Endocrine Abstracts

Background: Temporary hypocalcaemia occurs in up to 40% of patients following a total thyroidectomy. Serum calcium and parathyroid hormone (PTH) measurements are currently used to predict post-thyroidectomy hypocalcaemia. However, immediate access to PTH measurement is expensive and not widely available. Serum phosphate responds rapidly to changes in circulating PTH levels and its measurement is readily available in all hospitals. We evaluated the use of serum phosphate to pre...

Aim: To assess whether adults in Scotland currently receiving growth hormone (GH) meet the NICE criteria for starting and continuing GH replacement.Methods: We surveyed all endocrinologists in Scotland and identified the main centres using GH replacement. A cross-sectional case note review was carried out of all patients commenced on GH.Results: About 208 patients (51% women; 24% professionals, 90% Caucasian) were identified, 69 of...

In response to hormone activation of the glucocorticoid receptor, GR responsive promoters move through a complex series of activity states, a phenomenon we term promoter progression. Genome-wide profiling of glucocorticoid receptor (GR) regulated loci reveals several classes of response, including genes that are transiently activated and genes that are transiently repressed. In contrast to the conventional paradigm of activation and repression, GR modulation of genome function...

Case history: A 25 year old primigravid woman was referred through to the Joint Antenatal clinic with a 15-year history of Diabetes Mellitus Type 2 treated with metformin. Her past medical history included polycystic ovarian syndrome, (causing significant hirsutism and amenorrhoea), non-alcoholic fatty liver disease, dyslipidaemia and hypertension (previously investigated for secondary causes). Her HbA1c was well controlled at 30 mmol/mol, and her Metformin had been discontinu...

Currently, no treatment options exist to improve semen quality for the majority of infertile men, but it is well known that the interaction between Sertoli- and germ cells is essential to ensure complete spermatogenesis. A recent study suggested that denosumab, an inhibitor of receptor activator of nuclear factor kappa-B ligand (RANKL) signaling, may decrease germ cell apoptosis in human ex vivo testis cultures and stimulate sperm production in some infertile men. Her...

Introduction: Primary aldosteronism (PA) is both the most common form of secondary hypertension and a high-risk subset associated with increased cardiovascular, cerebrovascular and renal morbidity compared to essential hypertension. Unilateral PA is amenable to surgery, biochemical cure and reversal of this excess risk; whilst bilateral disease is best treated through mechanism-directed medical therapy. Currently, PA subtype classification relies on adrenal venous sampling (AV...

Background: Non-functioning pituitary adenomas (NFPA) account for 30-35% of pituitary adenomas. They can lead to hypopituitarism and visual field defects. Trans-sphenoidal resection of pituitary adenoma remains the treatment of choice.Methods: We compared clinical, biochemical, and imaging characteristics of NFPAs at presentation with post-surgical outcomes in a retrospective cohort study. Patients who underwent end...

Background: Non-functioning pituitary adenomas (NFPA) account for 30-35% of pituitary adenomas. They can lead to hypopituitarism and visual field defects. Trans-sphenoidal resection of pituitary adenoma remains the treatment of choice.Methods: We compared clinical, biochemical, and imaging characteristics of NFPAs at presentation with post-surgical outcomes in a retrospective cohort study. Patients who underwent end...

Introduction: Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. Diagnostic doubt can arise due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them to the phaeochromocytoma development. In such cases, surgical intervention is ideally limited to large or functional lesions due to the long-term consequences associated with hypoadrenalism. ...

Introduction: The provision of out-of-hours (OOH) care for hospital inpatients is currently a hot political topic with aspirations for ‘seven day working’ and earlier specialist involvement. Care for patients with diabetes or endocrine problems OOH (which accounts for 75% of each week) is variable and often falls as a default to the general medical team. Our centre (over 1000 beds, all major specialities) has, for many years, provided a 24/7 service for GPs and hospi...