Endocrine Abstracts

Background: Cushing’s syndrome (CS) is estimated to have a 10-fold increased risk of venous thromboembolism (VTE) compared with the normal population with VTE accounting for 3.6-11% deaths in CS patients. There are no specific guidelines for VTE prophylaxis in CS other than that it should be considered given the increasingly recognised risk.Methods: Via the Society for Endocrinology, we surveyed current VTE anticoagulation practice across UK Endocri...

Background: Central diabetes insipidus (cDI), a rare neuroendocrine condition affecting 1 in 25.000, is characterized by deficiency of arginine vasopressin. Data about treatment-related side effects, psychological co-morbidities, and incidence of wrong management due to confusion with diabetes mellitus are scarce and limited to small studies or case series. Furthermore, increasing interest has arisen on a potential need for re-naming the condition.<p class="abstex...

We all know that endocrinology is the most amazing specialty. However although some of the discoveries in the last 3–400 years have been amazing, some of the wrong turns have exhibited opportunism and quackery. Perhaps we should start with testosterone and the effects of castration. We know that removal of the testes before puberty has irreversible affects and that in 16th and 17th centuries these were exploited for music. Popes did not come out of this covered in glory a...

The GIRFT (Getting It Right First Time) visits, about which we have consulted the membership of the Society for Endocrinology and had positive feedback from many members, have now started. We have done four pilots in Birmingham, Leicester, Oxford and York. The objectives are to try to introduce a quantitative approach to help demonstrate best practice. It will explore surgical outcome data and complication rates with regard to thyroid, parathyroid, adrenal, pituitary and neuro...

Pituitary apoplexy is an uncommon emergency. It presents often with sudden thunder clap headaches and requires multidisciplinary team involvement. This includes an experienced neurosurgeon, endocrinologist, radiologist – the pituitary multidisciplinary team.Urgent treatment should be given often involving steroids (after a blood cortisol has been taken). Assessment includes neurological signs which if severe may merit urgent surgery.<p class="ab...

In order to test posterior pituitary function it is important to assess and replace corticotroph function before assessing posterior pituitary hormone production because ACTH deficiency leads to a reduced GFR and the inability to excrete a water load which may therefore mask diabetes insipidus.With diabetes insipidus the urine output is usually >3 l a day. Other causes of osmotic diuresis need to be excluded.The fluid deprivati...

Acromegaly is almost always due to a sporadic growth-hormone secreting pituitary adenoma, but familial acromegaly has been reported occasionally. Linkage and loss of heterozygosity studies have suggested that it is caused by a tumour suppressor gene located at 11q13. Recently mutations have been identified in a gene in some families with acromegaly alone or acromegaly and prolactinoma. The gene codes for the aryl hydrocarbon receptor interactive protein (AIP), a molecular chap...

The philosophy of my research over the years has been to ask clinically relevant questions which will enhance the practice of decision making in endocrinology, based on scientific assessment of reasonable cohorts. In hitherto unpublished data, we have done work on the assessment of somatostatin responsive headaches in acromegaly and show that they persist over many years, may respond to radiotherapy and may also remain problematic even if acromegaly is cured. We have also look...

This review was published in Nature Reviews Endocrinology. It covers recent advances in treatment of pituitary tumours secreting prolactin including long-term adverse effects of dopamine agonist therapy, outcomes following dopamine agonists withdrawal, advances in surgical tumour resection. In addition, there are sections on management during pregnancy, effects of hyperprolactinemia on bone and fracture risk, the management of cystic and aggressive prolactinomas. Prolactinomas...

There are 126 departments of adult endocrinology in England. We will be producing a national report towards the end of the year joint with the Society for Endocrinology. Endocrinology is not properly coded in hospital data systems. This is because of misattribution to general medicine or diabetes. Commonly accepted clinical standards are not being applied uniformly (e.g., steroid sick day provision). We have looked at surgical volumes. There are a large number of places where ...