Endocrine Abstracts

The aim of cortisol replacement in adrenal insufficiency is to mimic the normal cortisol circadian rhythm. Timing of the last dose varies. Paediatric practice doses as close to midnight or after as possible compared to no dose after 18.00 h in adults. Using a detailed questionnaire, we ascertained side effect prevalence in 226 patients with adrenal insufficiency (77 CAH, 82 Addison, 67 hypopituitarism) and compared frequency of problems with timing glucocorticoid replacement. ...

Background: As thyrotoxicosis is associated with significant morbidity, treatment and ultimately cure is essential. Along with anti-thyroid medication and surgery, the use of radioactive Iodine (I-131) has long been established. However, opinion still varies as to when to use I-131, in which patients and whether to give a fixed or tailored dose. To see if our practice was consistent with published data, we conducted an audit of patients treated with I-131 for benign thyroid di...

Background: Adrenal incidentalomas are becoming increasingly common due to the improvements in imaging techniques, increasing numbers of radiological investigations and an aging population. The current follow-up protocols are designed to avoid missing clinically relevant lesions (e.g. malignancy or hormone hypersecretion) by recommending repeated radiological and biochemical investigations. Large amounts of money are spent on patients who as it seems mostly have benign and non...

Aims and Methods:Obesity treatment is often unsuccessful despite the efforts of seemingly motivated patients. Awareness among the obese, regarding obesity, is important to facilitate weight loss and to prevent weight gain. We assessed the awareness of obese patients with regard to obesity, its complications and treatment options. Consecutive subjects attending outpatient clinics with BMI>/=30and <70years of age were interviewed.<p class="abstex...

Background: Patients with congenital adrenal hyperplasia (CAH) due to classic 21-hydroxylase deficiency have poor health outcomes. We compared disease control in CAH adults treated with modified release hydrocortisone (MRHC, Chronocort®, Diurnal Ltd) versus standard glucocorticoid (GC).Methods: 6-month, Phase 3 study in 122 patients randomised to either MRHC twice daily or standard GC followed by safety extension study on MRHC. Patients had 24-hr 17...

Background: Patients with salt-wasting congenital adrenal hyperplasia (CAH) due to classic 21-hydroxylase deficiency require glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy. Recently, it was shown that twice daily modified-release hydrocortisone hard capsules (MRHC, Efmody®, Diurnal Ltd) improved control of CAH with most patients showing good disease control versus standard GC therapy. However, no data has been reported on the renin-angiotens...

Background: Up to 2016, NIFT-P was considered a non-invasive encapsulated follicular variant of papillary thyroid carcinoma (FV-PTC) and was reclassified and downgraded to a pre-malignant lesion. However, if these nodules have peculiar ultrasonographic features able to pre-operatively suggest their histology is still a matter of discussion. We evaluated a large series of NIFT-P, FV-PTC, FTC, and FA to characterize their ultrasonographic features.Methods:...

Background: The therapeutic goal in CAH is androgen control on the lowest achievable glucocorticoid dose, preferably an adrenal replacement dose (15-25 mg hydrocortisone a day)1. However, the glucocorticoid dose required to control androgens frequently exceeds that required for adrenal replacement2. Modified-release hydrocortisone (MRHC) capsules, (Efmody, Diurnal Ltd, Cardiff, UK), replicate cortisol diurnal rhythm and improve CAH control compared to sta...

Background: Modified-release hydrocortisone (MRHC) capsules (Efmody, Diurnal Ltd, Cardiff, UK), have been developed to replicate the cortisol diurnal rhythm and shown to improve CAH disease control1. We have examined relative bioavailability of MRHC and disease control of congenital adrenal hyperplasia (CAH) patients switched from standard therapy to MRHC.Methods: An open label, randomised, 2 period, crossover study comparing the relative bioavailability...

Calcium mobilization from intracellular stores represents an important cell signalling process that is regulated, in mammalian cells, by inositol-1,4,5-triphosphate (IP3), cyclic ADP ribose (cADPR) and nicotinic acid adenine dinucleotide phosphate (NAADP). Intracellular calcium is important for mobilization of secretory granules to the plasma membrane in preparation for exocytosis. NAADP mobilizes calcium from lysosome-related acidic compartments and it has recently...