Searchable abstracts of presentations at key conferences in endocrinology

ea0003s43 | Why, Why Not and When to Irradiate the Pituitary | BES2002

Radiotherapy for pituitary disease

Gittoes N

Beclere first described the use of pituitary radiotherapy in 1909. Despite this long history of use, there is debate surrounding its role in the modern management of patients with pituitary disease. Whilst treatment with conventionally fractionated external beam radiotherapy (RT) is used infrequently as primary therapy in patients with pituitary adenomas, it is commonly administered following non-curative pituitary surgery. In acromegaly, Cushing's disease/Nelson's syndrome, a...

ea0009p215 | Clinical | BES2005

Pituitary tumours coexisting with meningioma and astrocytoma - description of 4 cases in unirradiated patients

Palin S , Gittoes N

Pituitary radiotherapy (RT) causes hypopituitarism that is associated with a doubling in standardised mortality ratio. Other potential complications of pituitary RT are less clearly defined. Retrospective observational studies have estimated the risks of secondary intracranial tumour formation to be as high as 1-2% following conventional pituitary RT but these figures have been calculated against background normal population data. The majority of cases of intracranial tumors f...

ea0003p62 | Clinical Case Reports | BES2002

Pituitary carcinoma - a pain in the head and a pain in the neck

Ayuk J , Gittoes N

A 73 year old man presented in 1995 with impotence and a bitemporal field loss. Endocrine testing revealed hyperprolactinaemia (2741 mU/L) and hypogonadotrophic hypogonadism. Pituitary imaging confirmed the presence of a macroadenoma with significant suprasellar extension. He underwent uncomplicated transsphenoidal surgery, which was successful in decompressing the optic chiasm. Histology revealed a pituitary adenoma that immunostained weakly for prolactin only. In 1998 routin...

ea0019p98 | Clinical practice/governance and case reports | SFEBES2009

Endocrine genes – have we improved the fit? (project development to service provision)

Stewart S , Gittoes N , Cole T

In 2006, responding to the Government White Paper, ‘Our future, our inheritance’, a project commenced promoting genetics in mainstream medicine.By 2008, the original project framework has evolved to address logistical constraints, patient preference and cost effectiveness, offering a streamlined service for clients with inherited endocrine disorders. Recognised patient pathways and a dedicated endocrine genetic clinical nurse specialist (EGCNS)...

ea0005p22 | Clinical Case Reports | BES2003

A little hard to swallow. A rare cause of dysphagia in scleroderma

Wright K , Albon L , Gittoes N

A 41 year old woman presented with a 4 month history of oropharyngeal spasms precipitated by eating, yawning or talking. Such manouvres caused her to fear for her life due to profound choking and 'going blue';as a result she had stopped eating. On direct questioning she complained of circumoral tingling, paraesthesia and carpopedal spasm. She described profuse diarrhoea over the preceding year and had lost 15 kilograms. She was taking no drugs to interfere ith calcium homeosta...

ea0003p201 | Neuroendocrinology | BES2002

Outcome of treatment for Cushing's disease in Birmingham; the experience of a single surgeon

Dale J , McGregor E , Johnson A , Gittoes N

Transsphenoidal surgery (TSS) is the most common first-line treatment for Cushing's disease (CD). We have examined the outcome of this intervention to identify pre-operative clinical factors that predict good surgical outcome and to determine the risk of adverse events.We performed a case-notes review of 30 consecutive patients, 20 (67%) female, treated by a single surgeon over a 14-year period. The mean (SE) age was 34.2 (2.1) years and median (range) ...

ea0003p205 | Neuroendocrinology | BES2002

Outcomes in the management of pituitary apoplexy; a conservative approach may be prudent

McGregor E , Ayuk J , Gittoes N

Due to the infrequency of pituitary apoplexy, there are no robust evidence-based guidelines for optimum care of these patients. The key controversy surrounds the role of acute neurosurgical intervention. Over recent years we have adopted a relatively conservative approach and the aim of this study was to determine whether this 'non-intervention' affected long-term outcome in a recent cohort of patients. 19 patients (8 female) presented between 1994-2001. Mean age at diagnosis ...

ea0019p223 | Neuroendocrinology and behaviour | SFEBES2009

Immediate memory deficits in patients with non-functioning adenoma: an fMRI pilot investigation

Tooze A , O'Sullivan N , Jones C , Humphreys G , Gittoes N , Toogood A

Background: Studies of memory function in patients treated for pituitary adenoma demonstrate deficits in immediate memory (IM) regardless of whether surgery or radiotherapy was received. We have previously shown variability in IM between patients who received the same treatment. The present study was designed to identify changes in the neurological pathways associated with memory function in patients treated for non-functioning pituitary adenoma (NFA) using functional magnetic...

ea0007p9 | Bone | BES2004

Outcome of parathyroidectomy for primary hyperparathyroidism in 249 consecutive patients

Ma Y , Toogood A , Campbell D , Ready A , Gittoes N

Much has been written on the attributes of preoperative localisation and minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism. A recent 'summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century' (Bilezikian et al, 2002) suggested however that in experienced hands, conventional open parathyroidectomy with visualisation of all four glands was still the gold standard. In light of this we have carried o...

ea0005p141 | Endocrine Tumours and Neoplasia | BES2003

Abnormal expression of 11beta-hydroxysteroid dehydrogenase 2 in primary cultures of human pituitary adenomas

Rabbitt E , Bujalska I , Stewart P , Hewison M , Gittoes N

Glucocorticoids (GCs) mediate many of their physiological effects through inhibition of cell proliferation. More contentious is the antiproliferative action of GCs and their possible tumour-modifying effects in neoplastic tissues. However, in recent studies we have shown that 'prereceptor' metabolism of GCs by the enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD) is a pivotal determinant of cell proliferation and tumour formation. Two isozymes of 11beta-HSD interconvert ...