Junior Members Forum, Thursday 22 November 2007

Junior Members Forum, Thursday 22 November 2007 Ulster Medical Society rooms, Whitla Medical Building, Belfast PROGRAMME Of the submissions, the following 5 were shortlisted for platform presentations: 1. Chronic Kidney Disease associated with mortality in Northern Ireland Dr M Quinn 2. Metformin, Chronic Kidney Disease and Lactic Acidosis: Is metformin absolutely contraindicated? Dr MC McCloskey 3. Folic Acid use and major congenital malformations in offspring of women with epilepsy. A prospective study from The UK Epilepsy and Pregnancy Register Dr SJ Hunt 4. Indications for Revision Total Hip Replacement in Northern Ireland Dr Ciara Stevenson 5. Randomised Controlled Trial to assess the vascular and biochemical effects of Cilostazol in patients with peripheral arterial disease Mr M O’Donnell The following 16 were shortlisted for poster presentations: 1. Transient Cardiomyopathy as presenting feature of Acute Disseminated Encephalomyelitis Dr E Mawhinney 2. Posterior Leucoencephalopathy Syndrome in a post-partum patient Dr KM McKnight 3. An audit of intravenous immunoglobulin use in the NI Neurology Department Dr E Devenney 4. Usefulness of a District General Neurologist in the diagnosis of nonorganic illness Dr A Fitzpatrick 5. Octreotide scanning in the detection of metastatic renal cell carcinoma Dr MC McCloskey 6. Carbon Monoxide Poisoning Dr A Hammond 7. Radical Trachelectomy: a case series Dr N Ratnavelu 8. Are alcohol related acute surgical admission rates falling? Dr GJ Fitzmaurice 9. Improving outcomes in squint surgery Dr MK O’Gallagher 10. Management of hypoglycaemia in Intensive Care: a prospective audit Dr Lloyd Turbitt 11. The two-week rule help or hindrance? Dr RS McCain 12. The documentation, interpretation and management of abnormal fetal heart rates in labour Dr M McCauley 13. Indolent thyroid metastasis from renal cell carcinoma presenting after a remarkable 24 year latency following nephrectomy Dr G McLean 14. Accuracy and role of ultrasonography in assessing shoulder pathology Dr KW Chan 15. Analgesia and function following subacromial decompression Dr J Campbell 16. The effect of modernising medical careers on junior medical doctor personality, anxiety and career choice Mr M O’Donnell The winner of the platform, poster and the remaining platform abstracts are published below: PLATFORM PRESENTATION WINNER: ChRONIC kIdNEy dISEASE ASSOCIATEd WITh MORTALITy IN NORThERN IRELANd M Quinn, C Cardwell, G Savage, AP Maxwell, F Kee, D Fogarty Departments of Nephrology, and Public Health and Epidemiology, The Queen’s University of Belfast Introduction: We investigated the association between chronic kidney disease (CKD) and mortality in Northern Ireland (NI). Methods: All creatinine results in NI between 1 Jan 2001 31 Dec 2002 were collected and linked to a patient database. Estimated glomerular filtration rates (eGFR) were calculated using the 4 variable modified diet in renal disease equation. The Registrar Generals office provided all cause and cardiovascular mortality follow up through to 31 Dec 2006. Results: 2,065,694 creatinine results from 585,566 patients were collected. 60,209 deaths occurred. Using eGFR as time varying covariate in a Cox survival model the following association between CKD and mortality was demonstrated. Adjusted† hazard ratios (CI 95%) for mortality eGFR > 60 ml/min/1.73m 45 59 ml/min/1.73m 30 44 ml/min/1.73m 15 29 ml/min/1.73m < 15 ml/min/1.73m All cause 1.00 (Ref) 1.01 (0.99-1.03) 1.45 (1.41-1.48) 2.19 (2.11-2.27) 3.45 (3.23-3.68) Cardiovascular 1.00 (Ref) 0.98 (0.92-1.02) 1.43 (1.38-1.45) 2.26 (2.13-2.40) 4.35 (3.93-4.80) †Adjusted for Age and Sex Conclusions: This study demonstrates a graded association between CKD and mortality in the tested NI population. Having previously calculated the prevalence of CKD (eGFR < 60 ml/min/1.73m) in NI as 3.69%; this work indicates the clinical and public health importance of CKD. REFERENCE: 1. Quinn, MP, Rainey A, Cairns KJ et al. The practical implications of using standardized estimation equations in calculating the prevalence of chronic kidney disease. Nephrol Dialysis Transplantation 2008;23(2):542-548.