Endocrine Abstracts

Background: Testosterone treatment has been shown to increase exercise capacity in men with chronic heart failure but the mechanism of benefit is unclear. The purpose of this study was to examine the acute haemodyamic effects of testosterone in men with heart failure.Methods: Twelve men with stable heart failure (age 62.8 (8.8)years; ejection fraction 30.9 (6.3)% (NR>60%)) were enrolled in a double-blind, placebo-controlled cross-over study. Cardiac o...

Objectives: Testosterone deficiency has been associated with depressive symptoms, which may be improved by replacement therapy. Patients with chronic heart failure have a high prevalence of depression, which is associated with early mortality in these patients. Men with heart failure may also have low plasma levels of testosterone, which could contribute to depressed mood. In a clinical study investigating whether testosterone treatment benefits men with heart failure, patient...

Background: Current evidence suggests that testosterone acts as a vasodilator in several vascular beds. This may have implications for men who are androgen deficient, in whom vascular reactivity may be impaired. We have studied vascular responses in vitro in femoral arteries from testicular feminised mice (Tfm), which lack a functional androgen receptor and are consequently androgen resistant and have reduced circulating levels of testosterone. Methods: Femoral arteries from m...

Case history: A 41-year-old lady had Total Thyroidectomy in 2007 for a large multi-nodular goitre. Post-operatively, she was hypocalcemic with mild inappropriately low Pth levels. She was treated with high dose α-calcidol and calcium supplements but the response was suboptimal. Following introduction of teriparatide, serum calcium has been improving to between 1.90 and 2.06 mmol/l. She continues on high dose α-calcidol.Investigations: Corrected...

Introduction: Adrenal incidentaloma is defined as a clinically inapparent adrenal mass that is incidentally detected after imaging studies conducted for reasons other than the evaluation of the adrenal glands. Existing guidance suggests that excess catecholamine and cortisol secretion should be ruled out all cases and excess aldosterone secretion should be ruled out hypertensive patients. Certain features on CT scanning such as a Hounsfield value of over 10 are useful in diffe...

Context: Testosterone replacement therapy (TRT) has shown benefit on insulin resistance, glycaemic control and cardiovascular risk markers in hypogonadal men with diabetes. Arterial stiffness and intima-media thickness (IMT) are vessel wall properties associated with future cardovascular risk which allow the progress of atherosclerosis to be assessed non-invasively. Low testosterone has been associated with the presence and progression of carotid atherosclerosis as assessed by...

Introduction: Adrenal incidentalomas are a common reason for endocrinology referral. We present a case of an incidentally discovered adrenal mass biochemically mimicking phaeochromocytoma with rapid resolution on subsequent imaging.Case report: A 53-year-old female was found to have a 5 cm mass adjacent to the right kidney on ultrasound performed to investigate abnormal liver function tests. CT confirmed a right adrenal mass. The patient was normotensive...

69-year-old male with background of hypertension and dyslipidaemia was admitted to ENT with a food bolus obstruction. CXR on admission revealed a well-defined mass in the right lower lobe consistent with lung cancer. Oesophagoscopy revealed a narrowing level secondary to external compression. A staging CT of chest and abdomen confirmed a mass on the right base invading the main right lower lobe bronchus. Incidentally there was an 8 cm infra renal abdominal aortic aneurysm. The...

A 35year old man presented to the cardiology clinic with effort dyspnoea, palpitations and light-headedness. He had just returned from a 6 month “round the world’ trip during which he had suffered a diarrhoeal illness. An echocardiogram performed in Bangkok revealed left ventricular dilatation but no other significant changes. A diagnosis of possible myocarditis was entertained and he was treated with 2.5 mg of Ramipril and 75 mg of Aspirin. When seen in the cardiolo...

Introduction: Testogel is now established treatment for male hypogonadism. The aim of TRT is to resolve hypogonadal symptoms and achieve physiological levels of testosterone.Objective: To determine the efficacy of Testogel 50 mg/day, in achieving symptomatic benefit and physiological testosterone level in 100 male patients.Method: Retrospective review of 100 case notes from the andrology clinic. Men included were between 16 and 80 ...