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Full NameProfessor Christopher Thompson
Organisation:Royal College of Surgeons in Ireland
- physiology and non-communicable disease
- neuroscience and mental health
- Emergency Medicine
- Sports and Exercise Medicine
1. Salt and water physiology. Epidemiology and mortality associated with hyponatraemia, including differential mortality according to aetiology, contribution of hypoadrenalism to hyponatraemia, effects of treatment modalities on hyponatremia.
Current fellows Dr M Cuesta; Hyponatreamia and mortality MD candidate,
Dr A Garrahy; Effects of treatment on hyponatraemia MD candidate.
2. Setting up a National Pituitary Database. This has the active participation of 6 major centres in Ireland. Initial inputting has been confined to acromegaly (see below), isolated ACTH deficiency and TSH secreting pituitary adenomas.
3. Acromegaly. A national database has been constructed, which will be the basis for epidemiological, health care and outcomes research. In addition, a prospective study of the effects of discrepant elevation of IGF-1 concentrations on patients treated to GH targets has been commenced. Collaboration with St Barts Hospital, London, on genetic variants of acromegaly has been commenced and studies on the predictive value of tumour receptor subtypes on clinical responses to somatostatin analogues and dopamine agonists is ongoing.
Current fellow Dr AM Hannon Morbidity and mortality in acromegaly PhD candidate.
4. Predictive value of thirst, copeptin and AVP responses to water deprivation to distinguish central diabetes insipidus from primary polydipsia.
Candidate to commence in 2017 Dr Zhia.
There are a number of key strategic areas which will be the thrust of our research programme:
1. Salt and water balance. The centre has an international reputation in this field and is considered a key opinion leader; I was senior author in the US guidelines for management of Hyponatraemia (Verbalis et al Am J Med 2013) and have served as President of the European Hyponatraemia Network.
Future studies planned:
- Development of gait assessment and symptoms scores with which to track response to treatment of hyponatraemia.
- Comparison of different modalities of treatment of acute hyponatraemia. This is a life threatening (mortality 50%), common condition. New guidelines suggest a shift from infusion of saline to bolus injection of hypertonic saline to rapidly elevate plasma sodium in order to reduce intracranial pressure. This has not been subjected to prospective evaluation, though retrospective data from our own centre (in press) suggests the new guidelines are safe, and cause more rapid return of GCS to normal. This project has the potential to alter management of severe hyponatraemia.
2. Traumatic brain injury (TBI) and hypopituitarism. The unit is considered a world authority in the field, with several MDs awarded and multiple publications.
The main thrust in this area is studies into the rationalisation of the screening process for post-TBI hypopituitarism, to improve the practicality for clinicians rather than research centres.
3. Development of the National pituitary data base; this is expected to generate sufficient data for MD theses in:
- craniopharyngioma – mortality and hypothalamic morbidity. One thesis already awarded through the unit in this field;
- Non functioning pituitary tumours – active collaboration in place with QE2 hospital in Birmingham, England;