Endocrine Abstracts

KICk-OFF is a 5 days structured education course for 11–16 years old with type 1 diabetes. It has been developed with input from school teachers, children and families and follows constructivist learning theory. A pilot study resulted in some changes to the curriculum.From 2008–2013 a cluster randomised controlled trial, funded by Diabetes UK, has been undertaken, involving 396 participants from 31 UK NHS diabetes centres. Centres were randomis...

We have been issued with the challenge of delivering structured education to our children and families, with much guidance on the standards we should be aiming to achieve. However translating that into effective educational packages that can be delivered by all centres is challenging, especially when operating within the constraints of staff resources, the need to deliver a clinical service and the lack of ‘teacher training’ opportunities for paediatric teams.<p ...

The low incidence of new cases of craniopharyngioma, 1-2 per million per year, and the great variability of morbidity at presentation, have made the evaluation of optimal tumour management extremely difficult. Two patterns of management have evolved over the last 3 decades, namely the performance of 'definitive' radical surgery at onset followed by the use of irradiation to deal with any later recurrence and subtotal tumour resection at onset followed by early irradiation to p...

Patients with neuroendocrine tumours require co-ordinated multidisciplinary and multimodal management, with appropriate referral pathways and access to timely expert care. This is exemplified by the European Neuroendocrine Tumour Society (ENETS) Centres of Excellence (CoE). There are forty CoE in Europe, ten of which are in the UK. The bar to achieve CoE status is set high, and the standards used for the audit assessments are appropriate to deliver best care even where centre ...

Recent years have seen major advances in our understanding of the causes of adrenal and pituitary Cushing’s syndrome. Careful molecular analyses have yielded new information about the underlying cellular mechanisms leading to the excess secretion of ACTH from the pituitary or cortisol from the adrenal. Unpicking these mechanisms has allowed proposals for new clinical trials of medical treatments for Cushing’s disease. Intriguingly, inherited germ line mutations appea...

Patients with neuroendocrine tumours require co-ordinated multidisciplinary and multimodal management, with appropriate referral pathways and access to timely expert care. This is exemplified by the European Neuroendocrine Tumour Society (ENETS) Centres of Excellence (CoE). There are forty CoE in Europe, ten of which are in the UK. The bar to achieve CoE status is set high, and the standards used for the audit assessments are appropriate to deliver best care even where centre ...

Recent years have seen major advances in our understanding of the causes of adrenal and pituitary Cushing’s syndrome. Careful molecular analyses have yielded new information about the underlying cellular mechanisms leading to the excess secretion of ACTH from the pituitary or cortisol from the adrenal. Unpicking these mechanisms has allowed proposals for new clinical trials of medical treatments for Cushing’s disease. Intriguingly, inherited germ line mutations appea...

All those involved in delivery of health care are obliged to deliver safe and effective management for patients. Effectiveness is often achieved where specialists for the condition are involved. In contrast, patient-safety depends of recognition of the condition in question and then use of appropriate treatment and management, regardless of who is seeing the patient. This is particularly the case where there may be a rare disease confused for a common one, and where the treatm...

Adrenal incidentalomas (AI) found on axial imaging are common. In ages <20 y the prevalence is <1%, but this increases around 10% of the population aged 70 y. Depending on definitions anything between 10–40% of these tumours exhibit low-grade cortisol excess, but patients are without the classic features of Cushing’s syndrome. This equates to 1–4% of the ageing population.Independent studies from our own group and others have demon...

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...