Endocrine Abstracts

Subtotal parathyroidectomy (SPX) and total parathyroidectomy with autotransplantion (TPXAT) are adequate techniques in treatment of secondary hyperparathyroidism (HPT2) in hemodialysed patients with identical results. Reinterventions required for persistence or recurrence of HPT2 may seem easy after TPXAT: no redo-surgery in the cervical area and removal of grafts in the forearm under local anaesthesia. The aim of this study was to analyze our results of reiterative surgery in...

Recurrent primary hyperparathyroidism (RPHPT) is defined as hypercalcemia occurring after 6 months of normocalcemia following initial operation. The aim of this study was to analyze our experience in RPHPT.Between 1980 and 2010 33 patients (1.2%) with primary hyperparathyroidism (HPT1) were reoperated in our tertiary referral centre for recurrence of disease: 24 adenomectomies, six subtotal parathyroidectomies, two total parathyroidectomies with autotran...

Screening for coeliac disease is routine at annual review in the Oxfordshire Children’s Diabetes Service and oro-gastro-duodenoscopy (OGD) is carried out following positive serology. Our protocol for Diabetes management during Day Case Endoscopy for confirming CD was revised in 2002 following audit. We re-audited our current practice to check adherence to the protocol and degree of blood glucose control.Data was collected from case notes, nursing no...

Obstructive sleep apnoea (OSA) is a condition strongly associated with cardiovascular disease. Obesity is often related to both clinical problems and it is also a risk factor for incident type 2 diabetes mellitus (T2DM).Aim: To assess cardiovascular risk among a cohort of patients with OSA in order to identify and optimise treatment of high risk patients.Methods: Prospective study that included 72 patients with OSA under continuous...

Background: Diets rich in polyunsaturated fatty acids (PUFA) n-3 may change the fluidity and composition of membrane phospholipids, leading to different prostanoids formation, decreasing IL-1β and TNFα releases and increasing the basal levels of corticosterone, important factors to promote acute phase response (APR) to stimuli. This study proposes to verify if PUFA n-3 or n-6 rich diets alters the APR of fibrinogen and haptoglobin after turpentine stimulus.<p cla...

We are reporting a rare case of ectopic ACTH secreting tumour causing cyclical Cushing’s syndrome. A 63-year-old lady presented in March 2013 with tiredness and bilateral leg swelling and weakness associated with easy bruising. She was admitted to local hospital in April 2013 with worsening proximal myopathy and peripheral oedema. Her midnight cortisol was elevated at 1710 nmol/l. ACTH 610 mU/l, prolactin 476 mU/l, GH 0.21 IU/l, TSH 0.73 mU/l, free T4 of 11.0 p...

Objective: Zinc-α2 glycoprotein (ZAG) stimulates lipid loss by adipocytes and may be involved in the regulation of adipose tissue metabolism. We analyze ZAG expression levels in adipose tissue from a group of morbidly obese patients, and their relationship with lipogenic and lipolytic genes and with insulin resistance (IR).Design: mRNA expression levels of PPARgamma, IRS-1, IRS-2, lipogenic and lipolytic genes and ZAG were quantified in visceral (VA...

Ganglion cells in the sella turcica are rarely associated with endocrinological disease. We report the case of a 72-year-old woman who presented with typical signs and symptoms of hypercortisolism. Endocrinological work-up confirmed ACTH-dependent Cushing’s syndrome with loss of circadian cortisol rhythmicity and a pathological dexamethasone suppression test. MRI revealed right-sided sellar floor excavation but no clear-cut adenoma. Via a right-sided transnasal approach, ...

Hepatic glucose metabolism is zonated. Glycolysis is mainly localized in hepatocytes surrounding the hepatic vein (pericentral zone) whereas gluconeogenesis is mainly carried out by hepatocytes surrounding the portal vein (periportal zone). Expression of the gene encoding the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK, PCK1) is reduced upon feeding, an effect mainly controlled by insulin. PEPCK is considered a peri-portal enzyme. However, the differential ef...

Myotonic Dystrophy is an autosomal dominant multi-system disorder characterised by muscle weakness and myotonia, with associated cardiac, ophthalmic, gastrointestinal and endocrine abnormalitiesA 16-year-old boy was referred with a 2 months history of difficulty releasing his hand-grip and problems with swallowing. The clinical diagnosis of myotonic dystrophy 1 was confirmed with genetic testing with the detection of a DMPK expansion mutation. During inv...