Endocrine Abstracts

Introduction: ‘Primary Aldosteronism Detection, Diagnosis and Treatment Guidelines’ from the Endocrine Society (2008) recommend the use of the aldosterone- renin ratio (ARR) to detect primary aldosteronism (PA) in patient groups with high prevalence of PA. The guidelines suggest cut-offs specific to assay type and measurement units. The department of Clinical Chemistry and Metabolic Medicine at RLBUHT recently moved to a direct renin method (iSYS, Immunodiagnostics) ...

Cardiovascular diseases account for more deaths in the Western world than from any other cause. Atherosclerosis has a chronic inflammatory component involving Th1 pro-inflammatory cytokines such as IFN-γ, which is known to induce endothelial cell inflammatory responses. CNP, acting via its receptors to elevate intracellular cGMP, is produced by endothelium and endocardium and is upregulated in atherosclerosis. It is believed to be protective yet its role in vascular infla...

Introduction: The National Paediatric Diabetes Audit (NPDA) provides a benchmark of performance for paediatric diabetic services across the UK. Whether intentional or not, a league table is created comparing units based on their mean HbA1c. Although the coordinators suggest submitting the patients’ most recent HbA1c, this may not necessarily be a universally adopted phenomenon. We examined the effect of selecting patient’s best, yearly average, and latest HbA1c on ou...

Introduction: In 2005, an explorative study was undertaken on behalf of the Pituitary Foundation (PF) to assess the psychosocial impact of living with a pituitary condition. The study found high levels of psychosocial distress among patients resulting in reduced quality of life (QoL). Improving QoL is central to the National Institute for Clinical Excellence guidance on improving outcomes for pituitary patients. The aim of this study was to utilise the same measures of psychos...

Background: Over the last two decades, supported by two metanalyses, the low-dose Synacthen Test (LDST) has gained in popularity, with many believing it to be more sensitive than the supra-physiological Standard (250 microgram) Short Synacthen Test (SSST). The literature reveals lack of consensus about its specific clinical applications, what is considered “low-dose” and how that dose is made up.Methods: To ascertain current UK practice,...

Introduction: NICE Guidelines NG18 (published 2015) advocate a more conservative approach to management of diabetic ketoacidosis (DKA) in children and young people up to the age of 18, in an attempt to reduce the risk of cerebral oedema.We aimed to assess if management of DKA in children at Manor Hospital was compliant with hospital guidelines, that were based on BSPED guidelines (issued 2009). We analysed the difference in total fluid administered if th...

Adrenal crisis (AC) is an acute life-threatening emergency contributing to excess mortality in patients with autoimmune adrenal insufficiency (AAI). Clinical, demographic and educational factors associated with high rates of AC admission remain unclear. We therefore examined the long-term clinical course of 91 patients with AAI.Methods: A retrospective observational study of 91 patients with AAI was performed. Electronic health records (...

Adult growth hormone deficiency (AGHD) is a metabolic syndrome characterised by osteoporosis, increased visceral fat, adverse lipid profiles, decreased muscle mass and reduced energy levels. As such, it is associated with reduced quality of life (QoL) and increased mortality from cardiovascular disease. Synthetic growth hormone (GH) can be given to replace natural GH; however, treatment is costly at around £3350 per patient per year and could cause side effects including ...

Background: Treatment of primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism due to idiopathic hypercalciuria (SHPT-IH) is markedly different. Nevertheless, differentiating one from another remains a challenge and robust diagnostic tools are lacking. The thiazide challenge test (TCT) has been proposed to aid clinicians in their decision making. However, evidence supporting its use is non-existent.Materials and me...

Background and aims: Estimating puberty using Tanner stages is usually done unconfidently by general paediatricians. Self-assessment methods are not reliable. As assessment of growth on the new UK growth charts necessitates establishing pubertal status, we have designed and evaluated a simpler non-invasive approach.Methods: The new system has three Phases– Pre-Puberty (Tanner stage 1), In-Puberty (stages 2/3) and Completing-Puberty (stages 4/5)....