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

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S u rgical Professorial Unit St. Raphael’s Wa rd St.Vincent’s Healthcare Group 144 Teh SH,Hill ADK,Lee AW, Foley D, Kennedy S,Young LS, McDermott EW, O’Higgins NJ. Raised plasma endostatin levels correlate inversely with breast cancer angiogenesis. J Surg Res 2004 116:165-175. Hegarty NJ, Young LS,O'Neill AJ,Watson RW, Fitzpatrick JM. Endothelin in unilateral ureteral obstruction: vascular and cellular effects.J Urol.2003 Feb;169(2):740-4. Young LS,Murphy G,Kelly SN,Smith TP, Cunningham SK,Joseph McKenna T. Differential production of adrenal steroids by purified cells of the human adrenal cortex is relative rather than absolute. Eur J Endocrinol. 2003 Jan;148(1):139-45. Abstracts E Myers,ADK Hill, EW McDermott, NJ O’Higgins,LS Young. The interaction of Ets-1 with the co-activator proteins AIB-1 and SRC-1 in human breast cancer. BJS,April 2004,100(2) 113 E Myers,ADK Hill, EW McDermott, LS Young. Mechanisms of HER2 resistance in endocrine tumours. Endocrine abstracts, March 2004,67 E Myers,ADK Hill, EW McDermott, NJ O’Higgins,LS Young.Modulation of PEA3 activity in HER-2/ neu over-expressing breast cancer Ir J Med Sci,March 2004,185 (4),24 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins,LS Young.The Co-activator protein SRC-1 and its interaction with the Ets protein PEA3 - potential targets in HER-2/neu positive breast cancer. Eur J Surg Oncol,Nov 2003,29 (9) 824-825 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins,LS Young. Transcriptional regulation of HER-2/neu: a role for the Ets family member Ets-1 – accepted for presentation. Eur J Surg Oncol,Nov 2003, 29 (9) 824 E Myers,ADK Hill,EW McDermott, NJ O’Higgins,LS Young. Expression of the co-activator protein SRC-1 and AIB-1 in human breast cancer. Ir J Med Sci,Nov 2003,183 (3) 39 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins,LS Young. The interaction of the Ets transcription factor family and it’s co-regulatory protein AIB-1 plays an important role in HER-2/neu over-expressing breast cancer. BJC, July 2003,22 (8) 332 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins,LS Young. Ets expression in breast cancer patients of known HER- 2/neu status. BJS,June 2003,90(1) 101 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins,LS Young. Transcriptional regulation by PEA3 in human breast cancer. Endocrine abstracts, March 2003,334 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins, LS Young. Ets transcription factor activity in HER-2/neu over expressing breast cancer. Ir J Med Sci, Sept 2003,172 (3),55 E Myers,ADK Hill,Y Buggy, EW Mc Dermott,NJ O’Higgins, LS Young. PEA3 and it’s co-activator protein AIB-1 and SRC-1 play a key role in the elevated tumorigenicity associated with HER-2/neu positive breast cancer. Ir J Med Sci,March 2003,172 (2),29 D Kavanagh,M Staunton1,A.D.K.Hill, D.E.Malone1, E.W.M. McDermott,N.J.O’Higgins. Water-Soluble Contrast Radiology in the Management of Acute Small Bowel Obstruction:Old-Fashioned or Old Faithful?. Ir J M S. Vol 171,No.1 Sep 2003 Suppl.1 D Kavanagh,E Myers,C O Riain,TB Crotty, EWM McDermott, NJ O’Higgins,LS Young Expression of the co-regulators SRC-1 and N-CoR and the ETS transcription PEA-3 in human thyroid cancer. Ir J M S. Vol 173,No.1 Sep 2004 Suppl.1 p.13 D Kavanagh,ADK Hill,F Fleming, E Myers,EWM McDermott,NJ O’Higgins, LS Young Modulation of coregulatory proteins at the estrogen receptor. Ir J M S. Vol 173,No.1 Sep 2004 Suppl.1 p.22 DO Kavanagh,ADK Hill1,TB Crotty, C Quinn,F Flemin1,A O’ Doherty, CD Collins,EW McDermott, NJ O’Higgins. Intradermal injection is the preferred route for injecting radioisotope for sentinel lymph node biopsy in patients with breast cancer. Br J Surg 91:S1: 2004:58 D Kavanagh,E Myers,C O Riain,TB Crotty, EWM McDermott, NJ O’Higgins,LS Young. Expression of the co-regulators SRC-1,N- CoR and the Ets transcription factor PEA3 in human thyroid cancer. Br J Surg 91:S1:2004:44 D Kavanagh,S Connolly, F Fleming,ADK Hill,NJ O’Higgins, EWM McDermott Meralgia paraesthetica following open appendicectomy. Ir J M S. Vol 171,No.1 Sep 2003 Suppl.1 Collaborators Marc Timmers Laboratory for physiological Chemistry, Utrect Utrecht University,The Netherlands. John Hassell,Institute for Molecular Biology and Biotechnology, McMaster University, Hamilton, Ontario, Canada. Invited Lectures outside UCD Graves Lecture, April 2003 Professor Joe Duffy was invited to speak at a number of International Meetings in 2003.These Conferences included: Association of Clinical Biochemist (UK) Focus Meeting, Manchester: Title of Lecture, Evidence for the use of tumor markers. XXXI International Society for Oncodevelomental Biology and Medicine (ISOBM): Edinburgh: Title of Lecture, uPA and PAI-1: validated prognostic markers in breast cancer. Continuing Education Meeting in Clinical Biochemistry : W i n d e r m e re (UK): Title of lecture, Prostate cancer: to screen or not screen? Association of Clinical Biochemists Ireland,Annual Conference: Dublin: Title of lecture:Tumor markers,current and future uses Other Honours/Invitations Professor Duffy was invited to Chair the National Academy of Clinical Biochemistry Panel to establish New Guidelines for the Clinical Use of Markers in Breast Cancer. Service Workload The Department continues its interest in General and Endocrine Surgery as well as in Surgical Oncology. There were a total of 888 admissions under the care of the Surgical Professorial Unit for the year 2003 into the 7day and 5 day wards.There were 471 admissions to the Day Care Ward and there were 247 new cases of Breast Cancer treated. Surgical Professorial Unit 2003 Total Inpatient Statistics Admissions = 888 Discharges = 833 St.Mark’s Day Centre 471 Extra Mural 96 OPD Day Ward 180 General & Endocrine Outpatient Clinic New patients = 279 Total = 1,397 Breast Clinic New patients = 1,932 Total = 7,121 Publications Cooley S,Geary M, McDermott E,Keane DP. Colonic pseudo-obstruction following elective caesarean section. J Obstet Gynaecol.2003 Mar;22(2):220. R Mofidi, R Walsh,PF Ridgeway,T Crotty, EW McDermott,TV Keaveny, MJDuffy, ADKHill, N O'Higgins. Objective management of breast cancer oestrogen receptor status through digital image analysis. European Journal of Surgical Oncology 2003;29 (1): 20-4. N O'Donovan,J Crown,H Stunell,ADK Hill,E McDermott, N O'Higgins,MJ Duffy. Caspase 3 in breast cancer. Clinical Cancer Research 2003;9 (2): 738-42. LM Greene,WOTwal,MJ Duffy, EW McDermott,ADK Hill,NJ O'Higgins,AH McCann, PA Dervan,WS Argraves,WM Gallagher. Elevated expression and altered processing of fibulin-1 protein in human breast cancer. British Journal of Cancer 2003; 88(6):871-878. SM Kennedy, L O'Driscoll,R Purcell, N Fitzsimons,EW McDermott,ADK Hill,NJ O'Higgins, M Parkinson,R Linehan, M Clynes. Prognostic importance of survivin in breast cancer. British Journal of Cancer 2003 88(7);1077-1083. RS Prichard,B Dijkstra,EW McDermott,ADK Hill, NJ O’Higgins. The role of molecular staging in malignant melanoma. European Journal of Surgical Oncology 2003,29 (4): 306-14. CE Healy, B Dijkstra, M Walsh,ADK Hill,J Murphy. Nipple adenoma:A differential diagnosis for Paget's disease. Breast Journal 2003,9 (4):325-6. C O'Shea,N McKie,Y Buggy, C Duggan,ADK Hill,E Mc Dermott,N O'Higgins,MJ Duffy. Expression of ADAM-9 mRNA and protein in human breast cancer. International Journal of Cancer 2003;105 (6):754-61. RS Prichard,ADK Hill,B Dijkstra,EW McDermott, NJ O'Higgins. Prevention of breast cancer. British Journal of Surgery 2003;90 (7):772-83 L O'Driscoll, R Linehan,S Kennedy, D Cronin,R Purcell, S Glynn,E McDermott,ADK Hill,N O'Higgins, M Parkinson,M Clynes. Lack of prognostic significance of survivin,surviving -Delta Ex3,survivin-2B,galectin-3, bag-1,bax-alpha, and MRP-1 mRNAs in breast c a n c e r. Cancer Letters 2003; 201 (2): 225- 236. 145

S u rgical Professorial Unit St. Raphael’s Wa rd Department of N u r s i n g Departmental Review 146 LM Kelly, ADK Hill, S Kennedy, EM Connolly, R Ramanath, STeh, BDijkstra, R Purcell, EW Mc Dermott, NJ O’Higgins. Lack of prognostic effect of Cox-2 expression in primary breast cancer on short-term follow-up. European Journal of Surgical Oncology 2003;29 (9):707-710. FJ Fleming,ADK Hill,D Kavanagh,C Quinn,A O'Doherty, CD Collins,E McDermott,N O'Higgins. Intradermal radioisotope injection optimises sentinel lymph node identification in breast cancer. European Journal of Surgical Oncology 2003;29 (10):835-838. JJ Sheehan,ADK Hill,NP Fanning,C Healy, EW Mc Dermott, DP O’Donoghue, NJ O’Higgins. Percutaneous endoscopic gastrostomy:5 years of clinical experience on 238 patients. Irish Medical Journal 2003;96 (9):265-7. Smyth GP, Greal GT, McDermott EW. Delayed presentation of a gastric colocutaneous fistula after percutaneous endoscopic gastrostomy. Nutrition.2003 Oct;19(10):905-6. O’Connor K,Dijkstra B, Kelly L,McDermott EW, Hill AD, O’Higgins N. Successful conservative management of neutropenic entercolitis: a report of two cases and review of the literature. ANZ J Surg.2003 Jun;73(6):463-5. Duffy MJ,van Dalen A,Haglund L,Klapdor R, Lamerz R,Nilsson O, Sturgeon C,Topolcan O. Clinical Utility of biochemical markers in colorectal cancer: European Group on Tumour Markers (EGTM) Guidelines. Eur J Cancer 2003;39:718. Look M,van Putten W, Duffy MJ,Harbeck,N.,Christensen,I.J., Thomssen, C., Kates,R., Spyratos, F.,Ferno, M.,Eppenberger- Castori, S.,Sweep, C.G.,Ulm,K., Peyrat, J.P.,Martin, P.M., Magdelenat,H., Brunner, N., Duggan, C.,Lisboa, B.W.,Bendahl, P.O.,Quillien,V.,Daver, A.,Ricolleau,G.,Meijer-Van Gelder, M.E., Manders, P.,Fiets,W.E.,Blankenstein, M.A.,Broet, P., Romain,S., Daxenbichler, G.,Windbichler, G.,Cufer,T.,Borstnar, S., Kueng,W., Beex,L.V.,Klijn,J.G.,O'Higgins, N.,Eppenberger, U., Janicke, F., Schmitt,M.& Foekens,J.A. Pooled analysis of prognostic impact of uPA and PAI-1 in breast cancer patients. Thromb Haemost 2003;90:538. Greene LM,Twal WO, Duffy MJ,McDermott E, Hill AD, O’Higgins,N,McCann A,Dervan PA,Argraves WS, Gallagher W. Elevated expression and altered processing of fibulin-1 protein in human breast cancer. Br J Cancer 2003;88:871. Executive Summary The nursing department,led by Ms. Pauline Doyle, continues to develop and provide quality-nursing care to patients in line with the mission,vision and ethos of the hospital and the Religious Sisters of Charity.The education and professional development of both registered nurses and nursing support staff remains a constant goal.Ms.Margaret Moran,Director of the Centre of Nurse Education, worked closely with the School of Nursing and Midwifery UCD to develop, organise and deliver a high standard of education and support for nurses.Ms Catherine Walshe, post registration course co-ordinator, clinical course facilitators,Nursing Practice Development and nursing staff in the clinical areas all play a pivotal part in achieving these aims. In addition to the BSc nursing programme, now in its second year, St Vincent’s University Hospital provides clinical placement to ten post registration higher diploma nursing courses in partnership with UCD. Service Developments and Activities External study is actively supported by a comprehensive study leave policy, and is availed of by increasing numbers of nursing staff.A new policy for Paid Study Leave and Financial Assistance for Nursing Staff,which incorporated a learning contract, was introduced in 2003. Clinical Nurse Specialists Anticoagulant Cancer Nurse Co-ordinator Transfusion Surveillance/ Haemovigilance CAPD Palliative Care Respiratory Rheumatology Stroke Care Orthopaedic Casting and Splinting Sleep Apnoea Tissue Viability Urodynamics A seminar was held for all Clinical Nurse Specialists in October 2003,on the Clinical Nurse/Midwife Specialist Role Resource Pack. Ms.Joan Gallagher, Project Officer from the Nursing and Midwifery Planning and Development Unit in the South Eastern Health Board addressed the group and shared experiences on the use of the pack. The Further Education and Training Awards Council (FETAC) Healthcare Support Certificate training programme for healthcare assistants commenced in December 2003 and will conclude in July 2004.The programme is delivered from the Centre of Nurse Education for the East Coast Area,coordinated by Liz Tuohy Nursing Support Service Manager.Three of the twenty healthcare assistants undertaking the programme are from St Vincent’s University Hospital.All newly employed healthcare assistants continue to receive hospital-based training. Submissions for funding were made to the National Council for Professional Development of Nursing and Midwifery seeking support to train two facilitators to run the Leading an Empowered Organisation (LEO) three-day course for the St Vincent’s Healthcare Group Ltd;,to purchase and train nursing staff in the application of the Quasar software for clinical audit and for additional funding for Advanced Cardiac Life Support (ACLS) training for nurses working in critical care areas. 147 Coloproctology Dermatology Haematology Liaison Health Failure Hepatitis C Liver Transplant Co-ordinator Multiple Sclerosis Oncology Liaison Cardiac Rehabilitation Cystic Fibrosis Diabetic Health Promotion Infection Control Lung Transplant Coordinator Occupational Health Osteoporosis Nursing Divisions In the clinical area,innovations in nursing practice continue throughout the seven hospital divisions. Divisions Cardio Respiratory Areas of Responsibility Coronary Care Unit,Cardiology Ward, St.John’s Ward,St. Paul’s Ward,Cardiac Rehabilitation,Respiratory, Cystic Fibrosis and Heart Failure.

S u rgical Professorial Unit <strong>St</strong>. Raphael’s Wa rd<br />

Department of<br />

N u r s i n g<br />

Departmental Review<br />

146<br />

LM Kelly, ADK Hill, S Kennedy, EM Connolly, R Ramanath, STeh,<br />

BDijkstra, R Purcell, EW Mc Dermott, NJ O’Higgins.<br />

Lack of prognostic effect of Cox-2 expression in primary breast<br />

cancer on short-term follow-up.<br />

European Journal of Surgical Oncology 2003;29 (9):707-710.<br />

FJ Fleming,ADK Hill,D Kavanagh,C Quinn,A O'Doherty, CD<br />

Collins,E McDermott,N O'Higgins.<br />

Intradermal radioisotope injection optimises sentinel lymph node<br />

identification in breast cancer.<br />

European Journal of Surgical Oncology 2003;29 (10):835-838.<br />

JJ Sheehan,ADK Hill,NP Fanning,C Healy, EW Mc Dermott,<br />

DP O’Donoghue, NJ O’Higgins.<br />

Percutaneous endoscopic gastrostomy:5 years of clinical experience<br />

on 238 patients.<br />

Irish Medical Journal 2003;96 (9):265-7.<br />

Smyth GP, Greal GT, McDermott EW.<br />

Delayed presentation of a gastric colocutaneous fistula after<br />

percutaneous endoscopic gastrostomy.<br />

Nutrition.2003 Oct;19(10):905-6.<br />

O’Connor K,Dijkstra B, Kelly L,McDermott EW, Hill AD,<br />

O’Higgins N.<br />

Successful conservative management of neutropenic entercolitis: a<br />

report of two cases <strong>and</strong> review of the literature.<br />

ANZ J Surg.2003 Jun;73(6):463-5.<br />

Duffy MJ,van Dalen A,Haglund L,Klapdor R, Lamerz R,Nilsson<br />

O, <strong>St</strong>urgeon C,Topolcan O.<br />

Clinical Utility of biochemical markers in colorectal cancer:<br />

European Group on Tumour Markers (EGTM) Guidelines.<br />

Eur J Cancer 2003;39:718.<br />

Look M,van Putten W, Duffy MJ,Harbeck,N.,Christensen,I.J.,<br />

Thomssen, C., Kates,R., Spyratos, F.,Ferno, M.,Eppenberger-<br />

Castori, S.,Sweep, C.G.,Ulm,K., Peyrat, J.P.,Martin, P.M.,<br />

Magdelenat,H., Brunner, N., Duggan, C.,Lisboa, B.W.,Bendahl,<br />

P.O.,Quillien,V.,Daver, A.,Ricolleau,G.,Meijer-Van Gelder, M.E.,<br />

M<strong>and</strong>ers, P.,Fiets,W.E.,Blankenstein, M.A.,Broet, P., Romain,S.,<br />

Daxenbichler, G.,Windbichler, G.,Cufer,T.,Borstnar, S., Kueng,W.,<br />

Beex,L.V.,Klijn,J.G.,O'Higgins, N.,Eppenberger, U., Janicke, F.,<br />

Schmitt,M.& Foekens,J.A.<br />

Pooled analysis of prognostic impact of uPA <strong>and</strong> PAI-1 in breast<br />

cancer patients.<br />

Thromb Haemost 2003;90:538.<br />

Greene LM,Twal WO, Duffy MJ,McDermott E, Hill AD,<br />

O’Higgins,N,McCann A,Dervan PA,Argraves WS, Gallagher W.<br />

Elevated expression <strong>and</strong> altered processing of fibulin-1 protein in<br />

human breast cancer.<br />

Br J Cancer 2003;88:871.<br />

Executive Summary<br />

The nursing department,led by Ms. Pauline Doyle, continues to<br />

develop <strong>and</strong> provide quality-nursing care to patients in line with<br />

the mission,vision <strong>and</strong> ethos of the hospital <strong>and</strong> the Religious<br />

Sisters of Charity.The education <strong>and</strong> professional development<br />

of both registered nurses <strong>and</strong> nursing support staff remains a<br />

constant goal.Ms.Margaret Moran,Director of the Centre of<br />

Nurse Education, worked closely with the School of Nursing<br />

<strong>and</strong> Midwifery UCD to develop, organise <strong>and</strong> deliver a high<br />

st<strong>and</strong>ard of education <strong>and</strong> support for nurses.Ms Catherine<br />

Walshe, post registration course co-ordinator, clinical course<br />

facilitators,Nursing Practice Development <strong>and</strong> nursing staff in<br />

the clinical areas all play a pivotal part in achieving these aims. In<br />

addition to the BSc nursing programme, now in its second year,<br />

<strong>St</strong> Vincent’s University Hospital provides clinical placement to<br />

ten post registration higher diploma nursing courses in<br />

partnership with UCD.<br />

Service Developments <strong>and</strong> Activities<br />

External study is actively supported by a comprehensive study<br />

leave policy, <strong>and</strong> is availed of by increasing numbers of nursing<br />

staff.A new policy for Paid <strong>St</strong>udy Leave <strong>and</strong> Financial Assistance<br />

for Nursing <strong>St</strong>aff,which incorporated a learning contract, was<br />

introduced in 2003.<br />

Clinical Nurse Specialists<br />

Anticoagulant<br />

Cancer Nurse<br />

Co-ordinator<br />

Transfusion Surveillance/<br />

Haemovigilance<br />

CAPD<br />

Palliative <strong>Care</strong><br />

Respiratory<br />

Rheumatology<br />

<strong>St</strong>roke <strong>Care</strong><br />

Orthopaedic Casting <strong>and</strong> Splinting<br />

Sleep Apnoea<br />

Tissue Viability<br />

Urodynamics<br />

A seminar was held for all Clinical Nurse Specialists in October<br />

2003,on the Clinical Nurse/Midwife Specialist Role Resource<br />

Pack. Ms.Joan Gallagher, Project Officer from the Nursing <strong>and</strong><br />

Midwifery Planning <strong>and</strong> Development Unit in the South Eastern<br />

Health Board addressed the group <strong>and</strong> shared experiences on<br />

the use of the pack.<br />

The Further Education <strong>and</strong> Training Awards Council (FETAC)<br />

Healthcare Support Certificate training programme for<br />

healthcare assistants commenced in December 2003 <strong>and</strong> will<br />

conclude in July 2004.The programme is delivered from the<br />

Centre of Nurse Education for the East Coast Area,coordinated<br />

by Liz Tuohy Nursing Support Service Manager.Three<br />

of the twenty healthcare assistants undertaking the programme<br />

are from <strong>St</strong> Vincent’s University Hospital.All newly employed<br />

healthcare assistants continue to receive hospital-based training.<br />

Submissions for funding were made to the National Council for<br />

Professional Development of Nursing <strong>and</strong> Midwifery seeking<br />

support to train two facilitators to run the Leading an<br />

Empowered Organisation (LEO) three-day course for the <strong>St</strong><br />

Vincent’s Healthcare Group Ltd;,to purchase <strong>and</strong> train nursing<br />

staff in the application of the Quasar software for clinical audit<br />

<strong>and</strong> for additional funding for Advanced Cardiac Life Support<br />

(ACLS) training for nurses working in critical care areas.<br />

147<br />

Coloproctology<br />

Dermatology<br />

Haematology Liaison<br />

Health Failure<br />

Hepatitis C<br />

Liver Transplant<br />

Co-ordinator<br />

Multiple Sclerosis<br />

Oncology Liaison<br />

Cardiac Rehabilitation<br />

Cystic Fibrosis<br />

Diabetic<br />

Health Promotion<br />

Infection Control<br />

Lung Transplant Coordinator<br />

Occupational Health<br />

Osteoporosis<br />

Nursing Divisions<br />

In the clinical area,innovations in nursing practice continue<br />

throughout the seven hospital divisions.<br />

Divisions<br />

Cardio Respiratory<br />

Areas of Responsibility<br />

Coronary <strong>Care</strong> Unit,Cardiology Ward,<br />

<strong>St</strong>.John’s Ward,<strong>St</strong>. Paul’s Ward,Cardiac<br />

Rehabilitation,Respiratory, Cystic<br />

Fibrosis <strong>and</strong> Heart Failure.

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