Endocrine Abstracts

Fetal stress, including inadequate nutrient supply and cessation of fetal growth, are major stimuli to the onset of parturition which acts to promote maturation of the hypothalamic-pituitary axis. These adaptations, together with rapid removal of lung liquid fluid and onset of endogenous heat production at birth, ensure oxygen supply is adequate and hypothermia prevented. A critical component of fetal organ maturation in preparation for life after birth is mitochondrial develo...

Growth in utero depends on adequate development and function of the fetal / maternal interface. During pregnancy, the insulin-like growth factors (IGFs), which are known to be critically involved in placental development, are controlled by a binding protein - IGFBP-1 - produced by maternal decidualised endometrium. We have recently found that decidua also produces a protease which cleaves IGFBP-1 into fragments that are unable to bind ligand. This study aimed to identif...

Case ReportA 36 year old Asian female presented to the Accident and Emergency with a sudden collapse.On examination, the patient was pyrexial at 38.3 degC and had a Glasgow Coma Scale of 4 associated with nuchal rigidity. The patient was ventilated and transferred to ITU. An MRI head scan revealed a large ring enhancing lesion in the hypothalamus which extended to the third ventricle. There was also diffuse lepto-meningeal enhancement with hydrocephalus....

Background & Methods: Occasional case reports of individual patients with scalp hairloss while receiving somatostatin analogues for acromegaly led us to audit similar patients in our departments.Results: Ten patients (four men, mean age at diagnosis 44.7years [range 26-65years]) who have received somatostatin analogues either initially as primary therapy (50%) or as post-surgical treatment (50%) for uncured acromegaly reported significant scalp hair...

Patients with Cushing's disease are well known to develop easy bruising due to cortisol excess but are also predisposed to thrombembolism.We present four patients who developed thromboembolism during active Cushing's disease.Case 1- Four year history of hypertension, osteoporosis and central obesity. A DVT developed prior to referral. Initial urinary free cortisol(UFC)was 524nmol/24hrs. Inferior petrosal sinus sampling indicated ...

Background: Acromegaly has until now been managed almost entirely in tertiary care. Introduction of nurses specialising in endocrinology has enabled us to take their care into the community.Method: 39 patients (P) mean age 57y(29-82) with active acromegaly, required Octreotide LAR treatment, and lived 5-173(median 38) miles from the endocrine unit. A shared care (SC) protocol was approved whereby the patient's first injection was given at the hospital, ...

Aim: To assess the relationship between clinical symptoms, growth hormone (GH) and IGF-1 during medical treatment for acromegaly.Methods and Patients: 6 patients, mean age 52y, (range 43-68), 4 males, were treated with Lanreotide SR (LAN). A growth hormone day curve (GHDC) and IGF-1 were assessed at week 0, pre LAN. All patients received LAN 30mg, 2weekly. GHDC was repeated at week 8, aiming for mean growth hormone (MGH) <5mu\/l. LAN was increased t...

Background: Anecdotal reports have suggested that silent ACTH tumours behave in an aggressive fashion, however, clear comparative data are lacking.Methods: 28 patients (16 men, mean age 51.3years [range 30-80years]) who underwent trans-sphenoidal surgery in Oxford between 1975 and 2001 for clinically non-functioning adenomas where the subsequent immunostaining was positive for ACTH were identified from the patient database. The mean follow-up period was...

Height and weight measurement is an important data source in affairs related to growth and development, puberty and nutritional status of children and adolescents. In clinical setting NCHS charts are used in Iran. Although there were significant differences among provinces, between urban and rural children and all the percentiles of growth charts from the data of national health survey in Tehran, in 1990-1992, were substantially below but similar to those of the NCHS charts. I...

Survival figures following the treatment of brain tumours continue to improve. Patients receiving cranial radiotherapy (XRT) frequently suffer a progressive loss of anterior pituitary function secondary to radiation damage to the hypothalamic pituitary axis (HPA), therefore long-term follow up is required. The time frame of radiation damage to the HPA is not known. There is also a suggestion from animal data that the HPA is more sensitive to damage by radiation when treated at...