Facts and Figures

I’m never satisfied until I’ve got some figures to back things up. Well, that’s not really true; I know my football team is the best in the world, even though I may have to stretch my confidence limits a little, but that’s something I’d rather not go into too deeply. So what are the stats on ICE/ECE 2012?

We are looking at a total of around 5500 attendees. I say “around”, because of course the figure continues to change, as people arrive perhaps for only a day or even an individual session. But whichever way you look at it, the 15^th ICE and 14^th ECE have certainly attracted a huge amount of delegates from all corners of the globe, so I think that both the ISE and the ESE can afford to pat themselves on the backs on this.

The delegates come really from just about everywhere. The biggest group of course come from Italy. There were 512 Italian pre-registrants, with Spain (323), South America (308) in the silver and bronze positions respectively (sorry, I’m just getting ready for the Olympics). Following those, we had the UK in the familiar Olympic role of being just outside the medal positions in 4^th (with 242 delegates), Turkey with 231, the USA with 209, and France with 206. Despite the well-publicised financial problems in Greece, they are to be congratulated on sending 178 delegates, just ahead of Germany on 170.

But there are also some interesting trends. For example, we had 180 delegates from the Middle East, which is an area of great importance to both societies. Next year’s ECE hosts, Denmark, sent 60 delegates, which shows the strength of endocrinology in a country with a population of 5.7 million. But on a per-capita basis, it may be that the Estonians (30 delegates for 1.3million population) or the Swiss (with 129 delegates for a population of 8 million) should take the overall prizes.

Thoughts from around the Congress

The ICE/ECE 2012 is a really great opportunity to get some conversation going about endocrinology, so we went around the venue to ask delegates their thoughts on the Congress:

“The highlights of the Congress have been the strength of the programme, which is possibly the best I’ve seen, and the truly international reach. The fact that there are people of so many different nationalities here has made it a huge success.”

Professor Paul Stewart (UK), ISE General Secretary

“As a clinician scientist I really like the varied sessions running in parallel – I work in thyroid autoimmunity and breast cancer and the Congress programme allows me to get lots of useful information on many different aspects of these.”

Dr Ilaria Muller (Italy) – Dr Muller received an ESE Basic Science Meeting grant to attend ICE/ECE 2012.

“The opportunity to interact with people from all over the world is what makes this so great – there is nothing like face-to-face contact.”

Professor Christian Strasburger (Germany)

"This has been a great success. Florence is a wonderful place to hold a congress – I had wanted this for some years, and it is so good to see it come to fruition.  The organising committee really deserve congratulations, and as an Italian I’m so pleased that Gianni Forti has been able to host the congress."

Professor Ezio Ghigo (Italy)

 “This is a wonderful Congress – I am particularly enjoying the bone sessions. And of course Florence is a wonderful place to be.”

Professor John Wass (UK)

“This is a big meeting but the facilities are very good, the food is better than I expected and it’s nice to be able to walk to your hotel. The city is obviously very interesting, with lots of art, so by coming here I’m getting more than science.”

Dr Gunnar Valtysson (Iceland)

“This is one of the best Congresses of Endocrinology, and I have been to a few. Lots of interesting lectures and symposia, especially the Meet the Expert Sessions. I have lots of information to take home. Thank you to the organisers.”

Ms Elena Shelestova (Georgia)

There’s lots more conversation going on via the ESE twitter feed (hashtag #iceece12), ESE facebook page and the networking tool on the ICE/ECE 2012 Congress app (access via your smartphone), and of course feel free to post your comment below.

On the ICE/ECE 2012 Congress Concert

It may come as a surprise to some attending the ICE/ECE 2012 Congress, but Florence has had a thriving cultural scene for the last, oh I’d say, 800 years. Last night’s Congress Concert brought us right to the heart of the renaissance, in Brunelleschi’s Basilica di San Lorenzo. Completed in 1459, the Basilica is rightly considered one of the masterpieces of renaissance architecture. Of course, it’s most famous for Michelangelo’s Medici tombs, in adjacent Cappelle Medicee, but last night’s concert took place in the main nave of the Basilica.

The Giuseppe Verdi Choir, under the direction of Enzo Consogno, gave a fine performance of a variety of choral pieces ranging from Handel to Mascagni. From where I was sitting, around halfway back, the acoustics tended to muddy the performances a little, so to me the pieces which worked best were the more distinctively choral (rather than for example where the chorus was supporting the tenor or soprano voices, or the excellent trumpeter). However, this shouldn’t detract from the overall performance, the choir was very good indeed: disciplined, coherent, and able to fill the Basilica with their voices. Italy is famous for its voices, and rightly so.

There were around 400 seats laid out for the ICE/ECE 2012 delegates, and indeed there were another 40 or so sitting on the various altar steps around the church, so it really was a full house, and the warm reception given at the end of the performance showed how much the audience valued the evening, in a setting which was quite breathtaking.

As we were heading out, ESE President Philippe Bouchard told us of attending a performance of the Mozart Requiem, two months ago, as part of another congress concert. He showed us some photos he took at that concert, and then by chance came across a photo he had taken of the famous Fra Angelico Annunciation (which is in San Marco). “It is one of the masterpieces of humanity”, he said. And as we headed out into the night, past Michaelangelo’s unfinished façade of San Lorenzo, it was difficult not to think “As is Florence itself”. We are lucky to be here.

Endocrinology & The Olympics

2012 is an Olympic year. I was in London last week where everyone was getting nervous about the preparations, and how visitors would cope with the entry regulations at London airport. The ICE/ECE 2012 marked the coming event with a session on Endocrinology and the Olympics. I caught only the last two talks, although reports of Dr Luigi Di Luigi’s presentation were very positive indeed.

Dr Arne Auchus discussed how the endocrine patient copes with subjecting their bodies to high performance sports. Endocrinology is such a varied field that it is impossible to go into detail on how individual athletes cope with their conditions, but as he pointed out, the fact that they can cope at all shows the great strides which have been made in clinical endocrinology. As he said, it would have been almost inconceivable 30 or 40 years ago to imagine someone with type 1 diabetes running a marathon.

Of course, there are some very high-profile sportspersons who have endocrine conditions and have reached the top of their field – in today’s world of sport perhaps Lionel Messi’s early problems with GHD are the best documents. The fact that he has become the best practitioner of the most popular sport in the world is a great tribute to him (and his endocrinologists, of course).

The World Anti-Doping Agency, WADA, regulates doping in sport. Although Lio Messi has been treated for growth hormone deficiency, he would benefit from WADA’s Therapeutic Use Exemption system, whereby a sportsman can be given permission to use a drug necessary to their general health. One of the great difficulties in this system of course is dosage, which is obviously important when one is taking an anabolic drug.

Dr Mario Thevis spoke about  some of the problems of testing, and reinforced a point made by Dr Auchus, that testing for testosterone doping is difficult because of genetic factors (testosterone seems to have been a theme in this year’s Congress). Dr Thevis illustrated some of the practical problems in drug testing with some entertaining examples of how human frailty can make the testing less effective. For example, the case in Germany of 8 identical urine samples, taken from different athletes at different times, and even from different cities. The common factor was identified as being a hard-working drug testing inspector who was too busy to test all the athletes, and so she provided her own urine.

Professor Ebo Nieschlag wound up the session in the course of a question from the floor. “We need to send a message to all endocrinologists – do not neglect the sportsmen and women”. He said that many endocrinologists  had stood aside during the development of the obesity epidemic, and we shouldn’t make the same mistake in sports. As he said, “We need to offer high quality endocrinology to help high quality sportspersons”.

For those interested in the subject, note Symposium 60, entitled 'Performance enhancing hormones in sports', is taking place at 15:15-16:45 on Tuesday 8 May in Hall H.

ESE meets Affiliated Societies

Sunday afternoon saw the annual meeting of the ESE President and the ESE Affiliated Society Presidents. This invitation-only get-together was instituted by ex-President Professor Eberhard Nieschlag, as a way of building bridges between the ESE and other European and affiliated societies – as Professor Philippe Bouchard, the current ESE President, said, it’s an “opportunity to catch up and build good relationships”.

Professor Bouchard introduced the meeting, saying that this was a forum which would allow societies to work together, share projects, and avoid duplication, something which is especially important at this time when funding and sponsorship is tighter than it had been in the past. He then opened the meeting to questions and a wide-ranging discussion, which included some direct questions to the ESE. Following a question on numbers from Professor Joerg Gromoll (Germany) the secretariat highlighted the increased number of purely basic scientists who have attended. Normally this runs at around 7 to 8% of delegates, but the Florence meeting has seen this figure rise to 12%.

There was some discussion of the various activities which the ESE can offer, including the new website, the 5 journals, the news reports, and so on. Professor Bouchard also described proposed e-learning initiatives with UEMS, and ESE plans to reach out to North Africa and Russia. There was also some discussion of next year’s elections, with 2 Executive Committee positions, and the post of Vice-President becoming available.

After the meeting, Marija Pfeifer of the Slovenian Endocrine Society told the ESE Press Office:

”It was a really good meeting. Philippe is very enthusiastic, and he has lots of ideas to increase collaboration between national and international Societies. He also realises the need to increase membership of the ESE, and so it is very important that endocrinologists throughout Europe know what it is that the ESE does: for example many members probably are not aware of the access to journals, or of the up-to-date news which the ESE distributes, which we sometime get before it reaches our national press. I think that the example we see here, where the Italian Society is hosting the European and International societies, is a good model, and I'd like to see more of this"

To find out more about ESE’s Affiliated Societies, visit the all new ESE website and our interactive map, providing information on Affiliated Society members from around Europe: http://www.ese-hormones.org/membership/affiliated/map.aspx

A weighty debate

The first debate at ICE/ECE 2012 - This house believes that metabolic (bariatric) surgery should be offered to every diabetic with a BMI over 30 - was sure to spark some interesting discussion.

With the global type 2 diabetes burden at epidemic proportions, and growing, the need for a safe and effective way of addressing the main contributing factor – obesity – is vast. Bariatric surgery is a radical but effective treatment that has the surprising effect of curing diabetes in 90-95% of patients who maintain the weight loss. Should it therefore be offered to all obese type 2 diabetes patients?

At the outset of the debate the audience voted overwhelmingly ‘no’ (83%). Arguing for the motion was Geltrude Mingrone, M.D. (Rome, Italy), who pointed to the three randomised controlled trials on bariatric surgery as a demonstration of the supremacy of bariatric surgery in effecting remission of diabetes. Edoardo Mannucci, M.D. (Florence, Italy), used the same three studies to demonstrate the comparative lack of research conducted on bariatric surgery in comparison to that required for approval of any drug, likening the current evidence base to that of a phase IIa trial.

The audience asked how the protagonists thought patients might vote, how an appropriate control for the surgery would be constituted, and how one could resource wide-scale provision of the surgery. Interestingly the final vote was almost exactly 50/50: clearly it is an area for further discussion.

Debate 1: This house believes that metabolic (bariatric) surgery should be offered to every diabetic with a BMI over 30, took place in the Main Hall at ICE/ECE 2012, 11:30-12:30, Sunday 6 May 2012, Florence, Italy. The Chair was Professor Valdis Pirags (Latvia).

First impressions of Florence

The ICE/ECE 2012 Congress team has been working tirelessly in Florence to put on a top-class Congress, and my what a city!

The Florence skyline, centred around the Duomu, is simply stunning, and the venue itself is no exception to this. Based in the walls of a Renaissance fort and featuring buildings both new and original, we’re sure you’ll enjoy the setting as you stroll between symposia, promenade towards the posters or simply take a break amongst the Tuscan garden.

Once you’re able to tear yourself away from the magnificent surroundings you’ll find a truly top-class programme awaiting you, kicking off today with a satellite symposium, a round table discussion on science publishing, our opening ceremony and of course the two ESE medal lectures. This year the Geoffrey Harris Prize is awarded to Professor Jonathan Seckl (Edinburgh, UK) who will deliver his talk entitled ‘Glucocorticoid metabolism and the brain, from fetal programming to senescence’ at 17:55. He will be followed by Professor Sadaf Farooqi (Cambridge, UK) who is awarded the European Journal of Endocrinology Prize lecture and will give her lecture, ‘Tackling obesity: lessons from genetics’ at 18:45. We would like to offer many congratulations to them both.

After the lectures you’ll be able to catch up with old friends from around the world, and make new ones, at the Welcome Reception. Don’t stay out too late though: the Congress starts anew tomorrow with the first Plenary lecture at 08:30.