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Saolta Newletter Issue #26

Research from the Breast Centre North West-Letterkenny University Hospital in conjunction with the Donegal Clinical Research Academy was recently presented at the 24th Sylvester O’Halloran Scientific Symposium. Mary Gallagher, a 4th year medical student, identified significant variation worldwide in the completeness of breast cancer excision at the first index operation the patient undergoes. On average one fifth of ladies having breast cancer surgery around the world have to return for re-excision. Breast Centre North West and Letterkenny University Hospital have achieved consistent results of less than 10% of patients having to undergo second and further surgery. This reduced re-excision rate is a result of teamwork within the Unit, combining a number of novel techniques developed at the Hospital and in conjunction with Radiology and Pathology. It benefits the patients and reduces resource requirements. 

Mr Kin Ng, Senior Registrar at LUH, identified novel techniques to assist in reducing the amount of breast tissue excised. Mr Michael Sugrue, Consultant Breast and General Surgeon, said that this is very exciting and will allow us to determine patients’ views of outcomes.
Two other 4th year medical students, Alison Leong and Adrinda Affendi, also presented their work at the meeting. Alison’s poster presentation was a meta-analysis of nipple discharge probabilities and diagnostic accuracy of investigations. The variability of breast implant loss from implant-based reconstruction surgery was the topic presented in Adrinda’s poster. All of the 4th year medical students were summer research fellows at the Unit and their posts were funded through local contributions from people in the North West.

Click here to download a flyer for the 10th Emergency Abdominal Surgery which is due to take place on April 1st, 2016.

Nobel prize winner supports DCRA

Ramelton, County Donegal, is a beautiful heritage village located just 12km from Letterkenny University Hospital/Donegal Clinical Research Academy. It is the birth place of William C Campbell who was jointly awarded the 2015 Nobel Prize in Physiology and Medicine for discoveries concerning a novel therapy against infections caused by roundworm parasites. Professor Campbell is a supporter of the on-going development of Donegal Clinical Research Academy.

Photo: Courtesy www.independent.ie

The 10th Emergency Abdominal Surgery Course run by Donegal Clinical Research Academy was held in Royal College of Surgeons of Ireland in Dublin on April 1st 2016. The 100 doctors who attended were treated to 9 international world leaders in Emergency Surgery from 3 continents. These included Professors Marja Boermeester-Amsterdam Holland, Rangjith Ellawala-Colombo Sri Lanka, Paula Ferrada-Richmond USA, Tina Gaader-Oslo Norway, Yoram Klein-Tel Aviv Israel, Hayato Kurihara-Milan Italy,Carlos Mesquita-Coimbra Portugal, Selman Uranus-Gratz Austria and Pantelis Vassiliu-Athens Greece.

The international key note speakers were complemented by 8 Irish Surgeons, Radiologists and Gastroenterologists including Professor Calvin Coffey-University Hospital Limerick, Professor Simon Cross-Waterford University Hospital, Professor Ronan O’Connell-St Vincent’s University Hospital, Dr Barry Kelleher-Gastroenterologist-Mater Dublin, Dr Leo Lawler-Radiologist-Mater Dublin, Mr Ken Mealy-Surgeon Co-Lead Acute Hospital Program, Dr Siobhan McGrane- Radiologist Limerick, Dr Chris Steele-Gastroenterologist Letterkenny University Hospital.

The participants, mostly from Ireland but some from Italy, raved about the course and the manner in which it was delivered. As one surgical trainee stated “Never been at such an excellent meeting, perfect organisation! Thank you”. The course was attended by a small number of nurses which Mr Sugrue feels is so important in selecting the team approach to care.

Mr Michael Sugrue from Letterkenny University Hospital, who developed and chaired the course, was proud that such an initiative (now in its 4th year) was leading emergency surgery care training around the world. The course was first run in Letterkenny in 2012; it will run this year in Asia, South America and next year in North America. Mr Sugrue said he would love to be able to run the course in the Donegal Clinical Research Academy’s newly designed auditorium, which has planning permission but needs further capital funding before it can proceed.
The Chair of Donegal Clinical Research Academy Trust Henry McGarvey said it will improve outcomes for those attending with acute abdominal conditions, such as appendicitis, gall bladder disease and bowel cancer.
The next course will be held in Donegal on July 25th where remarkably 40 of the world leaders in surgery will come to the North West.

Almost there, A beacon of light!

NUI Galway Medical Academy at Letterkenny, December 2015. This modern campus is getting excitedly close to completion. Our medical students, who are such integral and participatory components of life in Letterkenny University Hospital, will soon have a ‘state of the art’ building within which they will have great facilities to help consolidate their learning.

Letterkenny University Hospital’s 4th Annual Multidisciplinary Research Symposium was held on Friday 27^th November 2015. It was a hugely successful event showcasing the extensive range and quality of multidisciplinary clinical research being undertaken at the hospital. The judging panel had a tough job adjudicating as the calibre of research presented on the day was of an extremely high quality.

Two invited guest speakers delivered stimulating lectures on their specialist areas.  Dr Sam Huddart, Consultant Anaesthetist NHS Foundation Trust, Redditch UK, gave a stimulating talk on ‘Quality improvement and emergency laparotomy. Dr Petrousjka van den Tol, a Consultant Breast Surgeon from the University Hospital of Amsterdam Holland, shared her work on ‘New developments in Dutch Breast Cancer Surgery’. All the prizewinners (pictured below) were presented with their medals by Dr Sam Huddart and Dr Petrousjka van den Tol. 

Pictured: Mary Byrne, NUIG,
receiving her 1^st place medal for best medical students’ oral presentation. Mary’s research, centred on the bacterium-Yersinia entercolitica, was entitled ‘Is Yersinia entercolitica as a cause of community-acquired diarrhoea in the west of Ireland underdetected? A comparison of selective culture and molecular detection.

Pictured: Dr Sinead O’Gorman, Consultant in Emergency Department, accepting the 1^st place medal for best medical students’ poster presentation on behalf of Eoin Farrell. Eoin’s poster related to the ‘Development of a model to predict bed requirements for patients requiring admission from the Emergency Department’.

Pictured: Dr Ashfaque Memon - Reg with Dr Miranda receiving his 1^st place medal for best NCHD oral presentation. Dr Memon’s research was on ‘Thromboprophylaxis in patients with atrial fibrillation admitted by the medical team’. Best poster in the NCHD category went to Dr Michael Casey- SHO with Dr Keatings- who carried out an audit on emergency oxygen administration in Letterkenny University Hospital.

Pictured: Alison Johnston, Research Nurse at Breast Centre North West, accepting the 1^st place medals for best Allied health professionals’ oral and poster presentations. Alison presented the results of a research project carried out at Breast Centre North West, this study looked specifically at evaluating the current assessment and screening of primary relatives of breast cancer patients.

Letterkenny University Hospital’s re-excision rate in conservative breast cancer is one third the national average. A low re-excision rate must be a balance between oncological, functional and cosmetic outcomes. Better Outcomes for Breasts (BOBs Project) is a new exciting, objective patient-outcomes monitoring tool developed at the Breast Unit. The breast nurse specialist Geraldine MacGregor and Alison Johnston, research nurse, were delighted that their poster describing the development of this new outcomes tool in women undergoing breast conserving surgery  was 1^st place winner in the Allied health professionals category.

Saolta CEO Awards

The Breast Team at Letterkenny University Hospital and Donegal Clinical Research Academy attended the Saolta CEO Awards on 13th November 2015 in Sligo. Their Multidisciplinary Breast Cancer Course was a finalist in the Education and Training category. Pictured left to right: Mr Paddy Rooney- Assistant General Manager at Letterkenny University Hospital, Geraldine MacGregor- Breast Nurse Specialist, Mr Maurice Powers- CEO of Saolta, Ann McGowan-Mammographer and Alison Johnston- Breast Research Nurse. Missing from the Team photo are Dr Katherine McGowan, Dr Jiri Vyskocl, Dr Hajnalka Gyorffy and Mr Michael Sugrue.
Breast Centre North West and Donegal Clinical Research Academy organised this 2nd international Breast Cancer Multidisciplinary course at the Royal College of Surgeons in Dublin on Friday 31st July 2015. This course is unique in that it brings together all the disciplines involved in breast cancer care in a one day course that is a mixture of the latest evidence in breast cancer care and case scenario discussion. All attendees are exposed to some of the latest developments in breast cancer care.
This course is unique worldwide and it has received excellent reviews from its initial debut last year. Four international world leaders in breast cancer care complemented the excellent National Faculty of twenty consultants in surgery, radiology, oncology, pathology, radiation oncology nursing and allied health. The international leaders included Mr Asgeirsson from Iceland, Professor Degnim from the Mayo Clinic United States, Ms MacNeill from The Royal Marsden, London and Dr Rubio from Barcelona in Spain.
Mr Michael Sugrue, course convener, said the day was highly successful and rated by the attendees as one of the best breast cancer courses that they had attended.

Good News for The Breast Unit at Letterkenny University Hospital.

The Breast Unit at Letterkenny University Hospital, Breast Centre North West, was recently awarded with the William O’Keeffe prize in surgery at the Waterford Surgical meeting in conjunction with Royal Academy of Medicine in Ireland held on the 17th October 2015.

Michelle Choynowski was awarded the William O’Keeffe prize for best original research and Javid Ghomashi was awarded best prize for poster presentation of original research.

Mr Michael Sugrue, Breast Surgeon, was delighted with the outcome; he was particularly pleased as these two summer research students, 3rd and 4th year medical students at NUIG, were in competition against Surgical Registrars and those undertaking thesis and Masters in surgery. Michelle Choynowski’s work looked at variability and re-excision rates nationally and internationally following breast conservative surgery. This research was prompted by the desire to avoid repeat surgery in patients undergoing conservative breast surgery. Mr Michael Sugrue is particularly pleased as Letterkenny University Hospital has one of the lowest re-excision rates in Ireland and has been to the forefront nationally and internationally in providing one stop surgery to avoid re-operation. Currently the hospital’s re-excision rate is under 10% compared to 33% nationally.

Alison Johnston, Research Co-Ordinator at the unit who is funded by community donations, said that Javid Ghomashi’s work had been pivotal in the new Better Outcomes for Breasts (BOB) Project being undertaken at the hospital. Javid’s work had identified the variability in lymphedema internationally and came up with a range of new measures which have been implemented at Letterkenny University Hospital; all patients now undergoing conservative breast surgery are entered into the BOB Project with careful monitoring of their functional and cosmetic results. Breast Centre North West has received awards over the years but this award is particularly pleasing. Mr Sugrue said that the community funding had allowed research to take place at the unit and this year six summer research fellows contributed to an exciting research programme. Their information and data will be presented at the annual Hospital Research Day on 27th November 2015, the same day as our Breast Ball.

Calling for all Clinical Abstracts

Entries will be accepted from all Clinical Researchers, Nursing & Allied Professionals who have recently undertaken a Research Project.

DCRA continues its international education program with Leaders in Surgery from Iberian peninsula and South America when it runs its third Portuguese Surgery Course in Coimbra Portugal this November

Mr Sugrue says it is a great honour that this course, developed in Letterkenny Hospital has received such international acclaim. It will be run in Asia and South America next year

Breast Centre North West and Donegal Clinical Research Academy organised an international Breast Cancer Multidisciplinary course at the Royal College of Surgeons in Dublin on Friday 31st July 2015. This course is unique in that it brings together all the disciplines involved in breast cancer care in a one day course that is a mixture of the latest evidence in breast cancer care and case scenario discussion. All attendees are exposed to some of the latest developments in breast cancer care.

Geraldine MacGregor, Breast Nurse Specialist at Letterkenny Hospital, said that this course is unique worldwide and it has received excellent reviews from its initial debut last year. She was pleased that Letterkenny could bring four international world leaders in breast cancer care to Ireland to complement the excellent National Faculty of twenty consultants in surgery, radiology, oncology, pathology, radiation oncology nursing and allied health. The international leaders included Mr Asgeirsson from Iceland, Professor Degnim from the Mayo Clinic United States, Ms MacNeill from The Royal Marsden, London and Dr Rubio from Barcelona in Spain.

Mr Michael Sugrue said the day was highly successful and rated by the attendees as one of the best breast cancer courses that they had attended.

Some of the Faculty members of the 2nd Breast Cancer Multidisciplinary Course held in Royal College of Surgeons in Dublin. From left to right: Geraldine MacGregor, Kevin Barry, Hajnalka Gyorffy, Jiri Vyskocil, Fiona MacNeill, John Kennedy, Kristjan Asgeirsson, Isobel Rubio, Katherine McGowan, Reem Salman and Michael Sugrue.

Ms MacNeill Royal Marsden London lecturing at the course.