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meetings & events > calendar > GastroenterologyGastroenterology Update for the Clinical BiochemistACB South West and Wessex Regional Scientific Meeting
Thursday 10th November 2005 Education Centre, Dorset County Hospital, Dorchester A Glut of Gut Gurus
Reported by Aimee Smith, Queen Alexandra Hospital, Portsmouth
Dorset County Hospital in Dorchester on a cold November morning was the setting for the ACB Southwest and Wessex Region Gastroenterology Update for Clinical Biochemists. A series of well-presented lectures broached key biochemical topics in GI medicine. Dr Keith Wakelin from Dorchester chaired the morning session welcoming everyone. The meeting began with the Regional Bayer Award presentations, with three contenders for the award.
Regional Bayer Award Beverley Harris from Bath looked at the potential of NT-proBNP as a screening tool for heart failure. The focus was on a group of symptomatic primary care patients who had been referred for echocardiography. High sensitivity and a high negative predictive value for NT-proBNP were illustrated by the study. Beverley concluded that, in the defined population, echocardiography referrals could be reduced by up to 19% by using NT-proBNP measurements in the decision-making process. Dr Kirsty Knight from Southampton General Hospital had looked at new potential markers of sarcoidosis, to replace the use of the non-specific marker ACE. Out of four markers studied chitotriosidase appeared the most promising, giving a significant difference between the control and patient groups. Interferon gamma and interferon gamma inducible protein-10 also showed potential, although optimisation of the assays is still required.
Finally Dr Tim Thorpe from Bristol Royal Infirmary presented data obtained from a re-audit of bedside transfusion practice after the introduction of a training programme. Results suggested the current training programme was ineffective and highlighted that commitment to following guidelines set out by the British Committee for Standards in Haematology had fallen since 2003. Tim concluded that there was a need for an effective tailor-made training programme and the study would help by highlighting the key areas to be tackled. The winner of the Bayer Award was announced in the afternoon session. The panel of judges remarked that all presentations were of a high standard but a unanimous decision was made and Dr Kirsty Knight was declared the winner receiving a £100 cheque courtesy of Bayer Healthcare Diagnostics, with her two worthy adversaries both receiving £25.
The Future is Bright the Future is Calprotectin In the final presentation of the morning session by Dr Steven Bridger from Dorchester discussed new tests being used in gastroenterology. He highlighted the use of calprotectin in the diagnosis and management of inflammatory bowel disease in comparison to the current inflammatory markers (ESR and CRP). Steven also spoke about the future use of calprotectin as part of gastrointestinal out-patient screening, emphasising the potential reduction of barium follow-through procedures if using a negative calprotectin to rule out organic disease. A lavish spread for lunch brought a break to the procedures with a chance to look over three poster presentations. Sue Bird from Dorchester, who was onside for questions and comments, had carried out an audit of biochemistry lab investigations into chronic diarrhoea based on British Society of Gastroenterology Guidelines. There were also two posters focusing on the uses of calprotectin from Julie Wassell (Bristol) one study considering its use in patients with organic bowel disease and the other its use in inflammatory bowel disease.
Fibrosis and Function The afternoon session, chaired by Dr Joe Begley (Bournemouth), commenced as Dr Chris Hovell from Dorchester gave a comprehensive overview of abnormal liver function tests. He described markers of liver cell damage, choleostasis and synthetic (or “true”) liver function as well as considering their true value to clinicians. The second half of his presentation was dedicated to the hot topic of non-alcoholic fatty liver disease from its causes through diagnosis to treatment of the condition. Dr Neil Guha from Southampton then gave a talk on non-invasive markers of liver fibrosis and their potential to reduce the use of invasive biopsy procedures in the assessment of fibrosis. He outlined fibrosis in terms of the anatomy and histology and highlighted the marker of collagen turnover, PIIINP, in patients receiving methotrexate illustrating a high sensitivity of PIIINP in excluding fibrosis. Examples were also given of useful imaging techniques such as fibroscan and microbubble ultrasound and how they can improve diagnosis. He shared the generating hypothesis of metabolomics (study of metabolism) and the potential of the metabolic response being “finger printed” using serum and urine, by the use of mass spectrometry and nuclear magnetic resonance.
BSG Guidelines Update After a short break for tea and the trade exhibition Dr Paul Thomas Consultant Gastroenterologist (Taunton and Somerset Hospital) expanded the topic of Sue Birds' audit poster by giving the meeting an update of British Society of Gastroenterology Guidelines (2003) for the investigation of Chronic Diarrhoea. He outlined the uses of imaging as well as non-invasive faecal, urine and serum tests. This focused primarily on the initial assessment, investigations and the rationale for small bowel imaging endoscopy and concluded with a review of pancreatic and bile acid malabsorption.
Antibodies in GI Tract Disease The meeting ended with a presentation from Dr David Sinclair (Queen Alexandra Hospital, Portsmouth) on immunological testing in liver and gastrointestinal disease. David outlined liver and gut related antibodies, with examples of their uses. These were illustrated by the use of clinical cases with emphasis on the essential role of the laboratory and biochemist in aiding diagnosis. Dr Roy Fisher closed the meeting thanking all those involved in a very successful meeting. A special thank you, by way of a large bunch of flowers, was made to Sue Bird from Dorset County Hospital for all her hard work in organising the meeting. Thanks were also given to the sponsors Bayer Diagnostics and ScheBo Biotech UK Ltd.
Where individual presentations are available, please click on the highlighted underlined text. |
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