Endocrine Abstracts

Hypopituitarism has been reported in 28-65% of long-term survivors of traumatic brain injury (TBI). We attempted to define the natural history of post-traumatic hypopituitarism in order to devise guidelines for the optimal timing of patient assessment and hormone replacement.Fifty consecutive patients with severe or moderate TBI were enrolled in a prospective study of pituitary function during the acute phase, at 6 months and, at 12 months following TBI....

The syndrome of inappropriate antidiuretic hormone (SIADH) is characterised by euvolamic hyponatraemia. Patients with SIADH continue to drink normal amounts of fluid, despite plasma osmolalities well below the physiological osmotic threshold for the onset of thirst. The regulation of thirst has not been previously studied in SIADH. We studied the characteristics of osmotically-stimulated thirst and vasopressin (AVP) secretion, and the non-osmotic suppression of thirst and AVP ...

Recent evidence suggests a high prevalence of neuroendocrine dysfunction in patients following traumatic brain injury (TBI), but dynamic anterior pituitary assessment were performed in relatively small number of patients and posterior pituitary function remains poorly investigated.We studied 102 consecutive patients (84 males) who had survived severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13] at a mean (+/- standard deviation) of 19 +/...

Recently the American Diabetes Association (ADA) adopted a lower cut off for (IFG) Impaired fasting glucose (greater than or equal to 5.6 millimol per litre). We suggested that performing oral glucose tolerance tests (OGTT), in all subjects with IFG according to the new ADA criteria, would result in very little new diagnosis of Diabetes Mellitus (DM) and to test this hypothesis we reviewed our recent experience with OGTTs.Between August 2001 and June 200...

Studies in the general population have shown a prevalence of the metabolic syndrome of 17-25%. We have studied the prevalence of the metabolic syndrome in patients with diabetes mellitus (DM). A total of 150 consecutive patients with type 1 (21%) or type 2 DM (79%), mean age 59.1y (28-85), attending for annual review were studied to determine if they satisfy (ATP III) diagnostic criteria for the metabolic syndrome. Fasting plasma glucose, triglycerides, HDL cholesterol, blood ...

The insulin tolerance test (ITT) is the gold standard for assessing growth hormone (GH) and cortisol production in pituitary disease, However it is potentially hazardous, requires medical supervision and adequate hypoglycemia may not be achieved. We retrospectively examined the records of 185 consecutive patients aged 14-76 years with pituitary disease who underwent the ITT over 18 months. Testing was performed in the endocrine day ward by an experienced endocrine nurse. Absol...

Hypopituitarism is associated with premature vascular mortality. Growth hormone (GH) deficiency, over-replacement with glucocorticoid, cranial irradiation and traditional vascular risk factors are possible contributing factors to the excess mortality.We studied 200 consecutive adult hypopituitary age (mean standard deviation) 51.7 plus/minus 15.3 years, who attended our pituitary clinic between July and December 2002. Hypertension was defined as blood pr...

Pituitary hormone abnormalities have been reported in up to 50% of survivors of traumatic brain injury (TBI), tested several months or longer after the event. No information is available on the frequency of hypopituitarism in the immediate post-TBI period.We studied 50 consecutive patients who were admitted to the neurosurgical unit with severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13]. Testing was performed at a median of 12 days pos...

Corticosteroid therapy is associated with potentially serious side effects, but there is no information available regarding glucocorticoid requirements in adult hypopituitary patients with partial adreno-corticotrophin hormone (ACTH) deficiency.10 male adult hypopituitary patients with partial ACTH deficiency, baseline plasma cortisol > 200 nanomole/ litre but a peak stimulated cortisol < 550 nanomole/ litre, were randomised to a cross-over protoco...

Hypothalamic-pituitary (HP) dysfunction is common in children treated with cranial radiotherapy (RT) for brain tumours but there is little known about the risk of HP dysfunction in adults treated with RT for primary non-pituitary brain tumours.We aimed to investigate the frequency of HP dysfunction in adults after RT for primary brain tumours which are distant from the HP region.We studied 56 adult patients who received external be...