Endocrine Abstracts

Metformin is commonly used to treat insulin resistance in women with polycystic ovary syndrome (PCOS) and also has direct effects on the ovary. The mechanism of this action is unknown, but could be via insulin-independent pathways, namely AMP activated protein kinase (AMPK). AMPK is an energy sensor, activated when ATP levels are depleted causing an inhibition of anabolic and an activation of catabolic pathways. We hypothesised that in the ovary, metformin acts via</...

Historically, acute neurosurgical decompression has been considered treatment of choice for pituitary apoplexy with some studies advocating a conservative approach. We describe a patient, with reduced consciousness due to apoplexy of a gonadotroph adenoma, in whom there was spontaneous tumour shrinkage. A 68-year-old gentleman presented following a collapse with hypothermia, bradycardia and bitemporal hemianopia. Initial investigations showed low plasma sodium and glucose. Ove...

The biguanides metformin and phenformin enhance insulin sensitivity and improve glycaemic control in type 2 diabetes. Metformin is the most prescribed oral agent for type 2 diabetes but phenformin has been withdrawn because of its propensity to cause lactic acidosis. Metformin has a major effect in the liver where it reduces glucose output via AMPK activation. As the adipocyte is now considered to be a critical participant in whole-organism metabolic homeostasis we investigate...

Background: Grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are rare, aggressive tumors with poor prognosis. The WHO 2017 classification further subdivided G3 NENs into G3 neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Current guidelines favor medical management in most of these patients, and the role of surgical management is not well-defined. We performed a systematic literature review and meta-analysis of surgical management vs ...