Endocrine Abstracts

Objective: to investigate whether periconceptual undernutrition in sheep alters the timing and activation of the fetal HPA axis and thus pregnancy duration. Preterm birth is a major health problem, but its causes are poorly understood.Methods: Twentyeight nulliparous ewes were randomly assigned to an ad libitum (N, n=8) or restricted diet (maternal body weight reduced by 15-20%; UN, N=10) from 61 d before to 30 d after mating. Therea...

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Introduction: Hypothyroidism can present in a variety of ways, from unexpected abnormal blood results in seemingly asymptomatic patients to those with a multitude of debilitating symptoms. Levothyroxine dose titration is a challenge often faced by physicians. We identified 8 difficult cases which following MDT discussion underwent the Thyroxine Absorption Test (TAT) to gain further clarification (Walker et al. 2013).Aim: To identify if the issue...

The prevalence of adrenal incidentaloma on abdominal Computed Tomography (CT) is around 4.4%. This prevalence is increased in obese, diabetic, hypertensive patients, and could be as high as 10% in older patients. Unilateral adrenal masses larger than 4 cm should be considered for surgical removal to avoid missing adrenal carcinoma, particularly in younger patients.This is the case of a 67 year old gentleman with Type 2 diabetes mellitus, known to have hy...

Introduction: Roux-en-Y gastric bypass (RYGB) places patients at an increased risk of hypocalcemia due to the reduction in calcium absorption (because the procedure bypasses the duodenum and jejunum) and vitamin D deficiency. Subsequent thyroid surgery increases the risk of severe hypocalcemia due to potential post-operative hypoparathyroidism. Only a few cases have been published before of this kind of treatment-challenging hypocalcaemia.Case report: We...

Introduction: Diabetes mellitus is a condition on the increase, carrying a high risk of macro and microvascular disease. Previous studies suggest a link between microvascular and macrovascular complications in diabetes. However, just a few studies have investigated whether the presence of peripheral vascular disease (PVD) is associated with other macrovascular and microvascular complications in diabetes patients. So, this was the aim of our study.Patient...

Introduction: It is well known that diabetes confers a substantial burden of macrovascular disease. However, just a few studies have investigated the association between diabetic kidney disease (DKD) and cardiovascular disease. The purpose of this study is to investigate whether the presence of DKD is associated with macrovascular disease in diabetic patients.Patients and methods: 98 diabetic patients (48 males/50 females) were included in the study. DKD...

Adult endocrine specialist nursing (ESN) is a highly specialised role and in recent years nurses have expanded their roles according to local need (Kieffer.V, et al. 2015). As an Endocrine team we review our practice, striving to provide the highest standard of research based, patient centred care. This involves ensuring the best use of resources and service provision in an ever more demanding environment. A new initiative lead by the ESN with consultant supervision w...

Introduction: Thyroid cancer is the most common malignant endocrine tumour and represents 1% of all malignancies. Cancer Research UK in 2015 reported 3528 new cases and 382 deaths with annual incidence of 5.1 and 1.9 per 100,000 women and men respectively. The incidence is increasing globally, mostly due to papillary thyroid cancer.Ultrasound is the preferred examination with recommended U1-U5 grading system +/- fine-needle aspiration cytology (FNAC)...

The British Thyroid Association executive committee advised in 2015 that there was insufficient evidence that levothyroxine(T4) and liothyronine(T3) combination therapy was superior to levothyroxine monotherapy, which remains the standard treatment of primary hypothyroidism. It was considered an experimental approach in symptomatic patients on T4 therapy with a TSH level within normal range.We present a 47-year-old lady who had been diagnosed with primar...