Endocrine Abstracts

Obesity is a chronic disease associated with a number of co-morbidities. Management options include lifestyle changes, pharmacotherapy and bariatric surgery. European guidelines recommend the use of pharmacotherapy for BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with comorbidities in adjunct to lifestyle modification. Until 2015, orlistat was the only available medication for the treatment of obesity in Europe. Since then, further pharmacological agents ha...

Obesity is a chronic disease associated with a number of co-morbidities. Management options include lifestyle changes, pharmacotherapy and bariatric surgery. European guidelines recommend the use of pharmacotherapy for BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with comorbidities in adjunct to lifestyle modification. Until 2015, orlistat was the only available medication for the treatment of obesity in Europe. Since then, further pharmacological agents ha...

Bariatric surgery is a well established treatment for obesity and its associated co-morbidities. Many obese patients undergoing bariatric surgery have pre-existing micronutrient deficiencies which can potentially worsen post-bariatric surgery. Pre- and post- surgical nutritional monitoring and follow-up of these patients is imperative as part of long term bariatric care. This lecture will review common nutritional deficiencies post-bariatric surgery, and current guidelines for...

Introduction: Short Synacthen Tests (SSTs) are the gold standard for diagnosis of Adrenal Insufficiency. An early morning cortisol may be an acceptable alternative. We wished to establish current local practice in testing and what lessons could be learned. Clyde uses the Architect Cortisol Assay – adequate response taken as post-Synacthen cortisol of ≥430nmol/l.Methods: We aimed to gather data on ≥100 SSTs and this took 11 weeks (20/05/1...

A 39-year-old female was referred to the emergency department with a sore throat, fever, myalgia and odynophagia. She had presented to her GP three months previously with palpitations, erratic mood and fatigue and had been diagnosed with hyperthyroidism. She had been started on carbimazole 20 mg od and was awaiting review in endocrinology OPD. She had no other past medical history and was a non-smoker. On examination she was tachycardic with a heart rate of 113. She had cervic...

Obesity commonly occurs in PCOS and contributes to increased metabolic risk and low self esteem. Advice on weight loss underpins all management strategies in the obese lady with PCOS but weight loss can remain elusive despite best efforts. We wished to determine how diet advice alone compared to metformin and/or liraglutide in our patients.Methods: We conducted an observational retrospective anonymized review of patients attending an endocrinology clinic...

Objective: A case study that demonstrates the importance of thorough psychiatric assessment, intervention and follow-up in morbidly obese patients presenting for Bariatric surgery and risk of addiction transfer.Background: Positive correlation between psychiatric disorders and obesity is documented. Cases of addiction transfer have been reported complicating outcome post Bariatric Surgery.Case description: A 29 year old Caucasian f...

Introduction: Patients with complex health care needs and severely limited communication and mobility may be less likely to participate in research studies, and may find continued participation in such studies challenging. Allan Herndon Dudley syndrome (AHDS), due to defective thyroid hormone transporter (MCT8), causes severe neurological and physical disability. A multicentre trial (the TRIAC trial) studying the efficacy of the thyroid hormone analogue TRIAC in this rare cond...

Atheroma is accelerated in overt hypothyroidism (OH) and possibly in subclinical-hypothyroidism (SCH), and is not completely explained by increased LDL-cholesterol. There is little data available regarding post-prandial metabolic changes in OH or SCH.Subjects with OH (n=21), SCH (n=28) and age, sex and BMI matched controls (n=50) were studied fasting and for up to 8-h following a mixed-meal. Investigations included apolipoprotein(apo...

Introduction: Advances in the understanding of the natural history and genetics of phaechromocytomas and paragangliomas have altered the demographics of these conditions resulting in much higher rates of malignancy and association with known genetic abnormalities.Objective: To analyse the clinical and biochemical features of hereditary (H) and sporadic (S) phaeochromocytomas and paragangliomas.Design: Retrospective case-series at G...