Mater Misericordiae Hospital annual report 1987 (1.16 MB)
Item Type Report
Authors Mater Misericordiae Hospital, Dublin
Rights Mater Misericordiae Hospital
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CONTENTS
Page No,
Board of Management 5 Council 6 Executive Committee of the Medical Council 6 Development of Hospital 7 Address of the Diocesan Administrator — Annual General Meeting 10 Report of Chairman of the Executive Council 13 Financial Statements 22
Departmental Reports Academic Clinical Department of Medicine 41 Accident/Emergency 44 Admissions Unit 46 Adult Psychiatry 47 Anaesthetic 49 Cardiac Medicine 56 Cardio-Thoracic Surgery 59 Chaplaincy 60 Child and Family Psychiatry 64 Clinical Genetics 73 Dermatology 75 Diabetes/Endocrine 80 Endocrine/Metabolic 86 Gastrointestinal Unit 87 General Medical Unit 91 Geriatric Medicine 92 Infection Control Committee 93 Institute of Radiological Sciences 95 Mater Hospital College for Post Graduate Education and Research.. 99 Medical Social Services 102 Nephrology 104 Neurology 109 Nursing 111 Oncology 120 Ophthalmology 126 Orthopaedic 135 Out Patient 137 Pathology 142 Radiology 159 Respiratory Medicine 165 Rheumatology and Rehabilitation 167 School of Nursing 176 St. Paul's Hospital 181
1 Surgery: General Surgery 196 Urological 201 E.N.T 203 Gynaecological 207 Plastic 209 Oral & Maxillo-Facial 210
Publications, Papers, Presentations, Communications by Hospital Staff 211 Hospital Staff 254 Sisters of Mercy — World Wide 261
International Standard Serial Number ISSN 0790 — 6390 Annual Report — Mater Misericordiae Hospital
2 Photograph of the venerated painting of Our Lady of Mercy, in the Church of St. Pudenziana, Rome. His Holiness, Pope Leo XIII, blessed and sent a copy of the picture to Dublin, as an emblem of the Sisters of Mercy order.
3 Reminder
The Mater Misericordiae Hospital is a public voluntary hospital which, for many years, has been helped, in striving towards maintaining the highest standards in the provision of medical care and medical research, by the generosity of many members of the public. In order to continue to maintain such levels, the Board of Management of the hospital wishes to request all those who read this report, which reflects the work of so many individuals in the hospital in their pursuit of excellence in the provision of patient care, to consider the hospital and its on-going needs. All contributions and donations would be appreciated. When arranging the details of your will you might wish to include the hospital as a beneficiary. MATER MISERICORDIAE HOSPITAL ECCLES STREET, DUBLIN 7. Proprietors Congregation of the Sisters of Mercy, Convent of the Mother of Mercy, Carysfort Park, Blackrock, Co. Dublin.
Superior General Sister M. Sebastian Cashen
Superior, Mater Misericordiae Sister Rose Philippine Campbell (until Hospital September) Sister M. Gerard (from September)
Foundress of Order Mother Catherine MacAuley Born: 29th September, 1778 Died: 11th November, 1841 BOARD OF MANAGEMENT
Chairman Most Rev. Dr. Kevin McNamara Archbishop of Dublin, R.I.P. Died in April 1987.
Deputy Chairman Dr. T. Murphy
Secretary Mr. D.J. O'Flynn
Members Dr. B.G. Alton Sister John Berchmans Dr. J.T. Ennis Sister M. Gemma Sister Mary of the Incarnation (until September) Sister M. Margherita (from September) Doctor P. Keelan Professor J. Kelly Mrs. E. Lovatt-Dolan Mr. M. Lucey Sister M. Lucia Therese Mr. G.J. MacGabhann Mr. H. MacNeill Sister R. Murnane Mr. J.J. Nolan Mr. D.T. O'Connor Miss E. O'Leary Sister M. Rose Philippine (until September) Sister M. Gerard (from September) EXECUTIVE COUNCIL 1987
Chairman Mr. G.J. MacGabhann
Members Doctor J.T. Ennis Sister Mary of the Incarnation (unti September) Sister M. Margherita (from September) Doctor P. Keelan Mr. J. Smith Sister M. Lucia Therese
EXECUTIVE COMMITTEE OF THE MEDICAL COUNCIL 1987
Chairman Doctor P. Keelan
Secretary Mr. J. Smith
Members Mr. R. Bowell Professor T.B. Counihan Doctor J. Donohoe Doctor J.T. Ennis Mr. W.P. Hederman Doctor J.A. Kirrane Doctor D. Moriarty Mr. N. Mulvihill Doctor D. O'Connell Mr. F.X. O'Connell
6 DEVELOPMENT OF HOSPITAL
The phased development of the hospital is summarised in the following section and the Reverend Mother who was in office during each development term, is indicated:-
1861- East wing completed Sr. M. Patrick Kickham 1882
1882- West wing completed Sr. M. Berchmans Barry 1912
1912- Development of private hospital Sr. M. Stanislaus 1918 Kostka Farrell
1918- Additions to private hospital Sr. M. Callistus Sheedy 1924 First nurses' home built
1924- A modern x-ray department replaced 1930 the 'medical electrical department' Sr. M. Carmel Grennell
1930- Work commenced on the new Sr. M. Madeleine 1936 chapel McCormack
1936- Sr. M. Brigid Brennan 1942 New chapel completed
1942- Sr. M. Reginald Operating theatres rebuilt 1948 McHugh
1948- New nurses' home. Sr. M. Magdalene Fane 1954 (North Circular Road)
1954- Development of cardiac unit, Sr. M. Gabriel O'Leary 1960 establishment of school of physiotherapy, establishment of department of physical medicine and rehabilitation.
1960- Building of new department of child Sr. M. Josephine 1966 psychiatry. Planning of new operating Bourke theatres. Education and other facilities completed
7 1966- Building of new cafeteria, kitchen, Sr. Teresa Joseph 1972 non-consultant hospital doctors' Moylan accommodation, the Freeman Auditorium and a new accident and emergency department. Opening of the new open heart surgery theatres, administrative offices and central stores. Formation of the Board of Management and the adoption of a new constitution for the Mater Misericordiae Hospital.
1972- New cardio-vascular diagnostic unit. Sr. Gemma Galgani 1975 Establishment of endocrine Byrne laboratory.
1975- Establishment of additional temporary Sr. Marian Joseph 1980 out patient accommodation, Keogan computer unit, day centre for diabetic patients. Enlargement of the ophthalmic department. Erection of new gastro-intestinal unit. Provision of accommodation for full-time professors of medicine and surgery.
1981- Opening of new department of Sr. Rose Campbell radiology. Commissioning of computerised axial tomographic scanner. Work commenced on the ward block of the new Mater Hospital. A new ophthalmological professorial unit was completed in Nelson Street. Extension to intensive treatment unit. Second cardiovascular x-ray unit opened. Establishment of oncology laboratory. Commissioning of electron microscope unit. Foundation of Institute of Radiological Science. The introduction, specification and implementation of the integrated hospital information system.
8 MOTHER MARY CATHERINE MacAULEY
{Foundress of the Sisters of Mercy)
Cod bless her name forever and forever, Who loved God's poor above all fame and gold, Who gave her life to sacrifice and service, Triumphing o'er trials and rebuffs untold.
Who raised aloft the banner of God's mercy, And walked beneath it on a toilsome way; Gathering loyal hearts and hands to aid her In bringing sunshine to the darkest day.
Through sordid streets, through laneways black with sorrow She went upon her way with holy calm, To bring to many a pain demented sufferer The peace of God, and hope and soothing balm.
No load of toil too heavy for her shoulders, No pang of pain too piercing to endure. Two guiding stars shone all the way before her; God's mercy and the service of the poor.
God bless her name! God bless the flowers she planted, And raise them up in beauty and in grace, To guide His poor along the wide world's highways, And lead them to the sunshine of His face.
Cod speed the day, with souls she saved rejoicing Through all the spaces far from sky to sod, When Mother Mary Catherine MacAuley Is welcomed 'mong the holy saints of God! B. O'Higgins
9 ADDRESS OF THE MOST REVEREND JOSEPH A. CARROLL, D.D., DIOCESAN ADMINISTRATOR ON THE OCCASION OF THE ANNUAL GENERAL MEETING OF THE BOARD OF MANAGEMENT HELD ON THE 20TH OCTOBER, 1987.
I am very happy to be with you this afternoon for your annual general meeting. It is one of the big occasions of the year and it is of highly practical importance for the smooth administration of the hospital. This year, the meeting has an edge of sadness. You must all miss the gracious presence of the late Archbishop of Dublin. Archbishop McNamara was greatly devoted to the hospital and he took an active interest in its progress. During his tragically short term of office, he attended two annual general meetings and spoke at them, and he also attended the Alton Prize Dinner, as well as the study day. He knew what it means to be ill, and to be terminally ill, at that. Hence, his special care for the sick and his admiration for all who serve the sick. He was a witness to us all on how to live the Christian life, and he was a witness to us all on how to die. May he rest in peace.
I have had a glance through your annual report for 1986. A glance is sufficient to convince one of the size and complexity of this great establishment, of the wide scope of its activities and of the impressive range of talent and experience and skill at its command. I should like to congratulate all those, who in so many different ways, have contributed to the thriving condition of the hospital. In particular, I should like to congratulate and thank the Board of Management, who have overall responsibility for the welfare of the hospital. It may be permitted to mention, in particular, the Deputy Chairman, Professor Tom Murphy. He is a worthy successor of the late Mr. Joe O'Hanlon of happy memory. It was characteristic of Professor Murphy to accept this position in a spirit of generous service to the community. He is the right man to face up to the serious challenges that will be facing the hospital in the immediate future.
My congratulations and thanks, also, to the Chief Executive, Mr. Gearoid MacGabhann, to the Honorary Secretary of the Board of Management, Mr. Dermot O'Flynn, to the Chairman of the Executive Committee of the Medical Council, Dr. P. Keelan, to Sister M. Gerard, the Superioress of the Community, to the members of the various committees in the hospital, to the medical and nursing staff and to the members of the administrative staff, without whom the successful running of the hospital would not be possible. I also thank the hospital chaplains, for their devoted service as well as the personnel in the pastoral care programme. There is need to consolidate and to enhance this service, and to concentrate on the education and training of additional personnel.
The Mater Hospital is the pride and joy of the Sisters of Mercy. It is also the source of many headaches for any Superior General. It was splendidly served
10 by Sister Cora when she was Superior General and we send her our best wishes. I know that the future of the hospital greatly exercises the mind of her successor, Sister Sebastian and I sympathise with her in her heavy responsibility and wish her every success. The day to day burden, of course, on running the hospital falls on the shoulders of the local Superior, Sister Gerard. She succeeded Sister Rose Phillipine who carried the burden with great gentleness and patience. I wish Sister Gerard every success in her difficult task. I welcome on the Board of Management Sister Margherita who has replaced Sister Mary of the Incarnation. I wish her a happy and successful term of office.
The hospital suffered a grievous loss by the deaths of two of the senior surgeons, Prof. Eamon deValera and Mr. John Corcoran. The many tributes that were paid to them at the time of their deaths were fully deserved. May they enjoy the reward of their goodness.
In the financial field, the year 1986 was a year of many difficulties. There was a lot of pressure on the staff and on the services. New policies and guidelines emanating from the Department of Health were mainly restrictive in character, especially in the matter of finance. There was a trend towards socialisation in medicine. One recently noted, also, with some concern, the proposal to establish a Central Applications Bureau, including the selection of nurses for training. The drastic curtailment that is taking place at the present time in health expenditure is making things very difficult in the hospital. There is a widespread public unease about access to hospital care. The poor should not be the ones to suffer. All the efforts of the hospital should be directed towards equity — equity in access and equity in the quality of care. It is a stressful time. It is particularly stressful for the nursing staff, who have to work extra time by reason of the cut-backs. I should like to pay tribute to the nurses for the quality of their work. The fact that the Nurse of the Year award in 1986 was won by a Mater nurse is an indication of the high standard of nursing care in the Hospital. I congratulate Sister Rose Murnane on her achievement. I welcome a large number of new consultants on the staff. This has come about through the operation of the common contract which led to the retirement of a large number of consultants. I thank the consultants who have retired for their distinguished service to the Hospital. They have contributed towards making the Mater one of the most prestigious hospitals in the country.
The opening of the new Mater Private Hospital has added to this prestige. I am glad to have this opportunity of thanking the staff of the Private Hospital for the outstanding care that they bestowed on our late Archbishop during the course of his long illness. He spoke to me several times about it. He appreciated it more than I can say.
May I give you just a word for reflection. Never lose your sense of vocation. Never allow yourself to come to regard your work as just another chore, a
11 way of earning one's living. It is that, of course. But it is more than that. It is a call to the service of others in the Christian spirit of service. We are living in a highly mechanised society. It brings with it the danger of depersonalisation. Too many machines tend to downgrade the person. There is a loss of the sense of personal involvement, and a corresponding loss in the sense of fulfillment in one's work. If this depersonalised mentality were to infiltrate the medical and nursing profession, it would be a great pity. The danger is there, with so many advances in medical science — and they are to be welcomed — so many new technological aids. They carry with them the risk that the patient becomes just a number in the cause of greater efficiency. Never lose the sense that you have been called — called to the service of Christ in his suffering members: "I was sick and you visited me". Compassion — the ability to enter into another's pain — should be one of the distinguishing marks of your service. You do work after all, under the patronage of Mary, Mother of Mercy. To conclude, 1 congratulate the hospital once again on its achievements over the past year and I congratulate all who contributed to these achievements. In particular, I wish the Board of Management unity and courage and sound judgement in facing the challenges that undoubtedly lie ahead.
12 REPORT OF CHAIRMAN OF THE EXECUTIVE COUNCIL
We join with Dr. Carroll in his expression of sorrow at the death of our late Chairman, Dr. Kevin McNamara. Even though his period as Chairman was short, the impact which he made on those who came in contact with him was immediate and lasting. May he continue to guide, direct and inspire us.
The Board members wish to record publicly once more their indebtness to all members of the staff who overcame many personal difficulties in inappropriate working conditions in order to maintain the high level of activity recorded in the statistical sections of this report. It is difficult to express personally to each member of the staff the appreciation of the Board members and of the Sisters of Mercy. It is hoped that all will accept that their individual and collective contributions are recognised and genuinely appreciated. Whilst not wishing to differentiate between different categories, specific reference must be made to the contribution of the nursing staff throughout a most demanding year.
The impact of the fiscal and other policies introduced over the past three years are clearly reflected in the statistics hereunder:
1985 1986 1987 £ £ £ Admissions 19,562 18,674 17,936 Via A/E Department 5,950 5,882 5,526 Bed Days 151,694 145,952 123,629 Duration of stay (days) 7.75 7.82 6.98 Percentage occupancy 92.18% 94.27% 91.94% Theatre activity 14,186 13,092 11,123 Out-Patient attendances 625,424 678,514 642,275 A/E Department attendances 61,969 57,006 48,739 Cost per Bed Day 169 182 197
The most critical factor in the provision of health care in 1987 continued to be finance, as is reflected in various sections of the report.
Financial Report In the expectation that funding levels in 1987 would, at best, be of the same scale as for 1986, the Board of Management decided in December 1986 to continue in 1987 the same level of activity throughout the departments of the hospital as those prevailing in 1986.
Political developments resulted in the dissolution of Dail Eireann. The calling of a General Election and the appointment to office of a new Government contributed to a delay in notification of the finances available to the hospital for the year under review. We were not advised of our allocation of £23.7m (subsequently amended) by the Department of Health until April. This sum
13 represented a shortfall of £3.4m on the projected needs, based on 1986 activity levels and reflects a shortfall of 9%.
Because of the late notification and the serious underprovision, the Board of Management was faced with a very serious situation. In-depth discussions were undertaken with all departments, aimed at the preparation of a set of proposals which would maintain, as far as practical, the functional structure of the hospital and which would maximise the level of service available. The Board of Management was anxious to ensure that a major overspending would not be incurred in 1987.
In addition to the restrictions introduced in 1986 a number of additional measures were taken, including the following:
1. The staff complement was reduced by 121 posts and a decision was taken not to fill immediately further vacancies which might arise. 2. The remuneration of First Year Student Nurses was reduced in line with a directive of the Department of Health. 3. The bed complement was reduced from 456 to 342. 4. Out-Patient clinics were reduced in number by 30%. 5. The planned throughput of all service and diagnostic departments was reduced by a minimum of 25%. 6. A reduction of 20% in the level of activity in operating theatres was planned. 7. The number of cardiac surgery cases was reduced from four per day to three per day from June through to December 1987. 8. The heart transplant programme was deferred for a short period pending clarification of our ability to function within the resources available. 9. The intake of student nurses in the Autumn was reduced from 50 to 35. 10. In May, the accident and emergency department was planned for closure from 5.00 p.m. to 9.00 a.m. on week-days and on week-ends when the hospital was not scheduled for emergency duty. In December the north city accident and emergency rota was altered and the hospital was obliged to undertake a greater share of the rota without adequate facilities being formally restored. 11. The elimination, as far as possible, of premium payments. 12. The introduction of medical and surgical five day wards. 13. The introduction of the £10 charge for certain services contributed to a reduction in numbers attending accident and emergency department and out-patient clinics.
These measures were planned to achieve savings of the following scale:-
Salary Payments £1,531,000.00 Consumables and Non Pay Expenditure £1,588,000.00 Introduction of five day wards £ 45,000.00 Increase income of Cafeteria £ 100,000.00 TOTAL: £3,264,000.00
14 The programme which was introduced during the year militated against a continuation of the standard of service provided by the hospital in past years. Significant increases were recorded in waiting lists for admission to the hospital. In the latter part of the year the numbers attending certain out-patient clinics were so high that an inappropriate patient/staff ratio prevailed.
Stringent personnel policies were introduced by the Department of Health which made more difficult the task of providing service.
The closure of hospital beds, the reduction in activity and the other steps introduced and the very stringent control of expenditure resulted in a relatively small excess of expenditure over allocation of £37,000 being recorded for the year. Another factor which contributed towards the achievement of this result was an unplanned temporary reduction in service levels necessitated by an industrial dispute in the early part of the year. The rostering arrangements for non consultant hospital doctors introduced following discussion with the doctors also resulted in significant temporary savings being achieved.
No replacement of old or obsolete equipment was possible during the year. A full schedule of the major equipment costing £3,260,068 was sent to the Department of Health on 18th August, 1987. Funding levels prevented the Department from making an allocation.
The Income and Expenditure Account of the hospital for 1987 is contained in a later part of this report. This is shown in summary format hereunder:-
Allocation Income Variance (final) and Expenditure Remuneration £15,782,000 £15,979,000 £197,000 Supplies & £10,235,000 £10,031,000 (£204,000) General Charges £26,017,000 £26,010,000 (£7,000) Income 1,379,000 1,695,000 44,000 £24,278,000 £24,315,000 £37,000
Accident & Emergency Service In November, 1987, The Charitable Infirmary, Jervis Street and the Richmond Hardwick and Whitworth Hospitals were closed. We wish their staff and management every success in their new hospital in Beaumont.
Closure of these hospitals did not take place without serious impact to the Mater Misericordiae Hospital. We had identified and reported these implications in 1979 and in the early 1980s and had indicated to the Department of Health the needs of this hospital to cope with the projected changed circumstances. Unfortunately, our reasonable statement of needs was not met and, in fact, the range of facilities available at November 1987 to cope with the increased demand was less than those available in 1980.
Co-inciding with the closure of the two north inner city hospitals the
15 accident and emergency rota for north Dublin was revised in December, 1987. The Mater Misericordiae Hospital was obliged to undertake an increased frequency in the rota. The Department of Health was advised that it would be necessary to increase the bed complement from 340 to 390 and to appoint some thirty-four temporary staff to assist in meeting the extra caseload. The staff in question were appointed on a temporary basis on the understanding that the rota would be reviewed and revised in April 1988 in the light of experience.
The priority which we were directed to afford to trauma cases and the introduction of five day wards has resulted in a serious alteration in the type of patient being treated at the hospital. The five day wards have been of benefit in achieving a higher activity in respect of particular categories of patients. In addition, the high service demands occasioned by the accident and emergency rota result in very many patients remaining on our waiting lists who cannot be accommodated within the five day system. At the 31st December 1987 the in-patient waiting lists had grown to 3,400. Unfortunately, many of these patients are equally, if not more, in need of care than many of those admitted through the accident and emergency service.
Major Alert The hospital reacted to a major accident alert declared on the 1st January, 1987, on the occasion of the Raglan House gas explosion. In general, satisfaction was expressed at the manner in which the hospital staff reacted to the alert.
Technical Services Department
The financial restrictions had a major impact on the operation of the Technical Services Department, where the salary allocation was reduced and two permanent posts were lost. Two further additional posts which became vacant were not filled and overtime was severely curtailed.
The minimum amount of remedial works was undertaken on the mechanical and electrical services during the summer months, as were all upgrading and improvements on these services. As a result, a greater number of operating difficulties arose during the winter months when stop-gap measures had to be adopted to maintain services. Such practices may be contained in the short- term but, if continued over a longer period, will lead to significant curtailment in service in view of the age and nature of the services.
A limited number of special works were completed, including:-
The final commissioning of the fire detection and alarm installation in the radiology department.
Refurbishment of 38 Eccles Street following a fire outbreak.
The commissioning of a new telephone and paging system in the new ward building.
16 Fire Safety The designated Fire Officer, the Technical Services Manager, and the Chief Executive continued to monitor the fire protection standards in the hospital and submit regular reports to the Board of Management in respect of requirements. The older buildings of the hospital require significant improvements to bring them in line with modern standards. These needs have been identified and reported to the Department of Health. The Fire Safety Committee, established in 1986, continues to contribute to safety and to a realisation of the importance of all staff to be aware of fire hazards. The fire awareness programme of 1987 was based on two modules. The first consisted of illustrated talks, the second of the showing of a film retracing the events of a real fire in a Danish hospital which resulted in the loss of many lives. In addition, a special fire safety handbook written by the Technical Services Manager was distributed to those attending the fire awareness programme. In July, 1987, No. 38 Eccles Street suffered extensive damage following an outbreak of fire which started in a top floor room. The fire was detected at an early stage by a staff member and the house was evacuated within minutes prior to the arrival of the Fire Brigade. As a result of the damaged caused to the building the ophthalmic eye theatre and the c.a.t. scanning area were out of commission for five months. We wish to thank the Dublin Fire Brigade for the alacrity with which they responded to our call and for the manner in which they dealt with the outbreak. To the Mater Private Hospital, which co-operated with us and permitted emergency eye operations and C.A.T. scans to be carried out in their institution on public patients during this five month period, we record our appreciation. Unfortunately, waiting lists for eye surgery increased significantly during the period of re-instatement of the operating theatre in temporary accommodation in the new unused ward building. Computerisation The completion of the specification of the patient administration system and the commencement of the installation of the system in various departments took place early in the year. The admission/discharge/transfer and waiting list systems were introduced to the admissions office in April. Towards the year end, the two five-day wards were linked to the system to maximise benefits. This provides on-line activity reports on current bed status, admission and discharge details. It also provides various other facilities in the admissions office including improved waiting list management information.
17 Interviewing patient using hospital information system in the admissions office.
The introduction of the clinical/administration system into the accident andemergency department was facilitated by the active participation of the medical and nursing staff. This system allows the full clinical recording of all data relative to the attendance of patients at the department as well as providing comprehensive statistical and activity reports. Other modules of the patient administration system implemented during 1987 included out-patient registration and in-patient coding. The full general ledger system, together with appropriate management reports, were implemented. These now provide improved financial management reporting. In addition, the specification for the stores system was finalised. However, it was not possible to implement the system during the year as the additional hardware required was not available. The implementation of the above systems have made a significant contribution to the improved flow of information in the hospital.
18 Capital Development Programme The promised opening of the 1A Building during 1986 did not materialise as envisaged. We had hopes that 1987 would see these high class facilities made available for patients. We were, once again, disappointed in this respect and continue to hope that the pressing needs of the Mater Hospital will eventually be recognised and be given the appropriate priority. However, with the commissioning of the new telephone exchange our telephonist occupied the new building on the 26th September, 1987.
Telephonists at work in the new switchroom in phase 1A.
19 Golden Jubilee of Hospital Chapel
The Most Reverend James Kavanagh D.D. celebrated a special mass for the sick on the occasion of the 50th anniversary of the dedication of the hospital chapel. This mass took place on 14th December, 1987 and was concelebrated by twenty past chaplains. The mass was attended by the Community and members of the hospital staff from all departments within the hospital.
Bishop Kavanagh giving homily at Mass for 50th anniversary of hospital chapel.
Retirements
The following retired from their position in the hospital, having given many years of dedicated service:- Professor M.I. Drury Consultant — Diabetic/Endocrinology Dr. J. Dempsey Consultant — Histopathology Miss M. O'Reilly C.S.S.D. Operative Miss K. O'Sullivan C.S.S.D. Operative Mrs. M. O'Halloran Telephonist Mr. J. McLoughlin Porter Mr. J. Moloney Porter Mr. J. Quinn Porter Miss M.E. O'Neill Domestic Mrs. E. Steen Theatre Assistant Mrs. M. McGreane Seamstress Mr. A. Stewart Electrician Mr. J. Macken Painter
20 Sr. M. Augustine and Sr. M. Antonina also retired from their ward duties during the year 1987.
Resignation Sr. M. Gerard resigned from the position Theatre Superintendent. Congratulations are extended to her on her appointment as Reverend Mother.
Death and Condolences We record with regret the death of Mr. Joseph McCreamor. Appreciation
The continued support of the service provided by our auditors, R. J. Kidney and Company, legal advisors, Arthur O'Hagan & Son, insurance consultant, M.B. Fitzpatrick, property consultants Messrs. Harrington & Bannon, W. H. Byrne, Architects and other member firms of the Design Team. We also express our thanks to the Garda Siochana, and staff of the Dublin Fire Brigade. The Board of Management also wish to thank all those members of the public and of associated bodies, voluntary and statutory, associated with the hospital for their continued support.
21 FINANCIAL STATEMENTS YEAR ENDED 31st DECEMBER 1987
AUDITORS' REPORT TO THE MEMBERS OF MATER MISERICORDIAE HOSPITAL
We have audited the financial statements set out as required by the Department of Health on pages 23 to 28 in accordance with approved Auditing Standards and have obtained all the information and explanations we considered necessary. In our opinion proper books of account have been kept by the Hospital and the financial statements, which are in agreement therewith, give, so far as concerns the Department of health, a true and fair view of the state of the Hospital's affairs at 31st December, 1987 and of the result for the year then ended.
Robert J. Kidney & Co., Chartered Accountants, 12, College Green, Dublin 2.
22 Detailed Income and Expenditure Statement Year Ended 31st December, 1987
EXPENDITURE 1987 1986 IR£'000 IRF000 Pay Administration 1,306 1,347 Medical 3,255 3,286 Nursing 5,512 5,862 Para-Medical 2,510 2,700 Catering & Housekeeping 1,485 1,545 Maintenance 371 421 Other 112 73 Superannuation 615 493 Pay Related Social Welfare 744 809 15,910 16,536
Non-Pay Medical Expenses 6,050 7,316 Provisions 618 754 Maintenance, Power and Cleaning 1,814 2,184 Finance Charges 591 654 Office Overheads 1,028 1,005 10,101 11,913
26,011 28,449 Income Payroll Deductions 831 769 Cafeteria 395 371 Income from Patients 378 520 Other Income 91 68 JL695 1,728 DEFICIT 24,316 26,721 Deficit Grants Receivable for year 24J70 26J23 Expenditure Over Allocation for 46 548 year Capital Grants 1,907 3,585
Capital Expenditure 1,907 3,585 ON BEHALF OF THE BOARD Thomas Murphy Dermot J. O'Flynn The notes on pages 27 and 28 form part of these financial statements.
23 Balance Sheet as at 31st December, 1987 1987 1986 NOTES IRFOOO IR£'000
ASSETS
Investments 2 53 58
Grants Receivable 3 6,525 7,275 Accounts Receivable 987 577 Cash at Bank 3 2
7,568 7,912
CURRENT LIABILITIES
Accounts Payable 4,048 4,285 Bank Overdraft 1,963 3,959
6,011 8,244
NET ASSETSALIABILITIES) 1,557 (322)
Term Loan 1,884
(327) (332)
REPRESENTED BY:
Capital Statement (327) (332)
ON BEHALF OF THE BOARD Thomas Murphy Dermot J. O'Flynn The notes on pages 27 and 28 form part of these financial statements.
24 Capital Statement Year Ended 31st December, 1987 1987 1986 IR£000 IR£000
Excess of Expenditure over (46) (548) allocation Adjustments to allocations forward 51 215 Balance brought forward (332) \ (327) (332)
ON BEHALF OF THE BOARD
Thomas Murphy Dermot J. O'Flynn The notes on pages 27 and 28 form part of these financial statements.
25 Source and Application of Funds Statement Year Ended 31st December, 1987
IR£'000 IR£'000
Deficit for Year 24,316 26,722 Grants Received for Year 20,566 22,050
(3,750) (4,672)
Grants Received re: Prior Years 4,384 3,§08 Term Loan 1,884 - Capital Grants Received 1,967 3,976 Disposal of Investment 5 -
4,490 3,112
Capital Expenditure 1,898 3,846 Movement in Working Capital 597 (270)
Net lncrease/(Decrease) in Funds 1,995 (464)
Represented by Decrease/dncrease) in Bank Balances 1995 J464)
26 Notes to the Financial Statements Year Ended 31st December, 1987
NOTE 1. ACCOUNTING POLICIES
(a) Basis of Accounting
The Financial Statements are prepared on the historical cost basis of accounting and both the income and expenditure of the hospital, whether of a capital or revenue nature, are written off to the Income and Expenditure Statement in the year they arise with the exception of the following:-
Retrospective Pay Awards
The expense is charged in the year in which the Department of Health allows the corresponding revenue allocation and therefore not necessarily in the year to which the expense relates.
(b) Government Grants - Capital
Government Grants in respect of the capital expenditure which are unpaid at the accounting date are accrued and shown as being receivable.
(c) Property - Funded by the Department of Health
Expenditure on properties in connection with the Hospital Development Programme were previously accounted for on the basis of payments made less Government Grants received. This accounting policy has now been changed to the same basis of accounting as Government Grants - Capital (1.b.)
(d) Government Grants - Revenue
Government Grants in respect of revenue expenditure are shown as recoverable only to the extent that they have not exceeded the agreed allocation.
(e) Stocks
The stocks on hand at the year end are disregarded for the purpose of these Financial Statements.
27 Notes to the Financial Statements Year Ended 31st December, 1987
NOTE 2. INVESTMENTS
1987 1986 IR£'000 IR£'000
Quoted Investments
Cost 53 58
Market Value 273 260
NOTE 3. GRANTS RECEIVABLE
1987 1986
SRF000 IR£'000
Balance due from previous years (38) 223
Excess of Expenditure over Grants 3,750 4,672
Received
Less Excess over Allocation (46) (549)
3,666 4,346 Capital 2,859 2,929 6,525 7,275 In addition to the above there is an amount of IR£618,000 arising from the excess of expenditure over approved allocation which has been claimed from the Department of Health and which may be reimbursed to the hospital in future years. NOTE 4. BUILDINGS AND EQUIPMENT
The fire insurance valuation of the hospital buildings was £111,000,000 and the equipment was £20,000,000 at 31st December, 1987. These assets are not included in the balance sheet in accordance with the accounting policies in note 1.
NOTE 5. FINANCIAL STATEMENTS APPROVAL
These financial statements were approved on behalf of the Board of Management on 9th August, 1988.
28 DEPARTMENT ACTIVITY SUMMARIES
1983 1984 1985 1986 1987
Accident/Emergency Department
Attendances 63,461 64,586 61,969 57,006 48,739 New Patients 33,073 33,632 33,217 31,363 24,601
Admissions 18,432 18,836 19,562 18,674 17,936 Cardiac Diagnostic 2,682 2,826 3,232 3,591 2,893 Procedures
Cardiac Surgery 917 1,124 1,253 1,119 909
Catering-Main Course Lunches
Patient Kitchen 171,561 167,210 171,563 165,645 145,600 Restaurant 108,000 102,000 115,216 112,840 96,000
Coronary Care Unit 613 415 571 563 448 Admissions
Central Sterile Supply Dept. (Packs)
Hospital Joint Services Board 88,286 76,610 82,560 81,316 72,659 Department Prepared 48,557 49,010 48,410
Child Psychiatry Attendances 19,075 19,037 18,945 16,126 15,209
Clinical Photography Items 9,740 10,003 11,036 13,414 15,914
E.C.G. Examinations (excl. 22,045 20,982 19,226 16,196 15,015 E.C.G.s in CC.U.)
E.E.G. Examinations 1,188 1,054 973 993 718
G.I. Unit Examinations/ Procedures 4,321 5,346 5,989 4,905 3,950
Dietitians' Consultations 16,943 19,359 17,349 15,938 13,389
29 1983 1984 1985 1986 1987
Laundry - items laundered
Hospitals Joint Services Board 728,000 — Commercial Laundry 190,000 871,440 831,500 728,992 712,481
Maintenance Requests 15,000 15,360 14,900 14,000 14,123
Occupational Therapy 627 709 732
Operating Theatres
Main Ops 9,378 9,470 10,134 9,056 7,996 Minor Ops 4,462 3,868 4,152 4,036 3,127
Out Patient Attendances
Out Patient Clinics 101,149 104,070 104,673 105,293 96,889 Sevice Depts. 372,646 396,514 411,659 479,632 462,441 Treatment Depts. 52,630 49,568 47,122 36,583 34,204
Total 589,889 614,738 625,423 678,514 642,273
Pathology Tests 1,117,088 1,132,059 1,120,904 1,228,383 1,111,316
Physiotherapy Department
Total Patients 62,689 63,042 66,652 55,819 48,359 Total Treatments 88,231 88,236 87,350 69,524 62,856
Pulmonary Laboratory
Patients 1,752 1,744 1,852 — —
Radiology Examinations 198,657 101,499 93,341 97,365 83,521
Social Services Department
Interviews 5,221 5,440 5,786 5,565 4,876 Patients Helped 3,318 3,497 3,332 3,276 2,590
30 In Patient Statistics
1983 1984 1985 1986 1987
Admissions 18,432 18,836 19,560 18,674 17,923 Discharges 18,445 18,831 19,567 18,130 17,634 Deaths 379 482 466 508 457 Overall Yearly Percentage Occupancy 91.79% 90.00% 92.19% 93.89% 91.94% Overall Yearly Average Stay (Days) 8.24 7.87 7.75 7.84 6.98 Total Bed Days 152,120 148,188 151,694 145,949 123,629
BED DAYS:
Surgical 49,990 49,027 47,089 45,923 40,314 Medical 66,283 65,498 70,183 68,316 57,008 E.N.T. 3,432 3,226 3,054 2,449 1,680 Ophthalmic 5,763 5,685 5,625 6,285 6,157 Orthopaedic 10,814 10,118 11,201 10,937 9,240 Psychiatric 5,485 4,964 4,686 3,574 2,028 Gynaecology 6,287 5,869 5,688 4,687 4,909 Children 3,894 3,722 3,854 3,670 2,203 Other 172 79 314 108 89
31 Department of Child Psychiatry
1983 1984 1985 1986 1987
New Patients 2,071 2,069 1,703 1,652 1,599 Total Attendances 19,075 19,037 18,036 16,739 15,313 Social Work Sessions 2,342 2,791 2,491 1,836 1,825 Social Work Attendances 4,008 5,160 4,778 3,668 3,574 Psychology Sessions 2,370 2,081 2,365 2,301 2,635 Psychology Attendances 5,423 4,072 4,258 4,023 3,810 Psychiatric Sessions 2,046 2,270 2,104 1,614 1,550 Psychiatric Attendances 5,529 5,816 4,649 4,521 3,396 Speech Therapists Sessions 1,760 1,285 1,346 1,529 1,399 Speech Therapists Attendances 3,087 2,807 3,070 3,712 3,754 Remedial, Educational and Social/Perceptual 260 301 234 182 234 Training Sessions Attendances 1,028 1,182 1,281 815 779
Clinical Photography
1983 1984 1985 1986 1987
Lecture, Demonstrations, Publications — Slides 6,109 5,874 5,681 8,199 8,243 — Prints 2,004 2,607 2,015 2,316 3,681 Clinical Patient Slides/ Retinal Slides, Angiograms. 1,627 1,522 3,340 2,899 3,844
Total 9,740 10,003 11,036 13,414 15,768
32 E.C.G. Unit:
1983 1984 1985 1986 1987
In Patients 12,550 11,208 9,165 9,648 8,961 Out Patients 9,178 9,209 7,617 6,611 5,724 Effort Tests 317 475 388 433 330
Total 22,045 20,982 17,170 16,692 15,015
Coronary Care Unit
Admissions 613 415 571 563 448
E.E.G. Unit
1983 1984 1985 1986 1987
E.E.G.s
ln Patient 469 395 372 289 210 Out Patient 719 659 601 572 508
Total 1,188 1,054 973 861 718
Department 1,154 1,039 973 846 704 Portable 34 15 — 18 15
G.I. Unit
1983 1984 1985 1986 1987
Gastroscopes 2,311 2,593 3,048 2,410 2,177 Colonoscopy (total) 566 807 1,296 1,292 1,104 E.R.C.P. 147 166 160 172 140 Papillatomy 40 63 37 45 40 Sigmoidoscopy 660 510 255 90 17 Other Procedures 597 1,207 967 896 472
Total Procedures 4,321 5,346 5,763 4,905 3,950
33 Occupational Therapy
1983 1984 1985 1986 1987
In Patients 457 587 597 637 217 122 155 187 72 Out Patients 170 709 752 824 289* Total Patients 627
*No service for four months of 1987. Patient Department
1983 1984 1985 1986 1987
Accident/Emergency 63,461 64,586 61,969 57,006 48,739 Cardiology 4,601 4,843 4,860 5,261 5,289 Child Guidance 19,075 19,037 18,036 16,126 15,189 Chiropody 179 187 323 416 353 Colour Vision — — — 17 11 Dental 640 399 288 — — Dermatology 6,543 6,329 4,691 4,670 5,186 Diabetic Day Centre 7,382 5,933 4,618 4,127 4,573 E.C.C. 9,495 9,414 7,776 6,229 10,645 E.E.C 833 658 776 528 549 E.O.C. — — — 131 73 Endocrine 5,980 5,367 5,595 6,005 5,451 E.N.T. 4,347 4,161 4,524 4,323 3,728 E.M.G. 413 418 408 386 322 E.R.C. — — — 183 170 Fertility/Infertility 573 596 527 553 521 Fracture 7,356 8,460 7,988 8,977 8,513 Genetics 143 100 136 105 75 G.I. 3,277 3,121 2,911 3,711 3,331 Gynaecology 2,189 2,166 2,245 2,321 2,162 Haematology 1,159 1,591 1,575 1,767 1,452 Liver 203 274 273 291 318 Medical 6,525 6,262 5,794 5,152 4,966 Minor Procedures 4,788 4,328 4,664 3,582 4,703 Nephrology 649 651 822 778 789 Neurological 833 490 569 509 622 Oncology — 107 433 1,150 1,179 Ophthalmic 10,399 11,398 11,736 13,184 11,324 Orthopaedic 5,829 6,131 6,838 5,321 4,592 Pace Maker 398 430 388 329 315 Laboratory 37,946 58,640 77,407 49,837 24,906 Physical Medicine 5,514 5,683 5,670 5,858 5,318 Physiotherapy 3,555 30,531 29,217 20,457 19,105 Post Operative 2,059 2,183 2,242 1,990 1,697 Prothrombin Clinic — 3,881 6,513 6,678 6,463 Psychiatry 3,563 3,453 3,149 2,571 2,035 Pulmonary Laboratory 1,020 1,121 941 1,117 1,090 Radiology 23,355 26,681 24,759 21,024 21,227 Respiratory 1,596 1,622 1,450 2,224 2,253 Surgical 14,011 13,497 13,312 13,459 12,924 V.E.R. — — — 161 115
1 589,889 614,729 625,423 678,514 642,273
35 Pathology
1983 1984 1985 1986 1987
Patients
In Patients 701,892 697,397 673,513 736,377 660,364 Out Patients 337,946 357,424 370,182 448,837 425,446 48,842 52,778 26,191 Private Patients 49,582 1,103,663 1,096,473 1,211,405 1,085,810 Total Patients 1,089,420
Tests Biochemistry 601,415 609,631 594,086 616,259 538,066 Haematology 325,236 327,682 327,588 437,792 415,057 Bacteriology 127,725 133,287 133,523 113,442 105,488 Tissue (Histo- pathology Biopsy) 6,515 6,326 6,643 6,217 5,833 Immunology 21,546 18,761 24,234 16,849 14,403 Blood Groups 6,886 8,077 8,213 7,882 6,729 Radioimmuno Assay Laboratory 27,577 28,099 26,402 29,718 25,521 Post Mortems 188 196 215 224 219
Tests 1,117,088 1,132,059 1,120,904 1,228,383 1,111,316
ib Physiotherapy:
1983 1984 1985 1986 1987
Total Patient Attendances 62,689 63,042 66,652 55,819 48,359
Treatments
Exercises 21,556 16,969 16,252 12,996 11,083 Chest Unit 21,134 20,109 23,479 20,164 16,170 Orthopaedic Unit 12,465 13,157 13,598 11,713 9,532 Neurological Unit 6,629 8,019 8,427 7,183 8,873 Ultraviolet 2,729 3,320 2,721 2,905 2,875 Cervical Lumbar Traction 2,403 2,553 2,539 1,698 1,712 Hydotherapy — — — — — Mobilisation 3,280 8,683 4,611 3,037 5,132 Intra Farential — 3,255 3,042 2,671 Electrical 704 601 423 211 2,662 Heat.— Shortwave Diathermy, Infra Red, Ultra Sonic Therapy, Wax Treatments, Total:— 17,331 11,470 12,263 6,947 4,817
Total Treatments 88,231 88,236 87,355 69,524 62,856
37 Radiology:
1983 1984 1985 1986 1987
General Work 46,826 51,384 45,565 48,001 40,231 Specials 1,821 1,554 1,698 1,535 1,269 Barium Meals 3,156 3,503 2,777 2,862 1,960 Barium Enemas 1,487 1,558 1,454 1,591 1,120 I.V.P.s 1,525 1,543 1,430 1,460 1,416 G.B.s 857 838 742 740 475 Xerography 690 482 705 948 459 Scanning 3,946 3,215 3,403 3,240 2,621 Ultrasound 3,381 3,686 2,770 3,307 3,142
Total 63,689 67,763 60,544 63,684 52,693
Cardiovascular X-ray
Patients 861 954 1,087 1,105 982 2,826 3,232 3,500 2,893 Procedures 2,682
Accident/Emergency Department 33,176 32,797 30,977 26,953 X-Rays 34,968 103,765 96,573 98,161 83,521 Grand Total 101,339
38 Social Services:
1983 1984 1985 1986 1987
Interviews
New Patients 1,753 1,911 1,830 1,923 1,591 Others 3,468 3,529 3,956 3,642 3,285
Total 5,221 5,440 5,786 5,565 4,876
New Patients
In Patients 1,244 1,402 1,365 1,417 1,204 Out Patients 503 501 399 417 311 Private Hospital 7 11 8 7 3 Home Visits 35 58 58 41 44
Total 1,789 1,972 1,830 1,882 1,562
Return Patients 1,564 1,525 1,502 1,394 999
Total Patients Helped 3,318 3,497 3,332 3,276 2,590
39 Theatres:
1983 1984 1985 1986 1987
General 2,113 2,115 2,156 1,852 1,617 G.U. 854 762 874 721 873 Orthopaedic 1,311 1,322 1,640 1,655 1,489 Vascular 571 506 416 327 364
Cardiac Surgery
Open Heart Surgery 659 815 948 870 738 Pacemakers 151 138 125 108 47 Miscellaneous 107 171 167 138 124
Endoscopies 262 217 166 102 71 Thoracic 64 66 83 99 93 Ophthalmic 1,562 1,546 1,685 1,677 643 E.N.T. 1,535 1,581 1,734 1,689 1,687
Gynaecology 975 850 906 792 726
Dental 109 67 139 27 21 E.C.T. 45 19 60 20 6 Minor 3,262 2,880 2,941 2,686 2,167 Plaster of Paris 260 183 147 142 196 Plastic 267
Total 13,840 13,238 14,186 12,905 11,123
TOTAL MAJOR 9,378 9,470 10,134 9,056 7,996
TOTAL MINOR 4,462 3,868 4,052 4,036 3,127
40 ACADEMIC CLINICAL DEPARTMENT OF MEDICINE Staffing
CONSULTANT: Professor T.B. Counihan (Head, Department of Medicine, University College Dublin.)
ACADEMIC STAFF: Dr. D.A. Cusack Dr. N. O'Meara (Special Lecturers in Medicine University College, Dublin.)
NON-CONSULTANT 2 Registrars HOSPITAL DOCTORS: 3 Senior House Officers 2 Interns
ASSOCIATED 3 Research Assistants MEDICAL STAFF:
BIOCHEMIST: Ms. L Garvey
Scope of Service
The principal activities of the department centre around the education of the medical students. In addition, the department has full health service commitments, including on-call rota and acute coronary care rota. The arrangement with Dr. J. Donohoe, nephrologist, was continued as in recent years and junior staff were attached to his service in rotation.
Special Interests
The special interests of the department lie in cardiological service and research. Worthy of particular mention is the special prothrombin clinic which is held weekly in conjunction with Dr. B. Otridge and also the cardiac rehabilitation clinic which is also conducted weekly with the aid of members of the department of physiotherapy.
Research Activities
Research activities include fibrinolysis in the therapy of acute myocardial infarction, which has been shown to be of remarkable benefit when applied early; the use of the anti-arrhythmic drug, amiodarone, in the management of acute cases of tachy-arrhythmias and in the longterm prevention of recurrences, especially in coronary and hypertrophic heart muscle disease. Special study of
41 its effects of thyroid gland iodine metabolism are being conducted in conjunction with Dr. P. Smyth of the on-campus section of the department at Woodview. The effectiveness of the novel agent flosequinan in the treatment of resistant congestive cardiac failure is under study. The treatment and prevention of hypercholesterolemia and its attendant problems continued to occupy much attention. The department's special interest and expertise in this area of cholesterol metabolism received very welcome recognition in the form of the present of the new apheresis machine from Braun Medical and it is expected to be in clinical use in 1988. The helpful participation of the department of biochemistry of University College in the persons of Professor M.G. Harrington and Ms. L. Garvey in the groundwork herein is acknowledged gratefully. Laboratory research into the possible effects of beta-blockade on lipoprotein metabolism is continued by Dr. F. Callan and the work on the use of diltiazem in angina was completed by Dr. J. Kenny.
Overseas students continued to flock in and applications for electives were received and accepted from as far away as Australia. The Germans continued to outnumber all the others. If this demand continues to grow, it may require special arrangements as student resources may become overstretched.
An unfortunate effect of the financial squeezes was no provision of funds for the usual student research projects in the summer of this year, from our usual sources; but several consultants managed to procure funds to support a limited number of projects for their students, and the results were presented in the autumn at a lively meeting held for the purpose in the hospital.
Meetings and Conferences
Professor T.B. Counihan attended meetings of the Medical Research Society at the Charing Cross Hospital at Hammersmith Hospital and in Guilford; of the American College of Cardiology in New Orleans; the Association of Physicians of Great Britain and Ireland in Dundee; the British Cardiac Society in Dundee; the Joint Meeting of the Graduates' Hospital and Faculty of Medicine of University College, Dublin at Philadelphia; the symposium on plasma apheresis therapy for hypercholesterolaemias in Gottingen; the APSAC Thrombolysis Investigators' meeting in London; and the symposium on 'New Frontiers in Arrhythmias in heart failure' in London.
Addresses
Addresses given by Professor T.B. Counihan included those on coronary thrombolysis at the University College, Dublin Research Symposium in Belfield and on APSAC in the postgraduate centre at the Mater Misericordiae Hospital; and on medical v surgical therapy of ischaemic heart disease at Philadelphia, United States of America.
42 Publications
Hypertrophic cardiomyopathy: Ten years' experience. J. Kenny and others.
APSAC therapy of acute myocardial infarction. Multicentre study in the United Kingdom and Ireland. 5. Lane, M. Sheehan, R. Conroy.
Acknowledgements
Grateful acknowledgement is made to the administration of the Mater Misercordiae Hospital for facilitation of teaching and examining students; to Sr. M. Lucia Therese, Matron, Srs. M. Baptist, M. Benedict and A. Quigley and their ward staffs for their splendid co-operation in conducting the several clinical examinations, and especially the very demanding final medical examinations at various times during the year. Thanks to a number of very generous donors, many of whom prefer to remain anonymous, funds for the research activities of the department continued to do exciting work, even if more frugally than ever; and the essential part played in this support by Heart Care is especially gratefully acknowledged.
Out Patient Clinics
General/Cardiac: Wednesday 2.00 p.m. — 5.00 p.m. Cardiac: Friday 11.00 a.m. — 1.00 p.m. Prothrombin: Tuesday 2.00 p.m. — 4.00 p.m.
43 ACCIDENT/EMERGENCY DEPARTMENT Staffing CONSULTANT: Dr. P. O'Connor
NON-CONSULTANT 8 Casualty Officers HOSPITAL DOCTORS:
NURSING STAFF: 1 Departmental Sister 16 Casualty Staff Nurses 4 Casualty Course Staff Nurses
CLERICAL AND 2 Clerks ADMINISTRATIVE STAFF: 1 Porter Scope of Service
1987 has seen major changes within the accident & emergency department of the Mater Misericordiae Hospital. The first major change came in the introduction of severe cutbacks resulting in reduced hours of opening and ultimately in reduced numbers of casualty officers and nurses. These changes were introduced midway through the year and were compounded late in the year by a major change in the accident & emergency services on the north side of the city. In addition, a £10.00 charge was levied on all non-medical card patients at the same time as the hours of opening were reduced.
In November 1987 Jervis Street Hospital and St. Laurence's Hospital closed and Beaumont Hospital opened. As a result, the accident & emergency roster was changed, being now based on three major centres. All three hospitals are open from 9.00 a.m. to 5.00 p.m. and a rota exists covering the 5.00 p.m. to 9.00 a.m. time. As this new rota started only on 1st December, 1987 too little time has passed to allow for detailed analysis of its effects on the accident & emergency department of the Mater Misericordiae Hospital.
A further major change was the introduction of an on line computer system to the accident & emergency department. This new facility began in July and during the succeeding months the full impact of the system is slowly being evaluated. There are parctical problems in persuading doctors to become skilled in the entering of data into the system. It should be noted that the clerical and nursing staff have assimilated this skill to a far greater extent. The use of the medical students during busy times has proved a vital factor in maintaining a steady flow of first-class statistics. At the present the computer system is mainly for patient registration and incident evaluation. Its later
44 radiology department.
Teaching continues for the casualty officers and for the post The postgraduate etra.ning f^^^^^^S^^Z ssrsr i «^is si SOLS ^arxr-is=pSrtrainin8 |S a,so carned oui wifhin the confines of the casualty department. Publications
Communication and general practice. (In press). M Houston, P. O'Connor.
Entering data into accident/emergency computer system
45 ADMISSIONS UNIT Staffing
ADMISSIONS OFFICER: Miss S. O'Neill
The number of patients admitted during 1987 was seventeen thousand, nine hundred and thirty-six, a drop of 3.7% to 1986.
Early 1987 saw the introduction into the department of the first module of the hospital information system. This facilitated greater flexibility in the admission process and also provided significantly improved management information and communication. The system, together with the introduction of the two five day wards during 1987 helped considerably to inform patients in advance of their pending admission date.
The provision of enough accident/emergency beds still posed problems for the department.
1984 1985 1986 1987
Total Admissions 18,836 19,562 18,622 17,936
Admissions per Health Board
Eastern Health Board 14,411 15,109 14,133 13,668 North Eastern Health Board 1,701 1,615 1873 1,830 South Eastern Health Board 869 809 719 601 Midland Health Board 572 583 540 527 Southern Health Board 317 295 257 166 Mid Western Health Board 237 293 316 308 Western Health Board 256 324 315 284 North Western Health Board 432 493 569 515 Others 30 39 37
46 ADULT PSYCHIATRY DEPARTMENT Staffing
CONSULTANT: Professor J.P. Malone
NON-CONSULTANT 2 Registrars HOSPITAL DOCTORS: 1 Senior House Officer 1 Intern
SECRETARIAL STAFF 1 Secretary
The department is fully accredited by the Royal College of Psychiatrists as a centre for post-graduate training in psychiatry. Scope of Service
The department provides:—
(a) An outpatient assessment and treatment service. In 1987, there were one thousand nine hundred and thirty-two attendances to the out patient department, including one hundred and fifty-nine new patients.
(b) An inpatient treatment service in the Mater Misericordiae Hospital. In 1987, ninety-seven patients were treated.
(c) A psychiatric treatment service. In 1987, there were three hundred and three consultations. 58% were female and 41% were male. 11% were from surgical teams and 89% were from medical teams.
Reasons for referral:—
15% — Attempted suicide (parasuicide) 26% — Depression 10% — Neuroses (neurotic disorders) 7% — Acute organic brain syndrome 10% — Alcohol dependence syndrome 3% — Neurological disorders (epilepsy) 11% — Others (drug addiction, chest pain, personality disorders) 2% — Anorexia/bulimia nervosa 2% — Nil psychiatric 4% — Chronic organic brain syndrome (dementia). 10% — Functional psychosis.
(d) An extensive undergraduate and postgraduate training programme.
(e) An integrated inpatient and outpatient service with St. Vincent's Hospital, Fairview.
47 Referrals from Mater Misericordiae Hospital to St. Vincent's Hospital
Total — 23 Bereavement Counselling — 15 Total number of home visits — 236
Teaching
Mater Misericordiae Hospital Nurses — One hour each month, when possible taken on home visits.
Conferences
Royal College of Psychiatrists. London, England. Three quarterly meetings. J.P. Malone.
Association of University Teachers in Psychiatry. Annual meeting. London, England. J.P. Malone.
Regular Meetings
Tuesday — 11.00 a.m. Case conference with medical social workers.
Wednesday — 8.30 a.m. Case conference with Professor J.P. Malone.
Wednesday — 11.30 a.m. Case conference — St. Vincent's Hospital, Fairview.
Friday — 10.00 a.m. Monthly interdisciplinary journal club with department of child psychiatry.
Friday — 12.00 a.m. Weekly journal club.
Out Patients Clinics
Monday 9.30 a.m. — 12.30 p.m.
Thursday 9.30 a.m. — 12.30 p.m.
48 DEPARTMENT OF ANAESTHESIA AND INTENSIVE CARE
Staffing
CONSULTANT: Dr. D.C. Moriarty (Chairman) Dr. W.P. Blunnie (Hon. Secretary, Research and Undergraduate Teaching Co-ordinator.) Dr. J.B. Magner Dr. J.R. McCarthy Dr. D.A.C. Breslin Dr. D.G. Tyrrell Dr. M. Floyd Dr. R. MacSullivan Dr. D. Phelan (Director of Intensive Care)
University Department of Anaesthesia
Dr. D.C. Moriarty (Senior Lecturer) Dr. C. Fitzpatrick (Tutor) Dr. M.G. Coughlan (Senior Research Registrar)
NON-CONSULTANT 4 Senior Registrars HOSPITAL DOCTORS: 4 Registrars/Senior House Officers 3 Supernumeraries Dr. A. Al-Sherooqi, Bahrain. Dr. M. El Karamani, Egypt. Dr. A. Omar Shiref, Libya.
CLERICAL AND ADMINISTRATIVE STAFF: 1 Secretary
Dr. D. Moriarty continues as chairman of the Examination Committee of the Faculty of Anaesthetists, Royal College of Surgeons in Ireland and is the representative of the Royal College of Surgeons in Ireland on the Collegiate Liaison Group on Intensive Therapy of the Conference of the Royal Colleges. He is also exchange examiner in Part III of the Final Fellowship of Anaesthesia examination in London, England in July 1987.
Dr. J.R. McCarthy is chairman and examiner in Part I of the Final Fellowship in Anaesthesia examination, Royal College of Surgeons in Ireland.
Dr. R. MacSullivan is the Mater Misericordiae Hospital representative on the Medical Advisory Committee and on the Council of Academy of Medicine in Ireland Anaesthetic Section.
49 Dr. D. Tyrrell was nominated as representative of the Faculty of the Joint Higher Training Committee and continues as a member of the Electro Technical Council of Ireland.
Drs. McCarthy, Tyrrell, Magner, Breslin, MacSullivan and Moriarty were examiners in Part 111 of the Final Fellowship in Anaesthesia examination, Royal College of Surgeons in Ireland. Drs. MacSullivan and Moriarty examined in Part 11 of the Final Fellowship in Anaesthesia examination and Drs. MacSullivan, Phelan and Blunnie examined in Part I.
Dr. J.R. McCarthy is the Irish representative on the European Society of Cardiothoracic Anaesthetists.
Dr. W.P. Blunnie is the Mater Misericordiae Hospital representative on the Irish Committee of the Association of Anaesthetists of Great Britain and Ireland. A highly successful study day for trainees in anaesthesia was held in April 1987, organised by Dr. W.P. Blunnie.
INTENSIVE CARE
Director: Dr. D. Phelan
The hospital encompasses a busy thirteen bed intensive care unit catering for over twelve hundred admissions per year. The admissions are generally short stay in nature and most frequently follow major surgery in which circulatory and/or respiratory disturbance can be anticipated — the bulk of which comprise post-operative cardiothoracic patients. Patients from medical disciplines also account for a substantial proportion of the admissions e.g. those suffering from acute vital organ dysfunction such as severe pneumonia, status epilipticus and acute renal failure. Referrals are received from other institutions particularly of patients afflicted with "classic i.c.u. illnesses" e.g. tetanus, Guillain Barre and multiple traumatised patients.
The facility to manage all medical emergencies and multiple organ system dysfunction requires a high nursing presence and continuous medical resuscitative and management input. The maintenance of familiarity with relevant technological innovation and the medical co-ordination of the multidisciplinary team involved in the care of the critically ill is a central role of the department. Regular ward rounds are integral to this role and provide an important training opportunity for postgraduates and for medical students attached to the department.
Management of Chronic Pain
During 1987 the anaesthetic department became involved in the management of patients with chronic pain. The demand for this service increased significantly during the year and involved assessment, treatments and follow-up. Referrals
50 were from many specialties within the hospital but the main sources were orthopaedic, rheumatology, plastic surgery and oncology. They principally involved the management of sympathetic dystrophies and pain in the terminally ill. It is planned to formalise the service in the near future by developing a pain management unit within the hospital co-ordinated by Dr. R. MacSullivan. This will involve multidisciplinary approach to pain in the inpatient and outpatient. Meetings Attended
Faculty of Anaesthetists meeting. London, England. March 1987. D.C. Moriarty.
Winter meeting of Association of Anaesthetists of Great Britain and Ireland. London, England. January 1987. D.A.C. Breslin.
Symposium on volatile anaesthetics. Edinburgh, Scotland. October 1987. J.R. McCarthy.
Examination committee for Final Fellowship in Anaesthesia examination. J.R. McCarthy.
Symposium on propofol. London, England. November 1987. J.R. McCarthy.
European Society of Regional Anaesthetists Conference. Dublin. September 1987. J.R. McCarthy, W.P. Blunnie, R. MacSullivan.
Biological Science Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. W.P. Blunnie.
Biological Science Section, Royal Academy of Medicine in Ireland. Belfast. June 1987. W.P. Blunnie.
Anaesthetic Research Society. London, England. November 1987. W.P. Blunnie.
International Symposium on muscular relaxation. London, England. December 1987. W.P. Blunnie.
Autumn Anaesthesia Faculty Meeting. Royal College of Surgeons in Ireland. Belfast. September 1987. W.P. Blunnie, R. MacSullivan, D.C. Moriarty.
Annual scientific meeting. Intensive Care Society (Ireland), Royal College of Surgeons in Ireland. June 1987. Organiser: Dr. D.M. Phelan. Attended by: R. MacSullivan, D.C. Moriarty, D. Tyrrell, D.A.C. Breslin, W.P. Blunnie.
51 Critical Care 1987. British Journal of Hospital Medicine. London, England. August 1987. DM. Phelan.
Intensive Care Society meeting. Exeter, England. April 1987. DM. Phelan.
European Society Parenteral and Enteral Nutrition. Barcelona, Spain. September 1987. DM. Phelan.
Medical Scientific meeting. University College, Cork. September 1987. R. MacSullivan.
Presentations and Lectures
Role of colloid in resuscitation. Haematology Symposium — Mater Misericordiae Hospital Blood Bank. February 1987. K. Flynn.
Captopril in intensive care. Intensive Care Society. April 1987. K. Flynn, DM. Phelan.
Adult respiratory distress syndrome. Mater Misericordiae Hospital anaesthetic department study day. April 1987. DM. Phelan.
Organ transplantation — care of the donor. Association of Critical Care Nurses (Ireland). May 1987. DM. Phelan.
Theophylline toxicity. Stress atenuation in ophthalmology. Preservation of renal function in acute illness. Joint Mater Misericordiae Hospital/St. Vincent's Hospital Symposium. December 1987. G. Coughlan, V. Geary.
Intensive Care Society Ireland. Scientific meeting. June 1987. Haemodynamic manipulation — K. Flynn. Intensive care — whose subspecialty? — DM. Phelan. Intensive care medical training — D.C. Moriarty.
Captopril following cardiothoracic surgery. Guest lecture. Association Cardiothoracic Anaesthetists. June 1987. K. Flynn.
Parenteral and enteral nutrition. Anaesthetic Department, St. Vincent's Hospital. Guest lecture. September 1987. DM. Phelan.
52 Nutrition in intensive care. First scientific meeting for anaesthetists in training. Cork. October 1987. D.M. Phelan.
The role of the cell saver. Association of Anaesthetists meeting. Belfast. April 1987. D.C. Moriarty.
Changes in theatre blood requirements. Intensive Care — which way further. Bahrain. November 1987. D.C. Moriarty.
Alternatives to blood. Joint meeting of the Mater Misericordiae Hospital and St. Vincent's Hospital. November 1987. D.C. Moriarty.
Spirometers — a clinical measurement study. Biological Sciences Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. L.W. Curtin, LP Claffey, W.P. Blunnie, J.A. Dunphy.
The influence of light general anaesthesia on the absorption of oral sustained release morphine. Biological Sciences Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. N. McDonald, J. Fitzpatrick, K. O'Sullivan, A.J. Synnott, W.P. Blunnie.
The value of self administered perioperative physiotherapy. Biological Sciences Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. B. Crawford, W.P. Blunnie, A.C.P. Elliott.
The influence of cardiopulmonary bypass on plasma morphine levels after intrathecal morphine administration. Biological Sciences Section, Royal Academy of Medicine in Ireland. Belfast. June 1987. LP. Claffey, W.P. Blunnie, A.J. McShane, A.J. Synnott.
Pain management unit in Sir Charles Gardiner Hospital, Perth, Western Australia. November 1987. Attended by: R. MacSullivan.
Registrar's Prize. Morphine-6-glucuronide in cerebro spinal fluid after intra-muscular and oral administration; potential analgesic contribution. Royal Academy of Medicine in Ireland. Dublin. December 1987. LP. Claffey, W.P. Blunnie. WINNER OF MEDAL.
Evaluation of the Triflo incentive deep breathing exerciser after cholecystectomy. Anaesthetic Research Society of London. November 1987. B. Crawford, W.P. Blunnie, A.C.P. Elliott.
A comparison of nasal end tidal (PE1 C02) and arterial carbon dioxide (PaC02) tensions in cardiothoracic patients.
53 Biological Sciences Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. P.J. McArdle, LP. Claffey, J.A. Dunphy W.P. Blunnie.
The dilution effect of flush solution on arterial blood samples. Biological Sciences Section, Royal Academy of Medicine in Ireland. Dublin. January 1987. P. Glackin, LP. Claffey, W.P. Blunnie.
The perioperative use of slow release metoclopramide in cardiac surgery patients. Biological Sciences Section, Royal Academy of Medicine in Ireland. Belfast. C. Boyhan, LP Claffey W.P. Blunnie, J.A. Dunphy.
Comparison oi respirometers. Anaesthetic Research Society. Glasgow, Scotland. April 1987. J.A. Dunphy, LP. Claffey, W.P. Blunnie, LW. Curtin.
The influence of regional anaesthesia on the perioperative stress response. European Society of Regional Anesthetists. Dublin. September 1987. W.P. Blunnie.
Intrathecal morphine in cardiac surgery. Delaney Medal Competition — Royal College of Surgeons in Ireland. March 1987. C. Fitzpatrick.
Sustained release oral morphine — the influence of general anaesthesia. Anaesthetic Research Society of London. November 1987. / Fitzpatrick, N. McDonald, W.P. Blunnie, K. O'Sullivan, A.J. Synnott.
Slow release metoclopramide in the perioperative cardiac surgery period. Anaesthetic Research Society, London. November 1987. LP. Claffey, W.P. Blunnie, C Boyhan.
Current Research Activities
A wide range of research activites are ongoing. These include:
1. The use of Sufentanyl to suppress stress response. 2. Intrathecal opiates for post-operative pain relief. 3. Flumazenil after central catheter placements. 4. Evaluation of patient-controlled analgesia. 5. Analysis of efficacy of invasive modalities in intensive care.
54 Publications
Autotransfusion: quality of blood prepared with a red cell processing device. British Journal of Anaesthesia, 59: 1035-1039. 1987. A.J. McShane, C. Power, J.F. Jackson, D.F. Murphy, N. McDonald, D.C. Moriarty, B.W. Otridge.
A comparison of nasal end tidal (PEC02) and arterial carbon dioxide (PaC02) tensions in cardiothoracic patients. Irish Journal of Medical Science, 156: 295-296. 1987. P.J. McArdle, LP. Oaffey, J.A. Dunphy, W.P. Blunnie.
Cerebral oedema and the fat embolism syndrome. Intensive Care Medicine, 13: 291-292. 1987. R.I. Meeke, C.J. Fitzpatrick, D.M. Phelan.
Spirometers — a clinical measurement study. Irish Journal of Medical Science, 156: 295. 1987. L.W. Curtin, LP. Oaffey, W.P. Blunnie, J.A. Dunphy.
Potential analgesic contribution from morphine-6-glucuronide in cerebro spinal fluid. The Lancet, II: 1207-1208. 1987. C.W. Hand, W.P Blunnie, LP. Oaffey, A.). McShane, H.J. McQuay, R.A. Moore.
Radial artery cannulation: a prospective study. Irish Journal of Medical Science, 156: 279. 1987. C.J. Fitzpatrick, N. McDonald, D.C. Moriarty.
Comparison of respirometers. British Journal of Anaesthesia, 59: 1323. 1987. J.A. Dunphy, LP. Oaffey, W.P. Blunnie.
The dilution effect of flush solution (NaCI with 1,000 iu heparin L-1) on arterial blood samples. Irish Journal of Medical Science, 156: 298. 1987. P. Clackin, LP Oaffey, W.P. Blunnie.
The influence of light general anaesthesia on the absorption of oral sustained release morphine. Irish Journal of Medical Science, 156: 298. 1987. N. McDonald, J. Fitzpatrick, K. O'Sullivan, A.J. Synnott, W.P. Blunnie.
The value of self administered perioperative physiotherapy. Irish Journal of Medical Science, 156: 299. 1987. ft Crawford, W.P. Blunnie, CP. Elliott.
55 CARDIAC MEDICINE DEPARTMENT Staffing
CONSULTANTS: Professor S. Blake Professor T.B. Counihan Dr. C McCarthy Dr. D. Sugrue Dr. J. Horgan (also St. Laurence's Hospital)
NON-CONSULTANT 2 Registrars HOSPITAL DOCTORS: 1 Senior House Officer 2 Interns 1 Research Fellow
PARA-MEDICAL STAFF: 4 E.C.G. Technicians 3 Cardiovascular Technicians 1 Dietician
CLERICAL STAFF: 2 Clerk Typists
Scope of Service
All forms of heart disease are investigated and treated. Therefore patients were received from many sources, including general practitioners, other hospitals throughout the country, the accident/emergency department and the coronary ambulance service. Of late, following the reduction in total hospital bed numbers, the majority of the twenty-six cardiac beds are being filled from the accident/emergency department. This makes it difficult to admit patients electively for cardiac investigations so that the department is no longer capable of properly subserving its function as a tertiary referral centre. It is hoped that this unsatisfactory situation may be mended in the not too distant future.
There is a coronary unit of five beds which is inadequate to meet current demands, but it is expected that this problem will be resolved following transfer to the new block.
Special Equipment and Techniques
The cardiac laboratories are fully equipped for the various types of cardiac investigations. They provide facilities for cardiac catherisation, bi-plane cine and cut-film angiography, electrocardiography, doppler studies, Holter monitoring, resting and stress electrocardiography and plethysmography. They are also used for therapeutic procedures such as temporary or permanent cardiac pacing, electroconversion of trachyarrhythmias and coronary angioplasty.
56 Facilities for scintigraphic studies are available in the scanning section of the general radiology department.
Research Activities
Current research interest is in:-
1. Thrombolysin therapy in myocardial infarction. 2 The study of the results of heart surgery both in the Mater Misericordiae Hospital and in other centres in the country. 3. Drug therapy for hypertension and coronary heart disease. 4. Treatment of hyperlipidaemia. 5. Cardiac electrophysiology.
Publications
Out of hospital cardiac arrest in patients without clinically significant coronary artery disease — comparison of clinical, electrophysiological and survival characteristics with those in similar patients who have clinically significant coronary artery disease. British Heart Journal, 58: 322. 1987. D.D. Sugrue et al.
Impact of intracardiac electrophysiologic testing on the management of elderly patients with recurrent syncope or near-syncope. Journal of American Geriatric Society, 35: 1079. 1987. D.D. Sugrue et al.
The results of percutaneous transluminal coronary angioplasty for unstable angina pectoris in the elderly. Journal of American College of Cardiology, 9: 150. 1987. D.D. Sugrue et al.
T-lymphocyte subsets in patients with idiopathic dilated cardiomyopathy and their relationship to the durcation of symptoms. Circulation, 76: 263. 1987. D.D. Sugrue et al.
Repeat coronary balloon angioplasty for symptomatic restenosis: a note of caution. European Heart Journal, 8: 697. 1987. D.D. Sugrue et al.
Role of invasive electrophysiologic testing in patients with symptomatic bundle branch block. American Journal of Cardiology, 59: 817. 1987. D.D. Sugrue et al.
The state of cardiac transplantation. British Medical Journal, editorial, 295: 456. 1987. D.D. Sugrue et al.
57 Out Patient Clinics
Monday 2.00 p.m. Thursday 2.00 p.m. Friday 9.00 a.m.
1983 1984 1985 1986 1987
E.C.G. Unit: In Patients 12,550 11,208 9,165 9,648 8,961 Out Patients 9,178 9,209 7,617 6,611 5,724 Effort Tests 317 475 388 433 330
Total 22,045 20,982 17,170 16,692 15,015
Cardiovascular Invasive Studies Total Patients 861 954 1,087 1,105 982 Total Procedures 2,680 2,826 3,232 3,500 2,893
Coronary Care Unit Admissions 13 415 571 563 448
58 CARDIOTHORACIC SURGERY DEPARTMENT Staffing
CONSULTANTS: Mr. M.C. Neligan (also Our Lady's Hospital for Sick Children, Crumlin.)
Mr. A.E. Wood (also Our Lady's Hospital for Sick Children, Crumlin.)
Mr. D. Luke (also Royal City of Dublin Hospital, Baggot Street.)
Ms. E. McGovern (also Royal City of Dublin Hospital, Baggot Street and St. James's Hospital).
NON-CONSULTANT 3 Registrars HOSPITAL DOCTORS: 1 Senior House Officer 3 Interns
PARA-MEDICAL STAFF: 7 Perfusionists
The total number of operations this year was seven hundred and forty-nine. This was less than expected as the workload was restricted because of reduced nurse staffing levels and financial stringencies. The heart transplant programme continued and ten transplants have been performed.
Educational Activities
During the course of the year the unit participated in all teaching and all activities in undergraduate and postgraduate levels. The thoracic surgery case conference is on Friday mornings at 8.15 a.m.
Out Patient Clinics
Cardiac Pacemaker 1st Thursday 2.00 p.m. of every month
Mr. A.E. Wood — 10.00 a.m. Thursday Thoracic/Cardiac Surgery
Mr. M. Neligan 2.00 p.m. Thursday (Post-op. clinic)
59 CHAPLAINCY DEPARTMENT
Staffing
CHAPLAINS: Rev. F. Monks, O.S. Cam. Rev. M. Geraghty O.S. Cam. Rev. O. Dolan, O.S. Cam. Rev. W. Gourley Rev. E. Wilkinson
PASTORAL CARE WORKERS: Sr. M. Raymond Sr. Marian Joseph
SUPERVISOR: Sr. Louisa Ritchie (Clinical Pastoral Educations)
Illness can be a time of profound crisis and questioning for the sick themselves, for their families and for those who care for the sick. Questions arise about the meaning of life and death, the problems of suffering and pain, also about one's values and priorities in life and about faith and the goodness of God It can also be a time of grace, of great personal and spiritual growth when God invites us through Christ our Healer to draw closer to Him in faith, hope and love. The chaplain assists the patient and his/her dear ones in this growth by bearing witness to Christ's very special love and concern for the sick, by the celebration of the Eucharist and of the other sacraments, especially the Sacrament of the Sick, and by a broadly based pastoral couselling and supportive service to patients, their families and indeed the entire health care team of the hospital. In this way his work is seen as complementing the work of other hospital personnel in the common task of all to provide a service of total patient care.
Scope of Service
To help the patient cope with pain and suffering.
To administer the Sacraments to patients and staff.
To pray with the patient.
To assist the patient undergoing fears and anxieties resulting from sickness.
To support the patient with personal and family problems.
To visit patients before surgery and at other times of stress.
To help the patient face death with calmness and dignity.
60 To comfort the patient's relatives.
To arrange and provide ward masses for the sick.
To provide church services in the hospital for hospital staff.
To arrange and conduct funeral services in the hospital mortuary.
To contribute to the training and education of student nurses.
To be available to hospital employees. To organise courses in clinical pastoral education.
To keep all staff informed of latest developments in pastoral care.
Ongoing Projects
A small group representing different disciplines within the hospital was established to help organise mutual support days for staff. As a result of their efforts, a mutual support evening was held in May on 'Communication' led by Fr. F. Monks, Os Cam., Mr. G. MacGabhann, and Miss E. O'Leary.
Three basic units of the clinical pastoral education were supervised by Sr. Louisa Ritchie during the year.
The chaplaincy department met with members of the medical social services department to discuss areas of mutual support.
A meeting was held with the school of nursing staff to see how the chaplaincy department could contribute better to the training and education of the student nurses.
Happenings
History was made in the hospital chapel with the baptism in June of the baby of one of our patients who spent considerable time with us in intensive care unit no. 1 and with the baptism of the grandson of Professor Dwyer Joyce in December.
The 50th anniversary of the dedication of the hospital chapel was celebrated on December 14th 1987. Many past chaplains joined with the Most Reverend James Kavanagh D.D. in concelebrated mass. Representatives from the staff were involved in the readings, the prayers of the faithful and the offertory procession. Patients throughout the hospital were anointed during the ceremony. All retired to the convent refectory afterwards for refreshments.
61 Concelebrated Mass for 50th anniversary of hospital chapel.
The annual staff mass on the feast of Our Lady Health of the Sick was celebrated on November 16th 1987 at 8.15 a.m. for the night staff and again at 12.45 p.m. for the day staff. Symbols chosen by each department, which best described their role in the total care of the patients were presented at the offertory by Sr. M. Margherita. Chief celebrant was Fr. B. Molloy SS.CC.
A well attended retreat day for staff was conducted by Fr. Monks and Fr. Molloy at Emmaus Conference Centre, Swords. A half day of recollection for all eurcharistic ministers was also held during the year.
In May, the children from the child guidance clinic celebrated their First Holy Communion in the hospital chapel. Parents, teachers and relatives were among the special guests.
A member of staff conducted the stations of the cross every Friday during Lent in the hospital chapel.
In November, the new eye theatre was blessed by Fr. Monks Os Cam.
Ward masses, graduation masses, block masses, communal anointings and masses for relatives of staff celebrated on a regular basis throughout the year.
Fr. Monks Os Cam. went to the Holy Land walking miles for charity. The support of the staff was evidenced by the amount of money raised.
b2 Personnel
In January, Fr. M. Geraghty Os Cam., returned to Australia and was replaced by Fr. B. Conway Os Cam., who in turn was changed to St. Vincent's Hospital, Elm Park, to be replaced by Fr. P. O'Brien Os Cam.
Fr. Monks Os Cam. successfully completed a unit of clinical pastoral education at the Regional Hospital, Cork. Fr. B. Molloy SS.CC, filled in during his absence.
October brought further changes as Fr. P. Dolan Os Cam. was recalled by his order and has taken up duty in England, Fr. B. Molloy SS.CC. joined the staff as did Sr. M. Dolores.
Sr. M. Raymond and Fr. F. Monks Os Cam. were elected to the Executive of the National Association of Hospital Chaplains.
Conferences Attended/Courses Given
Through health to healing. Carysfort college, Dublin.
Death and dying Knock, Co. Mayo.
Ethics. Beaumont, Dublin.
A.I.D.S. Workshop. National conference of hospital chaplains. F. Monks, R. Ruddy.
A.I.D.S., care of the dying, aging and pastoral care. Throughout the year. Members of chaplaincy department.
63 DEPARTMENT OF CHILD AND FAMILY PSYCHIATRY
Staffing
CONSULTANT PSYCHIATRISTS: Professor J.P. Malone Dr. P.E. McQuaid (Acting Administrator from 1/9/87) Dr. E.M.P. Siung Dr. N. Byrne Dr. N. Healy
ADMINISTRATOR: Sr. Margherita (up to 1/9/87)
PRINCIPAL PSYCHOLOGIST: Mr. T.D. McQuaid
SENIOR PSYCHOLOGISTS: Mr. A. Conway
Mr. K. Mandos
SENIOR SOCIAL WORKER: Mr. J. Sheehan
PRINCIPAL SPEECH THERAPIST: Ms. J. Boyle
SENIOR SPEECH THERAPIST: Ms. M. Fanning
NON-CONSULTANT HOSPITAL
DOCTOR: 1 Senior Registrar
CLINICAL PSYCHOLOGISTS: 2
SOCIAL WORKERS: 2
SPEECH THERAPIST: 1
PSYCHIATRIC NURSE: 1
SPECIAL SCHOOL PRINCIPAL: 1 REMEDICAL TEACHING 3 PROGRAMME: PLAY THERAPIST: 1
CLERICAL STAFF: 3
The department experienced a signficant reduction in its professional staff numbers this year. The employment of temporary staff was terminated and a number of staff went on career breaks. Because of the restrictions it was not possible to recruit and replace staff.
64 Scope of Service
The department addresses itself to an array of concerns that beset the experience of childhood and youth within several significant social contexts.
The broader needs of children and their families located in a community which is experiencing many untoward and unforeseen shifts and changes is in constant focus. This demands a broader and congruent perspective on the professional's part in remaining responsive to and effective with emergent needs. The north and north-east sectors of Dublin City and County contain large and growing numbers of young people and children. Four multidisciplinary teams linked to specific geographical areas have improved the comprehensive and effective qualities of service delivery. In particular, in the past, the problems of lengthy waiting lists was circumvented. Plans for satellite clinics in Coolock and Swords have not materialised as yet. Organisation of services around areas of particular disadvantage or need, remains a feature of departmental strategy.
In order to maintain services on a divisional team basis, the previously existing four multidisciplinary teams could not be kept up to establishment strength. This posed serious difficulties in terms of referred children and their families obtaining appropriate service. A number of cutbacks and restrictions on types of service availability of necessity had to be made.
Assessment, diagnosis and treatment of children and adolescents and their families presenting with emotional disorders, educational and language difficulties forms the main activity of the staff.
The department maintains a well established expertise in the assessment of the developmental parameters — language, congnition and personality of pre school and latency aged children. Intensive remediation services are available within the clinic for young children with speech and language and associated educational difficulties. However, the psychological service to primary schools, which has been an important and much needed service in the department's catchment area, has had to be restricted and schools have been circulated to that effect. Despite the difficulties, it is the hope and intention of the department to continue to provide support and consultative assistance to primary schools, at least at the level of their professional staff. Specialist assessment and treatment of autistic and severely disturbed children and adolescents, on the north side and within our catchment areas is provided at St. Paul's Hospital, Beaumont, which also provides a service for similar clients from outside the Eastern Health Board area. (See under St. Paul's Hospital).
Mater Child and Family Centre — Ballymun
Opened in 1974, this clinic is located in the centre of the Seven Towers Shopping Centre and serves Ballymun and contingent areas of Glasnevin, Finglas and Santry. It is estimated that 45% of the Ballymun population is
65 under fourteen, almost double the national average. Thus, Ballymun provides an ideal setting for a Child and Family Clinic. There are many pressures on families bringing up very young children in high rise flats. Apartment blocks are often inadequately maintained, lifts frequently out of order, rising unemployment, and material and social deprivation contribute to much real hardship. Lately there has been a considerable increase in single parent families being housed in Ballymun. Problems of substance abuse have been widely publicised.
In 1987 Ballymun received 25% of all new referrals made to the entire department. Nevertheless, there has been a drastic loss of personnel in the second half of the year, so that at the end of the year, there was no social work cover and psychology cover was reduced by 50%. This has caused major problems for service delivery.
The clinic attempts to provide services to:
(a) the fourteen schools in the area including primary, post primary and special schools (b) special nurseries and the well developed and extensive playgroups.
However, because of the cutbacks, again there has been a restriction on services to the schools in the area. In addition, the staff work with and through other professionals in the area, including public health nurses and doctors, the adult psychiatric team, general practitioners, the clergy, gardai, community social workers and other community personnel. The clinic has been pleased to participate in an active inter-professional approach to the needs of the community with organisation of community meetings e.g. a monthly journal club for professionals and active members in the community. In addition to working with a large number of children and families presenting with a range of psychological, speech and language, psychiatric and social problems, there is a special emphasis on prevention and on developing community strengths.
Speech and Language Therapy
The department has an important section of service as follows:
(a) Provision of speech therapy services in the north-east side of the city, including a full-time clinic in the Ballymun area, serviced by a full-time senior speech therapist.
(b) Specific speech and language programmes for daily and afternoon children attending the special school.
(c) Specific language programmes for day and in-patients — St. Paul's Hospital, Beaumont.
(d) Treatment of adult patients, both in hospital and as out-patients.
66 (e) Other Specialist Services:- (i) Consultant services for therapists and patients where there is a complex language and speech disorder. These consultations come from all parts of the country. (ii) Treatment of adult stammerers through intensive group therapy. (iii) Group therapy for adolescent stammerers, with parental and multidisciplinary involvement.
This section of the department has been hit by the cutbacks also and particularly services to adult and adolescent stammerers.
New Developments
1. St. Joseph's Adolescent Unit at St. Vincent's Psychiatric Hospital, Fairview, continues to develop. A new unit has been built and is due to officially open in 1988. Dr. N. Healy continues to provide consultant input. The service has maintained its important position in the overall range of services in the catchment area and has continued to have a steady stream of referrals. Adoloscent in patient facilities are still lacking and the availability of acute and emergency admission facilities is sadly underlined. The difficulty for mental health professions in arranging crisis intervention on an in patient or residential basis has been acutely posed over the year.
2. The research sub-committee with Mr. J. Sheehan, senior social worker as chairperson, has been re-constituted as an ongoing capital research group with Mr. A. Conway as resource person. A number of projects are now operational and in the process of development as well as a number of new projects at the point of initial elaboration. 3. The department has been in the forefront of development of computerisation of data collection, with the already established item sheet and amended classification and diagnostic schedule, based on that provided by the Institute of Psychiatry in London, England. Mr. K. Mandos has been particularly involved in this project.
Ongoing Projects
1. Cuan Mhuire Assessment Centre continues to be serviced by Area Team 4. This remand and assessment service is also available for voluntary and health board placements for the purpose of evaluating what is in the best interest of the young adolescent girls referred. A research project incorporating the assessment aspects of this service has started with the involvement of Dr. P. McQuaid and Mr. A. Conway.
2. Children's Homes: Consultative services continue to be provided to a range of services including the services of the Sisters of Charity of Our Lady of Refuge, Gracepark Road, Drumcondra; St. Vincent's, Goldenbridge, Inchicore. Croi Nua, High Park, Drumcondra: this service continues to receive consultant
67 liaison support, providing an aftercare programme for women discharged from the hostel and residential facilities provided by the Sisters of Charity of Our Lady of Refuge.
3. Another ongoing project is the preliminary data collection with a view to research on children attending Diabetic Day Centre, which is organised by Mr. A. Conway and Dr. N. Healy.
Educational Training
Academic Programme
Invited distinguished speakers give seminars throughout the academic year to the department. These seminars are open to the more general professional public on an invited basis. In addition, there are monthly Journal Clubs, on an intra-disciplinary basis, and general departmental case conferences.
Student Training
These include social work students from University College, Dublin, University College, Cork, and Trinity College, Dublin, as well as psychology students from University College, Dublin and other universities abroad. Lectures in clinical supervision are provided to child care students. Sr. Margherita has been involved in negotiations with the Departments of Health and Education for the purpose of improving professional standards of training and practice for the discipline.
Post Graduate Training
The Department of Remedial Linguistics, Trinity College, Dublin, places speech therapy students in the department where they are trained and supervised by members of the speech therapy staff.
The Post Graduate Training Programme in Psychiatry — Child and Family Psychiatry, is run with the St. John of God Brothers' Child and Family Clinic at Rathgar, in the context of a weekly academic seminar. Only psychiatrists in training are eligible to participate in this programme which continues throughout the academic year. Dr. P. McQuaid serves on the Irish Psychiatric Training Committee and on the Eastern Region Sub-Committee of the same committee.
Family therapy training is a well established educational programme in the department. Basic training is provided in an orientation year and a professional training for people working in the field with already established professional background and experience in a two-year clinical programme.
The department has been greatly encouraged by its inclusion in the Masters Pyschotherapy programme run under the auspices of University College, Dublin.
68 The department has received inclusion in the Masters Programme as a seperate teaching unit to provide a two year graduate training in Systems Therapy: Child and Family. Dr. P. McQuaid, Dr. N. Byrne and Mr. J. Sheehan have been involved in the negotiations with University College, Dublin which have been successful. It is intended that the first programme will be in academic year 1988/89.
Dr. N. Byrne is specialty tutor in child and adolescent psychiatry on the Irish Psychiatric Training Programme Eastern Region Committee.
M. Tallon.
Secretary of Social Workers in Mental Handicap.
Departures of staff
The following are the full time staff members who have left the department:
Paula Long — clinical psychologist Anne Maher — secretary Ruth Kenny — secretary Caoimhe Ni Dhomhnaill — clinical psychologist Martina Barrett — speech therapist Lectures and Workshops
Child Development and Behavioral Management. Three seminars. Dublin 7 Area Pre-School Playgroups Association. March/April 1987. A Conway.
Human Development to Pastoral Course. Three lectures. Dublin Institute of Adult Education. June 1987. A Conway.
Child Development. Three seminars. Women's Development Group, Blanchardstown, Dublin. September 1987. A Conway.
Hyperactive Children — theory and management. Seminar. Community Care Team, South-Eastern Health Board, Clonmel, Tipperary. November 1987. A Conway.
M. Psych. Sc. Students, University College, Dublin; M.A./Dip. Psych. Students. Mater Misericordiae Hospital; student nurses, Mater Misericordiae Hospital. Lectures. A Conway.
Annual general meeting of Irish Diabetic Association. Lecture. Dublin. May 1987. N. Healy.
69 Meeting for county physicians. Lecture. Post graduate centre, Mater Misericordiae Hospital. May 1987. N. Healy.
Monthly meeting of endocrinology department. Lecture. Mater Misericordiae Hospital, November 1987. N. Healy.
Mater academic programme — music therapy. Lecture. A. Cregan.
Development of phonology and speech problems. Language acquisition and the analysis of spontaneous language. Lectures. St. Patrick's College, Dublin. M. Fanning.
Language disorders. St. Patrick's College, Dublin. / Boyle.
The role of the speech therapist. Lecture. Mater Psychiatric Residence, Mater Misericordiae Hospital. M. Fanning.
Language and fluency problems in the school. Speech problems in the school. Lectures. Virgin Mary Boys National School, Ballymun. M. Fanning.
Encouraging your child to talk. Lecture. Mothers' Group, Family Resource Centre, Ballymun. M. Fanning.
Ballymun pre-school project. Workshop. Psychological Society of Ireland, Calvvay. M. Fanning, F. McCarthy.
Lecture to physiotherapists. Mater Misericordiae Hospital. P. Siung, P. McQuaid, N. Byrne, N. Healy.
Emergency room nurses. Two lectures. Mater Misericordiae Hospital. P. McQuaid.
Lectures to medical students. University College, Dublin. P. McQuaid, N. Healy.
Block placement. Medical students — residency programme, Mater Misericordiae Hospital. P. McQuaid, P. Siung, N. Healy, N. Byrne, D. McQuaid, J. Sheehan, J. Boyle.
Monthly joint Children's Hospital, Temple Street/Mater Misericordiae Hospital academic programme. Presentation. P. McQuaid.
70 Conversations with families after incest disclosures. Two-day workshop to a multi-disciplinary group in psychiatry. Harndsand, Sweden. January 1987. N. Byrne, I. McCarthy, P. Kearney.
Conversations with families after incest disclosures. Institute for Systemic Behavioural Science. Stockholm, Sweden. Also Institute of Social Psychology. Gothenberg, Sweden. April 1987. N. Byrne, I. McCarthy, P. Kearney.
Conversations with families after incest disclosures. Two day workshop. University of Copenhagan, Denmark. May 1987. N. Byrne, I. McCarthy, P. Kearney.
Consultation to a group for women in the community. Kiltalown Community Centre, Tallaght, Dublin. September 1987. N. Byrne, I. McCarthy, P. Kearney.
Issues in pastoral care for families with serious problems. Two day workshop for seminarians. Dominican Priory, Tallaght, Dublin. October 1987. N. Byrne, I. McCarthy, P. Kearney.
Identification and management of child sexual abuse and sexually transmitted diseases. Annual general meeting of the Irish Medical Organisation. Kilkenny. October 1987. Chaired by: N. Byrne.
Papers Presented
Behaviour disorders in young people. Kildare Clinical Society, Kildare. P. McQuaid.
Conferences Attended
Music therapy. Dublin. A. Cregan.
Department of Health working group on child sexual abuse. Dublin. P. McQuaid N. Healy
Stress and anxiety. Malahide Grand Hotel, Malahide. A. Cregan.
Language disorder in childhood. Mid-western health board, Mullingar. M. Fanning.
Derbyshire language scheme. Trinity College, Dublin. M. Fanning, J. Boyle, U. Sharry.
71 Course in clinincal research. St. John of Cod Brothers, Carysfort. M. Fanning, P. McQuaid.
Clinical supervisors course. Trinity College, Dublin. M. Fanning, / Boyle.
Activity Analysis
Department of Child Psychiatry
1983 1984 1985 1986 1987
New Patients 2,071 2,069 1,703 1,652 1,599
Total Attendances 19,075 19,037 18,036 16,739 15,313
Social Work Sessions 2,342 2,791 2,491 1,836 1,825
Social Work Attendances 4,008 5,160 4,778 3,668 3,574
Psychology Sessions 2,370 2,081 2,365 2,301 2,635
Psychology Attendances 5,423 4,072 4,258 4,023 3,810
Psychiatric Sessions 2,046 2,270 2,104 1,614 1,550
Psychiatric Attendances 5,529 5,816 4,649 4,521 3,396
Speech Therapists Sessions 1,760 1,285 1,346 1,529 1,399
Speech Therapists 3,087 2,807 3,070 3,712 3,754
Remedial, Education and Social/Perceptual 260 301 234 182 234 Training Sessions
Attendances 1,028 1,182 1,281 815 779
72 CLINICAL GENETICS Staffing
CONSULTANT: Dr. S. McManus
Scope of Service
Countrywide referrals for genetic counselling in:
Chromosomal, monogenic and multifactorial conditions. Mental handicap. Malformation syndromes. Recurrent spontaneous abortion and infertility.
Since mid 1983, to avoid unnecessary chart duplication in the out patient department, entire families, regardless of number of persons contained in same, have been booked in as a single case. The number of patients counselled has in fact been steadily increasing, as the number of patients seen at one family referral could vary from one to four or more.
Medical Education
Courses
Given by Dr. S. McManus, as lecturer in medical genetics, University College, Dublin, to:
Third year medical students — Pathology Final year medical students — Paediatrics B. Science — Pathology Master of public health Audiology degree Diploma in child health Diploma in gynaecology and obstetrics Teachers of the deaf Membership of Royal College of Obstetrics and Gynaecology — part 11 — in Rotunda Hospital Paediatric student nurses, Children's Hospital, Temple Street. Student midwives, Rotunda Hospital.
Society Memberships
Member of British Society of Clinical Genetics. S. McManus. Member of Irish Paediatric Association. 5. McManus.
73 Research Activities
Cytogenetic studies in recurrent spontaneous aborters.
A genetic study oi four hundred and fifty Irish families with offspring with neural tube defects. Supported by grant from Research Department, Central Remedial Clinic, Clontarf, Dublin.
Is the incidence of trisomy 18 — Edward Syndrome increasing? In association with Dr. A. Bergin, Rotunda Hospital, Dublin.
Reproductive potentials of patients with balanced reciprocal translocation. In association with Dr. M. de Arce, Children's Hospital, Temple Street, Dublin.
A computer programme to facilitate counselling of reciprocal translocation carriers. In association with Dr. M. de Arce, Children's Hospital, Temple Street, Dublin.
A study of the incidence of possible aetiological factors in families with spina bifida and anencephabic offspring.
Out Patient Clinic
Wednesday 9.30 a.m.
74 DERMATOLOGY DEPARTMENT Staffing
CONSULTANTS: Dr. S. O'Loughlin Dr. F. Powell
NON-CONSULTANT 1 Senior House Officer HOSPITAL DOCTORS: (Dermatology)
1 Senior House Officer (shared with neurology)
1 Intern (shared with Ophthalmology and Endocrinology)
1 Clinical Assistant (Dr. B. Alton)
1 Research Fellow
NURSING STAFF: 1 Dermatology S.R.N.
CLERICAL STAFF: 1 Secretary
Scope of Service
The department is the regional referral centre for Dublin and the North Eastern Health Board region. It caters for a large out-patient service and provides in patient care for serious dermatologic diseases suffered by patients in this region. It also provides in-patient facilities for patients seen in James Connolly Memorial Hospital and Beaumont Hospital, to which the consultant staff are affiliated. The department is a major teaching centre for medical undergraduates from University College, Dublin, and the consultant staff provide teaching for students from the Royal College of Surgeons of Ireland.
Peripheral clinics are on a monthly basis in Cavan and Drogheda and every six weeks in Tullamore. A third consultant dermatologist is anticipated within the next year with a joint Beaumont/Mater appointment.
Special Equipment and Techniques
The department has an active phototherapy unit, and provides photochemotherapy, being one of only three such units in the country. Psoriasis and other selected dermatoses are treated in this unit. A contact
75 clinic for the investigation and diagnosis of contact and occupational skin disease has been established in the department and over two hundred patients have been patch tested for contact and industrial dermatitis in the past year. Expert application of patch tests are carried out by a staff nurse with special training in dermatology who in addition is experienced in cryotherapy. Minor surgery is also carried out in the department, three hundred such cases in the past year, as well as cryotherapy of minor skin lesions.
Special Interests and Research Activities
Consultants in the department have special interest in the histopathology and immunology of skin disease. Active research is ongoing into the etiology of melanoma, acne and hidradenitis suppuritiva, and the role of neutrophils in the pathogenesis of psoriasis. Rosacea, sarcoidosis, lupus erythematosis and epidermolysis ballosa are other areas of research and interest. Several clinical trials are on-going in the department and have enabled funding of a research fellow who conducts clinical research in addition to supervising on-going trials. Recent acquisition of a stereomicroscope has allowed study of hair shaft and root morphology.
Meetings Attended
Symposium on hair physiology. Zurich, Switzerland. March 1987. F.C. Powell.
Irish Association of Dermatologists. Belfast, Northern Ireland. April 1987. F.C. Powell.
World Congress of Dermatology. Berlin, West Germany. May 1987. F.C. Powell.
Spanish-Irish Dermatology meeting. Barcelona, Spain. October 1987. F.C. Powell.
Update of mycology. Brussels, Belgium. October 1987. F.C. Powell.
American Academy of Dermatology. San Antonio, Texas, United States of America. December 1987. F.C. Powell.
Symposium on seborrhoeic dermatitis. London, England. December 1987. F.C. Powell.
Irish Association of Dermatologists. Belfast, Northern Ireland. April 1987. S. O'Loughlin.
Atopy and immunology. Edinburgh University, Scotland. November 1987. 5. O'Loughlin.
76 Lectures
Common dermatoses. Carlow Clinical Club, Castledermot, Carlow. January 1987. F.C. Powell.
The skin in general practice. North Dublin General Practitioner's Club. February 1987. F.C. Powell.
Atopic dermatitis. National Exzema Society, Mansion House, Dublin. March 1987. F.C. Powell.
Acne, psoriasis and scabies. South Dublin Clinical Club. April 1987. F.C. Powell.
Pathophysiology of hair growth. Upjohn symposium, Dublin. April 1987. F.C. Powell.
Modulation of inflammatory response in psoriasis. World Congress of Dermatology, Berlin, West Germany. May 1987. F.C. Powell.
Peutz-Jeghers syndrome. Spanish-Irish Dermatology meeting. Barcelona, Spain. October 1987. F.C. Powell.
Dermatoses of childhood. Navan Clinical Club, Navan. November 1987. F.C. Powell.
Basic dermatology. South Dublin Clinical Club. February 1987. 5. O'Loughlin.
Alopecia Upjohn symposium. Dublin. April 1987. 5. O'Loughlin.
Clinical dermatology. Army Medical Corps, St. Bricin's Hospital, Dublin. May 1987. 5. O'Loughlin.
Diagnosis in dermatology. Midland General Practitioner's Society. Athlone. September 1987. 5. O'Loughlin.
Allergy and immunology. Edinburgh, Scotland. November 1987. 5. O'Loughlin.
Clinical dermatology. Limerick General Practitioner's Society. November 1987. S. O'Loughlin.
77 Publications Primary biliary cirrhosis and the crest syndrome. Quarterly Journal of Medicine, 62: 75-82. 1987. F.C Powell, A.E Schroter, ER. Dickson.
Cutaneous changes during pregnancy. Irish Medical Journal, 80: 50-55. 1987. F.C. Powell, B.M. Powell.
Glossodyia and other disorders of the tongue. Dermatology clinics, 15: 687-693. 1987. F.C. Powell.
Dermatoses of the umbilicus. International Journal of Dermatology. (In press). F.C. Powell.
Primary biliary cirrhosis. Association with cases 11 major histocompatability complex antigens. Hepatology, 7: 889-992. 1987. G.J. Cores, S.B. Moore, ED. Fisher, F.C. Powell, E.R. Dickson.
Cutaneous sarcoidosis and hypogammaglobulaemia. Clinical Dermatology, C.M.D. case collection: 337-338. 1987. F.C. Powell, MA. McCarthy.
Modulation of inflammatory process in normal and psoriatic neutrophils. Seventeenth World Congress of Dermatology Report, 1: 16. 1987. F.C. Powell, D.M. McLough/in, A.M. Ni Neill, A.M. Murphy, F.J. Bloom field.
Epidermolysis bullosa and aplasia cutis. International Journal of Dermatology. (In press). M. McCarthy, F. Clarke, F.C. Powell.
Calcinosis of the scrotum. International Journal of Dermatology. (In press). 5. Cormally, F. Dorman, F.C. Powell.
Penicillamine induced pemphigus — a report of two cases. Irish Journal of Medical Science. (In press). C Buckley, R. Woods, C Barry, P. Dervan, 5. O'Lough I in.
Chrons disease of the vulva. British Journal of Obstetrics and Gynaecology. (In press). M. Holohan, M. Cough Ian, P. Dervan, S. Oloughlin.
Teaching Dermpath and clinical corelation (with Dr. P. Dervan). Monday 1.15 p.m. — 2.00 p.m. Case presentation and clinical review. Thursday 8.00 a.m. — 10.00 a.m. 78 Out Patient Clinics
Monday 9.00 a.m. — 1.15 p.m. Dr. F.C. Powell 2.00 p.m. — 5.00 p.m. Patch test clinic Tuesday 9.00 a.m. — 1.30 p.m. Dr. S. O'Loughlin 2.00 p.m. — 5.00 p.m. Ward cryotherapy clinic. Wednesday 9.00 a.m. — 1.30 p.m. Dr. F.C. Powell 2.00 p.m. — 5.00 p.m. Patch test clinic Thursday 9.00 a.m. — 10.00 a.m. Joint consultations Dr. F.C. Powell/Dr. S. O'Loughlin 10.00 a.m. — 1.00 p.m. Dr. F.C. Powell (minor surgery) Friday 9.00 a.m. — 1.00 p.m. Dr. S. O'Loughlin 2.00 p.m. — 4.00 p.m. Dr. S. O'Loughlin (minor surgery) 2.00 p.m. — 4.00 p.m. Patch test clinic
79 DIABETES/ENDOCRINE DEPARTMENT Staffing
CONSULTANT: Dr. R.G. Firth
NON-CONSULTANT 1 Registrar (Shared) HOSPITAL DOCTORS: 1 Senior House Officer 2 Interns
PARA-MEDICAL STAFF: 1 Dietitian
NURSING STAFF: 1 Specialist Diabetes Nurse Instructor 1 Specialist Diabetes Nurse Instructor — (shared with Diabetic Day Centre)
SECRETARIAL: 1 Secretary 1 Temporary Secretary
DIABETIC DAY CENTRE: 1 Sister in Charge 1 Nurse Instructor (shared) 1 Dietician 1 Temporary Secretary 1 Chiropodist (2 sessions per week) 1 Student Nurse (rotating from Hospital)
RESEARCH CENTRE: Professor M.I. Drury 1 Sister (externally funded) 1 Staff Nurse (Part-time, externally funded)
Scope of Service
The unit offers a comprehensive service in clinical endocrinology with a special emphasis on diabetes mellitus. The concept of 'total care' is administered to diabetic patients of all age groups, with children, adults, and the elderly able to obtain medical and surgical help for acute and chronic diabetic problems.
In-house diabetes care is offered to patients of all other consultants in parallel with ongoing medical or surgical care. Out-patients support is provided by the diabetic day centre located near to, but outside the hospital itself and which is staffed by medical and para-medical personnel trained in all aspects of diabetes care. Large numbers of both personal visits and telephone enquiries are monitored daily.
A specialist general clinical endocrinology service is also offered including
80 newer techniques such a fine needle aspiration biopsy in nodular thyroid disease and thyroid cancer.
Courses Organised
Diabetes workshop/study day for Consultant Physicians/Paediatricians. Attended by eighteen participants. Mater Misericordiae Hospital, May 1987.
One week refresher course in diabetes for nurses in diabetic care. Attended by sixteen participants. Mater Misericordiae Hospital, November, 1987.
Lectures by Invitation
Address to Annual General Meeting. Irish Diabetic Association. Dublin. November, 1987. R.C Firth.
Diabetic complications. Symposium. Postgraduate education programme. Royal College of Physicians in Ireland. December, 1987. R.C. Firth.
Endocrine disease in pregnancy. Symposium. Rotunda Hospital, Dublin. November, 1987. R.C. Firth.
Aspects of anaesthetics and intensive care unit. Study day. Dublin. April, 1987. R.C Firth.
Waterford Clinical Society. November, 1987. R.C. Firth.
Continuing education and research unit. University College, Dublin. November, 1987. R.C. Firth.
Wexford Clinical Society. June, 1987. R.C. Firth.
Current topics on diabetes care. Novo symposium. Dublin. May, 1987. R.C Firth.
Clinical science course. St. Vincent's Hospital, Dublin. May, 1987. R.C. Firth.
Nasal insulin. Symposium. Copenhagen. September, 1987. R.C Firth.
Fellowship in clinical chemistry. Kevin's Street College of Technology, Dublin. April, 1987. R.C Firth.
81 Undergraduate course in obstetrics. Royal College of Surgeons in Ireland. R.C. Firth.
Undergraduate course in obstetrics. University College, Dublin. R.C. Firth.
Part II F.F.A.R.C.S.I. revision course. 1987. R.C. Firth.
School of Occupational Therapy. Trinity College, Dublin. 1987. R.C. Firth.
Study day conferences. Mater Misericordiae Hospital. 1987. R.C. Firth.
National Maternity Hospital, Dublin. Conference. November, 1987. R.C. Firth.
Diabetes. Workshop/study day for consultant physicians. Mater Misericordiae Hospital. May, 1987. R.C. Firth, D. Cregan.
Diabetes care. Refresher course for nurses. Mater Misericordiae Hospital. November, 1987. R.C Firth, D. Cregan.
Post registration course for staff nurses. Mater Misericordiae Hospital. July, 1987. R.C. Firth.
Annual study day for staff nurses. National Maternity Hospital, Dublin. October, 1987. R.C. Firth.
Study day. Mater Misericordiae Hospital nurses. December, 1987. R.C. Firth.
Undergraduate courses in diabetes. University College, Dublin. Medical School. 1987. R.C. Firth.
National Children's Hospital, Dublin. 1987. M.I. Drury.
Diabetes and cardiac disease. St. Vincent's Hospital, Dublin. 1987. M.I. Drury.
Student nurses, St. Vincent's Hospital, Fairview. February, 1987. D. Cregan.
Irish Diabetic Association meeting. Castlebar. April, 1987. D. Cregan.
82 Diabetic care. Seminar. Public Health Nurses. Malahide. May, 1987. D. Cregan.
Postgraduate nurses, Stewarts Hospital, Palmerstown. November, 1987. D. Cregan.
Public Health Nurses. Longford/Westmeath area. December, 1987. D. Cregan.
Papers Published Effects of tolazamide and exogenous insulin on pattern of post-prandial carbohydrate metabolism in patients with non-insulin dependent diabetes mellitus. Diabetes, 36, 1130-1138 (1987). R.C. Firth, P. Bell M. Marsh, R.A. Rizza.
Insulin action in non-insulin dependent diabetes mellitus: The relationship between hepatic and extrahepatic insulin resistance and obesity. Metabolism, 36, 1091-1095 (1987). R.C Firth, P. Bell, R.A. Rizza.
Effects of hyperglycaemia on isotopic measurement of glucose utilization using (2-3 H), (3-3 H), (6-14 c) glucose in patients with type 1 (insulin — dependent) Diabetes mellutis. Diabetologia, 30, 365-371 (1987) P.M. Bell, R.C Firth, R.A. Rizza.
Book Chapter Insulin therapy in non-insulin dependent diabetes mellitus: with and without oral hypoglycaemic agents. Primary care clinics of north America. (In press). R.C Firth.
Papers Submitted Meal disposal and post-prandial futile cycling and cycling through glycogen in type 2 diabetics. P.M. Bell, R.C. Firth, R.A. Rizza.
A multiple injection regimen using the Novopen in diabetes mellitus. D.P. Murray, P. Keenan, F. Gayer, P. Salmon, CH. Fompkin, M.I. Drury, D.J. O'Sullivan.
Is diabetic nephropathy becoing less common? PC Blake, R.M. Drury, M.I. Drury.
Hypothyroidism and Down's Syndrome. M. Brennan, M.I. Drury, E. Gayer, P. Keenan, C. Murphy.
Editorial. Irish Journal of Medical Science. M.I. Drury.
83 Poster Presentations
Asessment of postabsorptive and post-prandial futile cycling and cycling through glycogen in type 2 diabetes mellitus. European Association for the study of diabetes 23rd annual meeting. Leipzip, GDR. (1987). P.M. Bell, R.C Firth, R.A. Rizza.
The effects of basal/bolus therapy on glycaemic control and lifestyle. D.P. Murray, P. Keenan, £ Gayer, P. Salmon, C.H. Fompkin, M.I. Drury, D.J. O'Sullivan.
Irish Endocrine Society. 1987. Irish Journal of Medical Sciences. (In press). P.M. Bell, R.C. Firth, R.A. Rizza.
British Diabetes Association. Exeter, England. March, 1987. Diabetic medicine, 1987. P.M. Bell, R.C Firth, R.A. Rizza.
Meetings Attended
European Association for the study of diabetes. Leipzig, GDR. September, 1987. R.C Firth, M.I. Drury.
British Diabetes Association. Medical and scientific section. Spring meeting. Warwick, England. March, 1987. R.C. Firth, M.I. Drury.
British Diabetes Association. Autumn meeting. Exeter, United Kingdom. September, 1987. R.C. Firth, M.I. Drury.
British Diabetes Association. Education section. London, England. February, 1987. D. Cregan.
American Association of Diabetes Educators. Florida, United States of America. September, 1987. D. Cregan.
Workshop on Diabetes Education. Ipswich, England. May, 1987. S. Coyne, P. Long.
Diabetes care. Symposium. Royal College of Physicians in Ireland. April, 1987. D. Cregan, P. Keenan, M. Callinan, S. Coyne, F. Connolly.
Irish Endocrine Society. Belfast. September, 1987. R.C. Firth.
84 International Diabetes Discussion Group. Dublin. February, 1987. R.C. Firth, M.I. Drury.
Professor M.I. Drury's retirement
Professor Ivo Drury's retirement in January, 1987 marked the end of a special chapter in diabetes care in Ireland. His contributions to diabetes, both on a national and international level are unique, and have brought world-wide recognition to the Mater Misericordiae Hospital, under the care of the Sisters of Mercy. The present staff of the Mater Hospital Diabetes Centre would like to take this opportunity to wish Professor Drury and his family a long, happy and productive retirement.
Out Patient Clinics
Monday 9 a.m.
Wednesday 9 a.m.
Day Centre
Monday through Friday 8.30 a.m. — 5.00 p.m. By appointment. (Three evening sessions per month are also available.
Activity Analysis 1986 1987
In-patients 900 692 Out-patient attendances 6,005 5,575 Day centre patient attendances 4,127 4,573
Three hundred and twenty new diabetic referrals were seen in the Mater Diabetes Centre in 1987, in keeping with previous years.
85 ENDOCRINE/METABOLIC UNIT Staffing
CONSULTANT: Professor D. Powell
1 Registrar (shared) NON-CONSULTANT HOSPITAL DOCTORS: 1 Senior House Officer 1 Intern (shared) LABORATORY STAFF: 1 Principal Biochemist 1 Senior Biochemist (Fertility Work) 1 Senior Technician 1 Basic Grade Biochemist 1 Basic Grade Technician 1 Laboratory Aide 2 Secretaries (one shared with Gynaecology/Fertility Service) NURSING STAFF: 1 Staff Nurse (shared with Gynaecology for Fertility Work)
Scope of Service Clinical Service
A comprehensive service in general clinical endocrinology. There is a special clinical research interest in reproductive endocrinology and infertility, calcium disorders and renal stones, gut hormones, and pituitary problems. The unit has published many original papers on all these topics. Laboratory Service
A comprehensive range of endocrine analyses is provided by the Mater Misericordiae Hospital to other north city hospitals, to several south city hospitals and for certain specialised tests a service is provided for hospitals elsewhere in the country including Sligo, Castiebar, Galway, Limerick, Wexford and Waterford. Total Tests: 25,521
Out Patient Clinics
Tuesday 2.00 p.m. — 5.00 p.m.(General Endocrine) Wednesday 2.00 p.m. — 5.00 p.m.(Infertility Clinic)
86 GASTROINTESTINAL UNIT
Staffing
CONSULTANT: Dr. J. Crowe Dr. J. Lennon
NON-CONSULTANT Dr. B. Hayes HOSPITAL DOCTORS: 1 Senior House Officer (rotating) 2 Interns (rotating)
RESEARCH STAFF: Dr. E. Clarke
RESEARCH FELLOWS: Dr. D. Foley Mr. T. Ryan Dr. E. Gallagher
CHEMICAL ALALYST: Miss C. Hennessy
ELECTRONIC ENGINEER: Miss L. Hickey
RESEARCH NURSE: Miss P. Dunne
The major development in the gastrointestinal unit was the formation of the hepato biliary unit linking the departments of medicine and surgery into a formal unit, devoted to the management of hepato biliary disorders. Mr. T. Ryan, F.R.C.S.I., was appointed to the unit as senior research associate in July 1987 following which he spent three months in Germany, the United States of America and Japan learning new techniques for the non-surgical treatments of gallstones. Since his return, two of these techniques, viz stone dissolution by methyl tert butyl and Shockwave lithotripsy have been incorporated into the departments service.
Publications
Oesophageal function in diabetes mellitus with special reference to acid studies and relationship to peripheral neuropathy. American Journal of Gastroenterology. Sep. 87 (9); 840-843, 1987. F.E. Murray, M.G. Lombar, J. Ashe, D. Lynch, M.I. Drury, B. O'Moore, J.R. Lennon, J. Crowe.
Regulation of the hepatic transferrin receptor in heridatory haemochromatosis. American Association for Study of Liver Disease. Chicago, United States of America. October, 1987. Hepatology Vol. 7, 1107, 1987. Hepatobiliary Unit, Mater Misericordiae Hospital: M. Lombard, M. Hynes, J. Crowe. The Liver Unit, King's College Hospital in Medicine: M. Naoumov, A. Bomford, S. Roberts, R. Williams.
87 Chronic erosive gastritis; a clinical study. American Journal of Gastroenterology. 82. 302-307. 1987. C.G Gallagher, J.R. Lennon, J. Crowe.
Freeze drying technique for faecal fat analysis. Evaluation and comparison with the traditional methods. Scan. Journal of Gastroenterology. T. O'Callaghan, J. McCann, E. Wright, MA. Morgan, J. Crowe.
Colonoscopy, polypectomy and management of malignant colorectal polyps — a review in an Irish population. Irish Journal of Medical Science. In press. F. Murray, M. Lombard, R. Fitzgerald, P. Dervan, J. Lennon, J. Crowe.
Bleeding from multifocal heterotopic gastric mucosa in the colon controlled by a H2 antagonist. Gut. In press. F. Murray, M. Lombard, P. Dervan, R. Fitzgerald, J. Crowe.
A study of intracolonic hydrogen and methane concentrations in patients undergoing colonoscopy. American Journal of Gastroenterology. In press. E. Gallagher, I. Shanahan, M. Smith, J. Lennon, J. Crowe.
Oesophageal ulceration in Behcet's disease. Irish Journal of Medical Science. W. Powderly M. Lombard, F. Murray, D. O'Connell, J. Lennon.
Post-prandial angina; Does gastro-oesophageal reflux have a role to play? American Journal of Gastroenterology. Gut. In press. E. Johnston, B. O'Connor, J. Lennon, J. Crowe.
Spontaneous bacterial peritonitis and cardiac ascites. M. Lombard.
Coeliac disease in association with inflammatory bowel disease: A report of two cases. Postgraduate Medical Journal. In press. K. Bulger, M. Griffin, J. Crowe, J. Lennon, P. Dervan.
Mesenteric lymph node cavitation syndrome. Gastroenterology. In press. K. Bulger, P. Dervan, J. Crowe.
88 Presentations A double blind randomised multicentre study comparing maalox T.C. tablets and ranitidine in the healing of duodenal ulcer. British Journal of Gastroenterology. September, 1987. Gut. Vol. 28. no. 10. A.1337. / Hunger, J. Crowe, R. Gillies, K. Cough, S. Lober, R. Walker.
Is left sided colonoscopy as screening procedure for colorectal neoplasia in asymptomatic volunteers ^ to 45 years. British Society of Gastroenterology. September, 1987. Gut. 28. A.1367. 1987. D. Foley, P. Dunne, M. O'Brien, J. Crowe, T. O'Callaghan, j. Lennon.
A study of introcolonic hydrogen and methane concentration in patients undergoing colonoscopy. British Society of Gastroenterology. September, 1987. Gut. 28. A.1371. 1987. / Crowe, J. Lennon, E. Gallagher.
Controlled trial of Clofasamine in Crohn's disease en afthal. A. Long, J. Lennon, J. Crowe, D.P. O'Donoghue.
Controlled trial of clofasamine in Crohn's disease. British Society of Gastroenterology. September, 1987. Gut. Vol. 28. A.1391. A Long, J. Lennon, J. Crowe, D.P. O'Donoghue.
Controlled trial of clofasamine in Crohn's disease. En afthal. American Gastroenterology Association. New Orleans, United States of America, June 1987. A. Long, J. Lennon, J. Crowe, D.P. O'Donoghue.
Immunohistochemical analysis of c-myc oncogene expression in the development of colonic adenocarcinoma. Irish Society of Gastroenterology. September, 1987. P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D.N. Carney.
Immunohistochemical analysis of cell kinetic parameters in colonic ademocarcinoma, adenomas and normal colons. Irish Society of Gastroenterology. September, 1987. P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D.N. Carney.
Immunohistochemical analysis of c-myc oncogene expression in the development of colonic adenocarcinoma. Irish Society of Gastroenterology prize for outstanding presentation. P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D.N. Carney.
Gallbladder disease; non surgical alternatives. Mater Misericordiae Hospital study day. December, 1987. / Crowe.
Anaesthesia and perioperative care in chronic liver disease. Royal College of Surgeons in Ireland. May, 1987. / Crowe.
89 Conferences
Histology (Dr. P. Dervan) — Wednesday 8.30 a.m.
Clinical research review — Wednesday 9.30 a.m.
Combined radiology conferences— Friday 8.30 a.m.
Out Patient Clinic
Hepathology (Dr. J. Crowe) — Monday 2.30 p.m.
Gastroenterology (Dr. J. Crowe) — Tuesday 9.00 a.m.
Gastroenterology (Dr. J. Lennon) —Thursday 2.00 p.m.
Activity Analysis
G.I. Unit 1984 1985 1986 1987 1983 2,593 3,048 2,410 2,177 Gastroscopes 2,311 807 1,296 1,292 1,104 Colonoscopy (total) 566 166 160 172 140 E.R.C.P. 147 63 37 45 40 Papillatomy 40 510 255 90 17 Sigmoidoscopy 660 1,207 967 896 472 Other Procedures 597 Total Procedures 4,321 5,346 5,763 4,905 3,950
90 GENERAL MEDICAL UNIT
Staffing (with interest in Liver Disease)
CONSULTANT: Dr. H.T. Barniville NON-CONSULTANT 1 Registrar HOSPITAL DOCTORS: 1 Senior House Officer 1 Intern
ASSOCIATED MEDICAL STAFF: Dr. J. Crowe
Scope of Service
The unit offers in-patient and out-patient investigation and treatment of general medical disease with a special interest in liver disease.
Special Interest
Liver disease.
Research
Acquired immune deficiency syndrome.
Dates of Conference/Meetings
Gastroenterology radiology conference every Wednesday at 8.30 a.m. Medical conference every Friday at 12.30 p.m.
Out Patient Clinics
Friday 9.30 a.m. — 12.30 p.m. Monday 2.30 p.m. — 4.00 p.m.
(Staffed jointly with Dr. J. Crowe)
91 GERIATRIC MEDICINE DEPARTMENT Staffing
CONSULTANT: Dr. J. Noel Dr. J. Lavan
NON-CONSULTANT 1 Intern (shared with HOSPITAL STAFF: Orthopaedic Department)
Scope of Service
The department provides a consultative service (2 notional sessions) for the management of specific medical and allied problems related to the older patient, as part of an overall Dublin north city and county geriatric service.
Lectures
Three per year to undergraduate students. Twenty-four per year to undergraduate student nurses.
Committees
Actively involved in sub-committees of the Health Board concerning the development of services for the elderly.
92 INFECTION CONTROL COMMITTEE
Members
Dr. R. Hone (Chairman) Sr. M. Lucia Therese Dr.J. Donohue Dr. D. Phelan Mr. J. Smith Miss M. Teahan Mr. G. MacGabhann Sr. M. Gerard Dr. J. Kirrane Sr. M. Margaret Miss R. Ruddy (Control of Miss U. Bullen Infection Sister) Surgical Tutor Mrs. A. Douglas Medical Tutor
The Infection Control Committee is a sub-committee of the Hospital Executive Committee. The members meet on a regular basis. Problems related to nosocomial infection are documented, discussed and relevant action recommended. Hospital policies in relation to patient management are formulated and circulated.
The following hospital policies have been prepared.
(1) Guidelines on the use of antibiotics.
(2) Recommended disinfectants and detergents in wards and departments.
(3) Guidelines on intravenous therapy:— (a) Management and care of long intravenous lines.
(b) Management and care of Hickman Catheters.
(4) Urinary catheterization.
(5) Guidelines on the care of patients infected with:- (a) Tuberculosis. (b) Viral hepatitis. (c) Enteric pathogens (d) Varicella/zoster (e) Multiple resistant staphylococcus aureus. (f) Acquired immunodeficiency syndrome. (6) Guidelines on care of:— (a) Patients undergoing cardiac surgery. (b) Patients undergoing cardiac transplantation.
(7) Vaccination programme for staff at high risk of acquiring hepatitis B. This programme is being carried out in conjunction with Dr. P. O'Connor, consultant physician in-charge of the accident & emergency department.
93 Sister R. Ruddy has been elected chairperson of the Irish regional group of the Infection Control Nurses Association.
Conferences
Surgical conferences. Twice yearly.
Orientation course for non-consultant hospital doctors. Each July.
Invited Lectures
Control of hospital infection. Dublin, 1987. R. Ruddy.
Infection control aspects for care of patients with A.I.D.S. Study day. St. Columcille's Hospital, Loughlinstown. 1987. R. Ruddy.
Care and management of patients with A.I.D.S. National conference for hospital chaplins. Dublin, 1987. R. Ruddy.
Good stands are cost effective. Symposium. Hospital sepsis update 1987. Dublin. R. Ruddy.
Control of infection in an endoscopy unit. Irish Society of Endoscopy Nurses. Dublin, 1987. R. Ruddy.
Care and management of HIV positive and A.I.D.S. patients. Final year course. St. Patrick's College, Maynooth. 1987. R. Ruddy.
National symposium on caring for A.I.D.S. Symposium. London, England. 1987. R. Ruddy.
Presentations/Communications
Clinical and laboratory features of staphylococcus aureus septicaemia. First national conference of the hospital infection society. London, England. 1987. R. Hone.
Parenteral nutrition. Chairman of session. Hospital sepsis update 1987. Dublin. R. Hone.
94 INSTITUTE OF RADIOLOGICAL SCIENCES
Staffing
DIRECTOR: Dr. J.T. Ennis SECRETARY: Mr. D.J. Dowsett
LECTURER: Dr. J.P. Stack
The academic emphasis during 1987 was primarily in the development of new diagnostic techniques. The introduction of single photon emission tomography (SPECT) into routine clinical use, with particular emphasis on brain and liver imaging, resulted in considerable new diagnostic potential. Single photon emission tomography has the capacity to determine smaller lesions at greater depth in the organ than the conventional planar radionuclide techniques. Quantitive measurements of renal function and of responsiveness of metastatic disease to chemotherapy have been initiated through the combined methods of Mr. D.J. Dowsett and Professor J.M. Fitzpatrick.
The clinical utilisation of magnetic resonance imaging has now become firmly established. During the past year the advances which we knew had occurred in the diagnosis of intracranial disorders has been extended to include diseases of the spinal cord, the documentation of solid and soft tissue tumours and the early demonstration of response to therapy of various cancers. Magnetic resonance imaging demonstrates metabolic as well as morphological disorders of most organs. This is a relatively new technique and one's emphasis during the past twelve months has been on validating cerain new procedures. Innovative new techniques have been introduced that include fast imaging sequences to demonstrate spinal cord pathology which takes less than ten minutes. The use of magnetic resonance spectroscopy in differentiating benign from malignant tissue has proved to have significant advantages and is the major focus of several research publications. The value of magnetic resonance in demonstrating the extent of tumour involvement of both bone and soft tissue has made a major clinical impact on patient management.
MSc in Radiological Sciences
During the year, discussions took place with the Science Faculty in University College Dublin to interest them in holding a one-year full-time degree examination in radiological sciences leading to an MSc. The importance of this additional qualification has been made abundantly clear because of the scientific advances that have been made in diagnostic radiology. The fellowship examination held by the Faculty of Radiologists at the Royal College of Surgeons is an essential component for entry into the MSc degree course. After very detailed discussions, which took place between the Science Faculty, the Institute of Radiological Sciences and Faculty of Medicine, this course was
95 eventually agreed. It is hoped that the first participants will enter this course in October 1988. The course will concentrate on increasing the knowledge of the fundamental sciences involved in the separate disciplines of digital radiology, nuclear medicine, computerised tomography and magnetic resonance imaging. The application of computers to department organisation, image manipulation, transmission and archiving will also receive prominence. Radiological sciences in diagnostic imaging now embrace not only radiation physics, but have invaded chemistry, computer sciences and the mathematics of image construction and enhancement. This MSc degree course addresses itself to the urgent need for advances in scientific training in present day radiology.
Dr. J. Stack was appointed as lecturer at the Institute of Radiological Sciences in October 1987. Prior to this, Dr. Stack had spent two years as lecturer at the University of Manchester under Professor I. Isherwood, on the completion of his basic radiological training at the Mater Misericordiae Hospital. Dr. Stack had intensive training in magnetic resonance imaging of the central nervous system and brings this expertise to our department, which is of considerable clinical importance. Dr. Stack has shown a particular interest in innovating techniques and has introduced many fast imaging sequences that have speeded up the throughput of patients considerably.
During the year, a grant was obtained from the Health Research Board to employ a part-time research nurse that would enable the Institute to pursue a project in the early diagnosis of breast and lung cancer using magnetic resonance imaging and magnetic resonance spectroscopy. This project is jointly formulated with Dr. D. Carney and Dr. P. Dervan.
Visiting Professorships
Dr. P. McManamon, from Newfoundland, Canada, arrived in July 1987 to spend one year studying advanced nuclear medicine and magnetic resonance techniques. Dr. McManamon, who was a former student at the Mater Misericordiae Hospital, intends to introduce magnetic resonance imaging to his university hospital when he returns to Canada in 1988.
Dr. J.T. Ennis was appointed external examiner for the MD in radiology at the University of the West Indies, and acted as visiting professor during the month of May 1987.
In September 1987 Dr. J.T. Ennis was invited as visiting professor to the University of Jakarta, and also as a consultant to PARC Ltd. on medical management in hospital developments.
During 1987 the liaison with the University of the West Indies continued, with a steady flow of radiographers from the Mater Misericordiae Hospital to help in the running of computerised tomography scanning in Jamaica. During this year, Dr. S. Darby, who was appointed as lecturer at the University of the
9b West Indies, continued to give a most excellent, comprehensive service and to be responsible for introducing newer techniques in computerised tomography. It was also agreed that one of the registrars at the University of West Indies, Dr. N. Ramchander, would spend six to nine months in the department of radiology at the Mater Misericordie Hospital to gain further experience, and this was funded by the Department of Foreign Affairs in Ireland.
Scientific Presentations
Magnetic resonance imaging of the brain. North west region postgraduate diagnostic radiology meeting, University of Manchester, England. March 1987. J.P, Stack.
Magnetic resonance imaging of the brain: the role of Gadolinium-DTPA. Annual meeting, British Glioma Group, University of Manchester, England. March 1987. J.P. Stack, J.P.R. Jenkins, I. Isherwood.
Gadolinium-DTPA magnetic resonance imaging of intracranial mass lesions. Forty-fifth annual congress, British Institute of Radiology, University of Southampton, England. April 1987. J.P. Stack, R.A. Metcalfe, N.M. Antoun, I. Isherwood, J.P.R. Jenkins.
Use of steady-state free precession (SSFP) sequences in magnetic resonance imaging of the brain. Academic Radiologists meeting, University of Bristol, England. June 1987. J.P. Stack, I. Isherwood.
Contrast-enhanced magnetic resonance imaging of intracranial lesions using Gadolinium-DTPA. Sixth European congress of radiology. Lisbon, Portugal. May/June 1987. J.P. Stack, L. Sandall, J.P.R. Jenkins, I. Isherwood.
Gadolinium-DTPA enhancement in magnetic resonance imaging of acoustic neuromas. British academic ear, nose and throat conference. University of Glasgow, Scotland. July 1987. J.P. Stack, N.M. Antoun, R. Ramsden, J.P.R. Jenkins.
Magnetic resonance imaging of the mini-pig heart: the effect of Gadolinium- DTPA on normal myocardium compared with skeletal muscle. Sixth annual meeting, Society of Magnetic Resonance. New York, United States of America. August 1987. C.J. Williams, B. Loveday, J.P. Stack, I. Isherwood.
Steady-state free precession sequences, FAST and CEFAST in the detection of intracranial disease. Sixth annual meeting, Society of Magnetic Resonance in Medicine. New York, United States of America. August 1987. J.P. Stack, N.M. Antoun, J.P.R. Jenkins, M. Gyngell, I. Isherwood.
97 Magnetic resonance imaging of spinal lesions: the role of Gd-DTPA. Sixth annual meeting, Society of Magnetic Resonance in Medicine. New York, United States of America. August 1987. J.P.R. Jenkins, J.P. Stack, V. Watson, I. Isherwood.
Diagnostic imaging of pituitary abnormality. Joint endocrine/radiology symposium. Royal College of Physicians, Dublin. October 1987. J.P. Stack.
Publications Accepted
Trigeminal nerve tumour: a case report. Comparison of computerised tomography and magnetic resonance scanning. Journal of Neurosurgery. R. Lye, R. Ramsden, J.P. Stack, J.E. Gillespie.
Gadolinium-DTPA on normal myocardium. British Journal of Radiology. (In press). C.T. Williams, J.P. Stack, B. Loveday, V. Watson, I. Isherwood.
Invited Lectures
Clinical applications of magnetic resonance imaging. Society of Surgeons of the University of the West Indies. May 1987. J.T. Ennis.
Magnetic resonance imaging in medical practice. Department of Academic Medicine, University of the West Indies. May 1987. J.T. Ennis.
The importance of magnetic resonance imaging in clinical diagnosis. Metropolital medical centre, Jakarta. September 1987. J.T. Ennis.
The importance of medical participation in hospital management. University of Jakarta. September 1987. J.T. Ennis.
International Meetings Attended
First European Congress of nuclear magnetic resonance in medicine and biology. London, England. April 1987. O. Redmond.
Sixth annual meeting of the Society of Magnetic Resonance in Medicine. New York, United States of America. August 1987. O. Redmond.
98 MATER HOSPITAL COLLEGE FOR POSTGRADUATE EDUCATION AND RESEARCH
Board
Dr. J.T. Ennis, Chairman Dr. D.N. Carney, Secretary Prof. T.B. Counihan Dr. J. Crowe Mr. S.J. Heffeman Dr. J.A. Kirrane Prof. J.M. Fitzpatrick Prof. D. Powell Sr. M. of the Incarnation Sr. M.J. Berchmans Mr. C.J. MacGabhann Finance Sub-Committee
Dr. J. Crowe, Chairman Dr. D.N. Carney, Secretary Mr. G.J. MacGabhann Sr. M. of the Incarnation Prof. D. Powell Scientific Sub-Committee
Prof. J.M. Fitzpatrick, Chairman Dr. D.N. Carney, Secretary Mr. S.J. Heffernan Dr. J.A. Kirrane Prof. D. Powell Dr. D. Moriarty Prof. P. Eustace Nurse P. O'Sullivan Mr. F. Kyne Prof. J. Feely — Extern
During 1987 the Mater College continued its work in both supporting research in the hospital and in promoting the development of the clinical sciences block. In supporting the development of the clinical science block, the Mater College committed a total of £52,000 to its development. In the years ahead, it is felt that the College will continue to play a role in the development of this urgently needed department within the Mater Misericordiae Hospital campus. Recognising the expanding research departments within the hospital,
99 the College supported funding the appointment of a clinical statistician to the Mater Misericordiae Hospital. This post was activated on 1st January 1988.
Finally, during 1987 the College accepted with much regret the retirement of Dr. B. Alton. The College, with its members, acknowledged the major role Dr. Alton played in the setting up and development of the Mater College for post graduate education and research.
Grant Awards
Throughout 1987 the work of the Mater College in actively supporting research amongst the staff of the Mater Misericordiae Hospital continued. A total of eleven grants from different hospital departments were submitted for review to the Scientific Sub-Committee totalling £55,890. Following review, and on the recommendations of the Mater College, grants to a total of £38,500 were supported.
Grants supported were as follows:
Professor J.M. Fitzpatrick: Mr. P. Grace, Mr. P. Gillen
Ipislateral and contralateral renal blood flow following partial ureteric obstruction in the dog.
A study to compare the effects of pre-operative bile salts, lactalose, antibiotics, bowel preparation on renal function in jaundice.
A study to determine the dynamics of pancreatic blood flow in experimentially induced pancreatitis.
Ureteric replacement with human dura (tutoplast).
G6PD reactions in human bladder carcinoma.
Can ploidy status metastatic lymph nodes from colorectal carcinoma predict patient survival?
Dr. D.N. Carney, Dr. P. Johnston:
Biological characteristics of colonic tumours.
Dr. D.N. Carney, Dr. M. Teeling:
The long term effects of cisplatin and its analogues on renal function.
100 Dr. S. O'Loughlin, Dr. F. Powell:
Computerised regional register industrial/contact dermatitis. Computerised regional register melanoma and dysplastic naevi.
Professor D. Powell:
Tachykinins as possible carcinoid tumour markers.
Dr. G. Coughlan:
Narcotic infusions following surgery.
The scientific sub-committee recommended that an annual meeting would take place in the hospital at which papers, based on research supported by Mater College grant awards, would be presented.
Mater College Study Days
Three scientific meetings took place in the Mater Misericordiae Hospital during 1987. The study day, organised by Professor J.M. Fitzpatrick, involved a panel of international speakers who presented papers on a wide range of topics of urology. An oncology symposium (organised by Dr. D.N. Carney) and a symposium entitled "Immunohistochemistry in diagnostic pathology", organised by Dr. P. Dervan, completed the College meetings. All meetings were well supported.
Mater Foundation
The Mater Foundation during 1987 underwent considerable reorganisation with a view to greatly improving its role in fund-raising for the Mater Misericordiae Hospital and its members. With this new structure, the Foundation, with the provision of new funds, should ensure the continual development of the hospital and ensure its prominent role in research in these islands.
101 MEDICAL SOCIAL SERVICES DEPARTMENT
Staffing
Head Medical Social Worker — Miss E. O'Leary 1 Senior Medical Social Worker 3 Medical Social Workers 1 Clerk Typist
Scope of Service
As happened with all other departments, staff suffered cutbacks in that one medical social worker on a two year career break was not replaced. The result was that instead of responding to an increasing demand on services, the department had to prioritise on the referrals received by assessing which to be the most urgent.
The elderly and oncology patients represent the highest percentage of workload and are demanding more and more time. The complexities of life in society, plus the financial cutbacks in the health and social service fields have put such pressure and stress on families that unless they are offered advice and support they feel they can and must opt out of their responsibilities in caring for their elderly patients and terminally ill relatives. Hence, the social workers in the department aim to mobilise as many available resources as possible and meantime instil a calm atmosphere during this traumatic time for patients and their families. The support from ward staff and pastoral care department makes planning and care for patients easier to exercise.
Direct referrals from outside agencies are on the increase, i.e., public health nurses, general practitioners and relatives themselves.
Conferences Attended
Care of the terminally ill. 5. Sheridan.
Reminiscence as therapy for the elderly. P. Rooney.
The management of social work students. M. Mclnerney.
Psycho-sexual therapy. M. Mclnerney.
102 Practice-teachers workshop. 5. 5heridan.
A.I.D.S. Conference. E O'Leary.
Lectures Given
The social worker and psychiatry. University College, Dublin, medical students. P. Rooney, E. O'Leary.
Role of the medical social worker within different patient groups. Final year physiotherapy students. P. Rooney, M. Mclnerney, S. Sheridan, E. O'Leary.
Patient care in hospital. Pastoral care course. Marianella, Rathgar. E. O'Leary.
Croup therapy with young married woman suffering from depressive illnesses. M. Mclnerney.
The department is pleased to congratulate Ms. M. Mclnerney on being elected as a council member of the Irish Association of Social Workers.
Activity Analysis
Medical Social Services Department 1983 1984 1985 1986 1987
New patients 1,753 1,911 1,830 1,923 1,591 Others 3,468 3,529 3,956 3,642 3,285
Total 5,221 5,440 5,786 5,565 4,876
In patients 1,244 1,402 1,365 1,417 1,215 Out patients 503 501 399 417 300 Private hospital 7 11 8 7 4 Home visits 35 58 58 41 44
Total 1,789 1,972 1,830 1,882 1,563
Return patients 1,564 1,525 1,502 1,394 997
Total patients helped 3,318 3,497 3,332 3,276 2,588
103 NEPHROLOGY DEPARTMENT Staffing
CONSULTANT: Dr. J. Donohoe
NON-CONSULTANT: 1 Registrar (shared) HOSPITAL DOCTORS: 1 Senior House Officer (shared) 1 Intern (shared) Scope of Services
The department fulfills an intensively consultative role, together with the full scope of elective nephrologic evaluation. This includes care for patients with acute renal problems, in particular for cases with acute renal failure. In the latter regard, there is an instant availability of on-site acute haemodialysis or peritoneal dialysis when indicated. A single cubicle in intensive care unit (no. 2) has been specifically designed for the accommodation of a dialysis machine (haemodialysis or peritoneal). This cubicle is fully equipped and includes an electronic bed scale for precise monitoring of fluid balance status in critically ill patients.
An important, though as yet modest, new area of activity for the nephrology service, continues to expand. It is now accepted that selected patients maintained on chronic dialysis can benefit from coronary bypass surgery and during the past year, three such patients, transferred from other renal units, were successfully operated on at the Mater Misericordiae Hospital. The nephrology service provided for the continuing haemodialysis needs of these patients pre and post operatively.
The new dimension of cardiac transplantation at the Mater Misericordiae Hospital has also seen the involvement of the nephrology service. In this area, cross-experience with cyclosporine use in renal transplantation patients has been useful.
Elective nephrology has seen the evolvement of a busy renal biopsy service, which procedure is now routinely performed under real-time or static ultrasound imaging. It has been convenient to structure a Wednesday afternoon 'list' for these biopsies which facilitates the department of radiology and allows smoother handling of the workload. This significant development is consonant with the international experience that ultrasound imaging is the method of choice for percutaneous renal biopsy. Emergency renal biopsies are performed when necessary.
Through his association with Beaumont Hospital, the nephrologist can arrange full and immediate access for Mater Misericordiae Hospital patients with
104 chronic renal failure to this major chronic dialysis and renal transplant facility, where patients continue their treatment under his direct care.
Special Interests
Acid-base and electrolyte problems. Proteinuria. Metabolic renal stone disease. Renal hypertension. Diet and kidney function.
Research Activities in Progress
1. The haemodynamic and renal functional response to ACE inhibitors with renovascular hypertension. P. Cullen, T.B. Counihan, J. Donohoe.
2. Assessment of radio-isotope methods for measurement of glomerular filtration rate in patients with renal disease. / Dowsett, J. Donohoe.
3. End stage renal disease in diabetics. R. Drury, J. Donohoe, M.I. Drury, R. Firth.
4. Evaluation of percutaneous transluminal renal angioplasty for the treatment of renal artery stenosis. D. Legge, D. O'Connell, J. Donohoe.
5. The ESR in renal disease. 5. Eustace, J. Fennel I, J. Donohoe.
6. Restoration of renal function following revascularisation. M. O'Donoghue, F. Corrigan, J. Donohoe.
Conferences/Study Days
Nephro-Urological conference. Wednesdays, radiology conference room. 12.30 p.m. — 1.30 p.m.
Research review session. Wednesdays, 2.00 p.m. — 3.00 p.m.
Renal biopsy review conference (in association with Beaumont Hospital). Mondays, 11.45 a.m. — 12.30 p.m.
Journal club (in association with Beaumont Hospital). Mondays, 12.30 p.m. — 1.30 p.m.
105 Study day — Mater Misericordiae Hospital. (Convenor: J. Donohoe). December, 1987.
Recent Publications
Postischemic acute renal failure and cortical necrosis. Acute Renal Failure, Second Edition — (chapter). Eds.: B. Brenner and M. Lazarus. In press, 1987. N. Madras, J. Harrington, J. Donohoe.
Acute renal failure. Conn's Current Therapy (chapter). In press, 1987. / Donohoe.
Lisinopril in hypertension associated with renal impairment. Journal of Cardiovascular Pharmacology, 9, supplement 3, pgs 66 — 68. 1987. J. Donohoe, M. Laher, G. Doyle, W. Cooper.
Simultaneous presentation of ICA nephropathy and sarcoidosis. Sarcoidosis, 4: 134-136. 1987. F. Murray, M. Lombard, J. Donohoe et al.
Transient loss of ultrafiltration during CAPD: a compilation of severe hyperglycaemia — induced huperosmolar state. Peritoneal Dialysis Bulletin. (In press). 1987. F. Walker, J. Gilvarry, R. Regan, J. Donohoe.
Bone problems associated with renal failure. Irish Medical Times. November 1987. / Donohoe.
Renal transplantation with living — related donors — a review of one hundred and thirty-one consecutive cases. Proceedings, Irish Nephrological Society. 1987. Y. O'Meara, J. Hanson, D. Murphy, J. Donohoe et al.
Reversal of refractory cellular rejection: the role of OKT3. Proceedings, Irish Nephrological Society. 1987. Y. O'Meara, C. McAllister, J. Hanson, J. Donohoe.
Dialysis and transplantation for diabetic nephropathy: the Dublin experience. Proceedings, Irish Nephrological Society. 1987. / Donohoe.
Communications/Meetings
Atrial natriuretic peptide. Symposium on renal physiology. Jervis Street Hospital. January 1987. / Donohoe.
Emergency electrolyte disorders. Undergraduate lecture. Royal College Surgeons in Ireland. January 1987. / Donohoe.
106 Case presentations. Clinical club. February 1987. / Donohoe.
Common renal disorders. Undergraduate lecture. University College, Dublin. February 1987.
Acute renal failure. Sympsoium. Royal College of Physicians in Ireland. February 1987. / Donohoe.
Irish Nephrological Society annual meeting. Royal College of Surgeons in Ireland. March 1987. / Donohoe.
ACE inhibitors in patients with renal impairment. Symposium: The aging process. Montreux, France. March 1987. / Donohoe.
Association of Physicians of Great Britain and Ireland. Annual meeting. Dundee, Scotland. April 1987. / Donohoe.
Renal failure/heart failure. Symposium. Royal College Physicians in Ireland. April 1987. / Donohoe.
Diagnostic indices for acute renal failure. Faculty of Anaesthetists annual meeting. Royal College of Surgeons in Ireland. May 1987. / Donohoe.
Diabetes workshop. Postgraduate Centre, Mater Misericordiae Hospital. May 1987. /. Donohoe.
International Society of Nephrology. Free communication session. London, England. July 1987. Chairman: / Donohoe.
ACE inhibitors and the kidney. Lecture. London, England. July 1987. / Donohoe.
Meeting of Editorial Board. Nephrology, Dialysis, Transplantation Journal. London, England. July 1987. / Donohoe.
Lisinopril in renal hypertension. Presentation. International symposium. Monterey, California. October 1987. / Donohoe.
Advances in management of renal disease. Presentation. Boston University Faculty Symposium. Boston, Massachusetts, United States of America. October 1987. / Donohoe.
107 Renal hypertension. Lecture. Non consultant hospital doctors. Postgraduate Centre, Mater Misericordiae Hospital. November 1987. /. Donohoe.
Hypertension. Symposium. London, England. December 1987. / Donohoe.
Annual study day. Mater Misericordiae Hospital. December 1987. Convenor: / Donohoe.
Diabetic renal disease. Symposium. Diabetes. Royal College of Physicians in Ireland. December 1987. / Donohoe.
Out Patient Clinic
Monday 2.30 p.m. — 5.30 p.m.
Activity Analysis
1985 1986 1987
Procedures Performed:—
Percutaneous renal biopsy patients 42 38 41 Peritoneal Dialysis treatments 20 26 20 On-site haemodialysis treatments 36 47 52 Transferred to Jervis Street Hospital for 8 9 11 chronic dialysis/ transplant programme — patients
108 NEUROLOGY DEPARTMENT Staffing
CONSULTANT: Dr. B.C. O'Moore Dr. S. Murphy Dr. H. Staunton
PARA-MEDICAL STAFF: Mrs. P. Hill Miss K. Plaisted
SECRETARIAL STAFF: Mrs. D. Farrell (Part-time) Scope of Service
Daily E.E.G. clinics. Three out-patient E.M.G. clinics weekly. E.E.G. and E.M.G. testing of in-patients and out-patient consultations. Clinical neurological services including electroencephalography, brietal anaesthesia recordings, electromography, visual evoked potentials. The department is also involved in electro-diagnostic work with the ophthalmic department.
Special Interests
Full range of clinical neurophysioiogical equipment, including 21 channel E.E.G. machine and a portable 10 channel E.E.G. machine. E.M.G. and nerve conduction equipment and equipment related to evoked responses including pattern and flash stimulators and auditory click stimulator.
Dr. B.C. O'Moore is a member of the American Association of Electromyography and Electro-diagnosis and is also a member of the Association of British Clinical Neurophysiologists.
Conferences/Meetings
Eighth international congress of electromyography and related clinical neurophysiology. Sorrento, Italy. May, 1987. B. O'Moore.
Midlands evoked potentials workshop. Workshop. Department of Vision Sciences, Aston University, Birmingham, England. 12th-15th April, 1987. K. Plaisted.
Publications
Hereditary amyloid polyneuropathy in north-west Ireland. Brain, 110: 1231-1245. 1987. H. Staunton, P. Dervan, R. Kale, R.P. Linke, P. Kelly.
109 The clinical significance of microdysgenesis in temporal lobe epilepsy. Neurology. (In press). O. Hardiman, T. Burke, S. Murphy, J. Phillips, H. Staunton, M. Farrell.
Inter-ictal spike localisation with methohexitone: pre-operative activation and surgical follow-up. Epilepsia, 28 (4): 335-339. 1987. O. Hardiman, A. Coughlan, B. O'Moore, J. Phillips, H. Staunton.
Presurgical evaluation protocols — The Richmond Institute for Neurology and Neurosurgery. Surgical treatment of the epilepsies. New York Raven Press. 1987.
The clinical significance of microdysgenesis in temporal lobe epilepsy. Neurology, 37 (supplement 1): 247 (A). 1987. O. Hardiman, A. Coughlan, B. O'Moore, J. Phillips, H. Staunton, M. Farrell.
Hyperuricaemia in type V glycogenosis. Neurology, 37: 728-729 (letter). 1987. O. Hardiman, M. Farrell, C. McElvaney, K. Tipton, H. Staunton.
Presentations
The clinical significance of microdysgenesis in temporal lobe epilepsy. American Academy of Neurology. New York, United States of America. April 1987. O. Hardiman, A. Coughlan, B. O'Moore, J. Phillips, H Staunton, M. Farrell.
DNA analysis of duchenne and becker muscular dystrophies in families of Irish origin using PERT DNA probes. Irish Geneticists meeting. Trinity College, Dublin. April 1987. M. Gill, H. Staunton, P. Humphries.
Out Patient Clinics
E.M.G. Tests:— Monday 2.00 p.m. Tuesday Friday
E.E.G. Monday 9.00 a.m. — 5.00 p.m. Friday
Evoked Responses Monday 9.00 a.m. Thursday 2.00 p.m. Friday 9.00 a.m.
110 NURSING DEPARTMENT Staffing
SENIOR NURSING STAFF: 21 SISTERS AND NURSES: 241.5 STUDENTS AND OTHERS: 306 568.5
Applications for General Nurse Training
The number of applications processed for general nurse training for year ending 31st December 1987 has exceeded two thousand.
Post Registration Courses
Thirty-four staff nurses availed of the four post-registration courses during 1987. Priority was given to the successful nurses who applied for posts in the operating theatres, accident/emergency department, coronary care unit and intensive therapy complex following completion of courses.
The nurses were in post in September of the year under review. The accident/ emergency, coronary care and intensive therapy courses commence in mid- January and mid-July each year. The theatre technique course commences in January of each year.
Scope of Service
The year under review (1987) has been complicated by financial cut-backs in the health sector, resulting in closure of wards and reducing services in out patients' and accident/emergency departments and operating theatres. Temporary nursing staff in the hospital had to relinquish their posts in May 1987. The wards that remained open had to take extra beds very often resulting in increased clinical nursing throughput. This situation did not help the traditional patient-centred approached that is synonomous with nurse training here in the Mater Misericordiae Hospital.
The opening of two five-day wards proved very satisfactory, primarily for the patients; it also enabled nursing administration to roster the nursing staff for a straight five day week with off duty at weekends.
111 Computer system in use on 5 day ward.
Facilities in the existing hospital are deteriorating in spite of maintenance. It is hoped that Phase 1A extension will be commissioned without delay.
St. Mary's Orthopaedic Hospital, Cappagh
Nine staff nurses undertaking orthopaedic post-basic statutory nursing course in St. Mary's Orthopaedic Hospital, Cappagh, were seconded on a continuous basis for a period of four weeks each to this hospital during the year under review, in order to gain experience in orthopaedic trauma. These staff nurses were rostered for day duty in orthopaedic wards, orthopaedic clinics, the orthopaedic operating theatre and the accident/emergency department, in order to gain clinical experience in this specialty. Following experience at this hospital, the staff nurses were seconded to Temple Street Hospital and the National Rehabilitation Centre, Dun Laoghaire.
Special Interests
The annual re-union of past Mater Misericordiae Hospital nurses was held on Saturday 20th June 1987. The attendance was high, and all past Mater
112 Misericordiae Hospital nurses enjoyed the day very much. Catering for the occasion was excellent, as usual.
In-Service Training Programme
Requests from health boards, hospitals and other health service agencies for in-service training of personnel were met during the year under review:
Adelaide Hospital. Ms. Phelan, staff nurse, visited the operating theatre for a three month period commencing 12th January 1987 in order to gain experience.
Adelaide Hospital. Ms. E. Flood, staff nurse, visited the operating theatre for a three month period commencing 1st April 1987 in order to gain experience.
University of Edinburgh, Scotland. Ms. K. Chace, MSc in nursing education, visited the School of Nursing for five days commencing 6th April 1987 as an observer.
James Connolly Memorial Hospital Ms. F. Hussein Hassan visited the gastro intestinal unit on 19th May 1987 as an observer.
Galway Regional Hospital Miss M. Dempsey, staff nurse, visited the cardiovascular investigation unit from 8th- 12th June 1987 in order to gain experience.
Department of Justice. Mr. P.J. Doran, prison officer, visited the accident/emergency department for two weeks commencing 26th October 1987 as an observer.
Department of Justice. Mr. T. Ryan, prison officer, visited the accident/emergency department for two weeks commencing 26th October 1987 as an observer.
Midland Health Board. Ms. R. McKeon, nurse tutor, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Midland Health Board. Ms. A. McDonnell, staff nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
113 Jervis Street Hospital Ms. A.M. Carey, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Midland Health Board Ms. B. McEvoy, staff nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
North Eastern Health Board Ms. A. O'Dwyer, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Dr. Steeven's Hospital Ms. A. Cooney, staff nurse, atended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
South Eastern Health Board Ms. A. Kennedy, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
South Eastern Health Board Ms. H. Sheehan, public health nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Aut-Even Hospital, Kilkenny. Sr. R. Sheil, staff nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
International Missionary Training Mrs. M. Salter, staff nurse, attended a short Hospital, Drogheda, Co. Louth. refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Midland Health Board Ms. E. Gray, public health nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Eastern Health Board Ms. M. Fitzpatrick, public health nurse, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
St. James's Hospital Ms. B. Glynn, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Meath Hospital. Ms. H. O'Reilly, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
114 South Eastern Health Board Ms. H. Kennedy, ward sister, attended a short refresher course in diabetes from 2nd — 6th November 1987 inclusive.
Study Days
The Institute for Public Administration organised two courses for senior nursing personnel on 9th/10th February 1987 and 16th/17th February 1987. These courses were attended by many ward sisters and staff nurses.
During the year under review two study days were arranged on the 15th/16th December 1987 for ward sisters and these were well attended.
An oncology symposium entitled "Quest for a cure" was held in the Freeman Auditorium on 14th March 1987. This was attended by various members of the nursing staff. During the year under review An Bord Altranais organised four refresher courses in nursing entitled "Back to nursing" from 26th January to 6th February 1987, 11th May to 22nd May 1987, 5th October to 16th October 1987 and 16th November to 27th November 1987. The overall attendance for these courses was fifty-seven.
Miss E. Hennessy, a leaving certificate student from Alexandra College, Milltown, Dublin 6 spent three weeks at this hospital, as part of an on-going work experience programme for students, organised by the principal of this school.
115 Conferences/Seminars/Courses Attended
The financial allocation for attendance at conferences/seminars/courses was greatly reduced, due to the financial constraints within the hospital.
GRADE CONFERENCE/SEMINAR/COURSE ATTENDED
Two Staff Nurses Visited Bards Factory, Galway, makers of (St. Brendan's Ward & catheters for coronary angiography and Cardiovascular Unit) angioplasty on 19th February 1987. Funded by United States Catheters and Instruments and Surgical Distributors Limited.
One Sister British Diabetic Association Education (Diabetic Day Centre) Section meeting held in London, England, from 26th — 28th February 1987. Funded by Diabetes Research Fund.
Infection Control Sister National composing on caring for Acquired Immune Deficiency Syndrome held in London, England from 3rd — 6th April 1987.
Three Sisters Opthalmic nursing study day held in Royal Six Staff Nurses Victoria Eye and Ear Hospital on 4th April (Operating Theatre, Out Patient 1987. Department and St. Brendan's Ward).
Infection Control Sister and Seminar on Acquired Immune Deficiency Accident/Emergency Sister Syndrome held by Eastern Health Board on 5th/6th April 1987.
116 One Staff Nurse Cervical and breast cancer updated (St. Brigid's Ward) organised by Irish Cancer Society, held in Northumberland Road on 8th April 1987.
One Staff Nurse Angioplasty satellite symposium held in (Cardiovascular investigation General Hospital, Sheffield, England on 10th ward) April 1987. Funded by United States Catheters and Instruments International.
One Junior Sister Conference entitled "Beyond trauma" held Two Staff Nurses in post-graduate unit, Beaumont Hospital (Accident/Emergency Department) on 8th May 1987.
Two Sisters Symposium on diabetic care held in Royal Three Staff Nurses College of Physicians on 8th May 1987. (Diabetic Day Centre)
One Sister Study day in the Davis & Geek Plant in (Ophthalmic Theatre) Gosport, England on 8th May 1987. Funded by P.E.I. Surgical Limited.
One Sister Presented a paper on diabetes at a (Diabetic Day Centre) seminar for public health nurses held in Malahide on 15th May 1987.
One Sister British Diabetic Association meeting held in (Diabetic Day Centre) London, England on 15th May 1987. Funded by British Diabetic Association.
One Sister International nursing conference held in (St. Brendan's Ward) Canada from 18th May to 14th June 1987. Funded by Lucozade "Nurse of the Year Award."
One Staff Nurse Workshop on diabetes held in Ipswich, Diabetic Day Centre) England from 27th to 30th May 1987. Funded by Diabetes Research Fund.
One Staff Nurse University Hospital, London, England from (Operating Theatre) 1st to 12th June 1987. Funded by Ethicon Scholarship Award for theatre personnel.
Infection Control Sister National Executive Council meeting of Infection Control Nurses Association held in London, England on 8th June 1987. Funded by Infection Control Nurses Association.
117 Four Staff Nurses International intensive care conference held (Intensive Therapy Unit) in London, England, from 24th August to 28th August 1987.
One Sister American Association of Diabetes (Diabetic Day Centre) Educators meeting held in Florida, United States of America, from 8th to 11th September 1987. Funded by Ames Diagnostic Company.
Two Sisters National ophthalmic nursing study day (Operating Theatre) held in St. Mary's Hospital, Manchester, England, on 11th September 1987. Funded by Pharmacia Limited.
One Sister International paediatric ophthalmology Three Staff Nurses convention held in Killiney Court Hotel, (Operating Theatre) Dublin, on 2nd October 1987.
One Nurse Tutor Diploma/MSc in nursing administration (School of Nursing) held in Department of Post-graduate Nursing Studies in University of Edinburgh, Scotland, from 5th October 1987 to 3rd October 1988.
One Staff Nurse A.O. course held in St. Mary's Orthopaedic (Operating Theatre) Hospital, Cappagh, on 14th/15th October 1987.
One Sister Ear, nose and throat study day held in One Staff Nurse Royal Victoria Eye and Ear Hospital on 7th (Operating Theatre) November 1987.
One Sister Infection control conference for nurses Three Staff Nurses held in Beaumont Hospital on 14 (Operating Theatre) November 1987.
One Sister Study on the use of disposables in theatre (Operating Theatre) held by Hospital Joint Services Board and Travenol Laboratories at the Meath Hospital on 19th November 1987.
One Sister Irish Society of Endoscopy Nurses meeting Two Staff Nurses held on 20th November 1987. (Gastro-lntestinal Unit)
118 One Sister Presented a paper on diabetes at a staff (Diabetic Day Centre) study day held in Stewarts Hospital, Palmerstown, on 24th November 1987.
Two Junior Sisters Seminar on intensive care held in Belfast Two Staff Nurses City Hospital on 26th November 1987. (Intensive Therapy Unit)
One Sister Presented a paper on diabetes at a Diabetic Day Centre) meeting for public health nurses held in Mullingar on 3rd December 1987. Papers/Lectures within the Department
General Introduction to courses Sister M. de Lourdes
Introduction to operating, theatre Sister I. Greene
Introduction to intensive therapy unit Sister P. O'Leary
Introduction to accident/emergency department Sister O. McDonald
Infection control Sister R. Ruddy
Acquired immune deficiency syndrome Sister R. Ruddy
Basic e.c.g.s Sister M. Cleere
Nursing management of eye emergencies Sister B. Gogarty
Upper and lower limb injuries Staff Nurse P. May
Application of plaster of paris Staff Nurse P. May
Overview of fractures Staff Nurse P. May
119 MEDICAL ONCOLOGY Staffing
CONSULTANT: Dr. D.N. Carney
NON-CONSULTANT 1 Shared Intern/Senior House Officer HOSPITAL DOCTOR:
RESEARCH FELLOW: Dr. M. Teeling (Supported by grant from St. Luke's Hospital Cancer Research Fund)
RESEARCH TECHNICIAN: Ms. A. McCann (Supported by grant from M.R.C. Ireland
RESEARCH NURSE: Nurse P. Harford
Scope of Service
The unit's beds are provided to investigate, stage and treat patients with a wide range of malignancies, in particular, carcinoma of the lung, breast, testis, and lymphoma.
Special Interests
This oncology service has a special interest in determining optimium techniques for the diagnosis, staging and treatment, with systemic chemotherapy, of patients with small cell lung cancer, ovarian, testicular and breast cancer. In addition, studies are being developed to determine if the biological properties of tumour cells are of independent prognostic importance in patients with these tumours.
Clinical Research Activities
Clinical research protocols continue with special reference to clinical protocols in lung cancer, ovarian cancer, lymphomas and bone tumours. In addition, major efforts are endeavourous to expand and develop a laboratory sectum for the assessment of the value of tumour markers in a wide range of cancers.
Conferences
A combined multidisciplinary oncology conference is held each Thursday at 8.00 a.m. in the radiology conference room, Mater Misericordiae Hospital. On the third Thursday, a formal research seminar is held, attended by invited speakers.
120 Symposia
Quest for a cure. Oncology symposium. Mater Misericordiae Hospital. March, 1987:
The biology and treatment of chronic myelogenous leukaemia. 5. McCann.
Limb-sparing treatment for malignant bone tumours. B. Hurson.
Infection in the immunocompromised host. H. Gaya.
Clinical relevance of the biology of human tumours. D.N. Carney.
Advances in the biology and treatment of ovarian cancer. R. Ozols.
Invited Lectures
Cancer update. Midland Medical Society. Ballinasloe. January, 1987.
Cancer update. General Practitioner Association. Dunleer. January, 1987.
Testicular and lung cancer. Study day. St. Luke's Hospital. February, 1987.
Biology of human tumours. Oncology symposium. Mater Misericordiae Hospital. March, 1987.
In vitro chemosensitivity testing. Small cell national conference. Bologna, Italy. March, 1987.
Lung cancer biology. Small cell national conference. Bologna, Italy. March, 1987.
Plenary session: Advances in the clinical application of lung cancer biology. British Association for Cancer Research. Annual general meeting. Newcastle, England. April, 1987.
Management of the cancer patient. Symposium. Irish Cancer Society. Dublin. May, 1987.
121 The need for early detection of cancer. Mammography symposium. Mater Misericordiae Hospital. May, 1987.
Treatment and biology of bladder cancer. Study day. Mater Misericordiae Hospital. May, 1987.
Update in cancer care. Kerry Medical Society. Tralee. May, 1987.
Chemosensitivity testing of lung cancer: New druy screening program. National lung conference. Washington D.C., United States of America. May, 1987.
Drug resistance in lung cancer. European School of Oncology. Venice, Italy. June, 1987.
Lung cancer biology. European School of Oncology. Italy. June, 1987.
Hormonal control of lung cancer growth. First European Congress of Endocrinology. Copenhagen. June, 1987.
Oncogenes in lung cancer. Oncogene workshop. Cambridge, England. September, 1987.
Malignant lymphomas. Irish Association for Nurses in Oncology. Dublin. September, 1987.
Lung cancer biology and oncogenes. National lung conference. Clatterbridge, England. September, 1987.
Testicular cancer. Irish Cancer Society. Dublin. September, 1987.
Cancer prospects and future. Symposium. Irish Cancer Society. Limerick. October, 1987.
Biology of human tumours. Middle East conference. Bahrain. October, 1987.
Lung cancer management. Middle East conference. Bahrain. October, 1987.
Bombesin: A growth factor for small cell lung cancer. Growth factor symposium. Rome, Italy. October, 1987.
122 Small cell lung cancer. Small cell lung cancer teaching lecture. Fourth European Conference of Clinical Oncology and Cancer Nursing. Madrid, Spain. November, 1987.
Testicular cancer. Study day. Mater Misericordiae Hospital. December, 1987.
Abstracts and Presentations
Carboplatin/cyclorphosphamide in the treatment of advanced ovarian cancer. American Society of Clinical Oncology. 1987. M. Teeling, D.N. Carney.
Long-term renal function studies following cisplatin and carboplatin. British Association for Cancer Research. 1987. M. Teeling, D.N. Carney.
Combination chemotherapy in advanced ovarian carcinoma. British Association for Cancer Research. 1987. M. Teeling, D.N. Carney.
Bone marrow examination in small cell lung cancer patients. Is it indicated? Clinical oncology meeting. Royal College of Surgeons. October, 1987. D.N. Carney, P. Kiely.
Immunohistochemical analysis of c-myc and ki-67 expression in colonic mucosa, adenomas and carcinomas. Clinical oncology meeting. Royal College of Surgeons. October, 1987. P. Johnston, M. O'Brien, P. Dervan, D.N. Carney.
Renal function following cisplatin and carboplatin chemotherapy. Clinical oncology meeting. Royal College of Surgeons. October, 1987. M Teeling, D.N. Carney.
Immunohistochemical analysis of breast cancer oestrogen receptor. Correlation with biochemical assay and expression of c-myc oncogene. Irish Association for Cancer Research. 1987. P. Johnston, M. McAllister, P. Dervan, D.N. Carney.
Creatine kinase isoenzymes as tumour markers. Association of Clinical Biochemists in Ireland. 1987. PC McGing, M. Teeling, D. UaConaill, D.N. Carney.
Immunohistochemical analysis of c-myc oncogene expression in the development of colonic adenocarcinoma. Irish Society of Gastroenterology. 1987 (medal awards). P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D.N. Carney.
123 Immunohistochemical analysis of cell kinetic parameters in colonic adenocarcinomas, adenomas and normal colons. Irish Society of Gastroenterology. 1987. P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D.N. Carney.
Bone marrow examination in small cell lung cancer patients. Is it indicated? Mater Hospital research symposium. Award first prize. November 1987. P. Kiely, O. Redmond, D.N. Carney.
Publications
Neurotensin binds with high affinity to small cell lung cancer cells. Neural and endocrine peptides: In press 1987. A.E. Allen, D.N. Carney, T.W. Moody.
Myc family oncogene amplification in tumour cell lines established from small cell cancer patients and its relationship to clinical status and course. Journal of Clinical Investigation. 79:1629-134, 1987. B.E. Johnson, D.C Ihde, R.W. Makuch, A.F. Gazdar, D.N. Carney, H. Oie, E Russell, M.M. Nau, J.D. Minna.
Biochemical markers of lung cancer. In: Biology in Lung Cancer: Diagnosis and Treatment. Maral Dekker Inc. (Pub). Risen et al (ed.) pp. 43-58, 1987. M. Teeling, D.N. Carney.
Selective stimulation of small cell lung cancer clonal growth by bombesin and gastrin-releasing peptide. Cancer Research. 47:821-825, 1987. D.N. Carney, F. Cuttitta, T.W. Moody J.D. Minna.
The tachykinin physalaemin inhibits the in vitreo growth of human small cell lung cancer. Cancer Research. 47:2371-2375, 1987. C. Bepler, D.N. Carney, A.F. Gazdar, J.D. Minna.
Levels of high energy phosphates in human lung cancer cell lines by 31 p nuclear magnetic resonance. Cancer Research. 47: 3357-3359, 1987. R.H. Knop, D.N. Carney, CW. Chen, J.5. Cohen, J.D. Minna.
Small cell lunger cell line derived from a primary tumour with a characteristic deletion of 3p1. Cancer Research. 47: 2148-2155, 1987. S.L Graziano, BY. Cowan, D.N. Carney CR. Bryke, N.S. Mitter, B.E. Johnson, GE. Mark, A.T. Planas, J.J. Catino, R.L Comis, B.J. Poiesz.
Neuron specific enolase; application as a tumour marker. European Journal of Clinical Oncology. In press: 1987. D.N. Carney, M. Teeling.
124 The biology of paraneoplastic syndromes. In: The New Endocrinology of Cancer. Eds.: J. Waxman, R.C. Coombes. Arnold Pubs., 89-104, 1987. P. Johnson, D.N. Carney.
The biology of lung cancer. Cancer Bulletin, 74: 485-500, 1987. DM Carney.
The needs of cancer patients. Irish Journal of Medical Science. 156:168-171, 1987. D.N. Carney.
Monoclonal antibodies in lung cancer pathology. European Journal of Research. Dis. 70:11-17, 1987. J.LV. Broers, M. Rot Klein, L. de Leij, S.S. Wagenaar, D.N. Carney, C.P. Vooijs, F.C.S. Ramaekers.
The clinical implications of the biology of small cell lung cancer. European Journal of Research. Dis. 70:5-10, 1987. D.N. Carney.
In vitro chemosensitivity on non-small cell lung cancer. Cancer Treatment Report. 71:697-704, 1987. J.C. Ruckdeschel, D.N. Carney, H. Oie, A.F. Gazdar.
Clinical relevance of lung cancer biology. British Journal of Cancer. 56:884-885, 1987. D.N. Carney.
Out Patient Clinics
Dr. D.N. Carney Tuesday 9 a.m.
125 OPHTHALMOLOGY DEPARTMENT Staffing
CONSULTANT: Professor P. Eustace Mr. H.N. O'Donoghue Mr. R. Bowell Mr. R.W. Acheson Mr. M. O'Keeffe Ms. P. Logan
TUTOR Dr. E. Burke
NON-CONSULTANT 1 Registrar HOSPITAL DOCTORS: 4 Senior House Officers
PARA-MEDICAL STAFF: 1 Orthoptist 1 Electrodiagnostic Technician
NURSING STAFF: 1 Out Patient Sister 1 Ward Sister 2 Theatre Sisters
Scope of Service
All current ophthalmic techniques and treatment modalities are now available in the department. Routine ophthalmic clinics are held every day and there is a twenty-four hour casualty service. A full orthoptic service is also available.
Special Equipment
3 Operating Microscopes — Wild M690, Opmi 1, Opmi 6. Coherent radiation argon laser. O'Malley Log2 Photocoagulator. Topcon fundus camera-Fluorescein angiography. Topcon photo-slit anterior segment camera. Ocutome vitrectomy MK II. A and B scan ultrasound unit. Gansfeld stimulator with Medelec for V.E.R., E.R.G. and E.O.G. HGM PC Argon laser endophoto coagulator. Gricshaber air pump. DORC Silicone oil pump. KOWA automater perimeter.
126 Special Interests
Professor P. Eustace Sub speciality — Neuro-ophthalmology. Ophthalmic representative on the European Union of Medical Specialists. Council member of Irish Ophthalmological Society. Joint Secretary British Isles Neuro-ophthalmic club.
Mr. H.N. O'Donoghue Sub speciality — Ophthalmic plastic surgery. Diabetic eye disease. Laser treatment of diabetic retinopathy. Oculo- plastic surgery, ptosis and lacrimal surgery. Representative for Ireland on Committee of European Society of Ophthalmic Plastic and Reconstructive Surgery. Gonin Club — International Society of Retinal Diseases.
Mr. R. Bowell Sub speciality — Paediatric ophthalmology — strabismus — neonatal eye disease. Ophthalmic representative — Bord na Radharcmhastoiri. Member of Medico-political liaison committee Irish Faculty of Ophthalmology. Member of Editorial Committee, Year Book Irish Faculty of Ophthalmology.
Mr. M. O'Keefe Sub speciality — Paediatric ophthalmology. Holder of Paediatric Fellowship Hospital for Sick Children, Toronto, Canada.
Mr. R.W. Acheson Sub speciality — Vitreo retinal surgery. Fluorescein angiography, ultrasound. Diabetic eye disease. Laser treatment of diabetic eye disease, senile macular degeneration and other retinal conditions.
Ms. P. Logan Sub speciality - Neuro-ophthalmology. Corneal service.
Special Clinics
Electrodiagnostic clinic Monday and Wednesday mornings L.V.A. and contact lens clinic Thursday mornings
127 Fluorescein angiography clinic Friday mornings Ultrasound clinic Thursday mornings Diabetic clinic Wednesday mornings Orthoptic clinic Daily Drug toxicity clinic Monday afternoons Laser treatment clinic Friday, all day
Meetings Attended
British and Irish Association of Vitreoretinal Surgeons. Oxford, England. July 1987. R.W. Acheson.
Oxford Ophthalmological Congress. Oxford, England. July 1987. R.W. Acheson, H.N OVonoghue.
Ophthalmological Society of United Kingdom. P. Eustace, P. Logan.
Faculty of Ophthalmology. P. Eustace, P. Logan, R. Bowell.
French Ophthalmological Society. P. Eustace.
U.E.M.S. Strasbourg, Germany. P. Eustace
European Professors of Ophthalmology. Paris, France. P. Eustace.
German Ophthalmological Society. Heidelburg, Germany. P. Eustace.
Southern Ophthalmological Society meeting. September 1987. R. Bowell, M. O'Keeffe.
International Paediatric Ophthalmology meeting. October 1987. R. Bowell, P. Logan, H.N. OVonoghue, M. O'Keeffe.
Ophthalmic Society of the United Kingdom. Cardiff, Wales. April 1987. H.N. OVonoghue.
South of England Ophthalmological Society. H.N. OVonoghue.
World Congress Cornea. Washington, United States of America. April 1987. M. O'Keeffe.
128 St. Georges Hospital. London, England. March 1987. H.N. O'Donoghue.
King Edward VII Hospital. London, England. May 1987. H.N. O'Donoghue.
Mater Misericordiae Hospital. Dublin. September 1987. H.N. O'Donoghue.
Sutton General Hospital, Surrey. Surrey, England. October 1987. H.N. O'Donoghue.
British Isles Neuro-Ophthalmology Club meeting. November 1987. P. Logan, P. Eustace.
Neuro-Ophthalmology meeting. Lourdes Hospital. November 1987. P. Logan.
Publications and Papers Presented
Versinia gut infections in anterior uveitis. British Journal of Ophthalmology. (In press). D.F.P. Larkin, P. Eustace.
Pontine control of eye movements. Section of Neurology. Royal Society of Medicine in Ireland. P. Eustace.
A postgraduate examination in community ophthalmology. Annual meeting, Faculty of Ophthalmology. December 1987. P. Eustace.
Neuro-ophthalmology of corneal disease. French Ophthalmological/lrish Ophthalmological Society. October 1987. P. Eustace.
Lower motor neuron disorders of eye movement. International Paediatric meeting. Dublin. October 1987. P. Eustace.
Retinotoxic effects of potent oncological agents. Joint meeting Belgian/Irish Ophthalmological Societies. Bruges, Belgium. September 1987. P. Eustace.
When to refer. North Dublin Faculty, Irish College of General Practitioners. September 1987. P. Eustace.
Retinal ultrasound findings in cone degeneration. American Journal of Ophthalmology. (In press). T.A.S. Buchanan, T.A. Gardiner, V. dejesus, P. Eustace, D.B. Archer.
129 Management of intraocular pressure during cardiopulmonary bypass. Ophthalmoligica 65: 591-593. 1987. D.F.P. Larkin, R. Murphy, J.B. Magner, P. Eustace.
Paraneoplastic pupil oedema in neuroblastoma. Postgraduate Medical Journal 63: 873-876. 1987. M.J. Kennedy, P. Eustace, D.S. O'Briain, PA. Daly.
Lasers and the eye. Irish Medical Journal, vol. 80, no. 2: 47, (editorial). 1987. P. Eustace.
Ischaemic optic neuropathy complicating cardiopulmonary bypass. British Journal of Ophthalmology, 71: 344-347. 1987. D.F.P. Larkin, A.E. Wood, M. Neligan, P. Eustace.
Calcification of Bruchs membrane in angioid streaks with homozygons sickle cell disease. Archives of Ophthalmology 105: 93-98. 1987. L.M. Jampol, R.W. Acheson, R.C. Eagle, G.R. Sergeant, R.B. O'Grady.
Intraocular Argon laser photocoagulation. Eye, vol. 1. 1987. R.W. Acheson, M. Cupon, R.J. Cooling, P.K. Leaber, D. McLeod.
Epiretinal membranes in sickle cell disease. British Journal of Ophthalmology, 71: 466-469. 1987. B.J. Moriarty, R.W. Acheson, G.R. Sergeant.
Diabetic retinopathy and visual loss in Jamaican population. West Indian Medical Journal 36: 14-15. 1987. B.J. Moriarty, R.W. Acheson, J.N. Chan, G.R. Sergeant.
Neodynium Yag Laser vitreolysis in sickle cell retinopathy. Archives of Ophthalmology, 105. 1987. N.F. Hrisomales, L.M. Jampol, B.J. Moriarty, G.R. Sergeant, R.W. Acheson, M. Goldberg
Further thoughts on photography in ophthalmology. Irish Journal of Medical Science, 156, no. 3: 108. 1987. H.N. O'Donoghue.
Purtschers Syndrome associated with cerebral oedema. (Submitted). H.N. O'Donoghue, D. Phelan, D. Roden.
An operation for senile entropion. (Submitted to Orbit). H.N. O'Donoghue, D. Roden.
Orbital Fibrous Histiocytoma in an infant. British Journal of Ophthalmology. (Submitted). D.F.P. Larkin, H.N. O'Donoghue, P. Mullaney, £ Breatnach,
130 Evaluation of panretinal laser photocoagulation for proliferatic diabetic retinopathy — 1980 — 1986. (Submitted). H.N. O'Donoghue, D. Roden.
New methods of visual field testing. Royal Academy of Medicine in Ireland, Section of Neurology. P. Logan.
Gliomas of the anterior visual pathway. International Paediatric meeting. Dublin. October 1987. P. Logan.
Superior limbic keratitis. Faculty of Ophthalmology meeting. December 1987. P. Logan, E. Bonnar.
Herpes simplex keratitis. Mater Misericordiae Hospital. Study Day, December 1987. P. Logan.
Diabetic retinopathy. Symposium on the complications of diabetes. Royal College of Physicians. December 1987. R.W. Acheson.
Clinical anophthalmos. British Journal of Ophthalmology. August 1987.
Local steroid therapy in eyelid haemangiomas. Section of ophthalmology, Royal Academy of Medicine in Ireland. July 1987. R. Bowell, M. O'Keeffe, j. Burke.
A closer look at the eye in homocoystinuria — a screened population. Twenty-fifth Jubilee meeting of Society for the Study of Inborn Errors of Metabolism. Sheffield, England. September 1987. / Burke, M. O'Keeffe, R. Bowell, E. Naughton.
Cataracts in children with classic galactosaemia and in their parents. Twenty-fifth Jubilee meeting of Society for the Study of Inborn Errors of Metabolism. Sheffield, England. September 1987. / Burke, M. O'Keeffe, R. Bowell, E. Naughton.
Proteus Syndrome — ocular manifestations. Journal of Paediatric Ophthalmology and Strabismus. (In press). R. Bowell, J. Burke, N. O'Doherty.
Ectopia Lentis in homocystinuria. Southern Ophthalmological Society meeting. September 1987. R. Bowell.
Results of trabeculectomy in congenital glaucoma. International Paediatric Ophthalmology meeting. Dublin. October 1987. R. Bowell.
131 The fundus in hypertension. Postgraduate course, Mater Misericordiae Hospital. February 1987. H.N. O'Donoghue.
The ocular fundus. Membership course, James Connolly Memorial Hospital. May 1987. H.N. O'Donoghue.
Laser treatment in diabetes. Postgraduate nurses' course, Mater Misericordiae Hospital. November 1987. H.N. O'Donoghue.
Pathophysiology of Purtscher's Syndrome. Irish Ophthalmological Society. H.N. O'Donoghue, D. Roden.
Laser for diabetic retinopathy: Results 1980-1986. Irish Ophthalmological Society. H.N. O'Donoghue, D. Roden.
Axenfeld Syndrome in albinim. Royal Irish Academy meeting. Limerick. May 1987. H.N. O'Donoghue, D.F.P. Lark in.
D.C.R. in children. International Paediatric meeting. Dublin. October 1987. H.N. O'Donoghue.
Longterm complications in retinopathy of prematurity. Paediatric Ophthalmology. Dublin. October 1987. M. O'Keeffe.
Cataracts in classical galacteraemia. European Congress of Metabolic Disease. Sheffield, England. June 1987. M. O'Keeffe, J. Burke, R. Bo well, E. Naughton.
Follow-up in children with homocystinurea. European Congress of Metabolic Disease. Sheffield, England. June 1987. M. O'Keeffe.
Research in Progress
The Arklow eye study. Funded by Irish Fight for Sight.
E.r.g., e.o.g., v.e.r. Their predictive value in diabetic retinopathy.
Retinotoxic effects of potent oncological agents — electrodiagnostic evaluation.
Contrast sensitivity in diabetic retinopathy.
Pseudo exfoliation glaucoma in first degree relations.
132 Pursuit e.o.m. in neurological disease.
Computerised recording of e.o.m. in conjunction with Department of Computer Science, National Institute for Higher Education.
Congenital glaucoma — a prospective study — Acquired Immune Deficiency Syndrome and neo-natal eye disease.
Contrast sensitivity function in optic nerve disease.
Automated perimetry in neuro-ophthalmology.
Lectures
Diploma and fellowship in ophthalmology course. Royal College of Surgeons in Ireland. R. Bowell, H.N. O'Donoghue, R.W. Acheson, P. Eustace, M. O'Keeffe, P. Logan.
Diploma in Child Health Course. Royal College of Surgeons in Ireland. R. Bowell.
Basic Sciences Course. Department of Ophthalmology, University College of Dublin. R. Bowell, P. Logan.
Neuro-ophthalmology course. P. Logan.
Visiting Lecturers
Neuro-ophthalmic course. Kuwait. April 1987. P. Eustace.
Examiner D.O. and Fellow of the Royal College of Surgeons in Ireland. FRCSI, Damaam, Saudi Arabis. H.N. O'Donoghue.
Presidential meeting at Mater Misericordiae Hospital. President of South of England Ophthalmological Society. September 1987. H.N. O'Donoghue.
United Kingdom Implant Society meeting. Chepstow, England. April 1987. M O'Keeffe.
Controversy and results in the management of infantile cataracts. Royal Victoria Eye and Ear Hospital, Dublin. September 1987. M. O'Keeffe.
133 Courses organised in the department in 1987
Basic sciences course.
Neuro-ophthalmology course.
Opthalmic outpatients — phase 1A.
Opthalmic operating theatre phase 1A.
134 ORTHOPAEDIC DEPARTMENT
Staffing
CONSULTANT: Mr. P. MacAuley Mr. F. McManus Mr. N. Mulvihill Mr. M. Walsh
NON-CONSULTANT 1 Senior Registrar HOSPITAL DOCTORS: 1 Registrar 1 Senior House Officer 3 Interns
Scope of Service
All patients for elective orthopaedic surgery are seen in the out patient department of the Mater Misericordiae Hospital from which they are referred to St. Mary's Orthopaedic Hospital for surgery. Follow up treatment on an out patient basis takes place in the Mater Misericordiae Hospital. A very satisfactory integrated service is provided by this hospital.
All fracture associated injuries and acute orthopaedic conditions are treated in the Mater Misericordiae Hospital in the orthopaedic unit. Early transfer of the majority of the patients is arranged either to:
(a) Orthopaedic Hospital, Clontarf. (b) One of the Geriatric Units.
The work of the department is considerably enhanced by the very active and most helpful participation of the consultant geriatricians.
In addition to providing lectures for undergraduate and student nurse training programmes, the department has a teaching committment to the following:
(a) Post graduate nursing courses. (b) Mater Misericordiae Hospital School of Physiotherapy, University College Dublin. (c) An Bord Altranais post certificate training in orthopaedic nursing.
A weekly teaching conference for orthopaedic registrars is held on Tuesdays at 5.00 p.m. The conference on the last Tuesday of the month specifically deals with paediatric orthopaedics and is held in The Children's Hospital, Temple Street, Dublin.
135 Publications
One session surgery for bilateral corration of lower limb deformatus in spastic diplegia. O. Paediatrics and Orthopaedics, 7: 259. 1987. A.O. Browne, F. McManus.
Backache in obstetrics. Clinical aspects of perivative care and gynaecology. Pre-medical students. 1987. F. McManus.
Presentations
One stage surgery for lower limb deformatus in spastic diplegia. Irish American Orthopaedic Society. June 1987. F. McManus.
Scoliosis in muscular dystrophy. Irish Paediatric Association. May 1987. F. McManus.
Scoliosis in muscular dystrophy. Irish Orthopaedic Club. May 1987. D. Hynes, F McManus.
Meetings attended
Locking nail symposium. Strasbourg, Germany. February 1987. N. Mu/vihill.
Out Patient Clinics
Orthopaedic Clinics
Mr. P. MacAuley Friday 1.30 p.m. — 4.30 p.m. Mr. F. McManus Thursday 1.30 p.m. — 4.30 p.m. Mr. N. Mulvihill Tuesday 1.30 p.m. — 4.30 p.m. Mr. M. Walsh Monday 1.30 p.m. — 4.30 p.m. Wednesday 1.30 p.m. — 4.30 p.m. Fracture Clinics
Mr. P. MacAuley Tuesday 9.00 a.m. — 10.00 a.m. Mr. F. McManus Wednesday 9.00 a.m. — 10.00 a.m Mr. N. Mulvihill Monday 9.00 a.m. — 10.00 a.m Mr. N. Mulvihill Friday 9.00 a.m. — 10.00 a.m Mr. M. Walsh Thursday 9.00 a.m. — 10.00 a.m Spinal Deformity Clinic Mr. F. McManus Second Thursday each month.
136 Out Patient Department
1983 1984 1985 1986 1987
Accident/Emergency 63,461 64,586 61,969 57,006 48,739 Cardiology 4,601 4,843 4,860 5,261 5,289 Child Guidance 19,075 19,037 18,036 16,126 15,189 Chiropody 179 187 323 416 353 Colour Vision — - — 17 11 Dental 640 399 288 — — Dermatology 6,543 6,329 4,691 4,670 5,186 Diabetic Day Centre 7,382 5,933 4,618 4,127 4,573 E.C.C. 9,495 9,414 7,776 6,229 10,645 E.E.C. 833 658 776 528 549 E.O.C. — — — 131 73 Endocrine 5,980 5,367 5,595 6,005 5,451 E.N.T. 4,347 4,161 4,524 4,323 3,728 E.M.C. 413 418 408 386 322 E.R.C. — — — 183 170 Fertility/Infertility 573 596 527 553 521 Fracture 7,356 8,460 7,988 8,977 8,513 Genetics 143 100 136 105 75 G.I. 3,277 3,121 2,911 3,711 3,331 Gynaecology 2,189 2,166 2,245 2,321 2,162 Haematology 1,159 1,591 1,575 1,767 1,452 Liver 203 274 273 291 318 Medical 6,525 6,262 5,794 5,152 4,966 Minor Procedures 4,788 4,328 4,664 3,582 4,703 Nephrology 649 651 822 778 789 Neurological 833 490 569 509 622 Oncology — 107 433 1,150 1,179 Ophthalmic 10,399 11,398 11,736 13,184 11,324 Orthopaedic 5,829 6,131 6,838 5,321 4,592 Pace Maker 398 430 388 329 315 Laboratory 337,946 358,640 377,407 449,837 424,906 Physical Medicine 5,514 5,683 5,670 5,858 5,318 Physiotherapy 33,555 30,531 29,217 20,457 19,105 Post Operative 2,059 2,183 2,242 1,990 1,697 Prothrombin Clinic — 3,881 6,513 6,678 6,463 Psychiatry 3,563 3,453 3,149 2,571 2,035 Pulmonary Laboratory 1,020 1,121 941 1,117 1,090 Radiology 23,355 26,681 24,759 21,024 21,227 Respiratory 1,596 1,622 1,450 2,224 2,253 Surgical 14,011 13,497 13,312 13,459 12,924 V.E.R. — — — 161 115
Total 589,889 614,729 625,423 678,514 642,273
137 OUT PATIENT CLINICS
Clinic/Consultant Telephone Day & Time
ALLERGY SKIN TESTING
(No clinic first Thursday of every Tues/Wed/Thurs 2.00 month)
CARDIAC CLINICS ext. 2353 Mon 2.00 — Prof. S. Blake (alternate Mondays) ext. 2353 Wed 2.00 & Fri 10.30 Prof. T.B. Counihan Prof. T.B. Counihan Fri 11.00 — 100 Dr. Conor McCarthy) Combined clinic (Cardiology & Cardiac Surgical) Thurs 2.00 Mr. M. Neligan (Cardiac Post-Operative) 1st Thurs every month Mr. M. Neligan Mon 2.00 (Cardiac Pacemaker Clinic) (alternate Mondays) Dr. D. Sugrue
CHIROPODY
Mr. Whitney (Hospital In-Patients) Mon & Wed 9.00 -- 11.00
Mr. Whitney (Hospital Out-Patients) Fri 9.00 — 11.00
DEPARTMENT OF CHILD PSYCHIATRY
Mater Hospital 300700 Mon — Fri 8.30 — 5.30 Ballymun Centre 420319 Mon — Fri 9.30 — 5.30 DERMATOLOGY
Dr. S. O'Loughlin — Skin Clinic Tue 9.00 — 1.30 Dr. S. O'Loughlin — Psroiasis Clinic Fri 9.00 — 10.00 Dr. S. O'Loughlin — Skin Clinic Fri 10.00 — 1.00 Dr. F. Powell Mon & Wed 9.30 — 1.30
DIABETIC DAY CENTRE
48 Eccles Street, 307006 Phone for appointment
138 Clinic/Consultant Telephone Day & Time
EAR NOSE & THROAT
Mr. W. Grant Mon & Fri 9.00 — 1.00 Mr. A. Blayney Wed 9.00 — 12.30 (Follow up clinic) Mon 2.15
E.M.G. DEPARTMENT
Dr. B. O'Moore 300700 ext. 2242
FAMILY PLANNING CLINIC
Return Patients 308807 Wed 6.00 New Patients 308807 Wed 7.00
FERTILITY/INFERTILITY CLINIC;
Prof. D. Powell/Mr. M. Coughlan Wed 2.00
FRACTURE CLINICS
Mr. N. Mulvihill Mon & Fri 8.30 — 10.00 Mr. P. MacAuley Tue 8.30 — 10.00 Mr. F. McManus Wed 8.30 — 10.00 Mr. M. Walsh Thur 8.30 — 10.00
GENETIC CLINIC
Dr. S. McManus Suspended until further notice
GYNAECOLOGICAL CLINICS
Mr. M. Coughlan Fri 9.00 — 10.15 Dr. P. McKenna Wed 9.00 — (Follow up clinic by Gynaecology Tue 9.00 — 10.00 Department — referral only)
HAEMATOLOGY
Dr. B. Otridge Wed 9.30
139 Clinic/Consultant Telephone Day & Time
MEDICAL CLINICS
Dr. C. Barry (Physical Medicine) Tue & Thu rs 9.15 - 1.15 Dr. H. T. Barniville (Gen. Medicine) Fri 9.30 — 12.30 Dr. H. T. Barniville/Dr. J. Crowe Mon 2.30 -— 4.30 (Combined Liver Clinic) Dr. R.J. Coughlan (Physical Medicine) Wed & Fri 10.00 - 12.30 Prof. T.B. Counihan (Medical) Wed 2.00 -— 5.00 Dr. J. Crowe (Gastroenterology) Tue 9.00 -- 12.30 Dr. J. Donohoe (Nephrologist) Mon 2.00 Dr. R.G. Firth (Diabetic/Endocrine) Mon & Wed 9.00 - 12.30 Dr. P. Keelan (Respiratory Medicine) Tue 2.00 -- 5.00 Dr. B. Keogh (Respiratory Medicine) Fri 1.45 Dr. J. Lennon (Gastroenterology) Thurs 9.00 — 1.30 Prof. D. Powell (Endocrine) Tue 2.00
NEUROLOGICAL CLINICS
Prof. J.P. Malone (Neurology) Mon 9.00 -- 12.30 Prof. J. P. Malone (Psychiatry) Thur 9.00 -- 12.30 Dr. S. Murphy (Neurology) Tue 2.00
ONCOLOGY CLINIC Dr. D. Carney Tue 9.00 — 12.30
OPHTHALMIC CLINICS
Mr. R. Acheson (Diabetic patients only) Wed 9.00 — 12.00 (Retinal patients only) Thurs 9.00 — 12.00 (Laser treatment) Fri 8.45 — 12.00 Mr. R. Bowell Thurs 2.15 Prof. P. Eustace Mon 9.00 — 12.00 Prof. P. Eustace Tue 2.00 — 5.00 Ms. P. Logan Tue & Thurs 9.00 — 12.00 Mr. H. O'Donoghue (General) Wed & Fri 2.00 Mr. M. O'Keeffe Mon 2.00
ORTHOPAEDIC CLINICS
Mr. N. Mulvihill Tues 1.30 — 4.30 Mr. P. McAuley Terminated Mr. F. McManus (Scoliosis Clinic) Thurs 1.30 — 4.30 (2nd Thurs. each month) Mr. M. Walsh Mon & Wed 1.30 — 4.30
PROTHROMBIN CLINIC By appointment only ext. 2353 Tues 2.00 4.00
140 Clinic/Consultant Telephone Day & Time
S.T.D. CLINIC
Female patients 304488 Tues 4.00 — 7.00 & Thurs 3.00 — 4.00 Male patients 304488 Wed & Thurs 5.00 — 7.00
SURGICAL CLINICS
Mr. T. Corrigan (General & Vascular) Thurs 2.00 — 4.30 Prof. J.M. Fitzpatrick Tues 2.00 (Ceneral/Urological Surgery) Mr. W.P. Hederman (General Surgical Wed 9.30 — 1.30 Mr. W.P. Hederman (Varicose Veins) Wed 2.00 — 4.30 Mr. S.J. Heffernan (Soft Tissue) Mon 12.00 — 1.00 Mr. S.J. Heffernan (General Surgical) Tue 9.30 — 1.30 Mr. D. Lawlor (Plastic Surgeon) Fri 2.00 Mr. F.X. O'Connell (General Surgical) Fri 9.00 — 1.00 Mr. J. Smith (Urologist) Mon 9.00 & Fri 2.00 Mr. A.E. Wood (Cardio-Thoracic) Thurs 2.00
T.B. CLINIC
Dr. Keelan/Dr. Keogh Thurs 10.00 12.30
141 PATHOLOGY DEPARTMENT Staffing
CONSULTANTS: Dr. J. Dempsey Dr. P. Dervan Dr. R. Hone Dr. J.A. Kirrane Dr. M. O'Brien Dr. B. Otridge Prof. D. Powell Mr. D. UaConaill
CONSULTANT ADMINISTRATOR: Dr. J.A. Kirrane
CHIEF TECHNOLOGIST: Mr. T. Maloney (to 1/9/1987)
CLERICAL: Supervisor — Mrs. M. Gannon (to 1/9
BIOCHEMISTS: 1 Top Grade 4 Principal Grade 4 Senior Grade 5 Basic Grade
TECHNOLOGISTS: 1 Chief II Grade 6 Chief I Grade 18 Senior Grade 25 Basic Grade
PATHOLOGY TECHNICIAN: 1 Chief Grade
LABORATORY AIDES: 2
PHLEBOTOMISTS: 1 Chief Grade 8 Basic Grade
CLERICAL: 1 Grade IV 5 Grade II
ANCILLARY STAFF: 4 Porters
NON CONSULTANT: 1 Registrar HOSPITAL DOCTORS: 1 Senior House Officer
CLINICAL ASSISTANT: 1
STUDENTS: 4
142 The department suffered the effects of the cutbacks in 1987 with the loss of twelve posts through resignations or leave of absence. Additionally, holiday locum cover was withdrawn and the emergency rosters were cut. The non- pay budget was also substantially reduced. At the same time, with the closure of the wards and reduction in clinics, there was a substantial decrease in the workload of most divisions until late in the year. Then, with the impact of the five-day and one-day wards, workloads began to rise and serious problems developed in the microbiology and biochemistry areas and particularly, in the blood transfusion area where the reduced laboratory resources were unable to meet the demands for blood for surgery and surgery was proceeding without blood having been prepared. The attention of management was drawn to this potentially serious situation.
The department continues to suffer an acute shortage of space and hazardous working conditions. At the present time, laboratory personel are particularly conscious of handling potentially infectious material in unsafe, open conditions. The morbid anatomy and histopathology divisions are especially vulnerable in this regard and are under threat of withdrawal of recognition for training by the College of Pathologists, unless the conditions are made safe. The overall space requirements of the department were submitted to the project team in 1986 and it is anticipated that when phase 1A is opened in 1988, the expansion plans for the laboratory will be implemented without delay.
BIOCHEMISTRY
Staffing
Consultant Biochemist — Mr. D. UaConaill Principal Biochemist — Mr. F. Kyne Chief Technologist — Mr. E. Wright 2 Senior Biochemists 5 Biochemists 1 Technologist 1 Senior Technician 5 Technicians
Scope of Service
The biochemistry laboratory carried out five hundred and thirty eight thousand tests in 1987.
In addition to the routine service, the laboratory continued to provide a twenty-four hour emergency service, a special rapid glucose-analysis service to the diabetic clinic on Monday and Wednesday mornings, a rapid twenty-four
143 hour monitoring service for patients in intensive care and the maintenance and quality control of the ABL4 potassium and blood-gas analyzer in intensive care unit 1.
The demand for assay of the immunosuppressant drug cyclosporin-A led to the provision of a standby service for this assay at weekends, as well as a routine service on weekdays. A special early delivery of electrolytes reports to the various intensive care units was instituted. The purchase of the Glucoroder glucose analyzer made time available on the Encore centrifugal analyzer for the provision of magnesium assays.
Special Interests
Investigation of creatine kinase isoenzyme variants, including their use as tumour markers.
Lipoprotein and alkaline phosphatase isoenzyme profiling.
"Stone" analysis.
Drug analysis by HPLC and fluorescence polarisation immunoassay.
Oxygen free radicals.
Phospholipids (jointly with Immunology)
Computing.
Special Equipment and Techniques
The principal analytical equipment is the SMA-IIC eleven-channel analyzer, the IL-508 eight-channel electrolytes analyzer, the Baker Encore centrifugal fast analyzer, the IL-1302 and Corning 178 blood-gas analyzers, and the Abbott TDX fluorescence polarisation analyzer. The IL-282 CO-Oximeter makes the laboratory one of the few centres measuring true oxygen saturation and carbooxyhaemoglobin. In addition, the laboratory uses flame photometry, specific electrode measurements, reaction rate analysis, electrophoresis and high-performance liquid chromatography.
Educational
A number of the staff in this section are actively involved in the training of students. This consists of lectures as well as practical work. Some senior members of the staff also lecture to the fellowship course in medical laboratory science at the College of Technology, Kevin Street, Dublin.
144 ENDOCRINOLOGY Staffing
CONSULTANT: Professor D. Powell
SCIENTIFIC AND 2 Principal Biochemists — Miss O. Lanigan TECHNICAL STAFF: Mr. D. Cannon 1 Technologist — Ms. G. Houlihan 1 Research Biochemist 1 Basic Grade Biochemist 1j Basic Grade Technicians 1 Laboratory Aide Scope of Service
Clinical Service:
A comprehensive service in general clinical endocrinology. There is a special clinical research interest in reproductive disorders, calcium disorders, failure to grow, and pituitary problems. The unit has published many original papers on all these topics.
Laboratory Service:
A comprehensive range of endocrine analyses is provided on a regional basis by the Mater Misericordiae Hospital to other north city hospitals, to several south city hospitals and for certain specialised tests a service is provided for hospitals elsewhere in the country including Sligo, Castlebar, Galway, Limerick, Wexford and Waterford. A total of 25,521 tests were performed.
HAEMATOLOGY Staffing
CONSULTANT: Dr. B. Otridge
SCIENTIFIC AND 2 Chief Technologists TECHNICAL STAFF: Mr. M. Flaherty — Mr. B. Wall 2 Technologists 1 Senior Technician 8 Basic Grade Technicians Scope of Service
Dr. B. Otridge, consultant haematologist, his registrar and senior house officer, run the clinical and laboratory service in both the Mater Misericordiae Hospital
145 and St. Laurence's Hospital, with the help of a part time junior house officer in each hospital. All types of haematological diseases are managed with a strong emphasis placed on out patient care.
A combined out patient and day clinic is held in the C.I. unit each Wednesday. The case load is derived in the main from the Dublin area, but cases are referred from all four provinces.
A rapid consultative service is available and close collaboration has been established between the haematology and oncology services.
The laboratory provides a 24 hour service in both disciplines with a full range of tests during normal working hours. The work load is progressively increasing, and detailed figures are given in the activity analysis at the end of the pathology report.
Special Interests
Continued participation in local and United Kingdom Medical Research Council (Medical Research Council) trial of therapy for malignant blood diseases.
Research Activities
(a) Medical Research Council trials of chemotherapy in malignant blood diseases.
(b) Alpha and beta thalassemia.
(c) Studies on the efficiency of blood cell saver machines.
(d) Busulphen lung study.
Educational
Dr. B. Otridge is honorary lecturer in pathology, University College, Dublin and Royal College of Surgeons in Ireland.
Full participation in the post graduate medical teaching programme in the Mater Misericordiae Hospital.
Conferences/Meetings
Second and fourth Thursday each month, oncology conference in the radiology conference room, at 8.00 a.m.
146 HISTOPATHOLOGY Staffing
CONSULTANTS: Dr. J. Dempsey Dr. M. O'Brien Dr. P. Dervan
NON CONSULTANT 1 Registrar HOSPITAL DOCTORS: 1 Senior House Officer 1 Clinical Assistant
Non-Medical Staff
NON CONSULTANT 1 Chief Technician HOSPITAL DOCTORS: 1 Technologist 2 Senior Technicians 2 Basic Grade Technicians 1 Locum Basic Grade Technician 1 Post Mortem Room Pathology Technician
Dr. M. O'Brien, for family reasons, has returned to the Mallory Institute of Pathology, Boston, United States of America. Dr. J. Dempsey, after thirty-seven years of loyal service to the Mater Misericordiae Hospital has taken early retirement. Dr. Dempsey's replacement should join the hospital staff early in 1988. It is not clear when Dr. O'Brien will be replaced.
Scope of Service
The department provides training for medical laboratory technican students.
Workload for 1987:
Surgicals — 5,921 Peroperative frozen section consultations - 386 Immunoperoxidase examinations - 3,499 slides prepared. Electron microscopy - 200 Blocks - 13,465 Cytology — 2,468 Autopsies — 200
The department provides a comprehensive service, with excellent immunohistochemistry and enzyme histochemistry, electron microscopy and metabolic bone study facilities,
All histopathology reports are SNOMED coded and stored on computer.
147 The department provides the histopathology service for St. Mary's Orthopaedic Hospital, Cappagh (probably the largest source of primary bone tumours in the country) and St. Mary's Hospital, Phoenix Park.
Educational
P. Dervan — Part time lecturer and examiner, pathology department, University College, Dublin. — Board member, educational committee member and honorary secretary of the Faculty of Pathology, Royal College of Physicians in Ireland. — Member of cancer committee, Health Research Board. — Member of specialist advisory committee on immunopathology, British Association of Clinical Pathology.
Conferences
General medicine General surgery Dermatopathology/dermatology Radiology/g.i./surgery/pathology Oncology/pathology/radiology
Student undergraduate teaching (during term)
Research Activities
Application of immunohistochemical techniques to tumour diagnosis and spread.
Electron microscopy of tumours.
Immunohistochemical evaluation of oestrogen receptors in breast tumours.
Cell kinetics in tumours.
Cell kinetics colorectal adenomas and cancer.
Oncogene expression in breast cancer.
Workshops Attended
Computers in pathology and medical education. International Academy of Pathology. Chicago, United States of America. March 1987. P. Dervan.
148 Biology of malignant melanoma. International Academy of Pathology. Chicago, United States of America. March 1987. P. Dervan.
Fine needle aspiration cytology of the breast. International Academy of Pathology. Chicago, United States of America. March 1987. P. Dervan.
Diagnostic problems in surgical pathology and fine needle aspiration of the thyroid. International Academy of Pathology. Chicago, United States of America. March 1987. P. Dervan.
In-situ hybridization in histopathology. Oxford. February, 1987. ft Tobin.
Cytopathology tutorial workshop. Sussex postgraduate centre. Brighton, England. November, 1987. C. McSweeney.
Practical electron microscopy.
University of Wales. Cardiff, Wales. July, 1987. C. McSweeney.
Invited Lectures/Presentations
Epithelioid haemangioendothelioma of bone. Royal Academy of Medicine in Ireland. February, 1987. P. Dervan. Soft tissue rhabdoid sarcoma. Royal Academy of Medicine in Ireland. February, 1987. P. Dervan.
Tumour markers in urology. Urology symposium. Mater Misericordiae Hospital. May, 1987. P. Dervan.
Electron microscopy in human pathology. Electron microscopy symposium. University College, Dublin. May, 1987. P. Dervan.
Immunohistochemistry of thyroid disease. Endocrine division, Trinity College, Dublin. May, 1987. P. Dervan.
Epithelial markers in tumour diagnosis — their usefulness and limitations. Immunohistochemistry symposium in diagnostic pathology, an update. Mater Misericordiae Hospital. November, 1987. P. Dervan.
Desmosomes in malignant tumours, immunohistochemical evaluation. First annual research symposium. University College, Dublin. November, 1987. P. Dervan, D. Carney.
149 Laboratory computing for the future. Computers in Histopathology. Royal Academy of Medicine in Ireland. December, 1987. P. Dervan.
Electron microscopy and general principals of cell structure. Basis science course for ophthalmologists. Mater Misericordiae Hospital, 1987. P. Dervan.
Pathophysiology of asthma. Pathology of sarcoidosis. Idiopathic pulmonary fibrosis. Diploma course in tuberculosis and respiratory medicine. Royal College of Physicians in Ireland. October/November, 1987. P. Dervan.
Pathologic correlation in breast disease. Faculty of radiologists. Annual scientific meeting. October, 1987. P. Dervan.
Desmosomes are preserved in all grades of breast cancer. Faculty of radiologists. Annual scientific meeting. October, 1987. L. Doyle, P. Dervan, P. Johnston, D. Carney.
Immunohistochemical analysis of c Myc and !<; 67 expression in colonic mucosa, adenomas and carcinomas. Faculty of radiologists. Annual scientific meeting, clinical oncology meeting. October, 1987. P. Johnston, M. O'Brien, P. Dervan, D. Carney.
Multiple endocrine neoplasia. Royal Academy of Medicine in Ireland. January, 1987. M. Griffin, P. Dervan.
Immunohistochemical analysis of c Myc oncogene expression in the development of colon carcinoma. Irish Society of Gastroenterology. Dublin, November, 1987. P. Johnston, M. O'Brien, P. Dervan, D. Carney.
Ischaemic reperfusion injury in rat renal microvasculature. Irish Society of Urology. Annual scientific meeting. May, 1987. A. Leahy, G. McEntee, S. Maguire, F. Kyne, P. Dervan, J.M. Fitzpatrick.
How long can a kidney be partially obstructed without functional loss? An experimental study. Irish Society of Urology. Annual scientific meeting. May, 1987. A. Leahy, P.C Ryan, G. McEntee, P. Dervan, J.M. Fitzpatrick.
Amyloid structural classification Fellowship course. Academy of Medical Laboratory Science. December, 1987. / O tough/in.
The urgent specimen in histopathology. Fellowship course. Academy of Medical Laboratory Science. November, 1987. B. Tobin.
150 Research Presentations
Parathyroidectomy: A ten year review. A Phelan, I. Tobbia, E. Masterson, M. Feeley, P. Dervan, S.J. Heffernan.
Microvascular changes in the rat liver in caerulein induced acute haemorrhagic pancreatitis.
C. Delaney, G McEntee, K. McGeeney, P. Dervan, D. Cotteil, B. Cregg, J.M. Fitzpa trick.
Abstracts
A three dimensional study of the pancreatic microvasculature in chemically induced experimental pancreatitis. Irish Electron Microscopy Society. Galway. September, 1987. Royal Microscopical Society. G. McEntee, A. Leahy, P. Dervan, D.G. Cotteil, J.M. Fitzpatrick.
Hepatic artery ligation does not cause permanent liver damage: an experimental study. Irish Society of Gastroenterology. Derry. June, 1987. M.K. O'Donohoe, A. Blake, P.P. Waldron, P. Dervan, J.M. Fitzpatrick.
Immunohistochemical analysis of c Myc oncogene expression in the development of colon carcinoma. British Society of Gastroenterology. London, England. September, 1987. P. Johnston, M. O'Brien, P. Dervan, D. Carney.
Immunohistochemical analysis of cell kinetic parameters in colonic adenomas, carcinomas and normal colon. British Society of Gastroenterology. London, England. September, 1987. P. Johnston, M. O'Brien, P. Dervan, J. Crowe, J. Lennon, D. Carney.
How long can a kidney be partially obstructed without functional loss? an experimental study. Irish Journal of Medical Science. 156: 369, 1987. A. Leahy, PC. Ryan, G McEntee, P. Dervan, J.M. Fitzpatrick.
A morphological study of the microvasculature in a chemically induced pancreatitis model. Irish Journal of Medical Science. 156: 369, 1987. C. McEntee, A. Leahy, D. Cotteil, P. Dervan, M. Mc Gheeney, J.M. Fitzpatrick.
Publications
Hereditary amyloid polyneuropathy in north west Ireland. Brain. 110: 1231-1245, 1987. H. Staunton, P. Dervan, K. Rajendra, P. Kelly.
151 The use of monoclonal antibodies for the histopathological detection of mammary axillary micrometastases. European Journal of Surgical Oncology. 13: 409-411, 1987. / Byrne, D. McAvinchey, R. Waldron, P. Dervan.
Malignant rhabdoid tumour of soft tissue. An ultrastructural and immunohistochemical study.
Histopathology. 11: 183-190, 1987. P. Dervan, S. Cahalane, P. Kneafsey A. Mynes, C. McAllister.
Dedifferentiated chondrosarcoma with muscle and cytokeratin differentiation in the anaplastic component. Histopathology. (In press). P. Dervan, J. O'Loughlin, B. Hurson.
Hodgkin's disease: an immunohistochemical study of paraffin sections. Possible usefulness of Leu M1 and common leukocyte antigen staining pattern. Irish Journal of Medical Science. (In press). / O'Connell, P. Dervan, B. Tobin, M. Kennedy.
Multifocal heteroptoic gastric mucosa in the colon controlled by H1 antagonist. GUT. (In press). F.E. Murray, M.C. Lombard, P. Dervan, R.J. Fitzgerald, J. Crowe.
Aberrant expression of HLA DR in liver and salivary tissue in primary biliary cirrhosis. GUT. (In press). M.C. Lombard, 5. Forster, P. Dervan, J. Crowe.
Early gastric cancer. American Journal of Surgery. (In press). O. Traynor, J. Lennon, P. Dervan, F. Corrigan.
Immunohistochemical analysis oi oestrogen receptor. Correlation with biochemical assay. Irish Journal Medical Society. (In press). P. Johnston, P. Dervan, M. McAllister, J. Duffy, D. Carney.
Studies in Progress
Cell kinetics in breast tumours.
Nucleolar organising region assessment in breast, prostate, bladder and testicular cancer.
Immunohistochemical identification of carcinoma in situ of the testis.
152 IMMUNOLOGY Staffing
CONSULTANT: Dr. J.A. Kirrane
CHIEF TECHNOLOGIST: Mr. R. Woods
SCIENTIFIC AND 1 Technologist
TECHNICAL STAFF: 2 Senior Technicians 3 Basic Grade Technicians
Scope of Service
The immunology service investigated forty five thousand patients' samples in 1987, compared with fifty thousand, four hundred samples in 1986. Due to the cutbacks, some time-consuming assays were discontinued; (a) T & B lymphocytes and their sub-sets, (b) neutrophil function, (c) immune complex assays.
The laboratory carries out a comprehensive service in the investigation of underlying immunological disorders, including autoantibody screening consisting of microsomal, thyroglobulin, ANF, AMA, PCA, SMA, reticulin, cardiolipin and RF autoantibodies. Further investigations are automatically done if the ANF and AMA results are positive, including DNA, RNP, Sm, Ro-(SS-A) and La-(SS-B) antibodies. ANF patterns are examined using culture cell line cytosmears. The AMA patterns are investigated using specially prepared kidney tissue substrates.
Serum proteins including immunoglobulins, complement components (classical and alternate pathways), haptoglobins, L1, antitrypsis and C-RP are quantitated using rate nephelometry.
The enzyme linked immunosorbent and immunofluorescent assays are employed in the detection of antibodies against brucella abortus and toxoplasma gondii antigens and cardiolipin. Counterimmunoelectrophoresis and immunodiffusion are used to detect antibodies to aspergillus fumigatus, micropolyspora faeni and other type 3 immunoreactants.
It is important that further samples are submitted to the laboratory (fourteen — fifteen days later) if the initial screen samples are positive.
Myelaproliferative diseases are investigated and characterised by immunofixation and Immunoelectrophoresis. Quantitation of kappa and lambda light chains are measured by rate nephelometry.
153 The laboratory also examines skin biopsies by direct frozen section immunofluorescence for various dermatological disorders including lupus erythematosus, vasculitis, bullous pemphigus and dermatitis herpetiformis.
The laboratory participates in the Wellcome immunoassay quality assessment programme for serum proteins, the United Kingdom external quality assessment scheme, for autoimmuno serology and immunochemistry and the supraregional protein reference unit (Cardiff) for IgE estimations. The laboratory has also a close liasion with the lupus research laboratory at St. Thomas' Hospital, London, England.
Research Interests Lymphocyte sub-sets and their relationship to disease activity in hidradenitis suppurtativa. Paraprotein detection using immunoglobulin light chain quantitation.
C-reactive protein levels in relation to infections and inflammatory states.
Nuclear and cytoplasmic antigens in collagen vascular disorders.
Antiphospholipid antibodies and their relationship to disease activity in connective tissue disorders.
Antimitochondrial antibodies — M2, M4, M8 their detection and associations with primary biliary carrhosis.
Educational
Undergraduate and postgraduate teaching. Thesis supervision. Examiner, University College, Dublin. Extern Examiner, Dublin University and London University. Board member, Mater Hospital College for Research and Postgradute Education. Board member, Irish Cancer Research Board. Board member, Health Research Board Committee on Immunology.
Educational Awards
Ms. D. Merlehan graduated from the Institute of Biology and was admitted to membership of the Institute of Biology, London.
Mr. A. Wearan was awarded fellowship of the Institute of Medical Laboratory Sciences.
Ms. A. Burke successfully completed the diploma in Medical Laboratory Science.
154 Cou rses/Wo rkshops/Lectu res
IgG sub-classes and their relationship to disease states. Royal Liverpool Hospital, England. 1987. C. Coyle.
Antiphospholipid antibodies in demyelinating diseases. St. James's Hospital, Dublin. R. Woods.
Adlab. conference and exhibition. Middlesex Hospital Medical School, London, England. Autoimmunity day. Dublin. 1987. R. Woods.
Publications
Anticardiolipin antibodies in rheumatoid arthritis. British Journal of Rheumatology. 26: 346-350. R. Woods, A. Keane, V. Dowding, D. Roden, C Barry.
Hidradenitis suppurtativa i glucose tolerance, clinical and immunologic features and HLA frequencies in twenty seven patients. Arch. Dermatology. (In press). R. Woods, A. Byrne, S. Oloughlin, P. Kirke, F. Shanahan, M.I. Drury.
Rheumatoid arthritis and anticardiolipin antibodies. International synopses. (In press). R. Woods, A. Keane, V. Dowding, D. Roden, C. Barry.
Penicillamine induced pemphigus — a report of two cases. Irish Journal of Medical Sciences. (In press). R. Woods, C. Buckley, C. Barry, P. Dervan, S. Oloughlin.
A serial study of anticardiolipin antibody and antimitochondrial antibody in a patient with polyarthritis and polymyositis. British Journal of Rheumatology. Submitted. R. Woods, A. Keane, D. Foley- Nolan, D. Roden, R. Coughlan, C. Barry.
Hidradenitis suppurtativa: two B & T lymphocytes their sub-sets and humoral immunologic parameters in fifteen patients. (In preparation). R. Woods, A. Byrne, C. Coyle, S. Oloughlin, V. Dowding.
155 MICROBIOLOGY Staffing
CONSULTANT: Dr. R. Hone
SCIENTIFIC AND Chief Technologist — Mr. A. Murray TECHNICAL STAFF: 3 Senior Technicians 8 Technicians
Scope of Service
The microbiology department provides both a laboratory and a clinical service. A comprehensive range of tests are used in the isolation and identification of bacterial, fungal and parasitic infections. Antimicrobial sensitivity tests are carried out to a large number of antibacterial agents. Laboratory control of antibiotic therapy is provided by the antibiotic assay service. This specialised service is availed of by other Dublin hospitals and also by many hospitals around the country.
Clinical consultations on diagnosis and antimicrobial treatment of patients is provided by the consultant microbiologist at ward level. The number of specimens submitted to the laboratory was forty-five thousand and this generated approximately 180,000 tests. The department provides an emergency on call service.
Special Interests
Antimicrobial usage in hospitalised patients. The role of micro-organisms in infertility. Investigation of causes of pelvic inflammatory disease with special reference to the incidence of chlamydia trachomatis. Investigation and treatment of infection in immunosuppressed patients. Diagnosis and laboratory control of treatment of infective endocarditis. Investigation and control of nosocomial infection.
Research Activities
The consultant microbiologist is a member of the Hospital Infection Research Unit supported by the Medical Research Council of Ireland. Studies of multiple resistant staphylococcus aureus and multiple resistant gram negative bacteria are undertaken in close collaboration between clinical microbiologists and scientists specialising in plasmidology, genetics and pathogenicity at the Department of Microbiology, Trinity College, Dublin. Many important papers have now been published arising from the work of this team. The grant expired at the end of 1987 and it is regretted that the work of the Hospital Infection Research Unit cannot continue as no alternative source of funding is available.
156 Laboratory Scientists' Pre Fellowship Projects
Evaluation of two screening media for the isolation of methicillin resistant staphylococcus aureus. U.O. Byrne.
Educational
The consultant microbiologist lectures to third year medical students in the Department of Microbiology, University College, Dublin, and lectures on the following postgraduate courses — Membership examination of the Royal College of Physicians, Fellowship course for laboratory scientists at the College of Technology, Kevin Street, intensive care, casualty and theatre courses for nurses at the Mater Misericordiae Hospital, Diploma in Microbiology course for nurses in the Royal College of Surgeons. She was elected president of the Irish Society of Clinical Microbiologists and is a member of many international microbiology societies. She was elected president of the Pathology Section of the Royal Academy of Medicine in Ireland.
Publications Campylobicter jejuni, a common cause of gastroenteritis in rural Ireland. Irish Medical Journal, 80 9: 258-259. 1987. D. Foiey-Nolan, R. Hone, N.5. Lanaghy, K. Cuddihy.
Courses/Workshops
Topics in infection. London, England. January 1987. R. Hone.
Bactec user group meeting. Wolverhampton, England. March 1987. A. Murray.
Microbiology symposium. Institute of Medical Laboratory Science. Seventy-fifty anniversary. Edinburgh, Scotland. April 1987. U.O. Byrne.
Mycology workshop. Dublin. September 1987. L. Dyke, V. Shaw.
Quality control and assurance three years on. University of Liverpool, England. September 1987. A. Murray.
Infection of the central nervous system: Symposium. Cardiff, Wales. October 1987. A. Murray, M. Fitzpatrick, R. Hone.
Third European congress of Clinical Microbiology. The Hague, Belgium. 1987. R. Hone.
157 Presentations Clinical and laboratory features of staphylococcus aureus septicaemia. First international conference of the Hospital Infection Society. London, England. August 1987. H. Humphreys, D. Coleman, R. Hone, C Keane.
Skeletal tuberculosis: a ten year review in the Mater Misericordiae Hospital. Irish Rheumatology and Rehabilitation Association. Dublin. October 1987. D. Foley-Nolan, R. Hone.
Evaluation of a novel gas capture system for positive blood cultures. Academy of Medical Laboratory Science. Annual meeting. Kilkenny. October 1987. A Murray, R. Hone.
Antibiotic update. Monaghan Medical Society. November 1987. R. Hone.
An unusal infection: Case presentation. Irish Society of Clinical Microbiologists. Dublin. October 1987. E. Van der Berg, R. Hone, B. Otridge, M. O'Brien.
Infection in intensive care. Critical Care Nurses Association. Dublin. 1987. R. Hone.
Activity Analysis Pathology 1983 1984 1985 1986 1987 Patients
In Patients 01,892 697,397 673,513 736,377 660,364 Out Patients 37,946 357,424 370,182 448,837 425,446 Private Patients 49,582 48,842 52,778 26,191 —
Total Patients 1,089,420 1,103,663 1,096,473 1,211,40 1,085,810 Tests Biochemistry 601,415 609,631 594,086 616,259 538,066 Haematology 325,236 327,682 327,588 437,792 415,057 Bacteriology 127,725 133,287 133,523 113,442 105,488 Tissue (Histo- pathology Biopsy) 6,515 6,326 6,643 6,217 5,833 Immunology 21,546 18,761 24,234 16,849 14,403 Blood Groups 6,886 8,077 8,213 7,882 6,729 Radioimmuno Assay Laboratory 27,577 28,099 26,402 29,718 25,521 Post Mortems 188 196 215 224 219 Total Tests 1,117,088 1,132,059 1,120,904 1,228,383 1,111,316
158 DEPARTMENT OF RADIOLOGY
Staffing
CONSULTANT Dr. M. Behan RADIOLOGISTS: Special Interest: Diagnostic Ultrasound and Computerised Tomography
Dr. E. Breatnach Special Interest: Chest and Uroradiology
Dr. J.T. Ennis Special Interest: Nuclear Medicine and Computerised Tomography
Dr. D. Legge Special Interest: Angiography and Interventional Radiology
Dr. P. McCann Special Interest: Cardiovascular Radiography and Computerised Tomography
Dr. D. O'Connell Special Interest: Orthopaedic Radiology, Xeromammography and G.I. Radiology
MEDICAL PHYSICS: 1 Chief Physicist (Mr. D.J. Dowsett) 1 Senior Physicist 1 Basic Physicist
NON-CONSULTANT 4 Registrars HOSPITAL DOCTORS: 3 Senior House Officers
TRAINEES FROM OVERSEAS: 3 Trainee Radiologists from Jordan
VISITING PROFESSOR: Dr. P. McManamon, Newfoundland, Canada.
PARA-MEDICAL STAFF: 1 Superintendent Radiographer II Ms. J. Riordan 2 Superintendent Radiographers I Ms. M. Shortt and Ms. J. Wright 10 Senior Radiographers 20 Basic Grade Radiographers 2 Staff Nurses 1 Patients' Aide
159 SECRETARIAL STAFF: 1 Administrative Assistant, Grade V Ms. V. Murray 1 Administrative Assistant, Grave IV Mrs. G. Farrell 1 Grade III Clerk Typist 7 Grade II Clerk Typists
PORTERS: 4 Porters/Dark-room Technicians 3 General Porters
FACULTY OF RADIOLOGISTS: Secretary of Faculty Board — Dr. D. Legge.
Departmental Report
The past year saw the continuation of severe financial cutbacks and no further capital expenditure for replacement of essential equipment. No permanent employment could be made within the department which added to the staffing problem. In spite of this, the number of patients examined did not significantly decrease since the previous year. The amount of specialised examinations, particularly computed tomography and ultrasound, continued to increase.
In accordance with the scheme for aid to the third world, two of our department's radiographers rotate every three months to the radiology department in the University Hospital of the West Indies, Jamaica.
Papers Published
The accuracy of computed tomography in the intra-abdominal staging of renal cell carcinoma. Clinical Radiology, 38, 3: 335. 1987. £ Breatnach.
Digital radiography: A review of five years experience in collaboration with R.G. Fraser et al. Alabama Journal of Medical Science, 58: 110-128. 1987. E. Breatnach.
Rapid slide reproduction of text and radiographs. British Journal of Radiology, 60: 394. 1987. M.J. Towers, B.D. Daly.
Bilateral ureteric carcinoma. Clinical Radiology. 1987. B.D. Daly, E. Breatnach.
A comparative study of ultrasound, scintigraphy and computed tomography in the diagnosis of liver disease. Archives of Internal Medicine. 1987. W.A. Powderly, L. Coffee et al.
160 A case report of simultaneous benign and malignant phaechromocytomas. Irish Journal of Medical Science. 1987. / Donohoe, L. Coffey, 5. Smith.
Intravenous mercury injection — two further cases. Irish Medical Journal. May 1987. / Darby, P. Fitzgerald, D. O'Connell.
Percutaneous bailoon diltation of a mid-ureteric obstruction caused by retroperitoneal fibrosis. British Journal of Radiology: 84-85. 1987. D.B. Downey, D. O'Connell, J. Smith, J. Donohoe. Abstracts Published
An in vitro study of the accuracy and potential errors of quantitive computed tomography in measuring iron concentration on biological tissues. Irish Journal of Medical Science. Accepted for "Work in Progress" section, Radiological Society of North America. November 1987. M. Lee, D.J. Dowsett, £ Breatnach.
An investigation of the accuracy, reproducibility and clinical efficacy of quantitive computed tomography in patients with idiopathic haemachromatosis. Irish Journal of Medical Science, vol. 156, no. 7: 224. 1987. M.J. Lee, E. Breatnach, D.J. Dowsett.
Determination of liver iron concentration with single energy quantitive computed tomography: accuracy and sensitivity in clinical practice. Radiology 1987, 165. Radiological Society of North America supplement: 340- 341. D.J. Dowsett, M.J. Lee, E Breatnach.
Contrast venography and lymphoscintigraphy: a combined approach to the evaluation of localised limb oedema. Irish Journal of Medical Science, vol. 156, no. 7. 1987. P. Fitzgerald.
Thyroid imaging — an assessment of the role of ultrasound and radionuclide scanning. Registrar's Prize 1986. Royal Academy of Medicine. 1987. D.B. Downey. In Press
Percutaneous peripheral limb transluminal angioplasty: a review of one hundred and three cases. Irish Journal of Medical Science. M. Sugrue, M. Lee, D. Legge, W. Hederman.
The role of transthoracic needle biopsy of focal lung masses following unsuccessful transbronchial biopsy. Clinical Radiology. £ Breatnach et al.
161 Thrombophlebitis as the presenting feature oi extramedullary spread of multiple myeloma. British Journal of Clinical Practice. D.B. Downey, U. Martin, B. Otridge, J.T. Ennis.
Invited Chapters
Digital radiography of the chest: experience with a prototype unit — an update. CRC Reviews 1987, 16: 258-274. E. Breatnach, R.G. Eraser.
Systemised approach to use of thoracic computed tomography in the staging of bronchogenic carcinoma. Postgraduate Radiology. (In press). E. Breatnach.
Papers submitted for publication
Lymphoscintigraphy — diagnostic scintigraphic problems. Submitted to Clinical Radiology. L. Coffey, J.T. Ennis.
Presentations at Scientific Meetings
Peripheral limb arteriovenous shunts: diagnosis and localisation by intra-arterial injection of 99m Tc MAA. Irish Registrars' Prize Meeting. Faculty of Radiologists, Royal College of Surgeons in Ireland. November 1987. M. Lee, D.J. Dowsett, J.T. Ennis.
Colonic ring staple anastomses. A paper read at the combined meeting of the Radiological Society of Ireland/ Faculty of Radiologists of the Royal College of Surgeons in Ireland. 1987. B.D. Daly.
Bronchopulmonary dysplasia — a radiographic and clinical review of twenty cases. Registrars' meeting, Faculty of Radiologists, Roval College of Surgeons in Ireland. October 1987. P. Fitzgerald, V. Donoghue.
The role of angioplasty in the management of peripheral vascular disease. (The use of arterial embolisation techniques). Fifth Jordanian Medical Conference. Amnan, Jordan. March 1987. M. Behan.
The use of computed tomography in the diagnosis of sub-acute mediastinitis. Combined meeting of the Irish Faculty of Radiology and the Irish Radiology Society. Waterford. March 1987. E. Breatnach.
The sensitivity and specificity of computed tomography in the intra-abdominal staging of renal cell carcinoma: experience with fifty patients.
162 Annual Scientific Meeting, Irish Faculty of Radiology. Dublin. October 1987. £ Breatnach.
The newer imaging modalities: some clinical implications. University College, Cork. October 1987. £ Breatnach.
Advanced photographic course for radiology. Agfa Gaevert, Antwerp, Belgium. January 1987. D.J. Dowsett
Modern concepts and develooments in x-ray imaging. Dublin Institute of Advanced Studies Summer School. Lecture. July 1987. D.J. Dowsett.
Improving the sensitivity and selectivity of diagnosis with modern imaging procedures. Trinity College Medical School. Lecture. April, 1987. D.J. Dowsett.
Hazards associated with ionizng radiation and microwaves. National Institute for Higher Education, Glasnevin. Lecture. May 1987. D.J. Dowsett.
Comparitive risks and possible future developments in radiation protection. Civil Defence School. September 1987. D.J. Dowsett.
Chernobyl: one year after — its impact on Ireland. Radiation Research and Protection Society of Ireland. Seminar. Gort Mhuire, Dublin. May 1987. Organised by: D.J. Dowsett.
Radiation and man: hazards and benefits. Lecture series "Biology Today". Institute of Biology, Trinity College, Dublin. December 1987. D.J. Dowsett
Principles of physiological measurement in physics. A series of lectures to final year undergraduates. College of Technology, Kevin Street, Dublin. 1987. PA. Keniy.
Master's Degree
Awarded MSc by Dublin University for thesis entitled Physical Sciences in Medicine. P.A. Kenny.
Grants
Grant awarded by Mater College to employ physicist for one year to investigate staff radiation doses (Mr. D. Fenton). Results being processed for publication and presentations. LA. Ma/one.
163 Society Membership
Elected Honorary Secretary of Radiation Research and Protection Society of Ireland. D.J. Dowsett.
Elected to Executive Council of the Institute of Biology. D.J. Dowsett.
164 RESPIRATORY MEDICINE DEPARTMENT
Staffing
CONSULTANTS: Dr. P. Keelan Dr. B. Keogh Dr. W.D. Linehan
NON CONSULTANT 1 Registrar HOSPITAL DOCTORS: 1 Senior House Officer 2 Interns 1 Clinical and Research Assistant (The department is recognised for higher medical training in respiratory medicine).
ASSOCIATED MEDICAL STAFF: 1 Thoracic Surgeon
PARA-MEDICAL STAFF: 1 Pulmonary Laboratory Technician
Scope of Service
An extensive range of techniques is available for full assessment of pulmonary problems, including spirometry, lung volumes, gas transfer, flow volume loops, body plethysmography, exercise studies, blood gas analysis, bronchography, angiography, isotope biopsy, pleural alveolar lavage mediastinoscopy, needle lung biopsy, pleural biopsy, thoracoscopy, provocation tests, skin allergy tests, assessment of regional lung function, computerised tomographic scanning and gallium scanning. Twelve hundred pulmonary function studies were undertaken during the course of the year and four hundred and twenty bronchoscopies were performed.
Research Activities
Assessment of bronchoalveolar lavage as an indication of therapeutic proficiency in pulmonary sarcoidosis.
Evaluation of pathogenesis and therapy of lung involvement in rheumatoid arthritis.
Radiation pneumonitis as a model for pathogenic study in the interstitial lung diseases.
Assessment of early change, using broncho alveolar lavage in drug induced lung disease.
165 Pulmonary exercise testing and pre-operative evaluation of patients with chronic obstructive lung disease.
Oxygen therapy in exercised patients with C.O.P D.
Pulmonary exercise testing in evaluation of therapeutic response in interstitial lung disease. Assessment of small airways cisease using helium isoflow techniques in the body plethysmograph.
Industrial asthma.
Pneumoconioses.
Assessment of inhaled steroid versus systemic steroids in management of bronchial asthma.
Asbestosis.
Publications
The spectrum of pulmonary aspergillosis. Irish Journal of Medical Science, 156: 244. (Jointly). 1987. P. Keelan.
Conferences Attended
Corrigan Club. Belfast. March 1987. P. Keelan.
Irish Thoracic Society. Belfast. November 1987. P. Keelan.
American Thoracic Society.
New Orleans, Louisiana, United States of America. May 1987. B. Keogh.
Department Conferences
Wednesday 8.15 a.m. Outpatient Clinics
Tuesday 2.00 p.m. Friday 2.00 p.m.
Laboratory outpatients seen daily.
166 RHEUMATOLOGY AND REHABILITATION DEPARTMENT
Staffing
CONSULTANTS: Dr. C. Barry Dr. R.J. Coughlan
NON-CONSULTANT 1 Registrar HOSPITAL DOCTORS: 1 Intern
PARA-MEDICAL STAFF: 1 Superintendent Physiotherapist (Miss D. BernaD
5 Senior Physiotherapists 13 Basic Grade Physiotherapists 1 Occupational Therapist
Scope of Service
The department deals with the specialty of rheumatology and rehabilitation and is involved in the training of medical students from University College, Dublin. Various lectures and demonstrations are arranged during the year.
Patients are referred for consultation and treatment. The department provides a full rehabilitation service for the general hospital, and also for a large number of local and regional doctors.
In addition to the management of rheumatology and the rehabilitation of chronically disabled patients, there is a full service for intensive care, respiratory medicine, neurology, post operative and post accident cases. In recent years there has been a great increase in demand for physiotherapy services in the intensive care units, for the department of cardiac surgery and for acute respiratory medicine.
A cardiac rehabilitation class is held for those recovering from myocardial infarction or cardiac surgery.
1987 was a difficult year. Because of financial restraints, services had to be curtailed throughout the year and it was not possible to take out-patient referrals at times.
The department of occupational therapy remains seriously understaffed with Miss P. Greer in sole charge.
167 Dr. Coughlan commenced a combined hand clinic with Mr. Colville during the year in St. Mary's Orthopaedic Hospital, Cappagh. He was awarded an M.D. by University College, Galway, in 1987.
Dr. Barry continued as president of the Irish Association of Rheumatology and Rehabilitation for the first half of 1987.
Courses and Lectures
Diploma in advanced respiratory studies. Course. October, 1987. At Hourihane, M. Claffey, C. Mullen, J. Hussey.
Anatomy, physiology and pathology. Lectures. University College, Dublin.
Courses Attended
Maitland mobilisation — part 1. Belfast. 5. Farrell.
Biomechanical assessment of the lower limb. A Dowley.
Basic cervial spine mobilisation. / Kavanagh.
Orthotics — Langer. B. Walsh.
Basic sports injury. J. Kavanagh.
The back school — Lynwood Education, Surrey. B. Walsh.
Mobilisation techniques by Paul Chadwick. B. Kavanagh, S. Farrell.
Irish Society of Orthopaedic Medicine. Course on shoulder joint. 5. Farrell.
Irish Society of Orthopaedic Medicine. Study day. November, 1987. B. Walsh, S. Farrell.
Paediatric respiratory conditions. Study day. / Hussey, At McAlister, D. Bernal
Conductive education. Seminar. At McAlister.
168 Publications
Anticardiolipin antibodies in rheumatoid arthritis. British Journal of Rheumatology. 1987. Vol. 26-8. A. Keane, R. Woods, V. Dowding, D. Roden, C. Barry.
Anticardiolipin antibodies in rheumatoid arthritis. International synopses abstracts. 1987. A. Keane, R. Woods, V. Dowding, D. Roden, C Barry.
The value of pulsed electromagnetic therapy in persistent neck pain. British Journal of Rheumatology. November, 1987. Abstract. R.J. Coughlan, et. al.
Algodystrophy, a common unrecognised cause of knee pain. British Journal Rheumatology. 1987. R.J. Coughlan, et. al.
Presentations
The value of self administered peri operative physiotherapy. Royal Academy of Medicine in Ireland — Biological sciences meeting. January, 1987. B. Crawford, W.P. Blunnie, A.P.C. Elliott.
An evaluation of the triflo 11 — incentive deep breathing exercise after cholysystectomy. Anaesthetic Research Society. Harrow, England. November, 1987. B. Crawford, W.P. Blunnie, A.P.C. Elliott.
D. Foley-Nolan et. al.
The value of pulsed electromagnetic therapy in persistant neck pain. Meeting of Irish Association of Rheumatology and Rehabilitation. Cork. June, 1987.
The value of pulsed electromagnetic therapy in persistant neck pain.
Meeting of British Society of Rheumatology. London, England. November, 1987.
Anticardiolipin antibody as a predictor of S.L.E. retinal disease.
Skeletal tuberculosis in the Mater Misericordiae Hospital 1977-1987. Irish Association of Rheumatology and Rehabilitation. Dublin. October, 1987. Pulsed electromagnetic therapy an experimental rat arthritis — a negative result. Irish Association of Rheumatology and Rehabilitation. Dublin. October, 1987.
169 UNIVERSITY COLLEGE, DUBLIN, AND MATER MISERICORDIAE HOSPITAL SCHOOL OF PHYSIOTHERAPY
Staffing
ACTING HEAD OF DEPARTMENT & DEPUTY DIRECTOR: Dr. M. Garrett
COLLEGE LECTURERS: Sr. M. Reparata Hanly Miss R. Jeffers Mrs. M. Lynch
ASSISTANT LECTURERS: Dr. M. McAteer Mrs. C O'Donnell
Miss B.V. Jones retired as Director in June 1987 after twenty-five years service. The department's best wishes go to her. Dr. M. Garrett was appointed acting head of department from 1st July 1987.
Dr M. McAteer and Mrs C. O'Donnell were promoted to college lecturers
Report on Examinations for the Bachelor of Physiotherapy, National University of Ireland.
June and September, 1987.
1st Year
Thirty students entered for the examination, four gained first class honours, fifteen gained second class honours and nine students passed. Of the two students who failed, one passed in the autumn and one re-entered first year in October 1987.
2nd Year
Thirty students entered for the examination, ten students gained second class honours and sixteen passed. Four students sat the autumn examination, two passed and one re-entered second year.
3rd Year
Twenty-nine students entered for the examination. All passed, eleven with second class honours.
4th Year — Bachelor of Physiotherapy — Degree course
170 Twenty-eight students entered for the examination and passed; three with first class honours and twenty-two with second class honours. Miss M. Smyth was awarded the Irish Society of Chartered Physiotherapists prize.
Courses and Conferences Attended
Dr. M. Garrett
Conference on gait analysis and medical photogrammetry. Classification of levels of walking accomplishments in stroke patients. (Paper presented). Chairman session 5. St. John's College, Oxford, England. March/ April 1987.
European Economic Community comae workshop: Restoration of walking for paralysed persons. Classfication of patients. (Paper presented). University of Twente, Enschede, Netherlands. April 1987.
Partner Eureka project — computer assisted locomotion by implanted electro stimulation.
Association of Medical Deans in Europe/Association for Medical Education in Europe. Trinity College, Dublin. September 1987.
First research symposium. Classification of functional walking capability in stroke patients. (Paper presented). Medical School, University College, Dublin.
Sr. M. Reparata Hanly
Winter conference of the association of Teachers of the Chartered Society of Physiotherapy. London, England. November 1987.
Workshop on spasticity. Trinity College, Dublin. 1987.
Anatomy of the spine. Lecture. National Industry Fire and Safety Training Centre Limited. Dublin. November 1987.
171 Dr. M. McAteer
Aspects of grief in physiotherapy practice. Ph.D. conferred. Pacific Western University, Los Angeles, California, United States of America.
Loss, grief and growth.
Counselling course. Turning point. October 1987.
Miss R. Jeffers
Sports injuries course. Study morning — respiratory care, St. James's Hospital, Dublin. November
1987.
Mrs. C O'Donnell
Workshop on spasticity. Trinity College, Dublin. November 1987. Publications Classification of levels of walking accomplishment in stroke patients. Proceedings of conference: Gait analysis and medical photogrammetry: 57, Oxford, April 1-3. 1987. M. Garrett, J. Gronley D. Nichonson, J. Perry.
CENTRAL REMEDIAL CLINIC, CLONTARF
Staffing
MEDICAL:
Dr. C Barry - Medical Director Dr. O. Hensey - Assistant Medical Director Dr. S. Dockeray - Consultant Paediatrician Dr. P. Rowland - Consultant Paediatrician Mr. F. McManus - Orthopaedic Consultant Mr. T. O'Brien - Orthopaedic Consultant Dr. E. Burke - Ophthalmic Consultant
PARA-MEDICAL STAFF:
1 Superintendent Physiotherapist — (Miss K. Keating) 2 Senior Physiotherapists 6 Basic Grade Physiotherapists
172 — (1 sessional Physiotherapist in Tallaght Health Centre) 1 Research Physiotherapist 7 Occupational Therapists 2 Speech Therapists 1 Dietitian 1 Chiropodist
The physiotherapy department in the Central Remedial Clinic gives a highly specialised service to children with physical and multiple handicaps. Particular emphasis is placed on the assessment and the care of the very young child with a handicap and this service is on a national scale. An important aspect of the work of the clinic is the support offered to colleagues throughout the country in the management of patients referred from other units.
Adults referred to the Central Remedial Clinic come mainly from the orthopaedic and rheumatological departments of the Mater Misericordiae Hospital. A wide range of modalities are offered including hydrotherapy and all the other standard methods of treatment. This area is staffed by three sessional physiotherapists. There is also an active occupational therapy department, with a staff of seven occupational therapists, which provides sensory and perceptual training, vocational training, and advice on special seating for the handicapped individual usually in co-operation with the physiotherapists. Two speech therapists give advice and training for feeding problems in infants and young children and for disorders of speech and language. There is a training unit for incontinent children, and in particular for those with spina bifida.
Approximately eighty to eight-five per cent of the estimated number of new cases of cerebral palsy born in the Republic each year, are seen in the Central Remedial Clinic so that it is by far the largest unit for such children in Ireland. With Temple Street Hospital it is a national centre for the management of arthrogryposis multiplex. It is also a national referral centre for children with muscular dystrophy and adults with motor neurone disease who have bulbar involvement with poor hand function or communication difficulties.
The Micro-electronic Resource Centre is known internationally for its expertise and is run by Mr. R. Allen and highly skilled professional staff. Numerous associations have been established with other units in the United States of America, the United Kingdom, Canada and Sweden. There is a national school on the premises with 150 children enrolled and 14 teachers. The principal teacher is Miss K. Ryan. There is also a sheltered workshop with 90 handicapped employees with Mr. M. O'Connor as workshop manager.
The day centre caters for the most disabled people attending. During the year, the Central Remedial Clinic continuted to collaborate with the Eastern Health Board and the Parents Association to run a day centre in Coolock. With the help of the community care services and the National Rehabilitation Board, it
173 is envisaged that similar units will be established under the care of different health boards as these units are highly cost effective.
Many visitors came to the Central Remedial Clinic during 1987. Notably Professor Rubenstein (Rubenstein Tanbi Syndrome) and Dr. Ingemah Olow from Gothenburg.
Many athletic medals were won at home and abroad by handicapped people attending the clinic. Teresa Ward broke the world record in her class in the shot putt. Christopher Nolan won the Whitbread Award with his book 'under the eye of the clock' and is now regarded as one of the most exciting writers of the present time.
Research
A number of research projects were carried out during the year. Dr. V. Dowding continued with her important epidemiological survey of cerebral palsy in the Eastern Health Board area.
Arrangements were made for the development of a clinical gait laboratory (one of the first in Europe).
Miss M. Smith started work on an M.Sc. thesis on 'the development of reading skills in the non-reading, physically handicapped child of average intelligence.
Mr. P. O'Donoghue began work for a Ph.D. on the topic of 'integration of physically disabled children into mainstream education'. The Central Remedial Clinic supported research by Dr. S. McManus and Dr. M. de Arce on 'boundaries of chromosomal imbalance separating handicap from inviability — a study of balanced reciprocal translocation carriers and their families.
Offices Held
Dr. C. Barry continued as president of the International Cerebral Palsy Society until October, 1987. He was elected a fellow of the American Academy for Cerebral Palsy and Development Medicine and appointed to the International Affairs Committee of that body. During the year he attended meetings in Cambridge, London, Boston, Brussels and Oxford.
Meetings/Conferences Attended
Technology for the disabled. Irish Society of Chartered Physiotherapists. Annual conference. 1987. A Jenkinson, R. Allen.
174 Muscular dystrophy. Medical School of Liverpool University. International meeting. 1987. O. Hensey, J. Hurley, C. Murray. European Association of Muscular Dystrophy. Guest of Irish Muscular Dystrophy Association. Annual conference. Oslo. O. Hensey. Study Day/Lectures Teenager with handicaps. Central Remedial Clinic. Annual study day 1987. Treatment of celebral palsy. Parents organisation of Central Remedial Clinic. First study day. Various members of the staff. Lectures and demonstrations in Central Remedial Clinic and throughout Ireland. Publications One stage correction of lower limb deformities in spastic diplegia. Journal of Paediatric Orthopaedics. 1987. F. McManus et al. Psychiatric disorder amoung boys with duchenne muscular dystrophy. Abstract. Developmental Medicine and Child Neurology Supplement, no. 55. October, 1987. C Htzpatnck, C. Garley, C Barry. Physiotherapy: 1983 1984 1985 1986 1987 Total Patient Attendances 62,689 63,042 66,652 55,819 48,359 Treatments Exercises 21,556 16,969 16,252 12,996 11,083 Chest Unit 21,134 20,109 23,479 20,164 16,170 Orthopaedic Unit 12,465 13,157 13,598 11,713 9,532 Neurological Unit 6,629 8,0198,427 7,183 8,873 Ultraviolet 2,729 3,320 2,721 2,905 2,875 Cervical Lumbar Traction 2,403 2,553 2,539 1,698 1,712 Hydotherapy Mobilisation 3,280 8,683 4,611 3,037 5,132 Intra Farentia 3,255 3,042 2,671 Electrical 704 601 423 211 2,662 Heat- Shortwave Diathermy, Infra Red, Ultra Sonic Therapy, Wax Treatments, Total:- 17,331 11,470 2,263 6,947 4,817
Total Treatments 88,231 88,236 87,355 69,524 62,856
175 SCHOOL OF NURSING
Staffing
TUTORS: Sr. M. de Lourdes Miss P. O'Sullivan Sr. M. Therese Moylan Sr. N. McCarthy Sr. M. Eugene Miss A. Murray Miss N. O'Callaghan Miss C Browne
CLINICAL TEACHERS: Miss R. McCabe Miss P. Walsh
Scope of Service
The department assists student nurses in the attainment of maximum personal and professional development through a carefully selected curriculum and by progressive education in the art, science and practice of nursing. On-going education is encouraged and assisted.
Academic Achievements
For the year ending 31st December 1987 a total of one hundred and one student nurses sat for the registration examination of An Bord Altranais. One hundred and one were successful, thirteen obtaining honours.
A total of ninety-eight student nurses presented themselves for the registration part 1 examination of An Bord Altranais. Ninety-two were successful at the first attempt.
The four attempts who completed the four year integrated course in sick children and general nursing in Our Lady's Hospital, Crumlin, were all successful in their State Final examination. Three obtained honours.
Annual Prize-Giving
The annual prize-giving and distribution of certificates was held in the auditorium. The programme was as follows:-
A mass of thanksgiving was offered in the hospital chapel by Reverend Fr. F. Monks, O.S. Cam., chaplain. Mass was followed by the distribution of prizes and certificates by Alderman C Hederman, Right Honourable Lord Mayor of Dublin. The 3M Littman award was presented by Mr. Paul Tyrrell from 3M
176 (Ireland) Limited. Sr. M. Lucia Therese, Matron, presided and welcomed the students, parents and friends. Afterwards, tea was served in the hospital restaurant.
Secondments
The second year students enjoyed their secondments — for geriatric nursing in St. Mary's Hospital, Phoenix Park, for community care in the health centres, for obstetrics experience in the National Maternity Hospital, Dublin and for psychiatric experience in St. Vincent's Hospital, Fairview.
Our Lady's Hospital for Sick Children, Crumlin, continues to send their students (four per year) to the Mater Misericordiae Hospital for the general part of their course.
Two student tutors from University College, Dublin, were seconded for teaching practice and experience, in clinical teaching during the Hilary and Michaelmas terms.
New students were welcomed in March and October to the introductory course of eight weeks before taking up duty in the wards of the hospital. The student intake was reduced from fifty to thirty-five as part of the hospital cutbacks.
Special Interests
Students went for their annual retreat to All Hallows Retreat Centre. Second year students performed in the inter-hospital concert organised by the Irish Guild of Catholic Nurses.
Before Christmas a group of student nurses sang carols to collect funds for charity as part of the fund-raising campaign of the Irish Guild of Catholic Nurses.
Five students submitted essays written in conjunction with the "Johnson and Johnson Travel Award".
Two students attended the Students' National Seminar in Letterkenny.
Sr. de Lourdes attended a meeting with representatives from the European Community at the Irish Cancer Society to discuss basic and post basic oncology education to nurses in Ireland.
Ms. C Chase, an M.Sc. student in Nursing Education from the Department of Nursing Studies, Edinburgh University, Scotland, visited us for four days. She was very interested in the curricula for post-registration courses and in the clinical areas for intensive therapy and coronary care.
177 The Past Nurses' Committee presented a cheque for four hundred pounds to the School of Nursing to purchase a new skeleton for the classroom.
The May finalist class presented the school with a cheque for two hundred pounds and a beautiful clock for the Library.
The Irish Nurses' Research Interest Group held a meeting in the school during the year.
The department had visits from many recruiting personnel especially from the United States who wish to recruit nurses for their hospitals.
Miss P. O'Sullivan is at present studying for a degree in nursing administration at Edinburgh University, Scotland.
Nurse Tutors journal Club met each month.
Conferences/Seminars/Courses
The tutorial staff of the School of Nursing were represented at the following, during 1987:-
Nursing — continuous learning. The sixth annual nursing and research conference. Faculty of Nursing, Royal College of Surgeons.
Acquired Immune Deficiency Syndrome. Lecture. Royal College of Physicians.
Pressure sores. Day seminar. Cardiac Services Limited. Gresham Hotel, Dublin.
Geriatrics. Seminar. Organised by Irish Nurses Research Interest Group. St. Mary's Hospital, Phoenix Park, Dublin.
Nursing and politics — communication. Association of Nurse Tutors. Summer school, St. Patrick's College, Maynooth.
The use of therapeutic reminiscence with elderly people. Conference. Trinity College, Dublin.
Prevention of coronary artery disease. Two day seminar. Irish Heart Foundation. Trinity College, Dublin.
Clinical update. Evening session. Sponsored by Lederle Laboratories. Broc House, Dublin.
Tutors continue to attend courses at the Faculty or Nursing, Royal College of Surgeons.
178 MAY FINALISTS 1987 N.B. ALL STUDENTS ARE PLACED FROM LEFT TO RIGHT IN PICTURE: 1st ROW C. Boyle, C. Corcoran, E Kavanagh, M. Drea, Y. Dunleavey, A.M. Hughes, D. Ha 2nd ROW: A.P. Doyle, A. Rowley, P. McEvoy, R.Hegarty A. Faulkener, C. Morris, £ Leonar M.C Harman, C. Leavey 3rd ROW: S. Ryan, E. McDunphy, D. Kearney, M. O'Brien, A. Brennan, E. Howley, B. MacG C. Murphy, P. O'Sullivan. 4th ROW: Sr. B. Martin, Sr. B. Donohoe, A. McGovern, E Ryan, M. Ruane, R. McCabe, E F Furlong. Sr. Eherese. 5th ROW: C. Brown, A.M. Walsh, S Sheehy, R. Pearson, E Noone, G Murray, P. Loner Dowel, H. Dempsey. NOVEMBER FINALISTS 1987 N.B. ALL STUDENTS ARE PLACED FROM LEFT TO RIGHT IN PICTURE: FRONT ROW: L. Brothwick, C. Brown, M.Duggan, N. Cadden, F. Delaney, F. D'Arcy, Sr. de Lou 2nd ROW: Sr. Nora, M. Connolly, A. Lee, M. Deesing, M. O'Hara, S. Scollard, F. Moylan, C 3rd ROW: N. O'Byrne, S. Murphy, F. Whelan, A. O'Neill, T. Lowry, S. Gould, A. O'Brien, R. 4th ROW: S.A. Flattery, A. Dolan, A.M. Jones, Alderman C. Hederman (Lord Mayor), S. H M.A. Quinn, G. Doran. 5th ROW: M. Moloney, F. Boyle, F. Finn, J. Maloney, M. Horgan H. Shannon, 5. Kilcoyne, P 6th ROW: M. McAree, M. McGrath, P. Finnegan, P. O'Neill, I. Glackin, K. Fogarty, H. Cumm M.E. McKeown. ST. PAUL'S HOSPITAL AND SPECIAL SCHOOL FOR AUTISTIC AND EMOTIONALLY DISTURBED CHILDREN, BEAUMONT, DUBLIN 9.
Staffing
MEDICAL DIRECTOR: Dr. P.E. McQuaid
MATRON/ADMINISTRATOR: Mrs. M. Jefferies
CLINICAL PSYCHOLOGISTS: Ms. E. McCrann
SPEECH THERAPIST: Ms. M. Shiel
SOCIAL WORKER: Miss M. Duff P.S.W.
SCHOOL PRINCIPAL: Mrs. E. Lyng
GENERAL PRACTITIONER: Dr. M. Malone
PSYCHIATRIC REGISTRAR: 1
STAFF NURSES: 7
TEACHERS: 8
NURSING AIDES: 14
PLAY THERAPIST: 1
HOUSE PARENTS: 7
CLERICAL OFFICER: 1
GRADE II CLERK TYPIST: 1
COOK: 1
DOMESTICS: 4
Honorary Consultant Staff
Dr. CJ. Barry Professor N.V. O'Donohoe Mr. P. Eustace Dr. D. Kennedy
181 Scope of Service
This service was established in 1970, under the aegis of the Board of Management of the Mater Misericordiae Hospital and operates as a department of the Mater Misericordiae Hospital. The complex has a resident population of twenty five children and seven adolescent young people who reside in an adjacent hostel. In addition, twenty eight children attend from the north city and county Dublin catchment area, which is the responsibility of the Department of Child & Family Psychiatry of the Mater Misericordiae Hospital.
The assessment facility is multi-disciplinary and comprehensive. It usually requires three days for completion of assessment, with residence of the child in St. Paul's Hospital. Local provision is made for the parents who attend on a daily basis to participate in the assessment process. Following full investigation, which may include neurological, special sensorial investigation, blood tests, E.E.G. and x-ray examinations, the parents are given a descriptive and diagnostic report as part of the final diagostic process. A decision is then taken with the parents as to the most appropriate arrangements for the child, in conjunction with the services provided at St. Paul's. Contact is then made with the referring agent. Follow-up genetic counselling is regularly proferred.
Long stay residential treatment may be required for a small number of children, most of whom reside outside the Eastern Health Board area. Many of these children are significantly handicapped, intellectually, neurologically, sensorially, educationally, etc. Some of the children require institutional support and care for life, while others can be rehabilitated to take their place in the community. The majority continue to require some type of special education and care as well as treatment and training for the remainder of their lives. This function is usually handed to some other service agency when the children reach sixteen years of age. In the case of more severely handicapped children, transfer is effected at twelve years.
Development
The adolescent unit is housed in a small semi-detached house in Santry which provides significant change in the status and orientation of the hospital after care programme.
In service training for staff continues and staff find this of great benefit.
St. Paul's Special School
St. Paul's Special School provides, education for approximately fifty five autistic emotionally disturbed and/or language disordered children. The age range is from four to sixteen years.
Twenty eight children reside at home and attend the school on a day basis,
182 the remainder are resident in St. Paul's Hospital or in the Adolescent Hostel.
The school staff includes a principal, eight full-time and two part-time teachers, a state registered nurse, four nursing aides, a school secretary and a cleaner domestic. A training programme is provided for two young people and a part- time caretaker is employed under the National Manpower Social Employment Scheme. The school is administered by a Board of Management under the auspices of the Department of Education.
The school programme is individualized to provide for the educational, social and emotional needs of each child. About six deaf children are taught communication by Irish Sign Language. The range of instruction is from pre- nursery school level through early secondary school to whatever level is within the child's potential.
Teaching
This continues to be an important aspect of the programme and graduate students in medicine, psychology, child care, speech and language therapy continue to be provided for in the context of the assessment and treatment of the population of the hospital. Lecturing and training of other services staff concerned with mentally handicapped and disturbed children is provided by senior members of the consultant staff of the hospital.
183 DEPARTMENT OF SURGERY
Professorial Unit
Staffing
CONSULTANT: Professor J.M. Fitzpatrick
ACADEMIC STAFF: Mr. P. Gillen Mr. P. Grace(Special Lecturers in Surgery)
NON-CONSULTANT 1 Senior House Officer HOSPITAL DOCTOR: 2 Interns
Scope of Service
The unit consists of sixteen beds and a full range of general surgical and urological conditions is managed. There is a special interest in the management of urinary calculi and the opening of the new lithotriptor unit has meant an increased experience and throughput of this condition. The management of urinary incontinence has been helped considerably by the acquisition of a urodynamics machine which makes the exact diagnosis easier. Expertise is also present in the management of male impotence and in the new reconstructive techniques involved in the radical treatment of urological malignancies.
Medical Education
Undergraduate surgical education includes courses of lectures, clinical demonstrations and clinical attachments which are conducted by the professor and lecturers.
Projects are organised for students who wish to do an elective period in research. The research of the work is presented at a meeting in the hospital and the surgical project judged to be the best, is awarded the Henderson Prize.
Postgraduate surgical teaching is arranged in association with the Dublin Postgraduate Training Committee for doctors studying for the fellowship examination of the Royal College of Surgeons in Ireland.
Research Activity
The emphasis on experimental and clinical research continues. Work on the microvascular changes in partial ureteric obstruction was awarded the Alton Prize and the Irish Society of Urology Medal. Further studies into regional renal blood flow in this condition are being undertaken. Other experiments are being
184 performed into the effect of pancreatitis on other organs in the body. Further clinical studies are being carried out with the pathology and nuclear medicine departments.
Hospital Conferences and Visiting Professors
Every week, conferences are held in urology and general surgery and are attended by the surgical consultants and non-consultant staff as well as radiologists. A wide range of topics is covered.
The Mater Study Day was organised by Professor Fitzpatrick in March 1987. In addition to contributions by Dr. J. Ennis, Dr. P. Dervan, Dr. D. Carney and Professor J.M. Fitzpatrick, four visitors were invited to give lectures at the meeting. They were Mr. P.H. Smith from the Bristol Royal Infirmary, Mr. K. Parsons from the Royal Liverpool Hospital, Mr. C.R.J. Woodhouse from the Royal Marsdon Hospital and Mr. R. Miller from the Institute of Urology, London, England.
Professor M. Papp from Budapest, Hungary, a world authority on pancreatic disorders, was a visiting lecturer to the Department of Surgery in March.
Dr. R. Babayan and Dr. A. Nelson from Boston University Medical Centre, United States of America, were visiting lecturers in April and lectured on "Continent Urinary Diversion".
The Urological Research Society was hosted by Professor Fitzpatrick in June and a number of delegates from Europe, the United States of America and Japan attended. A wide range of topics was covered, including pathophysiology of impotence, oncogenes and monoclonal antibodies in urological cancer, research aspects of bladder and prostate cancer and ureteric obstruction.
Committees and Editorial Boards
Professor J.M. Fitzpatrick is president of the Urological Research Society, president of the Urostomy Association (Irish branch), president-elect of the EIRSS and past-president of the St. Peter's Society. He is secretary of the Irish Society of Urology and of the Urological Travelling Society. He is a member of the Council of the Irish Society of Urology and of the surgical section of the Royal Academy of Medicine of Ireland. He is the Irish urological representative to the Union European des Medicins Specialistes and the Irish delegate to the European Association of Urology.
He is a member of the editorial boards of:
1. British Journal of Urology. 2. World Journal of Urology. 3. European Urology.
185 4. Urological Research 5. Societe Internationale d'Urologie. 6. British Journal of Surgery. 7. Archive Italino di Urologia Nefrologia Andrologia.
Examination Boards
Professor J.M. Fitzpatrick examines outside University College, Dublin in the intercollegiate specialist fellowship in Urology. He is examiner to the Royal College of Surgeons in Ireland for the final professorial examination, the primary fellowship and the final fellowship examinations and is extern examiner in the final medical examination to Trinity College, Dublin. Professor J.M. Fitzpatrick
Invited Lecturers
Institute of Urology. London, England. January 1987.
Symposium on urinary calculi. Royal College of Physicians. Dublin. April 1987.
Boston University Medical Centre. Boston, United States of America. August 1987.
First annual research symposium of the Medical School. University College, Dublin. November 1987.
Surgical discussion group. Dublin. December 1987.
Guest lecture
Recent trends in the management of superfician bladder carcinoma. Fifty-third Abraham Colles lecture. Royal College of Surgeons in Ireland. April 1987.
Visiting Professorships
King Faisal University. University Hospital, Dammam. February 1987.
Brown University. Rhode Island Hospital, Providence, Rhode Island, United States of America. August 1987.
Chairman of Sessions at Meetings
Experimental urology. Research meeting at Guy's Hospital. London, England. January 1987.
186 Urology. Sir Peter Freyer surgical symposium. Galway. September 1987.
Surgical research. First annual research symposium of the University College Dublin Medical School. Dublin. November 1987.
Papers Presented at Meetings
A total of twenty-two presentations (podium or poster) were made.
Research meeting. Guy's Hospital. London, England. January 1987.
Surgical Research Society. Guildford, England. January 1987.
International Academy of Pathology. Chicago, United States of America. March 1987.
Royal Academy of Medicine. Belfast. March 1987.
Royal Academy of Medicine. Drogheda. April 1987.
Irish Society of Urology. Dublin. May 1987.
American Urological Association. Anaheim, United States of America. May 1987.
British Association of Cancer Research. London, England. June 1987.
Urological Research Society. Dublin. June 1987.
Fifth Forum of International Andrology. Paris, France. June 1987.
British Association of Urological Surgeons. Edinburgh, Scotland. July 1987.
European Pancreatic Club. Marseilles, France. September 1987.
187 Fourth European Conference on Clinical Oncology. Madrid, Spain. November 1987.
Pancreatic Society of Great Britain and Ireland. London, England. October 1987.
Prizes at Meetings
Relief of obstruction and recovery of function: an experimental study. The Irish Society of Urology medal. 1987. A Leahy, P.C. Ryan, G. McEntee, D. Cottell, P.C. Dervan, J.M. Fitzpatrick.
Partial ureteric obstruction — microvascular changes. The Alton Prize. 1987. A Leahy, J.M. Fitzpatrick.
Lectures at Courses
Urology for the F.R.C.S. Liverpool, England. March 1987.
Publications
Can flow cytometry predict recurrence and invasion in stage D bladder carcinoma? Lab. Invest, 56: 86A. A.B. West, R. De Vere White, A.D. Deitch, J.M. Fitzpatrick.
Operational experience of the Irish Testicular Tumour Registrary: Implications for National Cancer Registry. Irish Journal of Medical Science, 156: 47. 1987. J.A. Fhornhill, A. Walsh, D.G. Kelly, J.J Fen nelly, J.M. Fitzpatrick.
A role for the public in testis cancer. Journal of Irish College of Physicians and Surgeons,16: 23. 1987. J.A. Fhornhill, A. Walsh, D.G Kelly, J.J. Fennelly J.M. Fitzpatrick.
Could vasectomy accelerate testis cancer? The importance of pre-vasectomy investigation. British Journal of Urology, 59: 367. 1987. J.A. Fhornhill, M. Butler, J.M. Fitzpatrick.
Primary non-obstructive megaureter in adults. Clinical Radiology, 38: 181. 1987. S. Hamilton, J.M. Fitzpatrick.
A cytophotometric study of neoplastic field change in the human urinary bladder. Journal of Urology, 137: 125A. (Supplement). 1987. A. O'Brien, M.R. Butler, J.M. Fitzpatrick.
188 A new probe for bipolar diathermy for upper tract urothelial tumours. Journal of Urology, 137: 234A. (Supplement). 1987. LED. McDermott, J.M. Fitzpatrick, D. Suatengco, H.B. Grossman.
Patients' delay in the presentation of testis cancer in Ireland. British Journal of Urology, 59: 447. 1987. J.A. Thornhill, J.J. Fennelly, D.G Kelly, A. Walsh, J.M. Fitzpatrick.
Editorial: Prostate cancer. Irish Journal of Medical Science, 156: iii. 1987. J.M. Fitzpatrick.
Effects of verapamil and hypovolaemia on canine renal haemodynamics. British Journal of Surgery, 74: 531. 1987. A.L Leahy, J. Galla, J.M. Fitzpatrick, R.N. Wait.
Experimental ureteric obstruction: a new variable canine experimental model. British Journal of Surgery, 74: 531. 1987. P.C. Ryan, J.M. Fitzpatrick.
Testis in Ireland (1980 — 1985): Incidence and clinico-pathological features. Irish Medical Journal, 80:120. 1987. / Thornhill, A. Walsh, J.J. Fennelly, DC. Kelly, J.M. Fitzpatrick.
Ultrasound diagnosis of prostatic cyst causing acute urinary retention. Journal of Ultrasound in Medicine, 6: 385. 1987. 5. Hamilton, J.M. Fitzpatrick.
Three-dimensional study of the microvasculature in caerulein-induced pancreatitis. Digestion, 38.39. 1987. G.P. McEntee, A. Leahy, D. Cottell, P. Dervan, KF McGeeney, J.M. Fitzpatrick.
Ureteric meatotomy by Sachse urethrotomy in the management of lower uretheral stones. Journal of Urology, 138: 566. 1987. M.G Donovan, J. Hegarty, J.M. Fitzpatrick, M.R. Butler.
Experimental partial uretreic obstruction: Pathophysiological changes in upper tract pressures and renal blood flow. Journal of Urology, 138: 674. P.C. Ryan, K.P. Maher.
Bladder cancer in one hundred and fifty-six patients aged eighty years or more. Irish Journal of Medical Science, 156: 259. 1987. J.M. Fitzpatrick, M. Durazi, M.R. Butler, V. Lane, J.D. O'Flynn.
Die Wirksamkeit der intravesikalen verwendung von Epodyl bei patienten mit riskoarmen superfiziellen hamblaenkarzinomen. Cherotherapie des Oberflachlichen Harnblasenmarzinoms. Edited by G. Lunglmayr and C. Kratzik; Verland FRIC, Vienna, Austria: 71-80. J.M. Fitzpatrick, A.B. West, M.R. Butler, V. Lane, J D. O'Flynn.
189 Recent trends in the management of superficial bladder cancer. Journal of the Irish College of Physicians and Surgeons, 16: 134. 1987. J.M. Fitzpatrick.
The canine kidney in haemorrhagic shock: Effect of Verapamil. European Urology, 13: 401. 1987. A.L Leahy, J. Galla, J.M. Fitzpatrick, R.B. Wait.
The surgical approach to inferior vena caval extension of renal carcinoma. British Journal of Urology, 60: 492. 1987. M.K. O'Donohoe, F. Flanagan, J.M. Fitzpatrick, J.M. Smith.
Partesticular Leiomyosarcoma. British Journal of Urology, 60: 590. 1987. M.G. Donovan, J.M. Fitzpatrick, F.F Gaffney, A.B. West.
A morphological study of the microvasculature in a chemically induced pancreatitis model. Irish Journal of Medical Science, 156: 369. 1987. GP. McEntee, A. Leahy, D. Cottell, P. Dervan, K.F. McGeeney, J.M. Fitzpatrick.
How long can a kidney be partially obstructed without significant functional loss? An experimental study. Irish Journal of Medical Science, 156: 369. 1987. A. Leahy, PC. Ryan, GP. McEntee, P. Dervan, J.M. Fitzpatrick.
Presentations at Meetings
A total of six presentations were made at the following meetings:
The Society of University Surgeons. Columbus, Ohio, United States of America. February 1987.
The University Surgical Residents Conference. Columbus, Ohio, United States of America. February 1987.
The Surgical Section of the Royal Academy of Medicine in Ireland. Drogheda. April 1987.
The American Gastroenterological Association. Digestive disease week. Chicago, Illinois, United States of America. May 1987.
St. Laurence's Hospital Scientific Meeting. Dublin. May 1987.
The Surgical Research Society. University of Leeds, England. July 1987.
190 Prizes
The Shepard Memorial Research Prize. St. Laurence's Hospital. Dublin. May 1987. P.A. Grace
Publications
Risks of percutaneous transhepatic drainage in patients with cholangitis. American Journal of Roentegenography, 148: 367-371. J.F. Lois, AS. Gomes, G.A. Grace, LS. Deutsch, A.H. Pitt.
Inhibition of oxy gen free radical production acute stress acute stress ulceration in the rat, British Journal of Surgery, 74: 547. 1987. N.F. Couse, P.A. Grace, M. Zinner.
Intraduodenal fat inhibits resting and CCK-stimulated sphincter of Oddi motility. Gastroenterology, 92: 1411. 1987. PA. Grace.
Duodenal acidifacation alters sphincer of Oddi motility. Journal of Surgical Research, 43: 68-74. 1987. P.A. Grace, P.J. Romano, H.A. Pitt.
Cholecystectomy alters the hormonal response of the sphincter of Oddi. Surgery, 102: 186-194. 1987. PA. Grace, H.A. Pitt.
Surgery in Somerset. Irish Medical Times, 21: 19. 1987. PA. Grace.
The influence of motilin and cholecystokinin on sphincter of Oddi and duodenal pressures in the prairie dog. American Journal of Physiology, 253 (Gastrointestinal Liver Physiology, 16): G679-G683. 1987. El. Muller, PA. Grace, R.L. Conter, J.J. Roslyn, H.A. Pitt.
Immediate return of nerve function following microsurgical repair. British Journal of Surgery, 74: 1142. 1987. P.A. Grace, 5. Augustine, G. Lynch.
Ketamine inhibits sphincter of oddi phasic wave amplitude. Current Surgery, 44: 403-405. 1987. PA. Grace, T.H. Webb, P.J. Romano, H.A. Pitt.
Immediate return of nerve function of nerve function following microsurgical repair. Irish Journal of Medical Science, 156 (12): 370. 1987. P.A. Grace, S. Augustine, G Lynch. P. Gillen
Presentations at Meetings
A total of seven presentations were made at the following meetings:
191 Academic Departments of Surgery in Europe. Pavia, Italy. 1987.
Surgical Research Society. Guilford, England. 1987.
European Society for Surgical Research. Aarhus, Denmark. 1987. ical Section. Registrar's Prize meeting. Drogheda. 1987.
Sir Peter Freyer meeting. Calway. 1987.
British Society of Gastroenterology. London, England. 1987.
Prizes
Registrar's Prize.
Royal Academy of Medicine in Ireland (Surgical Section). 1987,
Publications
Barrett's oesophagus: A pathophysiological study. Diseases of the oesophagus: 540-541. 1987. P. Gillen, A.B. West, P. Keeling, T.P.J. Hennessy. Gastro-oesophageal reflux treated by submucosal injections. Diseases of the Oesophagus: 1120-1122. 1987. P. Gillen, P Keeling, PH. Byrne, A.B. West, T.P.J. Hennessy.
A possible role for alkaline reflux in the development of complications of Barrett's oesophagus. Irish Journal of Medical Science, 156 (6): 198. 1987. P. Gillen, M. Healy, P. Keeling, P.J. Byrne, R.R. O'Moore.
The pH profile of Barrett's oesophagus and its implications. Irish Journal of Medical Science, 156 (5): 163. 1987. P. Gillen, P. Keeling P.J. Byrne, A.B. West, T.P.J. Hennessy.
Alcohol-induced pancreatitis: Social and surgical aspects. British Journal of Surgery, 74 (5): 402-404. 1987. GP. McEntee, P. Gillen, A.L.G Peele.
Experimental Barrett's oesophagus: The contributions of acid and bile reflux to it pathogenesis. European Surgical Research, 67: 36. 1987. P. Gillen, P. Keeling, P.J. Byrne, A.B. West, T.P.J. Hennessy.
192 The patterns of acid and bile reflux in Barrett's oesophagus. European Surgical Research, 97: 53. 1987. P. Gil/en, P. Keeling, P.J. Byrne, A3. West, T.P.J. Hennessy.
Barrett's oesophagus: pH profile. British Journal of Surgery, 74 (9): 774-776. 1987. P. Cillen, P. Keeling, P.J. Byrne, T.P.J. Hennessy.
K. O'Malley
The Tenth Millin Lecture
A new look at mechanisms of vascular occlusion. Royal College of Surgeons in Ireland. 1987.
Presentations
A total of two presentations were given at the following meetings:
Senior Registrar annual meeting.
Royal College of Surgeons in Ireland. Dublin. 1987.
The Twelfth Sir Peter Freyer Surgical Symposium.
Publications
Norepineprine induced vasoconstriction is increased in intimal hyperplastic arteries of the dog. Surgery, 101: 217-223. 1987. M.K. O'Malley, J.J. Morris, R.C. Makhoul, P-O. Hagen.
Association of polymorphonuclear leukocytes with sites of aortic deendothelialization in rabbits.
Atherosclerosis, 67: 229-236. 1987. C.W. Cole, P-O. Hagen, JR. Lucas, P.M. Mikat, M.K. O'Malley et al.
T.N. Walsh
Presentations
A total of twelve presentations were made at the following meetings:
Royal Academy of Medicine in Ireland. Belfast. March 1987.
193 British Association of Endocrine Surgeons. Edinburgh, Scotland. May 1987.
Irish Society of Gastroenterology. Derry. June 1987.
European Pancreatic Club. Marseilles, France. September 1987.
Twelfth Sir Peter Freyer Symposium. Galway. September 1987.
Pancreatic Society of Great Britain and Ireland. London, England. November 1987.
Senior Registrars Out of Town Meeting. Galway. November 1987.
Royal Academy of Medicine in Ireland. Case presentation. Dublin. December 1987.
Publications
Dispersed pancreatic graft cryoreservation in the dog:- In vivo assessment of preservation protocols. Cryobiology, 24: 256-263. 1987. T.N Walsh, D. Alderson, J.R. Farndon.
Malignant duodenocolic fistula treated by extended Whipples procedure. Dis. Colon Rectum, 30: 636-637. 1987. D. Barton, T.N. Walsh, T. Keane, J. Duignan.
Pancreatic inlet transplantation: Studies of metabolic effects of fresh an dcryopreserved grafts. In: Proceedings of the Bicentennary of the Royal College of Surgeons in Ireland: 1079-1082. 1987. T.N Walsh, D. Alderson, K.G Albert/, JR. Farndon.
Pancreatic inlet transplantation: Effects on diurnal hormonal and metabolic profiles. British Journal of Surgery, 74: 862. 1987. T.N. Walsh, D. Alderson, K.G Alberti, J.R. Farndon.
An epidemic of pseudomembranous colitis: Importance of person to person spread. Gut, 28: 1467-1473. 1987. N.P. Nolan, C.P. Kelly, J.F Humphreys, C. Cooney, R. O'Connor, T.N. Walsh, D.G. Weir, D.S. O'Brlain.
Starch extraction in pancreatectonised dogs. Digestion, 38: 40. 1987. K. McGeeney, M.D. OVonnell, T.N. Walsh.
194 Metabolic and hormonal effect of pancreatic inlet transplantation for insulin dependent diabetics. Irish Journal of Medical Science, 156: 163-164. 1987. T.N. Walsh, N. O'Higgins.
195 GENERAL SURGERY Staffing CONSULTANT Mr. T.P. Corrigan
NON-CONSULTANT HOSPITAL DOCTORS: Senior Registrar (shared) 1 Senior House Officer (shared) 1 Intern Honorary Registrar
Scope of Service
General and vacular surgery with special interest in:-
Extracranial vascular disease Renovascular disease Venous thromboembolism Breast disease
Research
1. Subcutaneous heparin in treatment of venous thrombosis — a controlled study.
2. The incidence of venous thrombosis following major vascular surgery.
3. Surgical management of renovascular hypertension.
4. Blood changes following graft replacement for abdominal aortic aneurysm.
5. Local recurrence following mastectomy.
Operating Sessions
Monday All day Wednesday All day
Out Patient Clinic
Thursday 2.00 p.m. — 4.30 p.m.
196 Staffing
CONSULTANT . W.P. Hederman
NON-CONSULTANT HOSPITAL DOCTORS: 1 Senior Registrar 1 Senior House Officer 2 Interns (shared)
Scope of Service
General surgery including emergency on take rota. Peripheral vascular disease, both arterial and venous.
Meetings Attended
Surgical section of Royal Academy of Ireland Meeting. Belfast. March 1987.
Association of Surgeons of Great Britain and Ireland. Liverpool, England. April 1987.
European Union of Medical Specialists. Copenhagan, Denmark. May 1987.
Venous Forum of Royal Society of Medicine. May 1987.
Surgical Travellers meeting. Istanbul and Antalya. June 1987.
James IV Association of Surgeons. Edinburgh, Scotland. September 1987.
Sir Peter Freyer memorial lecture and surgical symposium. Galway. September 1987.
Annual clinical meeting of American College of Surgeons. San Francisco, United States of America. October 1987.
Venous Forum Royal Society of Medicine. London, England. October 1987.
Surgical Travellers. Manchester, England. November 1987.
197 Presentations
Modern management of leg ulcers. Venous Forum of Royal Society of Medicine. May 1987.
Out patient surgery for varicose veins, local anaesthetic. Venous Forum Royal Society of Medicine. London, England. October 1987.
The anatomical society of Great Britain and Ireland. Centenary meeting. St. Hugh's College, Oxford, England. January 1987. T.C. Lee.
Publication
The site of the tendinous interruption in human semitendinosus muscle. Irish Journal of Medical Science, 156, 10: 292. 1987. T.C. Lee.
Research
Right common carotid blood flow and exercise, a study using pulsed doppler ultrasound. T.C Lee.
Review of eight year follow up of long term results of trans thoracic endoscopic sympathectomy for hyperhidrosis and Raynaud's disease.
Out Patient Clinic
General Surgery Wednesday 9.00 a.m. — 1.30 p.m.
Varicose Veins Wednesday 2.00 p.m. — 4.30 p.m.
Staffing
CONSULTANT: Mr. S.J. Heffernan
NON-CONSULTANT 1 Senior Registrar HOSPITAL DOCTORS: 1 Senior House Officer Interns
Special Interests
Peptic ulcer surgery.
Fine needle aspiration thyroid biopsy.
Segmental mastectomy for breast cancer.
198 Mr. S.J. Heffernan is a:-
Past president and Member of Council, Irish Society of Gastroenterology. Member of Council, Royal College of Surgeons in Ireland. Past examiner to the Royal College of Surgeons in Ireland for Primary and Final Fellowship examinations. Fellow of the American College of Surgeons.
Presentations
Recurrent duodenal ulcer. Surgical workshop. Royal College of Surgeons in Ireland. April 1987.
Parathyroidectomy: A ten year review. Sir Peter Freyer Meeting. Gal way. September 1987.
Reversed patch for intractable post-vagotomy diarrhoea. Royal Academy of Medicine in Ireland, Surgical Section. December 1987.
A parathyroid odyssey. Mater study day. December 1987.
Publications
Recurrent duodenal ulcer. Journal of Irish College of Physicians and Surgeons, 87, 16, 4: 159-162. 1987.
Meetings attended
Meeting of Association of Surgeons of Great Britain and Ireland. Liverpool, England. April 1987.
Colles Surgical Travelling Club visit to Glasgow, Scotland. May 1987.
Sir Peter Freyer Meeting. Galway. September 1987.
Out Patient Clinics
Soft Tissue Monday 12.00 noon — 1.00 p.m. General Surgical Tuesday 9.30 a.m. — 1.30 p.m.
199 Staffing
CONSULTANT: Mr. F.X. O'Connell
NON-CONSULTANT 1 Senior Registrar HOSPITAL DOCTORS: 1 Senior House Officer 2 Interns
Scope of Service
General surgery with the following speciality interests:
1. Hepato biliary/pancreatic surgery. 2. Endocrine tumours of the G.I. tract. 3. Inflammatory bowel disease. 4. Diseases of the breast.
Operating sessions: Tuesday and Thursday. Accident/emergency service: Two days in ten. Surgical conference presentations: Tuesday 5.00 p.m. Undergraduate teaching class: Wednesday 9.00 a.m. Out Patient Clinic- Friday 9.30 a.m. — 12.30 p
200 UROLOGICAL DEPARTMENT
Staffing
CONSULTANT: Mr. J.M. Smith
NON-CONSULTANT 1 Senior House Officer (shared) HOSPITAL DOCTORS: 1 Intern
Scope of Service
Renal stone surgery Lithotripsy Surgical oncology Endo-urology Urodynamics Reconstructive urological surgery
Research Activities
Ongoing clinical studies and clinical trials in carcinoma of the prostate, carcinoma of the bladder.
Assessment of results of reconstruction of the lower urinary tract.
Publications
Primary lymphoma of the prostate. Urology, 1987, 29: 555-556. P. Felle, M. O'Connor, J.M. Smith.
Percutaneous balloon dilatation of a mid ureteric stricture caused by retro peritoneal fibrosis. British Journal of Urology, 1987, 60: 84-85. D.B. Downey, D. O'Connell J. Donohoe, J.M. Smith.
Surgical approach to inferior vena caval extension of renal carcinoma. British Journal of Urology, 1987, 7, 60: 234-239. M.K. O'Donohoe, F. Flanagan, J.M. Fitzpatrick, J.M. Smith.
Second generation lithotripters. Irish Doctors, 1980. 1: 544-547. J.M. Smith.
201 Clinical versus urodynamic evaluation of patients with prostatic outflow obstruction. Irish Journal of Medical Science. (In press). M. O'Donohoe, J.M. Fitzpatrick, J.M. Smith.
Benign and malignant pheochromocy toma in the same patient. british Journal of Urology. (In pess). M. O'Donohoe, J.M. Smith.
Presentations
Agressive surgery for primary disease of renal cell carcinoma. Charriere Urological Club. Newcastle, England. April 1987. J.M. Smith
Surgical management of localised prostatic carcinoma. Urological postgraduate study day. Dublin. April 1987. J.M. Smith.
Renal stone surgery — past and future. Dublin Biological Club. April 1987. J.M. Smith.
Recent advances of stone surgery. Bon Secours Hospital study day. May 1987. J.M. Smith.
Urodynamic assessment of patients undergoing prostatectomy. Irish Society of Urology. Dublin. May 1987. M.K. O'Donohoe, J.M. Smith.
Surgical management of inferior vena caval extension in renal cell carcinoma. British Association of Urological Surgeons. Edinburgh, Scotland. July 1987. M.K. O'Donohoe, J.M. Fitzpatrick, J.M. Smith.
Lithotripsy for renal stone disease. Mater Misericordiae Hospital study day. December 1987. J.M. Smith.
Out Patient Clinics
Monday 9.00 a.m. to 12.00 noon Friday 2.00 p.m. to 5.00 p.m.
202 E.N.T. DEPARTMENT Staffing CONSULTANTS: Mr. A.W. Blayney Mr. W. Grant
NON-CONSULTANT 1 Registrar HOSPITAL DOCTORS: Scope of Service
All types of e.n.t. disorders are assessed and treated. There are five operating sessions weekly. The full range of surgical procedures in the field are available. The- department has a long established link with St. Mary's School for the Deaf at Cabra to which it refers for assessment, children with difficult hearing problems. Special Interests
Surgical treatment of deafness from:-
(a) Chronic suppuration in the middle ear cleft. (b) Otosclerosis.
Middle ear microsurgical reconstruction. Education
A post-graduate registrar training scheme is in operation under the guidance of a committee on which there are representatives from the Royal College of Surgeons and the Department of Health. The Mater Misericordiae Hospital's e.n.t. department is part of this rotation scheme.
Undergraduates of University College Dublin are given lectures and clinics twice a week during Hilary Term.
A series of lectures is given to those nurses doing post-graduate studies and in particular the intensive care course.
The consultant staff act as examiners in the undergraduate examinations of University College Dublin and the Royal College of Surgeons and in the diploma in laryngology and otology of the Royal College.
Out Patient Clinics
Monday 9.30 a.m. — 1.30 p.m. 2.00 p.m. — 4.00 p.m. Wednesday 9.30 a.m. — 130 p.m. Friday 9.30 a.m. — 1.30 p.m.
203 Conferences and Meetings attended
Faculte de Medecine de U.C.L. Brussels, Belgium. March 1987.
Transplants and implants in totology. Internation sym posium. Vinice, Italy. April 1987.
Oxford summer meeting. Oxford, England. June 1987.
Reunion annuelle, Bureau International, Fondation Portmann and annual meeting of the Societe Francaise d'O.R.L. Paris, France. September 1987.
Irish Otorhinolaryngological Society meeting. Dublin. October 1987.
W. Grant
Invited lectures
Bony disorders of the cochlea with special reference to otosclerosis, pre- fellowship course in otolaryngology. Royal College of Surgeons. November 1987. W. Grant.
A.W. Blayney
Invited lectures
Experimental mastoid obliteration with hydroxyapatite tricalcium phosphate (zimmer-xomed) and fibrin glue (Tissucol' ; Immuno Austria). International symposium on transplants and implants in otology. Venice, Italy. April 1987. A.W. Blayney, A. Dhem, J.P. Eire, C.A. Teysonneau, M. Portmann.
Experimental and clinical aspects of carbon as a middle ear prosthesis. International symposium on transplants and implants in otology. Venice, Italy. April 1987. A.W. Blayney J.A. Romero-Rio, A. Guilhaume, M.Bagot D'Arc, M. Portmann.
Middle ear reconstruction. Royal Academy of Medicine, section of otolaryngology. June 1987. A.W. Blayney.
204