Endocrine Abstracts

Pancreatic neuroendocrine tumours (pNET) in patients with MEN1 pose a particular and challenging clinical problem. Whilst patients with a pNET and clear clinical and biochemical evidence of hormonal hypersecretion are usually candidates for some form of surgical or medical therapy, the decision-making is far harder for those who are found to have a non-functioning tumour on surveillance imaging. There is a lack of knowledge of the differing biological behaviour between pNETs i...

Pituitary radiotherapy plays an important role in the overall management of pituitary disease, but needs discussion at an expert regional pituitary MDT. Repeat surgical exploration is increasingly performed either as an alternative to radiotherapy or to further reduce tumour bulk ahead of radiotherapy. Careful discussion with the patient on the risks and benefits of radiotherapy, and all the other options, is essential. It is best to consider the control of tumour growth and a...

Background: Prolactinomas are usually highly sensitive to dopamine agonists. We report the use of temozolomide in a 47-year-old gentleman with MEN 1 and a highly dopamine agonist-resistant, and aggressive prolactinoma.Case summary: He presented in 2001 with a 3rd nerve palsy and recurrent headaches. MRI revealed a pituitary tumour extending into the left cavernous sinus. Prolactin levels were 29 000 mU/l. (NR<360). Primary hyperparathyroidism, a lesi...

BackgroundCushing’s disease (CD) is caused by high levels of blood cortisol resulting from excess secretion of adrenocorticotropic hormone (ACTH) from an anterior pituitary corticotroph adenoma. Clinical manifestations include diabetes, hypertension, osteoporosis, and depression. If untreated, CD has an increased mortality of five-fold owing to cardiovascular comorbidities, stroke or raised vulnerability to infection. Currently, transsphenoidal surg...

Introduction: Trans-sphenoidal Surgery (TSS) remains the primary treatment for acromegaly in most patients, but no previous data exist on outcomes for patients treated with gamma knife radiosurgery (STRS) as a primary treatment.Methods: 20 patients with acromegaly underwent primary STRS at the National Centre for Radiosurgery, Sheffield, UK between 1985 and 2015. Data collection: note review, database, laboratory results, patient questionnaire, and death...

Introduction: It is postulated that uptake rates for gestational diabetes mellitus (GDM) screening would be improved if offered in a setting more accessible to the patient. However, this has not been previously investigated, nor has the feasibility or the acceptability of such an alternative. The aim of this study is to evaluate the rate of uptake of GDM screening in the primary vs secondary care setting, and to qualitatively explore the providers’ experience of primary c...

Aim: We had noted that certain patients with metastatic mid-gut carcinoid had subcutaneous nodules in the gluteal region. This prompted us to assess this in more detail as the concern was whether these represented metastases.Method: A cross-sectional study was designed to assess CT scans of 56 patients with metastatic mid gut carcinoid attending the Neuroendocrine Tumour Clinic. These were analysed by two independent radiologists blinded as to the treatm...

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...

Aims: The aim of this paper is to report on the outcomes of a clinical trial investigating the clinical effectiveness of universal screening for gestational diabetes mellitus (GDM) in primary care vs secondary care.Design and methods: A parallel group randomised controlled trial of universal screening for GDM in primary vs secondary care. The primary outcome – uptake of screening in primary vs secondary care is reported elsewhere. In this article we...

Aim: The aim of this paper is to report on the outcomes of a randomized controlled trial designed to evaluate the effectiveness of a group-based lifestyle intervention programme for reducing the risk factors associated with diabetes in women with pre diabetes following gestational diabetes. We expected that the group based intervention through its educational and supportive approach would enable improvements in psychosocial health, health behaviours, anthropometry, and glucose...