Endocrine Abstracts

Physical examination in thyroid diseases, should it be relied on?M Sadri, C Y Yiangou, A. DhandaDepartment of thyroid surgery Queen Alexandra Hospital, PortsmouthObjective: Assessment of the accuracy of physical examination performed by thyroid surgery team doctors at thyroid clinic.Method: Random review of 120 new referrals to thyroid clinic, with review of clinical findings on physica...

Reactive hypoglycaemia is usually mild, often presents with non-specific symptoms and may be difficult to distinguish from neuropsychiatric illnessThe diagnosis should be considered when these symptoms are related to eating. We present a severe case of idiopathic hypoglycaemia which responded dramatically to the alpha-glucosidase inhibitor acarbose.A 25 year old woman presented with a nine year history of intermittent thirst, feeling hot, distal paraesth...

Background: The absorption kinetics of soluble insulin are complex. Soluble insulin is absorbed after a delay as the hexameric form dissociates before being absorbed as the dimer.Patients using soluble insulin are instructed to inject 15-30 minutes before meals.In practice few patients comply with these recommendations.The aims of this study were to identify the proportion of patients injecting at the recommended time and to assess any association between injection timing and ...

A 54yr old female presented with a 12-month history of tremor, sweating, anxiety and occasional palpitations. There was no past medical or family history of note. On examination, she had a fine tremor but no neck masses or eye signs. Her FT4 20.8 pmol/l (8pmol/l-22pmol/l), FT3 7.3 pmol/l (3.5-6.5pmol/l) with a suppressed TSH less than 0.01mu/l (0.35mu/l-5.5mu/l); 99Tc scan showed an autonomous hot nodule in the right lower lobe of the thyroid with partial suppression of the re...

Introduction: Evaluation and management of thirst and polyuric syndromes can be challenging in endocrine practice.Case report: A 24-year old lady presented with weight loss, thirst, polyuria, vomiting and abdominal pain. She had acromegaly treated by transsphenoidal surgery 5 years ago. Medications included hydrocortisone, thyroxine (T4), the oral contraceptive pill as well as bromocriptine for postoperative acromegaly. Examination revealed postural hyp...

Background. The endothelial dysfunction prevalent in hypertension and diabetes is associated with an imbalance in the levels of nitric oxide (NO) and superoxide (SO). NAD(P)H oxidase is the predominant source of SO in the vasculature. Objectives. To manipulate levels of SO using the NAD(P)H oxidase inhibitors, apocynin, phenyl arsine oxide (PAO) and 4(2aminoethyl)benzenesulfonyl fluoride (AEBSF) and relate this to NO bioavailability. Methods. NO bioavailability was compared in...

Introduction and aims: The role of screening for thyroid disease in diabetes (DM) remains controversial. We assessed the prevalence of thyroid dysfunction on first screening in a population of patients with diabetes who previously had thyroid function tests (TFT) only on clinical suspicion.Methods: TFT and thyroid peroxidase antibodies (TPO) were measured in 236 consecutive patients with DM (mean age 59±13 years, type1 16%, type2 84%, female 48%)...

Serum IGF-I is increasingly used, and IGFBP-3 has been proposed, as a marker of treatment efficacy in patients with acromegaly. IGF-I bioactivity and half-life are dependent on the degree of IGF-I incorporation into 150kDa ternary complexes with IGFBP-3 and ALS. When serum GH is lowered in patients with acromegaly all three ternary complex components decline, but effects on ternary complex formation have not been described. We investigated GH action on ternary complex formatio...

Background: Pheochromocytoma (PHEO) and paraganglioma (PGL) of abdominal origin secrete catecholamines which are metabolized to metanephrines. Head-and-neck paraganglioma (HNPGL) are considered as non secretary tumors.Objectives: To find the utility of plasma free metanephrine (MN), normetanephrine (NMN) and 3-methxytyramine (3-MT) for the differential diagnosis PHEO/PGL after excluding MEN2 and VHL patients.Methods: A total of 79 ...

Aim: Following the general concern regarding the association between various diabetes treatments and cancer risk, the present study evaluated the cancer specific mortality in adult insulin-treated diabetes patients.Materials and methods: All diabetes patients residing in a major urban area, aged over 40 years and receiving insulin treatment were included at the moment of their first diabetes outpatient visit from 01/01/2001 to 12/31/2008. A total of 1136...