(held in NSW, Australia, July 1999)
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ENDOCRINOLOGY & RENAL WEEKEND CONFERENCE for the Mid North Coast Division of General Practice (NSW, Australia) held at Coffs Harbour (on the NSW north coast) on July 24th-25th 1999.
Approximately
fifty Addisonians, close relatives and friends, along with one hundred and
twenty Professors, General Practitioners and representatives of Drug
Companies who sponsored the Conference, gathered at the Opal Cove Resort
at Coff’s Harbour on Saturday 24 and Sunday 25 for what was to be an
interesting time for all. The invitation to attend came from the convenors
of the Conference, Dr Fatehali Ladhani and Moira Daniel.
The weekend consisted of a series of lectures on Endocrinology and Renal
topics, given by a number of distinguished Professors, as well as the
Annual General Meeting of the Australian Addison’s Association, ( A
report on this meeting is to be found elsewhere in this newsletter).
Conversations between Association members, Doctors and Drug Company
representatives held during meal and coffee breaks, also added to the
learning experience for all.
We would like to express our appreciation to our Executive Committee, Dr
Ladhani and Moira Daniel for organising the Conference, and for giving us
the opportunity to attend. All members agreed that it was an enjoyable and
informative weekend. We not only had the opportunity to get to know one
another a little better, but everyone who attended gained some new
knowledge about Addison’s Disease and associated Endocrinology topics.
Thank you again Moira and Dr Ladhani.
A synopsis of the lectures of interest follows. (Audio tapes of some of
these sessions are available. click here
for details).
Recent
Advances In The Diagnosis And Management Of Thyroid Disease
Presenter: Professor Creswell Eastman AM
Director, Institute of Clinical Pathology and Medical Research, Westmead
Hospital.
Senior Advisor to Ministry of Public Health in Beijing.
Professor Eastman spoke of Thyroid function testing and what the results
indicated. He encouraged doctors to test for Thyroid function, when
presented with a range of obscure symptoms to eliminate a thyroid
disorder. Thyroid tests are especially
indicated when
other risk factors are present. If test results are abnormal, treatment
should be the decision of a fully informed patient and the doctor.
He continued by discussing thyroxine therapy, how much to give, and some
factors that can impact on the absorption of thyroxine.
Hyperthyroidism, its causes and treatment were briefly covered. It seems
that treatment is influenced by factors such as the country in which an
individual lives, cultural influences, prejudices and other social
aspects. Once again, Professor Eastman said that the doctor and the
patient who has been fully informed of the choices available, should
decide treatment.
The second half of his address centred on the recent visit to Tibet, of a
team led by him in his role as Senior Advisor to the Ministry of Public
Health in Beijing. His sincerity towards, and concern for the people of
Tibet was evident. He spoke of harsh environments, a forgotten country and
a forgotten people. While we watched a fascinating selection of slides
showing the physical effects of thyroid disorders caused by iodine
deficiency, he also spoke of mental deficiencies. Most of those present
became convinced that any salt we use should be iodised. He stressed the
difficulty in formulating a plan of attack for this almost overwhelming
problem, because of the influence of cultural, economical and social
factors.
Addison’s
Disease and Endocrine Auto-Immune Disorders
Presenter: Professor Robert Clancy
Professor of Pathology at the University of Newcastle since 1978
Director of Hunter Immunology Unit
Director of Vasse Research Institute.
Professor Clancy began by giving us a definition of auto-immunity, i.e. a
state that occurs when the body’s defence system is directed against
self-tissue. He added that genes heavily influence Auto-immune diseases
and that there is frequently a family history of Auto-immune disorders.
Although treatment for Auto-immune disorders has remained the same for 35
years, he assured us that we are using our medicines better. He also
stated that Science is getting closer to being able to predict the chances
of an individual developing Auto-immune Diseases using genetic markers.
Prevention of disorders in high-risk individuals is being looked at in
studies around the world, but science is still a long way from answers in
humans.
He continued by giving some information on organ specific Auto-immune
disorders, in particular Thyroid Diseases, Premature Ovarian Failure, and
Addison’s Disease. He told us that Addison’s is not easy to diagnose
because of the many non-specific symptoms, but he strongly advised the
General Practitioners present to look for it. He added that lifelong
management of Addison’s is important, and that bone density scans should
be carried out. Weight and blood pressure should also be monitored.
Management of
Addison’s Disease
Presenter: Professor Creswell Eastman
Director, Institute of Clinical Pathology and Medical Research, Westmead
Hospital
Senior Adviser to Ministry of Health in Beijing.
The Addisonians who had heard Professor Eastman lecture on this topic at a
previous conference in Wentworth Falls were not disappointed. He told us
what he knew about Addison’s Disease including: a definition, causes,
associated auto-immune disorders, as well as treatment and drug therapy.
He encouraged us to become informed about the disease and to become
actively involved in partnership with our doctors, in the management of
the disease. He stressed the importance of wearing a medical alert
identification, knowing how, and when to give an injection if necessary,
and carrying a medical history.
His ability to present information to the combined audience of doctors and
Addisonians was appreciated by all. It is difficult to do justice to his
words in this synopsis, so I would encourage those who were unable to
attend to arrange with the Association to obtain a copy of the handouts of
his talk.
Renal
Hypertension
Presenter: Professor Shane Carney
Associate Professor of Medicine, University of Newcastle.
Professor Carney began by saying that, not a lot is known about the exact
causes of hypertension although there are some theories. Treatment for
Hypertension can be anything that lowers blood pressure.
He challenged all doctors present, by saying that blood pressure is
generally not treated well in the community. He believes there is a need
to control blood pressure more effectively in the elderly, and in other
difficult-to-treat sectors of the population, e.g. diabetics. Although the
treatment of blood pressure is a complex issue, sometimes made more
difficult by the patient’s noncompliance in taking medication for a
variety of reasons, doctors need to be more diligent about its treatment.
He continued by discussing blood pressure targets, which can be influenced
by a variety of factors. He spoke about different types of medication
stressing that the most important thing was to get the blood pressure
down.
Disorders
Of Serum Minerals
Presenter: Professor Michael Hooper
Clinical Professor in Medicine, University of Sydney.
President-elect of the Australian and New Zealand Bone and Mineral
Society.
(Unfortunately, only part of this lecture was recorded and the quality of
the tape makes it a little difficult to understand. As I didn’t attend
this lecture I have made an attempt to present a synopsis, as I believe a
number of our members will be interested.)
Professor Hooper mentioned several different types of Densitometers, or
Bone Density Scans and what they measure. The level of two different
scores, (I think I heard T score and Z score) determines a diagnosis of
Osteoporosis (an imbalance between absorption and formation of bone), and
necessary treatment. He looked at a number of different patient profiles
discussing matters, such as underlying causes of fractures and high-risk
patients. There is a wide variety of treatments available, including
Hormone Replacement Therapy, and the use of anabolic steroids. He spoke of
the need to prevent bone density loss in post-menopausal women and men. He
concluded by stressing the importance of monitoring patients, who need to
be informed of the range of treatments, the wide variety of medications
available, sensible exercise and the need to avoid activities which can
cause fractures.
