Endocrine Abstracts

Background: Insulin resistance and ageing are risk factors for the development of type 2 diabetes and atherosclerosis. Insulin signalling in macrophages affects their inflammatory responses and foam cell formation capacity, yet the mechanisms linking these remain unclear. Recent evidence has emerged linking macrophage lipid metabolism and inflammatory response such as an interferon-cholesterol pathway flux axis. Insulin has been shown to directly regulate chol...

The widespread use of cross-sectional imaging has led to increased detection of adrenal masses in 2% of general population and over 7% of those above age 70. Although majority are benign, it is important to exclude hormonally active or malignant lesions. Mild autonomous cortisol secretion (MACS) is the most common and found in 30-50% of patients with adrenal mass. We reviewed our adrenal incidentaloma database for patients who attended the nurse-led pathway for biochemistry in...

The General Medical Council’s publication ‘Outcomes for Graduates’ places emphasis on doctors being able to integrate biomedical science, research, and scholarship with clinical practice. In response, a new paradigm of assessment was introduced for the intercalated Bachelor of Science (iBSc) in Endocrinology program at Imperial College School of Medicine. The approach involves authentic “active learning” assessments analogous to tasks encountered in a ...

Background: Cranial Diabetes Insipidus (CDI) or Arginine-Vasopressin Deficiency (AVP-D) is a potentially life-threatening condition requiring treatment with desmopressin. Omission or delay in desmopressin can result in serious patient harm.Aims: Evaluation of desmopressin prescription/administration practice and implementation of an action plan to improve patient safety.Methods: Re...

Background: An estimated 462 million individuals are affected by type 2 diabetes mellitus (T2DM), corresponding to 6.28% of the world’s population. Many epidemiological studies have indicated that T2DM may be a risk factor for neurodegenerative diseases, including Parkinson’s disease (PD). Whilst research suggests there are common molecular mechanisms underlying the conditions, studies investigating the epidemiological association have revealed conflicting res...

Context: Steroid hormone-producing tumors account for 0.1% of all primary ovarian tumors. According to the cellular origin they are classified into stromal luteomas, Leydig cell tumors and steroid tumors not otherwise specified. Symptoms and phenotype depend on the specific hormones and concentrations released from the tumor. In this report, we present a postmenopausal woman with virilization during two pregnancies and in menopause caused by an androgen producing ovarian tumor...

Respiratory disorders are a major cause of illness and impaired physical function in patients with acromegaly, contributing to 25% of all recorded deaths, with respiratory mortality 3-fold higher than in normal subjects. Sleep apnoea (SA), the phenomenon of recurrent cessation or decrease of airflow to the lungs during sleep, is the commonest reported respiratory complication. Both obstructive (OSA) and central (CSA) sleep apnoeas are known to occur, although the overall preva...

Background: Primary aldosteronism (PA) is a common, curable and high-risk subset of hypertension, mandating detection. In all but the most severe cases, learned society guidelines recommend confirmatory testing. Whilst a variety of confirmatory tests exist, data describing their safety are limited. Concerns centre around the potential of some tests to precipitate hypokalaemia or a hypertensive emergency in a patient with PA on sub-optimal anti-hypertensive medication. In this ...

Background /Methods: Adrenal incidentalomas pose a significant burden to endocrinology services in assessing the clinical significance of these lesions. Following vetting of the incidentaloma referrals, the patients at our centre are initially seen in a nurse-led clinic for biochemical investigations and to ensure completion of radiology assessment using a structured proforma. This step facilitates efficient patient flow and quicker decision making. The clinical outcomes of th...

Introduction: Frimley Park Hospital, Surrey had been a negative HbA1c outlier for 3 consecutive years. The Children’s and Young People’s (CYP) diabetes team embarked upon the RCPCH National CYP Diabetes Quality Improvement (QI) Programme in November 2019. There was little qualitative data on ward nurse education, however, experience revealed engagement in staff training was the main barrier. Although regular education sessions were available to ward staff, attendance...