UL academic’s discovery could prompt new area of medical science

An Irish professor has turned more than a century of anatomy on its head by identifying a new organ in our guts.

Prof J Calvin Coffey identified an emerging area of science, having reclassified the mesentery as a single organ.

The remarkable discovery by J Calvin Coffey, professor of surgery at University of Limerick’s Graduate Entry Medical School, has already resulted in the rewriting of medical text books and the possible creation of a new area of medical science.

Prof Coffey’s research has led to the re-classification of the mesentery — a key part of the digestive system which connects the intestine to the abdomen — as an organ.

For well over a century, scientists and medics believed it was a fragmented, complex structure made up of several separate parts.

However, Prof Coffey found that it is actually one continuous structure — by definition, an organ.

He has outlined his findings in the November issue of one of the world’s top medical journals, The Lancet — Gastroenterology and Hepatology.

“In the paper, which has been peer-reviewed and assessed, we are now saying we have an organ in the body which hasn’t been acknowledged as such to date,” said Prof Coffey.

“The anatomic description that had been laid down over 100 years of anatomy was incorrect.

‘This organ is far from fragmented and complex. It is simply one continuous structure.”

Prof Coffey, who is from Cork, said a better understanding and further study of the mesentery could lead to less invasive surgeries, fewer complications, faster patient recovery, and lower overall costs.

He also said mesenteric science is its own specific field of medical study in the same way as gastroenterology or neurology.

“Up to now, there was no such field as mesenteric science,” he said.

“Now, we have established anatomy and the structure.

“The next step is the function. If you understand the function you can identify abnormal function, and then you have disease.

“Put them all together and you have the field of mesenteric science, the basis for a whole new area of science.”

His research has seen one of the world’s best-known medical textbooks, Gray’s Anatomy, being updated, with medical students now learning about the mesentery as a continuous organ.

UL GEMS And UHL Research Wins At Irish Society Of Clinical Microbiologists

Dr Ciara O’Connor, MD candidate at University of Limerick’s  Graduate Entry Medical School, has been awarded the Irish Society of Clinical Microbiologists prize for best Oral Presentation at a meeting held in Dublin on 27th Feb 2016.

Dr O’Connor, who is supervised by Prof Colum Dunne (GEMS Director of Research) and Dr Nuala O’Connell (Consultant Microbiologist and Adjunct Clinical Senior Lecturer at GEMS), presented two studies focused on the clinical challenges posed by multidrug-resistant bacteria: “A report of the first outbreak of New Delhi metallo-beta-lactamase (NDM) – 1 carbapenemase producing Enterobacteriaceae in Ireland” and “Irrepressible carbapenemase-producing Enterobacteriaceae in the Mid-West of Ireland? A retrospective epidemiological and microbiological review of 140 isolates from 2009 to 2015”.

Dr O’Connor has also recently published a report describing the incidence of a multidrug-resistant bacterial outbreak and its successful management, with a focus on patient outcomes.

This can be found here: http://www.journalofhospitalinfection.com/article/S0195-6701(15)00031-6/abstract and

The Photograph shows (left to right): Prof HGM Niesters, UMC Groingen Holland, Dr Ciara O’Connor (GEMS and University Hospital Limerick) and Dr Susan Knowles, President of the Irish Society of Medical Microbiologists.

UL GEMS signs MOU with leading US Medical School

(L-R) Professor Javier Escobar, Associate Dean for Global Health (Rutgers), Emmeline Searson GEMS International, Professor Paul McCutcheon UL Vice President, Eugene Griffin, Limerick City & County Council, Professor Vicente Gracias, Medical School Dean (Rutgers),Christy O’Connor, Limerick City & County Council, Professor Michael Larvin Head of the GEMS and Sharon Nolan GEMS
(L-R) Professor Javier Escobar, Associate Dean for Global Health (Rutgers), Emmeline Searson GEMS International, Professor Paul McCutcheon UL Vice President, Eugene Griffin, Limerick City & County Council, Professor Vicente Gracias, Medical School Dean (Rutgers),Christy O’Connor, Limerick City & County Council, Professor Michael Larvin Head of the GEMS and Sharon Nolan GEMS

The University of Limerick has signed a Memorandum of Understanding between its Graduate Entry Medical School (GEMS) and one of North America’s leading comprehensive medical schools, the Robert Wood Johnson Medical School, located in New Brunswick, New Jersey and part of Rutgers, The State University of New Jersey.  The agreement will facilitate the exchange of undergraduate and postgraduate students studying Medicine between both institutions. It will open up opportunities for UL medical students to study overseas as part of their programme at GEMS.  It is also hoped to develop research collaboration.

There is an added dimension to this new agreement as Limerick and New Brunswick are sister cities, linked by direct flights daily between Newark and Shannon airports. This agreement is particularly important for the city of Limerick as it builds on relationships initiated through Limerick City and County Council and the City of New Brunswick. Key in the development of the emerging relationship were Eugene Griffin at Limerick City & County Council, and Professor Bill Shannon, UL GEMS Director of International Liaison.

The agreement was signed on behalf of UL by Professor Paul McCutcheon, Vice-President Academic & Registrar,  he commented:  “The University is moving forward later this year with its new five year Strategic Plan, ‘Broadening Horizons’, one of the aims of which is to further strengthen the institution’s international profile.  This MOU presents exciting opportunities for co-operation, not only of benefit to both medical schools, but also for wider collaboration between our Universities.”

The MOU was signed during an official visit to UL by leading faculty at Robert Wood Johnson Medical School, including Professor Javier Escobar, Associate Dean for Global Health and Professor Vicente Gracias, Medical School Dean and Chief Executive for the Robert Wood Johnson Hospital group.  Commenting on this new agreement, Professor Michael Larvin, Head of the GEMS, said, ‘We are delighted to have concluded this new agreement with Robert Wood Johnson Medical School and Rutgers University.  We are all looking forward to developing the relationship between both institutions, and to realising the significant opportunities this offers both our students and research staff.’

Robert Wood Johnson Medical School encompasses 20 basic science and clinical departments, hosts centres and institutes including The Cardiovascular Institute, the Child Health Institute of New Jersey, the Center for Advanced Biotechnology and Medicine, the Environmental and Occupational Health Sciences Institute, and the Stem Cell Institute of New Jersey. The medical school maintains educational programs at the undergraduate, graduate and postgraduate levels on its campuses in New Brunswick and Piscataway and provides continuing education courses for health care professionals and community education programs. In addition, Robert Wood Johnson Medical School has 34 other hospital affiliates and ambulatory care sites throughout the region.

UL Celebrates Conferring of 156 Students of Medicine & Clinical Therapies

Special Distinction Awards recipients (left to right), Jennifer Johnson, First Prize in the Discipline of Obstetrics and Gynaecology, Aine Fox, Swords Co. Dublin, First Prize in the Discipline of Paediatrics, Carla Henderson, Canada, First Prize in the Discipline of General Practice/Primary Care, Deirdre Smith, Kilbride Co. Meath, First Prize in the Discipline of Psychiatry, Emma Tierney, Ennis Co. Clare, First Prize in the Discipline of Medicine and winner of overall student prize, and James Dalrymple, Curragha Co. Meath, First Prize in the Discipline of Surgery.
Special Distinction Awards recipients (left to right), Jennifer Johnson, First Prize in the Discipline of Obstetrics and Gynaecology, Aine Fox, Swords Co. Dublin, First Prize in the Discipline of Paediatrics, Carla Henderson, Canada, First Prize in the Discipline of General Practice/Primary Care, Deirdre Smith, Kilbride Co. Meath, First Prize in the Discipline of Psychiatry, Emma Tierney, Ennis Co. Clare, First Prize in the Discipline of Medicine and winner of overall student prize, and James Dalrymple, Curragha Co. Meath, First Prize in the Discipline of Surgery.

The University of Limerick celebrated the graduation of 156 students today from the Graduate Entry Medical School (GEMS) and Clinical Therapies Department. Among the graduates 106 doctors were conferred with their medical degrees as they became the 5th graduating class of the Graduate Entry Medical School at the University of Limerick. 50 Clinical Therapies graduands received their awards – 24 from the MSc in Occupational Therapy and 26 from the BSc in Physiotherapy, the 10th graduating class of the Physiotherapy programme at UL

Established in 2007, the Graduate Entry Medical School Programme at UL is open to graduates from any discipline and employs practical and interactive approaches to learning.
Among the doctors who graduated at UL today are students with undergraduate degrees varying from zoology, business, law, languages and sociology. The programme is also the only medical education programme in the country founded on the modern pedagogical principles of Problem Based Learning (PBL).  PBL encourages team-working and self-directed enquiry, both skills being vital for their future careers in the fast moving world of medicine.

 

 

Speaking at the conferring ceremony Professor Don Barry, UL President, paid tribute to the Health Service Executive, “I’d like to acknowledge the support of the healthcare community – the many practices, clinics and hospitals, their consultants, doctors, nurses, therapists, managers and all of the healthcare professionals who gave so willingly of their time to engage our students and allow them their first glimpses into their future careers.  I would like to pay particular tribute to the Health Service Executive and to express my appreciation for the support that we have received from its staff at local, regional and national levels.  We are looking forward to the opening next September of the Clinical Education and Research building, a shared facility to be located on the University Hospital Limerick campus which will enhance the delivery of our healthcare programmes but also support the post-graduate education services required by the University Hospital Limerick community.
The four-year Bachelor of Science in Physiotherapy is the only academic physiotherapy programme in Ireland outside of Dublin. The programme is accredited by the Irish Society of Chartered Physiotherapists and this year celebrates the 10th year of Physiotherapy Graduates.   The Masters of Science in Occupational Therapy is the only graduate-entry Occupational Therapy course in the country and is accredited by both the Association of Occupational Therapists of Ireland and by CORU, Ireland’s multi-professional health regulator.

“Today 50 graduates from Clinical Therapies will cross the stage to receive their degrees. These qualifications represent many years of study, thousands of hours in work placements and grueling assessments.  26 students have completed the four-year Bachelor of Science in Physiotherapy – the only physiotherapy academic programme in Ireland situated outside of Dublin. 24 students have also graduated from the Masters of Science in Occupational Therapy, the only graduate entry Occupational Therapy course in the country.  Increasingly, health systems are trying to address health needs in the community and primary care settings to reduce the need for costly hospital-based services. Building on this trend, our Masters course is unique as it assists modern healthcare practitioners to evaluate their practice and extend, or refocus, their skills and knowledge to meet the new challenges of healthcare provision,” said Professor Don Barry.

UL researchers find simple blood iron test predicts fatal outcomes in the general population

Members of the Kidney Health Research Consortium at the Graduate Entry Medical School and University Hospital Limerick. (left to right) Dr Ells Gillis, Darya Yermak, Dr Mohamed Elsayed, Dr Liam Casserly, Professor Austin Stack, Professor Ailish Hannigan, Dr John Ferguson, Dr Hatim Yagoub, Dr Waleed Mohamed.
Members of the Kidney Health Research Consortium at the Graduate Entry Medical School and University Hospital Limerick. (left to right) Dr Ells Gillis, Darya Yermak, Dr Mohamed Elsayed, Dr Liam Casserly, Professor Austin Stack, Professor Ailish Hannigan, Dr John Ferguson, Dr Hatim Yagoub, Dr Waleed Mohamed.

 

Study finds extreme levels of Transferrin Saturation Ratio reflecting blood iron levels linked to increased risk of death.

A new study led by researchers at the Graduate Entry Medical School (GEMS), University of Limerick (UL) has found that people with low levels and very high levels of a commonly measured laboratory test, the “transferrin saturation ratio” are at an increased risk of death. The test is a measure of the amount of available iron in the bloodstream with low levels generally reflecting a state of iron deficiency and high levels suggesting a relative excess.

The study found that subjects with extremely low transferrin saturation levels (less that 17.5%) were at a 45% higher risk of death. On the other hand, the risk of death was also significantly higher for subjects with very high levels of transferrin saturation above 31.3 %. According to primary author, Professor Austin Stack, Foundation Chair of Medicine at University of Limerick Graduate Entry Medical School, and Consultant Nephrologist at University Hospital Limerick, “the transferrin saturation ratio” is a commonly used blood test to assess the amount of iron in a patient. Low levels of transferrin saturation ratio generally indicate iron deficiency, while high levels;-traditionally > 50% indicate an excess of iron, which can be detrimental to health. High levels usually occur in states of iron overload like haemochromatosis, multiple blood transfusions and cirrhosis. There is some uncertainly as to what the optimal levels of transferrin saturation ratio are to maintain normal health, and while some studies to date have shown that low levels are associated with elevated death risk, others have suggested the contrary.”

In this study of 15, 823 adults from the Third National Health and Nutrition Examination Survey (NHANES III) conducted from 1988 to 1994 in the US and with follow-up 2006, the research team sought to examine in detail the risks associated with transferrin saturation ratio and determine the optimal levels that were associated with best survival. “In this very large population-based study, we found that individuals at both ends of the spectrum-people with very high and very low levels were at increased risk of death” said Professor Stack. This pattern of association was what we call a j-shaped relationship. We found that adults with the lowest levels of transferrin saturation ratio (< 17.5 %) had higher percentage of anaemia and several other chronic conditions like heart disease, diabetes, and poor socioeconomic status, indicators that might have accounted for the higher rates of death. Yet, when we accounted for these factors in our analysis, low levels continued to predict higher death risk.”

“What was even more surprising, was that adults who had high transferrin saturation ratio > 31% also experienced higher rates of death, a relationship that was not accounted for by levels of inflammation or other medical conditions.” “When we looked at the relationship between transferrin saturation and deaths from cardiovascular disease, the results were even more striking. A low transferrin saturation ratio less than 17.5 % increased the risk of cardiovascular death by over 200% while a higher TSAT level above 31% increased the risk by almost 60%” said Dr John Ferguson PhD, biostatistician and senior author of the study. “We believe that these results have important practical implications for the wider medical community” said Professor Stack. Our analysis suggests that the optimal transferrin saturation range for patient survival should be between 23% to 40% and that careful clinical assessment is warranted for patients with low and high levels in order to identify states of iron deficiency or iron excess. Our study demonstrates that transferrin saturation ratio is a useful prognostic tool in assessing a patient’s health and while we support the correction of low transferrin saturation levels in the general population, we would also advise caution against excessive iron loading to levels beyond 40%.

 

The study ‘Transferrin Saturation Ratio and Risk of Total and Cardiovascular Mortality in the General Population’ is published by Quarterly Journal of Medicine (QJM): An International Journal of Medicine and authored by ¹²³Austin G. Stack MD MSc, ²Arif I. Mutwali MBBS, ¹³Hoang T. Nguyen PhD, ¹³Cornelius J. Cronin MBBCh, ¹³Liam F. Casserly MBBCh MSc, John Ferguson PhD

The Graduate Entry Medical School is leading a number of national and international projects to evaluate the health status and clinical outcomes for patients with chronic disease in order to improve patient outcomes. The study was performed at the Graduate Entry Medical School in collaboration with the Departments of Nephrology and Internal Medicine, University Hospital Limerick.