Endocrine Abstracts

A 27 years old primigravid lady presented with nausea and recurrent vomiting at 35 weeks gestation. She was diagnosed with hyperemesis gravidarum at 5 weeks gestation. TPN was commenced but she continued vomiting. On examination, foetal size was normal for gestational age, BP was 105/70 mmHg. Electrolytes were normal except potassium of 2.7 mmol/l, LFT was normal, albumin 29 g/l and uric acid 307 umol/l. 16 days after admission, she rapidly deteriorated with weakness and plasm...

Background: The objective of this study was to define the incidence and prevalence of treated thyroid dysfunction in a complete and representative population base.Method: We used record-linkage technology to retrospectively identify subjects treated for hyperthyroidism or hypothyroidism in the general population of Tayside, Scotland from 1 January 1993 to 30 April 1997. Thyroid status was ascertained by record-linkage of patient-level datasets containing...

Patient empowerment through informed choice is an important message; consistently reinforced through Government initiatives, Trust directives and our Professional Code of Conduct. Historically the Endocrine Nurse Specialist (ENS) performed the role of clinic nurse during Endocrine Clinic. Recognising this as a waste of specialist expertise and resource; identified drug company funding provided a replacement clinic nurse, liberating the ENS to see patients following their docto...

Aims: Previous studies of acromegaly have suggested a prevalence of 60 per million and an incidence of 3-4 per million per year. We have performed a population-based survey to ascertain prevalence and incidence of acromegaly, and biochemical outcomes to treatment. Methods: We have reviewed case notes of all patients with acromegaly under the care of the endocrine unit (referral population of 700,000). Growth hormone (GH) and IGF-1 levels at follow-up were examined. Results: Th...

A 71-year-old man presented with a three week history of nausea, vomiting, constipation, polyuria, nocturia, polydipsia and feeling weak. He had sustained a wrist fracture six weeks prior to admission. Since then he had started to consume calcium containing mineral water, cod liver oil and seven seas oil.Examination revealed a palpable mass in the right lower thyroid. Serum calcium level was 4.37 millimols/litre (ref. 2.10-2.70), parathormone level of 72...

Acute critical illness has an effect on normal physiology resulting in changes in the inter-relations of the endocrine system.Evidence suggests that these changes may be due to the pro-inflammatory cytokines (e.g. interleukin-6 (IL-6)), which are known to have a paradoxical effect on the hypothalamo-pituitary axis, stimulating the adrenal axis, whilst suppressing the remaining axes.Multiple myeloma (MM) patients have elevated IL-6 ...

A 71-year-old man presented with a three week history of nausea, vomiting, constipation, polyuria, nocturia, polydipsia and feeling weak. He had sustained a wrist fracture six weeks prior to admission. Since then he had started to consume calcium containing mineral water, cod liver oil and seven seas oil.Examination revealed a palpable mass in the right lower thyroid. Serum calcium level was 4.37 millimols/litre (ref. 2.10-2.70), parathormone level of 72...

Islet amyloid deposition is a characteristic feature of Type 2 diabetes. Accumulation of IAPP by abnormal intracellular peptide degradation in beta-cell could promote fibril formation. IAPP is present in high concentrations in beta-cell lysosomes. To determine if fibrils form in lysosomes and the pathway for the accumulation human islets were cultured under conditions of elevated production of insulin (11mM glucose) and inhibition of secretion (0.6mM diazoxide) and/or lysosoma...

Bone turnover decreases markedly following both oral glucose and feeding. The mechanism for this is unclear. The aim of this study was to examine whether insulin itself could be responsible for the effect of feeding. We examined the acute effect of a hyperinsulinemic euglycemic clamp (E) and stepwise hyperinsulinemic hypoglycemic clamp (H) on bone turnover and PTH. Sixteen healthy male volunteers (mean age 22) attended on two occasions at 0800 after an overnight fast. The stud...

Introduction: Proinflammatory cytokines, for example interleukin-6, have been found to stimulate the HPA axis at all levels. In animal models glucocorticoids have been shown to suppress cytokines. There may therefore be a balanced interaction during stress when both are raised. For this reason, we investigated patients undergoing routine coronary artery bypass grafting on day 3 post-operatively (CABG) to examine the mechanisms for failure of suppression of the HPA axis in resp...