Endocrine Abstracts

Contemporary management of pituitary tumours is based on a multidisciplinary approach involving surgery, radiotherapy (RT) and medical therapy. External beam RT significantly reduces the likelihood of tumour re-growth following surgery for non-functioning pituitary adenomas and suppresses hypersecretion in hormonally-active tumours. However, over the years, a number of potentially significant complications of pituitary RT have been described.Radiation ma...

It is now around 20 years since the identification of SRY as a primary testis-determining gene and the molecular characterisation of many of the key enzymes and receptors involved in androgen synthesis and action. Although significant progress has been made since then in identifying other components involved in sex development, we are still unable to find an underlying genetic cause in many individuals with these conditions. Efforts to identify specific genetic causes o...

This talk starts by focussing on how to set insulin to carbohydrate ratio and duration of insulin action and then how to test if they are set correctly. The talk then progresses into showing the mismatch between carbohydrate absorption and insulin action and how to use practical tips and pump tricks to reduce post-prandial glycaemia. The talk finishes with suggestions of when to use different bolus options such as dual wave (split) and extended (square)....

For most trainees there is a well-worn path to a consultant post in the NHS. There are however alternatives to this career path- either temporarily or long term. I am one of a number of endocrinologists working in the pharmaceutical industry as medical advisers, clinical research physicians, and medical directors. I will describe my pathway from training in paediatric endocrinology to the industry. I will consider some of the challenges and differences from working in the NHS....

Primary aldosteronism is the most common secondary cause of hypertension. Less than 50% of patients with the disorder have a solitary aldosterone producing adenoma. In the most common presentation, patients present with bilateral hyper-secretion of aldosterone. The aetiology of this is uncertain. Studies within our own group have suggested that there is an underlying genetic predisposition to develop hypertension with a raised aldosterone to renin ratio (ARR) associated with v...

In this lecture, fundamental concepts in the area of molecular biology will be presented. These include biology’s and biotechnology’s central dogma; the ‘human genome project’; the discordance between human gene number and corresponding protein number; and gene cloning techniques. Also presented will be procedures used to determine gene number and location (Southern blotting) and levels of gene expression at the RNA (Northern blotting, reverse transcription...

DAX1 (NR0B1) and steroidogenic factor-1 (SF1, NR5A1) are two nuclear receptors that play a central role in adrenal development and disease. DAX1 was discovered as the cause of X-linked adrenal hypoplasia congenita in 1994 and, to date, more than 250 individuals and families with this condition have been reported. Boys tend to present with salt-losing adrenal failure in the neonatal period or with signs and symptoms of glucocorticoid insufficiency throughout childhood. Hypogona...

Aldosterone has important effects on blood pressure regulation and electrolyte haemostasis: recent data from Framingham confirm that plasma levels of the hormone predict subsequent development of hypertension in young adults, while our own data show that plasma aldosterone correlates with blood pressure in older subjects, and is inversely associated with birth weight. It is clear, therefore, that long-term regulation of aldosterone is important in setting blood pressure levels...

The use of drugs for weight loss dates back to the first half of the 20th century. These older agents were mostly amfetamine-derived, centrally acting sympathomimetics, and although effective, their side-effect profile would not be acceptable today. A new generation of drugs, acting on brain serotoninergic pathways was developed in the 1960’s, including fenfluramine and later dexfenfluramine. In the 1990’s, a combination of fenfluramine with an older agent – phe...

In order to test posterior pituitary function it is important to assess and replace corticotroph function before assessing posterior pituitary hormone production because ACTH deficiency leads to a reduced GFR and the inability to excrete a water load which may therefore mask diabetes insipidus.With diabetes insipidus the urine output is usually >3 l a day. Other causes of osmotic diuresis need to be excluded.The fluid deprivati...