Endocrine Abstracts

Introduction: Incompletely controlled acromegaly has a three-fold excess all-cause mortality, with stroke being the predominant cause of death. Debate exists about the relationship between fractionated radiation (FRT) and risk of stroke, with radiation damage to cerebral vasculature potentially being a cause. We present outcomes in patients treated by gamma knife STRS at the National Centre for Stereotactic Radiosurgery in Sheffield, with...

Background: Cushing’s syndrome (CS) is estimated to have a 10-fold increased risk of venous thromboembolism (VTE) compared with the normal population with VTE accounting for 3.6-11% deaths in CS patients. There are no specific guidelines for VTE prophylaxis in CS other than that it should be considered given the increasingly recognised risk.Methods: Via the Society for Endocrinology, we surveyed current VTE anticoagulation practice across UK Endocri...

Introduction: Trans-sphenoidal Surgery (TSS) remains the primary treatment for acromegaly in most patients, but no previous data exist on outcomes for patients treated with gamma knife radiosurgery (STRS) as a primary treatment.Methods: 20 patients with acromegaly underwent primary STRS at the National Centre for Radiosurgery, Sheffield, UK between 1985 and 2015. Data collection: note review, database, laboratory results, patient questionnaire, and death...

Objective: Denosumab is a highly specific MAB, which binds to RANK Ligand thus inhibiting osteoclast formation, function and survival1.It’s efficacy in the treatment of osteoporosis was demonstrated in the FREEDOM trial which was an international, randomised, placebo controlled trial involving 7686 post menopausal women. The trial demonstrated a reduction in risk for vertebral fractures (68%), non vertebral fractures (20%), and hip fractu...

Introduction: Current testosterone replacement therapies have limited acceptability: gels can be messy and risk inadvertent dosing of others; injections are painful; and oral testosterone undecanoate (TU) delivers variable testosterone levels, requires concurrent ingestion of a fatty meal and may produce supraphysiological dihydrotestosterone (DHT) levels1. We present the first human trial of an oral native testosterone preparation formulated to deliver testosterone...

Cushing’s disease (CD) is a rare condition, associated with significant morbidities.The long-term morbidities in a series of patients with CD who presented in two tertiary referral centres between 01/1967-06/2009 were assessed. All information was collected as documented in the records of the patients.224 patients were identified (174 females) with median age at diagnosis 39 years (range 10–76 (females 38 (12–72) &#1...

Anecdotal reports suggest that management of Graves’ disease (GD) is more challenging in patients with concomitant autoimmune disease, however there are few studies evaluating this premise and thus no satisfactory evidence base to guide clinicians. We aimed to identify the impact of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) on treatment outcomes of GD.We identified all GD patients (n=265) who attended endocrinology clin...

Background: Increased levels of cortisol are associated with worse prognosis in heart failure (HF). The final step in cortisol production is catalysed by 11β-hydroxylase encoded by CYP11B1, which is highly homologous with CYP11B2. A common polymorphism in the aldosterone synthase gene (CYP11B2 −344T) is associated with a raised ratio of 11-deoxycortisol/ cortisol (S/F). We examined the relationship between −344C/T polymorphism and corticos...

Background: Cortisol is an essential stress hormone and deficient patients suffering a systemic inflammatory response (SIR) will rapidly die if not replaced. However, controversy remains on the definition for a normal adrenal response in critically ill patients. We investigated cortisol status in patients undergoing coronary artery bypass surgery (CABG), surgery frequently associated with a SIR, varying in severity from sub-clinical, to life-threatening....

Hypercalcemic complications of PHPT include renal, cardiovascular, gastrointestinal, neuromuscular and neuropsychiatric issues, all potentially impacting negatively on HRQOL. As control of the hypercalcemia associated with PHPT might improve HRQOL, the SF-36 and a 6-item scale on cognitive functioning (CF) were included in a phase 2, single-arm study evaluating the ability of cinacalcet to control serum calcium levels in 17 patients with intractable PHPT. Mean±S.E....