Endocrine Abstracts

Introduction: Failure to recognise critically ill patients delays escalation to intensive care units (ICU) and results in increased mortality. Objectively identifying the sickest patients on admission remains challenging for healthcare professionals. This study proposes a novel Metabolic Index as a marker of metabolic disturbance based on a patient’s sodium, potassium and bicarbonate. The Metabolic Index is proposed as a predictor of outcome in patients presenting to A&#3...

Background: Hydrocortisone day curves (HCDCs) are commonly used to assess hydrocortisone replacement for patients with adrenal insufficiency (AI).Methods: HCDCs were obtained for 216 adrenally insufficient patients between 2004 and 2012 at Imperial College Healthcare NHS Trust. The area under the curve (AUC) was calculated for each patient’s day profile. Lipid profiles and glycated haemoglobin (HbA1c) values were recorded for each patient at both th...

Background: Glucocorticoid-induced osteoporosis is one of the major clinical concerns of long-term steroid treatment. Previous studies have shown that immunosuppressive doses of glucocorticoid can lead to osteoporosis. This study investigated whether there is a relationship between cortisol exposure and the development of osteoporosis in patients receiving replacement doses.Methods: Hydrocortisone day curves (HCDCs) performed a...

Background: Hydrocortisone day curves (HCDCs) are commonly used to assess hydrocortisone replacement for patients with adrenal insufficiency (AI).Methods: HCDCs were obtained for 216 adrenally insufficient patients between 2004 and 2012 at Imperial College Healthcare NHS Trust. The area under the curve (AUC) was calculated for each patient’s day profile. Lipid profiles and glycated haemoglobin (HbA1c) values were recorded for each patient at both th...

Background: Glucocorticoid-induced osteoporosis is one of the major clinical concerns of long-term steroid treatment. Previous studies have shown that immunosuppressive doses of glucocorticoid can lead to osteoporosis. This study investigated whether there is a relationship between cortisol exposure and the development of osteoporosis in patients receiving replacement doses.Methods: Hydrocortisone day curves (HCDCs) performed a...

Short synacthen tests (SST) are used to investigate patients with suspected HPA pathology and a rise of serum total cortisol > 550nmol/L is accepted as demonstrating sufficient cortisol reserve. However, cortisol is 80% bound to cortisol binding globulin (CBG) and therefore abnormal values of CBG can influence serum total cortisol used to interpret dynamic tests of the HPA axis. The free cortisol index (FCI) is a surrogate marker for serum free cortisol and is defined as s...

Background: Symptom management is a cornerstone of clinical care, particularly for patients with cancer. However, often patient’s symptoms go undetected by health care providers between clinic visits. Mobile health applications are increasingly used in oncological care to support cancer patients.Aims: To develop a patient focussed mobile application to enable patients to track symptoms, record quality of life, communicate with their clinical teams a...

Most tests of the hypothalamo-pituitary-adrenal axis (HPA) use total cortisol measurements, although only free cortisol is biologically active. Total cortisol is 90% bound to cortisol binding globulin (CBG). CBG varies between individuals, is elevated by oestrogens and reduced by acute illness or surgery. Low CBG levels may result in individuals apparently failing such tests, and receiving inappropriate steroid replacement. We hypothesised that correcting total cortisol for CB...

Digital technology has an important role in the monitoring and management of long term conditions. The purpose of this study was to evaluate the feasibility of using PROMS to monitor symptoms, via a disease specific mobile application. Secondary endpoints included QoL and patient engagement. In addition, we reviewed the total number of symptoms reports and time required for patients to complete and submit these.Methods: Unmet patient nee...