Endocrine Abstracts

Introduction: Between 5-10% of patients with hypothyroidism treated with levothyroxine (T4) continue to experience profound symptoms, despite achieving free T4/thyroid stimulating hormone concentrations within reference range. Liothyronine is sometimes added to levothyroxine, but its use is controversial due to uncertainties in clinical/cost effectiveness.Methods: An economic model was developed to estimate the incremental cost per quality-adjusted life ...

Objective: Published results of reduced morbidity and mortality with tight Glycemic Control of critical patients could not be reproduced in large prospective trials. Glycemic goals according to current respective guidelines include a target blood glucose range 140-180 mg/dl, while lower blood glucose targets may be appropriate for some patients. This study aims to provide real world evidence to this field.Methods: We performed a retrospective study using...

Background: PCOS is a common female endocrine disorder, exacerbated by obesity. International guidelines therefore suggest weight loss as first line management. This service evaluation assessed the care pathway of patients referred to Queen Elizabeth Hospital Birmingham (QEHB) with suspected PCOS. We aimed to assess the referral wait time, reason for referral, treatment offered, and weight management in clinic.Methods: We undertook a cross-sectional stud...

Hypercortisolaemia (Cushing’s Syndrome) is characterised by abdominal fat accumulation and gluteofemoral fat loss. The mechanisms underpinning this fat mass redistribution are unknown. Adipose tissue blood flow (ATBF) and net fatty acid release rate (lipolysis) are important determinants of depot-specific fat mass. We hypothesized that hypercortisolaemia may result in increased femoral ATBF and lipolysis promoting gluteofemoral fat mass loss. We recruited nine healthy mal...

Background: TSH secreting pituitary adenomas represent small proportion of functional pituitary tumours presenting as hyperthyroidism with elevated thyroid hormone levels and inappropriately normal or increased TSH concentration. They are ≥1 cm in size and quite aggressive with tendency to relapse following transphenoidal adenomectomy (TSA). Surgical resection remains gold standard in their definitive treatment while pharmacotherapy with long-acting somatostatin analogue...

Introduction: Pituitary surgery is associated with post-operative complications including hypopituitarism and visual field defects. In order to ensure that our surgical outcomes were comparable with other centres, we audited the outcome of a cohort of patients referred for surgery at a single centre.Methods: A retrospective audit of 27 consecutive patients diagnosed with pituitary adenoma at Heartlands Hospital Birmingham, who underwent trans-sphenoidal ...

Introduction: Generously supported by IPSEN)-->Clinically nonfunctioning pituitary adenomas (CNFPA) represent 25–50% of all pituitary lesions. They may be asymptomatic and discovered incidentally or they may be diagnosed due to visual impairment or symptoms of pituitary hormone insufficiency. There is little data on apoplexy frequency in the CNFPA.The aim of our study was to assess the frequency of CNFPA a...

Introduction: The association of thyroid disorders including autoimmune thyroiditis with the risk for breast cancer is controversial (1–4). A recent study found that triidothyronine (T3) levels are positively associated with breast cancer specific mortality (5). Experimental studies have shown that T3 mimics the effects of estrogen in human breast cell lines and induces the expression of progesterone receptors (6).Purpose: The ...

Reactive oxygen species (ROS) are involved in the pathogenesis of atherosclerosis. Atrial natriuretic peptide (ANP) reduces thioredoxin in heart failure patients, whereas adrenomedullin, acting as an antioxidant, protects rat cardiomyocytes from infarction and mouse vascular smooth muscle cells from angiotensin II (AII) oxidative effect. Besides AII, aldosterone (Aldo) is also an activator of ROS. Aim of the study was the investigation of the eventual antioxidant effect of ANP...

Introduction: Treatment options for progressive metastatic unresectable medullary thyroid carcinoma (MTC) include tyrosine kinase inhibitors (TKIs) or somatostatin analogues (SSA), although the efficacy of the latter is debatable. In such cases, combined treatment of TKIs and SSAs has not previously been reported.Aim: To present a metastatic MTC case successfully treated with a combination of Vandetanib and Lanreotide Autogel.Case ...