Lyon Report of Conference 2009
The AFMS / AFMB have just completed their 26th meeting in Lyon.
Delegates enjoyed a superb social and scientific programme.
Thursday 24th September ; Mornex opened the meeting with a fascinating study of bronchioalveolar cancer in humans and the possible relationship with other tumour types in animals. The aetiology of this rare lung cancer is not clear; it is not related to smoking but perhaps to exposure to sheep and goats who themselves are pre- disposed to certain types of viral-induced tumours of the respiratory tract.
Dr. Belinda Johnston followed this up with a presentation on screening for large bowel cancer in England; she highlighted the pro-fessional hurdles that are required to be met in order to become a screening centre. We learnt that 25% of endoscopists “fail” their endoscopy assessments and have to re-sit!…probably a good and reassuring statistic on balance….initial results are encouraging and a lively debate followed.
Prof. Laurent Guyot delivered a tour de force on nasal re-construction across the ages. The origin of nasal surgery was in India and their practice forms the basis of modern techniques, which of course, even includes facial transplants in some cases. French surgery took off in WW1 whereas in the UK it was in WW2.The second morning session was started by the Medical Director of Fondation Merieux which has played, and continues to play, a pivotal role in the development of vaccines and prevention of infectious diseases in the developing world. This famiy-led foundation is led now by Alain Merieux and recent developments include new offices and research centres in China. Laos, Haiti and Cambodia in co-operation with WHO and CDC in the USA.
Mr Didier Carnet appraised us of the motives of French doctors working in the UK. There were many reasons for emigration to the UK, and some were “head hunted” by the NHS after Tony Blair’s initiative to grow the NHS to the average level in the EU.
Acupuncture in General Practice was the title of Sean Bennett’s talk. He explained the differences between Western and Traditional Chinese approaches and where this complementary therapy may have a role in patient management.
Before lunch, Dr Alain Jean spoke of the effectiveness (or not) of M. Chirac during his term as President…mais il était une blague, il parle d’un autre! Dr Chirac was a famous French doctor of the late 17th and early 18th centuries who came to attention during the war of succession as he helped treat many maladies in the French army; he later became keeper and manager of the King’s Gardens and joined together the specialities of chemistry, botany and pharmacy – as well as surgery and anatomy. He was appointed as personal physician to Louis XV at the age of 80. Friday 25th September ;
The second day kicked off with a fascinating overview of the ethical, surgical and practical issues around disorders of sexual development given by Prof. Pierre Mouriquand from Lyon. The role of the MDT is vital involving sensitive management of all the issues surrounding personal, social and behavioural sex orientation. There is a slight disagreement between Europe and USA .
Prof. Peter Smith described “Edwards Sapiens” and “Corevalves”; both new transcutaneous aortic valve replacements. The use of these technologies enables high risk patients to be operated upon, such as those with chronic renal disease and other co-morbidities. It was pointed out that, statistically, probably 2 members of the conference attendees will be future beneficiaries!
After this the James Tudor competition took place (see report below). After the James Tudor competition Clarie Vaudreuil, final year medical student from Paris, who spent an elective in London, continued the student theme and gave an excellent talk on the life of British Medical students from the viewpoint of a French student. Saturday 26th September; Prof. Vincent des Portes (Lyon) discussed Fragile XSyndrome which is responsible for a significant amount of mental handicap; it would appear that the transmission is not strictly Mendellian, but there is a pre-mutation which is activated in females who subsequently transmit an active mutation to their children. Whereas one would expect only male children to be affected it is possible for some females (the carriers) to suffer due to inappropriate activation of the abnormal X chromosome in the majority of their cells. Moreover, the grandfathers with the pre-mutation often suffer from a severe form of Parkinsonism in late life. Like most rare syndromes, it can only be diagnosed after being considered in the differential diagnosis. There are, luckily, several possible therapeutic avenues that are being explored.
Dr Hervé Testard let us know of his experiences in Paediatrics in the UK and compared the two countries’ systems.The main challenges would appear to be financial, both in terms of recruitment and service provision. Despite this both France and the UK would appear to have good functioning systems. Dr Nicola Strickland examined the uses of CT and MRI. CT remains very useful for bone and lung imaging whereas MRI is better for soft tissue and highlighting invasion of cancers, as well of course for cartilage in knees.
Penny Fraser explained that Switzerland is not only chocolate and cuckoo clocks! There is a new Anglo-Swiss Medical Society any AFMS members who may wish to join this group as well are directed to www.angloswissmedical.com
The Gala Dinner presentation was by Professor Mornex, former Doyen of the medical School in Lyon, now retired from the practice of endocrinology, but remaining very active. His account of the history of Medicine in Lyon was enlightening. A family connection was revealed in that our conference had been opened by our first lecturer, his son, now a professor in Lyon.
The Conference Dinner took place in Le Grand Réfectoire, in the Hôtel-Dieu (original hospital in Lyon, still a working hospital to-day). Once again we were treated to a sumptuous location for the conference dinner, with a 17th century hall as the venue. The James Tudor prize was presented to the winners by the AFMS president Andrew Hassan and the AFMB President Michel Dubuisson. After dinner, the meeting also had the great pleasure to welcome the son of Jacques Foray, founding president of the AFMB, who presented the first ever Prix Jacques Foray to Claire Vaudreuil, and Roger Celestin then paid tribute to his old friend Jacques. And Finally we all enjoyed being serenaded by Rex Melville in his inimitable style! Overall it was felt by all that the conference was a great success especially as there were several new younger delegates and some returning after a few years. One delegate entertained us(and put some us in touch with our maternal and paternal sides) with a beautiful, and well behaved, little baby girl. The social and accompagnantes’ programmes were very well received, although made a little more difficult by a transport strike. The hotels were comfortable and the food and wine plentiful! The post conference trip to the mediaeval village of Oingt and the vineyard in such good weather, was definitely one of the highlights. If you wish to see over 200 photographs from the conference email firstname.lastname@example.org. A blank email with subject “AFMS Lyon” will guarantee you a personalised invitation from Jo Girgis to view his pictures on the Kodak gallery website. You can see even more photos from our French colleagues
The James Tudor Prize
Alice Brunker (Manchester: Obstetrics & Gynaecology in Nantes) discussed a case of Twin Transfusion Syndrome and its treatment and risks of that treatment.
Abigail Frank (now FY1 trainee Wrexham, Pays de Galles graduate from Cardiff): Robotic Surgery, Geneva) presented the pros and cons of robot-assisted surgery. Despite the cost Swiss Insurance companies are now recommending robot-assisted prostatic surgery because of such good results.
Lona Jawaheer (Manchester , Plastic Surgery, Brussels) presented a detailed case of abdomino-plasty and one of ear-lobe reconstruction using Zplasty. David-Ian McGregor (French student studying in London) gave an over-view of medical education in the UK highlighting differing approaches between traditional universities and newer establishments. The Working Time Directive of course gives us all many problems; particularly in surgery. Delegates voted on all the presentation: as last year the voting was extremely close and final results were:
1st Prize, Lona Jawaheer; 2 nd Prize, David Ian McGregor and 3rd Prize, Abigail Frank. However, as the results of voting were so close and the delegates so impressed by the standard of the presentations that it was subsequently decided by the French arm of the meeting to award a one-off prize to Alice Brunker.