 studies,both of which neared the completion of their accrual during 2003.Both these studies are chaired/co-chaired by St.Vincent’s investigators. On the educational front,post-clinic teaching conferences are held approximately twice per week. Professor Crown was awarded the Thomas Baldwin Chair in Translational Cancer Research by Dublin City University, in recognition of an ongoing research affiliation between St. Vincent’s and that institution, which complements our existing relationships with University College Dublin.Research projects in drug resistance conducted by Dr. Michael O’Leary reached their completion during 2003. Ms Brigid Browne commenced work as a doctoral student in the area of HER-2 biology, jointly in DCU and UCLA.Professor Crown was elected to the Educational Committee of the American Society of Clinical Oncology. Meetings In 2003,Professor Crown lectured or presented at the Post San Antonio meeting for German Gynaecologists,Munich;the Miami Breast Cancer Conference;Anglo Celtic meetings,London, Sheffield & Leuven;Various Aventis Advisory Board Meetings; Herceptin meeting,Dublin;ESGO Congress,Brussels; Oncology Speakers Bureau,L.A.,New York and Chicago;ASCO, Chicago; ASCO Education Committee Meeting,Chicago;ECCO, Copenhagen;Austrian Society of Surgical Oncology meeting, Vienna;Third International Symposium on Translational Research,California;Breast Cancer Symposium,New Jersey; ICORG Strategy Meeting;Annual San Antonio Breast Cancer Symposium,December. Abstracts 2003 Crown J, Leyvraz S,Verrill M,Guillem V, Efremedis A, Garcia Conde-Bru J, Welsh R, Montes A,Leonard R,Baselga J. Superiority of Tandem High-Dose (HDC) Over Conventionally- Dosed Chemotherapy (CDC) in Patients (Pts) with Metastatic Breast Cancer (MBC):Updated Results of the International Randomised Breast Cancer Dose-Intensity Study (IBDIS).Ann Meet Am Soc Clin Onco 22:88,2003. Crown J, Leyvraz S,Verrill M,Guillem V, Efremedis A, Garcia- Conde-Bru J, Welsh R, Montes A,Leonard R,Baselga J. Superiority of Tandem High-Dose Over conventionally-dosed Chemotherapy in Patients with Metastatic Breast Cancer: Updated Results of the International Randomised Breast Cancer Dose-Intensity Study (IBDIS).Eur J Can Supp 1: 5,S134,2003. Donnellan P, Crown J, Hall W. HTLV seroprevalence in Irish populations is low.Ann Meet Am Soc Clin Onco 22: 3 5 5 1 ,2 0 0 3 . Publications 2003 O’Donovan N, Crown J,Stunell H, Hill AD, McDermott E, O’Higgins N,Duffy MJ. Caspase 3 in breast cancer. Clin Cancer Res.2003 Feb;9(2):738-42. Ballot J,McDonnell D, Crown J. Successful treatment of thrombocytopenia due to marrow metastases of breast cancer with weekly docetaxel. J Natl Cancer Inst.2003 Jun 4;95(11):831-2. Crown J, Pegram M. Platinum-taxane combinations in metastatic breast cancer: an evolving era of molecularly targeted therapy. Breast Cancer Res Treat.2003; 79 Suppl 1:S11-8.Review. Crown J. Chemotherapy dose and schedule in adjuvant treatment of breast cancer: phoenix,turkey or dodo? Lancet 2003 Aug 30; 362(9385):677-8. 109
St.Vincent’s Healthcare Group Department of Medicine for the Elderly Departmental Review 110 Departmental Statistics: 2001 2002 2003 Inpatients Admissions 426 425 317 Discharges 457 443 403 Outpatients New 261 280 277 Review 532 500 543 Carew Day Hospital New 404 420 523 Review 1402 1395 824 Stroke Service 194 255 Total Attendance New 665 700 800 Review 1934 1895 1622 In Patient Consultations In 2003 over 800 inpatient consultations were seen in St Vincent’s University Hospital by the Elderly Care team.Meetings are held weekly between Dr. O Shea,the elderly medicine registrars and the Medical Social Work Department to facilitate planning of discharge of those elderly patients on whom consultant colleagues have requested advice. Stroke Service Weekly meetings are held and chaired by Dr. Crowe. Representatives of the nursing,physiotherapy, occupational therapy, speech and language therapy and other medical departments attend. There are now 8 dedicated beds,on Our Lady’s Ward, for patients with stroke. Ms.Imelda Noone, Stroke Nurse Specialist,is involved in further development of this unit and the introduction of set guidelines and protocols. An active stroke follow-up programme is now up and running in Carew House Day Hospital. A once weekly dedicated TIA clinic was initiated in January 2003, to facilitate assessment and treatment of patients with TIA’s, thus avoiding hospital admission.All necessary investigations are performed at this clinic. To date 105 patients have been assessed. speech therapy posts have been filled we hope to be able to run this at the maximum capacity.The Day Hospital at the Royal in Donnybrook continues to provide outstanding care and outpatient rehabilitation services to those with multidisciplinary needs. The long established links with long-term care facilities continue to evolve through the dedicated work of Dr Mary Deane, Medical Director. Efforts to further enhance and strengthen these links are under discussion (with the C.E.O. in The Royal,Mr. Lindsay). Staffing Close liaison is maintained with St.Columcille’s Hospital, Department of Medicine for the Elderly under the direction of Dr. Morgan Crowe and with St Michael’s Hospital under the direction of Dr JJ Barry. Achievements / Conferences Attended The multidisciplinary team members at Carew House Day Hospital attended The Stroke Information Day, Annual Stroke Study Day,The Irish Gerontological Society Conference, Parkinson’s Association Meeting,National Council on Ageing and Older Peoples Conference Publications / Abstracts Appropriateness of Implementing Current Recommendations for Primary and Secondary Prevention of Vascular Disease in the Extended Nursing Care Setting. N Boyle, M Deane, M Crowe, JJ Barry, D O’Shea - IGS Meeting 2003 Diagnosing Stroke: The Value of Clinical Assessment - St.Vincent’s University Hospital N.Boyle, I.Noone, D. O’Shea,M. Crowe. – IGS Meeting 2003 Factors Associated with Delays in Acute Stroke Management. I. Noone, M. Crowe, D. O’Shea – IGS Meeting 2003 Long-term Waiting List in the Community - The Importance of Regular Review. O. Collins,A.Collins,L.Murray, D. O’Shea.- IGS Meeting 2003. How does Clinical Classification of Stroke Subtype compare with CT findings? J Ryan,I Noone, D O’Shea,M Crowe - Platform Presentation - IGS 2003. 111 The number of in-patients treated has remained unchanged on previous years, though out-patient attendances have increased. New patient attendance is up from 665 in 2001 to 800 in 2003.This is reflected in the throughput in both outpatients and Carew House Day Hospital. Great credit is due to Ms.Angela Moriarty, Clinical Nurse Manager and her multidisciplinary team for the throughput and quality of work there. Service Developments / Activities The department’s clinical services provide an in-patient and out-patient consultation service, treatment and rehabilitation, primarily for elderly patients from the hospital’s catchment area in South East Dublin and East Wicklow. Issues continuing to challenge the service include the lack of resources to maintain people in their home with dignity and a consequent increase in the number of people awaiting long-term continuing care. Falls and Syncope Service Space has been provided on Our Lady’s Ward for a falls and syncope service for the hospital and the neurocardiovascular service, which is being run by Dr. Diarmuid O’Shea. This is geared at providing a comprehensive assessment of elderly patients presenting with recurrent unexplained falls (> 4 in the preceding 6 months) to look for attributable and modifiable risk factors for falls.In total 71 patients were seen this year (of all age groups). Some progress has been made but the hoped for introduction of a Falls Nurse Specialist will be crucial to the further development of what is currently a rudimentary service. The Royal Hospital Donnybrook The Royal Hospital Donnybrook makes a very important contribution to the rehabilitation of our elderly patients.There are now 40 rehabilitation beds in this unit and when the nursing,physiotherapy, occupational therapy, social work and Congratulations to S/N Deborah Sinnot and S/N Jenny Hughes on Our Lady’s Ward, who were prize winners at the National Council for the Professional Development of Nursing and Midwifery Conference in November 2003, for "Screening for Visual Impairment in Elderly Rehabilitation Patients".
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