Endocrine Abstracts

Background: Bilateral neck exploration (BNE) as a routine surgery for PHPT is favored by many experts in endocrine surgery as it may provide the identification of preoperatively undetected multiglandular disease. But for a large cohort of patients BNE remains unnecessary and its possible higher rate of surgical complications is being widely discussed.Objectives: The aim of the study was to evaluate the complication rates of bilateral neck exploration in ...

Aim: This audit aims to access the compliance in management of adrenal incidentalomas with reference of European society of endocrinology guidelines.Background: An adrenal incidentaloma is a mass lesion greater than 1 cm in diameter, serendipitously discovered on radiological examination. It is important to determine its malignant potential and functional status. European society of Endocrinology (ESE) has published its guidelines in 2016 for management ...

Background: Endocrinology, taught in Year 2 of the Edinburgh undergraduate MBChB curriculum to approximately 200 medical students, can present a complex challenge and a test of engagement. Core biomedical curriculum content is delivered as large group teaching (lectures) and then revisited in smaller groups (clinical-cased based tutorials, PBL) designed to integrate learning by applying basic knowledge in a clinical context. PBL first implemented in the 1960s at McMaster Unive...

Introduction: Severe Cushing’s syndrome (CS) is defined by extremely high serum cortisol levels (usually >1000 nM), along with severe and deadly complications, including sepsis, heart failure, acute psychosis, vascular thrombosis, digestive haemorrhage and bowel perforation. Rapid control of such hypercortisolism is mandatory and has been shown to decrease operative mortality and complications. Oral treatments such as ketoconazole and metyrapone are often inadequate i...

Case history: A 59-year-old lady with a background of type 2 diabetes, hypercholesterolemia and hypertension presented with a 3-week history of progressively worsening central abdominal pain and vomiting. Her drug history included bezafibrate and atorvastatin on which she was unable to meet her cholesterol and lipid targets and hence were stopped two weeks prior to her admission. The plan had been to start once fortnightly Alirocumab, a PCSK9 inhibitor; which had been delayed ...

A comprehensive pregestational prenatal monitoring and early detection of diabetes amongst pregnant patients is the cornerstone of the updated ADA recommendation 2016 in Diabetes Care.It is our main objective to lay out an attainable management plan for early diagnosis, and management of gestational diabetic in a community clinic.The plan includes implementation of family planning and effective contraception for known women with pr...

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Introduction: Despite high rates of recurrence after anti-thyroid drug (ATD) withdrawal, ATD (mainly Carbmazole) remain the first line of treatment for Graves’ disease (GD) in the UK. Limited retrospective observational studies have shown that a low TSH post ATD withdrawal had a positive predictive value of 70% and a negative predictive value of 62% (specificity 85%) for relapse of Graves’ disease.Aim: We wished to determine the relationship be...

Introduction: Graves’ disease (GD) is associated with a number of cardiovascular complications, including rhythm disturbances, mitral valve prolapse, pulmonary hypertension and heart failure. Pericardial effusion in the context of GD has only been reported in a small number of cases.Case: A 59-year-old gentleman presented with a 3-day history of dyspnoea and pleuritic chest pain. He had a previous history of GD 8 months ago, pulmonary embolism (PE),...

A 64-year-old Sri Lankan female was admitted with a 1 week history of vomiting and poor oral intake. She had an episode of pneumonia 4 months previously and reported headaches, weight loss and dizziness since then.On admission, her blood tests showed marked hyponatraemia with a sodium of 118 mmol/l and low serum osmolality of 243 mOsm/kg. A short synacthen test confirmed adrenal insufficiency and thyroid function tests showed secondary hypothyroidism des...