Endocrine Abstracts

The Women’s Health Initiative (WHI) placebo-controlled trial of conjugated equine estrogens (CEE) plus medroxyprogesterone (MPA) in 16 608 postmenopausal women, aged 50–79 at randomization, was stopped after an average of 5.6 years of follow-up, due to increased risks, including increased coronary heart disease (CHD), stroke, and pulmonary embolism (PE), compared to health benefits. The WHI trial of CEE only in 10 739 women with prior hysterectomy, also aged 50–...

Insulin resistance (IR) is a condition where beta cells are producing insulin, sometimes in large amounts, but the peripheral targets develop an inadequate response to the hormone. Classically insulin resistance has been associated with pathologic conditions. However, there is also physiological IR, associated with the last period of pregnancy and in different moments of the development. We have previously characterised a period of physiological IR, around the ablactation peri...

Introduction: The testicular disorder of sexual differentiation (DSD) is a rare clinical condition with a reported incidence of 1:20 000 newborn males. It is characterised by a male phenotype with 46,XX karyotype. There are three clinical phenotypes: normal male phenotype, males with genital ambiguities and males who are true hermaphrodites. SRY positive 46,XX testicular DSD results from the translocation of a Y chromosome segment containing the SRY gene during spermatogenesis...

The nutrient demands of cancer cannot be met by normal cell metabolism. Cancer cells undergo dramatic alteration of metabolic pathways in a process called reprogramming, characterized by increased nutrient uptake and re-purposing of these fuels for biosynthetic, bioenergetic or signaling pathways. Partitioning carbon sources toward growth and away from ATP production necessitates other means of generating energy for biosynthetic reactions. While much research has examined the ...

A 42 year old lady presented to the Endocrinology clinic with a longstanding history of exertional dizziness, increasing in frequency over the preceding two months. She reported marginal symptomatic improvement with the introduction of frequent carbohydrate rich meals. She was asymptomatic in the post-prandial period. She had no associated nausea, confusion, palpitations, diaphoresis, collapse or weight gain. She was on medication (SSRI) for anxiety. Her father and paternal gr...

The Sodium Iodide Symporter (NIS) is responsible for active transport of iodide into thyroid cells. Its expression in thyroid tumors allows the use of radioactive iodine (131I) as co-adjuvant therapeutic tool to eliminate remaining tumor cells and metastases after total thyroidectomy. Nevertheless, certain subsets of patients with advanced forms of thyroid cancer lose the ability to respond to radioiodine therapy, which drastically reduces their survival rates. Recent studies ...

Introduction: Patients with adrenal insufficiency (AI) lack endogenous cortisol and require oral hydrocortisone. In primary AI (PAI) endogenous aldosterone synthesis is also lost and patients require oral fludrocortisone. Important long-term issues include wearing MedicAlert jewellery (MAJ) and adequacy of steroid replacement including fludrocortisone, assessed by plasma–renin activity (PRA).We identified patients with AI attending our unit and aime...

The recently published Endocrine Society Clinical Practice guideline on phaeochomocytoma and paraganglioma (PPGL) recommends measuring plasma metanephrines (PMets) with patients in the supine position after an overnight fast and using appropriately defined reference intervals.1 Studies have shown higher diagnostic sensitivities using the latter pretesting criteria.2 However, this testing protocol is resource intensive and arguably impractical in routine c...

International best practice guidelines provide well-defined recommendations for the management of differentiated thyroid cancer (DTC) measuring ≤1 cm, >4 cm and for those with defined risk factors. However, the extent of surgery and requirement for radioiodine remnant ablation (RRA) are less clearly defined for tumours 1–4 cm in size. Guidelines recommend a ‘personalised decision making’ approach for this cohort, with therapeutic decisions based on pat...

Dynamic pituitary testing is a time consuming and high cost investigation. For effective use of this procedure a close audit of the effectiveness and outcome of testing is required. At UCH we have developed a streamlined nurse led service with medical supervision and we now present an audit of 1 year of testing.Forty-one patients underwent pituitary function testing for growth hormone (GH) and ACTH during 2006. Referral source was from the endocrine team...