Endocrine Abstracts

Hyponatraemia is the most common fluid and electrolyte disorder encountered in clinical medicine, with incidences as high as 15% to 30% in both acutely and chronically hospitalized patients. Differential diagnosis is complicated by a long list of potential etiologies. Traditional diagnostic strategies entail an initial characterization of the patient's extracellular fluid volume status to differentiate euvolemic hyponatraemia from hypovolemic hyponatraemia (generally indicatin...

Primary Aldosteronism (PA), as defined by the autonomous and inappropriate secretion of aldosterone, causes mineralocorticoid hypertension. Key features of this include suppression of plasma renin and hypokalaemia. Recent studies that have used the ratio of aldosterone to renin (ARR) as a screening test have suggested that the prevalence of PA in unselected populations of patients with hypertension is around 10%. Only a minority of these patients, however, have a low potassium...

The association between inflammatory bowel disease (IBD) and osteoporosis has been known for many decades but has only recently received appropriate recognition. This has largely resulted from the increasing awareness of the high morbidity and mortality attributable to osteoporosis in the general population and the application of advances in its detection to populations with gastrointestinal disease Recent population-based studies in individuals with inflammatory bowel disease...

Thyroid nodules and goitre are a common problem, with a very high prevalence evident from screening studies of the general population. In contrast, thyroid cancer is rare accounting for <1% of all new malignancies diagnosed in England and Wales each year. The challenge to the clinician is therefore to identify, amongst the large number of patients referred because of thyroid enlargement, the small proportion thyroid neoplasia. This differentiation is critical since most wit...

Hypertension affects 20-60% of people with type 2 diabetes and people with hypertension are more than twice as likely to develop diabetes. Together, hypertension and diabetes are potent risk factors for cardiovascular disease. Resistance to insulin-mediated glucose uptake and dysfunction(s) of the vascular endothelial monolayer are important pathophysiological features of both conditions which are associated with obesity and accelerated atherosclerosis. In recent years, it has...

In the human endometrium, the postovulatory rise in ovarian progesterone results in the influx of distinct local immune cells and induces the coordinated expression of certain gene sets that initially define a limited period of uterine receptivity and subsequently control differentiation of the stromal compartment (decidualisation). Decidualisation is critical for trophoblast invasion and the formation of a haemochorial placenta. Pathologically, a spectrum of reproductive diso...

Radioiodide therapy of thyroid cancer represents the most effective form of systemic radiotherapy available to the clinician today. The ability of thyroid cancer cells to concentrate iodide is induced by expression in the follicular cell membrane of the sodium iodide symporter, NIS. Some thyroid cancers lack expression of this protein and therefore the ability to concentrate iodide, making them insensitive to 131-I therapy. Several investigators have characterized the expressi...

Patients are increasingly anxious to know what is being done to them, and the matter of properly informed consent has become a politically sensitive topic. From a clinician's point of view there are four aspects to consider; first, consent to examination and treatment; secondly consent to the use of biological samples for research or other purposes; thirdly consent to necropsy and the retention of post-mortem material; and fourthly consent to the use of personal clinical infor...

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11beta-Hydroxysteroid dehydrogenase type 1 (11beta-HSD-1) is a key enzyme which amplifies intracellular levels of active glucocorticoids within specific tissues, including the brain. The hippocampus highly expresses both corticosteroid receptors and 11beta-HSD-1, making it a prime target for glucocorticoid actions. This brain region plays an important role in fear/anxiety behaviours and learning and memory. We examined the anxiety-related behaviours (elevated plus maze and ope...