Endocrine Abstracts

Background: The incidence of adrenal crisis remains constant, despite the introduction of behavioural interventions to educate and empower patients. To increase the success of future behaviour change interventions, theoretically informed and empirically supported behaviour change frameworks are available. The current review aimed to identify and evaluate available evidence of interventions used to prevent adrenal crisis in people with primary adrenal insufficiency to inform fu...

Background: Behavioural interventions have been developed to empower patients with adrenal insufficiency and prevent adrenal crisis. Behavioural theory, such as the theoretical domains framework, can inform future intervention development. The current systematic review aims to describe what techniques have been employed in previous interventions and highlight neglected behavioural barriers that could be targeted in future interventions.Methods: We perfor...

Adrenal crisis and death still occur frequently in people with adrenal insufficiency, despite interventions being developed to prevent this. Interventions focus on increasing patients’ knowledge of their medication, their condition, and the action to take during acute stress. It is not known why the application of this knowledge does not happen during times of need. Behaviour change models/frameworks can aid the understanding of this knowledge gap. We performed a systema...

Patient referred to us for Short Synacthen test following, low baseline cortisol in the community, symptoms of fatigue, background history of neck pain on mild opioids, Paracetamol, codeine and Tramadol. Asthmatic on prn salbutamol inhalers. Before attending for Synacthen test patient asked to withhold inhalers and any steroid based medications. Synacthen performed at 08:30am: Pre Cortisol level: 96mmol/lPost Synacthen administration: 388mmol/lInadequate response to synacthen ...

Introduction: Type 2 diabetes mellitus (T2DM) is associated with urological and endocrine complications, including erectile dysfunction (ED) and hypogonadism.Aim: REVITALISE was conducted to assess men with/without T2DM at risk of ED and/or hypogonadism, and highlight gaps in current clinical management.Methods: Data were collected from 13 UK primary care practices on incidence of ED, hypogonadism (defined as serum total testostero...

An 82 year old gentleman was admitted with lethargy, shortness of breath and weight loss of 26% total body weight over a two-year period. His past medical history included hypertension, pulmonary fibrosis, thalassaemia trait and unexplained thrombocytopenia.He had previously been investigated for weight loss with a CT thorax/abdomen/pelvis in 2014 which demonstrated no evidence of malignancy and FDG PET had shown no disease.On admi...

Introduction: We hypothesised that children with type 1 diabetes would have more hyperglycaemia following a British as compared to a European breakfast.Methods: Children were asked to take a continental breakfast and a typical British breakfast cereal on separate days. Pre breakfast glucometer readings were documented and then regular readings until lunchtime. The meals were prescribed by a dietitian; they were approximately carbohydrate matched but of d...

Introduction: Adrenal insufficiency can result in a life-threatening situation if undetected. This pathology is diagnosed by performing an ACTH-Test. Most symptoms like fatigue, loss of weight or arthralgia are rather unspecific. Therefore it is difficult to assess which patients really need an ACTH-Test. Aim of this study was to identify risk factors and indications in order to specify which patients actually require it.Material and methods: 324 patient...

Introduction: Besides the classical thyroid hormones T4 and T3 the endogenous thyroid hormone metabolite 3,5-diiodothyronine (3,5-T2) attracted attention during the last years due to its metabolic activity. 3,5-T2 exerts thyromimetic action on the hypothalamus-pituitary-thyroid axis and the heart as well as on energy and lipid metabolism. In previous liver transcriptome analyses of 3,5-T2-treated lean and diet-induced obese male mice, effects on hepatic lipid, steroid, xenobio...

The thyroid gland functions in supplying thyroid hormones (TH) to the body periphery, which is enabled by cathepsin-mediated thyroglobulin proteolysis and TH translocation across membranes by the Mct8, Mct10, and Lat2 transporters. Previously, we showed that cathepsin K-deficient mice feature normal thyroid phenotypes which is, in part, due to the functional compensation through cathepsin L upregulation that is independent of the classical hypothalamus–pituitary–thyr...