Endocrine Abstracts

Aim: Audit was carried out in accordance with trust policy to review all adult patients initiated on Growth Hormone during the period April 2009 to April 2011 and primarly to evaluate efficacy and to ascertain if care is consistent with NICE guidelines.Method: Medical notes of all patients initiated on Growth Hormone during the stated period were retrieved. The cases we're audited against criteria 1, 2, 4, 5 and 6 as specified in NICE guideline TA 64, Ap...

Introduction: Ipilimumab (Yervoy, BMS) is a human monoclonal antibody increasingly used in oncology. It targets cytotoxic T lymphocytes antigen 4 (CTLA-4) promoting their proliferation and augmenting an anti-tumour response. It is licensed for the treatment of unresectable or metastatic melanoma and multiple clinical trials using this medication for other malignancies are ongoing. Ipilimumab related adverse reactions are mainly autoimmune and occur in 61% of patients, of which...

Background: Pulmonary-NETs are classified in low-grade typical carcinoid (TC), intermediate-grade atypical carcinoid (AC), and high-grade large cell carcinoma (LCNEC) and small cell carcinoma (SCLC). However, the proportion of pulmonary-NETs with similar histology that behave quite differently is not negligible. Recent studies favour the use of the proliferation marker Ki67.Aim: To evaluate the utility of Ki67 for predicting metastasis in a cohort of pat...

The purpose of the study: Is to study the efficiency of the treatment by Sandostatin-Lar in patients with non-functional pituitary macroadenomas (NFPA) Material and methods.: Under our observation there were 20 patients with NFPA, of whom women were 8, men - 12. The average age of patients was 29,2/36.4 years. All patients were subjected to transnasal adenomectomy of pituitary gland (TAG) in our clinic. The whole patients were performed by research compl...

Introduction: A Nurse-led Thyroid Clinic (NLTC) in a tertiary-care Endocrinology centre (EC) in Oxford was set up in 2005. The patients were managed by an Endocrine Advanced Nurse Practitioner.Aims: To evaluate standard of clinical care (SOCC) quality of service provision (QOSP) and cost effectiveness (CE) of the NLTC.Methods: Three aspects of service were assessed:a) SOCC: ...

Somatotroph adenomas (SA) causing acromegaly exist as two major pathological variants: densely and sparsely granulated, according to the number and distribution of growth-hormone-containing secretory granules. These variants are increasingly recognised by neuropathologists and endocrinologists, but the consequences for tumour behaviour and patient outcome remain to be defined. Sparsely granulated SAs are associated with younger, female patients and are more invasive and prolif...

Background: Several new gene mutations have been reported in recent years to be associated with a risk of familial phaeochromocytomas (PHAEOs). However, it is unclear as to whether extensive genetic testing is required in all patients (pts).Methods: Clinical data of consecutive patients operated for PHAEO over a decade in a tertiary referral centre were reviewed. Genetic screening was performed using a ten-gene panel: RET, VHL, SDHB, SDHD, SDHA, SDHC, SD...

A 35 year old woman was referred to Endocrinology after imaging investigating unexplained pyrexia demonstrated an absent uterus. She was of Pakistani origin and was born phenotypically female with reported normal female genitalia. During late teenage years she experienced virilisation with deepening voice, increased pubic and axillary hair and clitoromegaly. She had absent breast development. Her parents were first cousins and siblings were unaffected. Investigations in Pakist...

Background: Pre-pituitary surgery, patients attend a ‘Pre-Pituitary Surgery Clinic’ (PPSC), to discuss management options and risks. Clinicians in attendance are; pituitary surgeon (1) registrar (1) endocrine team consultants (1–3), registrars (1–2) nurses (1) senior house officer (1) visiting doctors/medical students (4–6). Patients are informed a number of clinicians attend the clinic due to the multidisciplinary nature (MDT) and unit teaching respon...

While phaeochromocytomas are rare tumours, their identification is essential to avoid morbidity and mortality; their biochemical identification is crucial. Plasma and 24 urinary metanephrines are used as first line investigations, with plasma metanephrines increasingly used first due to its simplicity and high sensitivity/specificity. False positive results, however, can be as high as 20%, particularly secondary to medications; their exclusion is essential to avoid unnecessary...