Endocrine Abstracts

The aim of this audit was to assess the efficacy of vitamin D replacement therapies (oral Ergocalciferol D2 and Cholecalciferol D3) on serum Vitamin D (25(OH)D), when dispensed to endocrine outpatients. After exclusions, clinic records of 54 patients were analysed for pre- and post dosage serum 25(OH)D levels, PTH levels, total dosage given, and duration of replacement. Results: Mean total dose of D2 (n=24) was 350,000 (IU) against D3 (n=30) 305,000 (IU), with av...

Background: In May 2010 a dedicated Consultant-delivered Endocrine Telephone Advice Clinic (ETAC) was launched at St Bartholomew’s Hospital as a direct point of access for primary care doctors to obtain endocrine advice about new patients. The proposed benefits of this clinic were to: 1. Reduce unnecessary clinic attendances that could be managed in primary care. 2. Allow for more detailed and less hurried discussions of non-urgent cases than was possible via the on-call ...

The preproglucagon derived peptides glucagon, glucagon-like peptide-1 (GLP-1) and oxyntomodulin are all known to inhibit appetite and have been previously shown to activate the nucleus tractus solitarius (NTS) in the brainstem. The NTS is involved in the processing of signals transmitted from the periphery to the brain via the vagus nerve. The anorectic effects of peripherally administered glucagon and GLP-1 have been shown to be diminished or ablated by subdiaphragmatic vagot...

Background: The Royal College advises 500–800 MBq of Radioiodine(RAI) for toxic multinodular goitres (MNG), and 400–800 MBq RAI for euthyroid MNG. In our institution, a standard low dose of 370 MBq has traditionally been given to all patients with benign thyroid disease. This audit examined whether outcomes are optimal with low dose therapy, and whether a variable dose protocol should be adopted.Patients and Methods: We analysed 49 patients at ...

Introduction: Palpable thyroid nodules have a prevalence of 4–7%, which increases with imaging. About 5% are malignant. Efficient management is essential. USG and FNAC are valuable in assessing and preventing unnecessary thyroidectomies. Objective To compare our practice with local and Royal College of Pathologists guidelines. Methods All thyroid nodule patients seen in clinic between April to September 2010 were included. Data collected included age, gender, TFT, thyroid...

Background: A detailed assessment of children’s diabetes services across 21 units in the Y&H SHA identified a significant variation in care with the number of children with an HbA1c <7.5% ranging from 3 to 30%. This variation could not be explained by demographics or resource.Methods: Agreement was obtained from three units in Yorkshire to pilot a Peer review visit in conjunction with the national Cancer Peer Review Team and too develop the ...

Aim: To audit the current congenital hypothyroidism (CHT) management practice in our centre.Standards: Guidelines published by UK Newborn Screening Policy and Standards in 2005 and ESPE in 1999.Method: Retrospective audit from 2006 to 2010. The list was compared with the regional newborn screening lab to ensure data collection was complete.Results: Thirty cases were referred to the unit giving local incidence...

Introduction: The strong correlation between HbA1c and blood glucose (BG) has been recognised in many studies. We investigated this relationship using BG data from 119 children with diabetes, to better understand factors affecting HbA1c and characteristics of children with good versus poor control.Methods: BG data was obtained on 119 children over a 1-month period and on a subset of 43 children over three consecutive months using the Diasend System (Aide...

Introduction: Non-ketotic hyperglycaemic hyperosmolar (HHNK) coma is rare in children, is associated with high mortality rate. The incidence of this condition is reported to be increasing and considered to be related to increased prevalence in obesity and type 2 diabetes in children. Hyperglycaemic hyperosmolar syndrome (HHS) is rare in children. The pathophysiology and management of HHS is a distinct entity from diabetic ketoacidosis (DKA).Case report: ...

Background: Pigmented hypertrichotic dermatosis with insulin-dependent diabetes (PHID) syndrome is an autosomal recessive disorder due mutations in SLC29A3. SLC29A3 encodes for an equilibrative nucleoside transporter 3 (ENT 3). A hallmark of PHID syndrome is the chronic inflammation characterised by the persistently raised erythrocyte sedimentation rate and C-reactive protein. A key pathway involved in triggering inflammation is the nuclear factor kappa β (N...