Endocrinology & Renal Conference

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.