Endocrine Abstracts

Gout, which is commonly associated with hyperuricaemia, affects 0.2% of the population. Hyperuricaemia has a heterogeneous aetiology that may be due to either over production and/or reduced renal clearance, of urate. In order to identify the mechanisms underlying reduced excretion of urate, we undertook positional cloning studies of familial juvenile hyperuricaemic nephropathy (FJHN), which is an autosomal dominant disorder characterised by hyperuricaemia, a low fractional ren...

VA Thornton-Jones, JAH Wass and HE Turner, OBJECTIVE: Despite a recommended injection frequency of 4 weekly(4w), prolonged duration of GH suppression has been observed in some patients following treatment with long-acting somatostatin analogues. The aim of our study was to perform a prospective systematic study to determine whether extending the interval between doses of Octreotide LAR (LAR) allows maintenance of 'safe' GH in selected patients with acromegaly.<p class="abs...

Background: Acromegaly has until now been managed almost entirely in tertiary care. Introduction of nurses specialising in endocrinology has enabled us to take their care into the community.Method: 39 patients (P) mean age 57y(29-82) with active acromegaly, required Octreotide LAR treatment, and lived 5-173(median 38) miles from the endocrine unit. A shared care (SC) protocol was approved whereby the patient's first injection was given at the hospital, ...

Aim: To assess the relationship between clinical symptoms, growth hormone (GH) and IGF-1 during medical treatment for acromegaly.Methods and Patients: 6 patients, mean age 52y, (range 43-68), 4 males, were treated with Lanreotide SR (LAN). A growth hormone day curve (GHDC) and IGF-1 were assessed at week 0, pre LAN. All patients received LAN 30mg, 2weekly. GHDC was repeated at week 8, aiming for mean growth hormone (MGH) <5mu\/l. LAN was increased t...

A 63-year-old type 2 diabetic gentleman with paranoid schizophrenia presented in October 2008 with systemic sepsis arising from multiple neuropathic foot ulcers. Foot MRI confirmed extensive osteomyelitic change. This admission followed two previous similar episodes which culminated in surgical debridement of the ulcers and amputation of the second and third toe of his left foot. Post-operatively, as his condition improved he was unable to comply with IV antibiotics, VAC dress...

BackgroundTransdermally absorbed alcohol-based testosterone gel has presented an alternative method of gonadal therapy. This study was designed to investigate the clinical effectiveness of this alternative hormonal replacement.Method97 men requiring testosterone replacement therapy for primary (21%) or secondary (79%) hypogonadism were recruited. The subjects underwent physical examination, psychological asse...

BackgroundThis study was designed to monitor the clinical effectiveness of transdermal replacement. Psychological well-being was assessed by questionnaire at 3, 6 and 12MethodWe recruited 97 men requiring testosterone replacement therapy for primary (21%) or secondary (79%) hypogonadism. All had a physical examination, biochemical and haematological blood sampling (Meston et al 2004) and psychological assessm...

Background:Long acting somatostatin analogues are an effective treatment for acromegaly but require administration by nurses.To improve patient convenience we have taken care into the community with endocrine specialist nurse education of practice nurses in administration of injections.Methods:After an initial pilot study, a questionnaire was administered to patients receiving, and practice nurses administering, Somatuline Autogel(SA) n=10 and Sandostati...

Carcinoid tumours are neuroendocrine tumours that may arise as isolated non-familial cancers or in association with multiple endocrine neoplasia type 1 (MEN1), which is an autosomal dominant disorder characterised by the combined occurrence of tumours of the parathyroids, the anterior pituitary and the pancreatic islets. The molecular mechanisms underlying carcinoid tumourogenesis have not been fully defined and in order to further characterise these, we undertook 2 approaches...

BACKGROUND: Antiangiogenic effects have been demonstrated with currently available somatostatin analogues. The mechanism remains unclear, although some studies suggest inhibition of the pro-angiogenic tumour vascular endothelial growth factor (VEGF) production.OBJECTIVE: To determine whether pre-operative Lanreotide (LAN) in patients with acromegaly influences circulating VEGF.PATIENTS AND METHODS: Serum samples from six acromegal...