Endocrine Abstracts

The porphyrias encompass a group of disorders characterized by inherited or acquired derangements in the biosynthesis of heme.Porphyria cutanea tarda is the most common form and is characterized by chronic skin lesions and hepatic disease.It may rarely be complicated by hepatocellular carcinoma. We present a 67 year old man who presented with hepatocellular carcinoma on a background of previous porphyria cutanea tarda.The patient was diagnosed with Type ...

Patients with hypoadrenalism are at risk of life-threatening events if they do not receive adequate glucocorticoid replacement during intercurrent illness. We think that these patients should know when and how to adjust their steroid dose when ill. We also think they should possess, and know how to give themselves, an injection of hydrocortisone for emergencies.Current education is given ad hoc at clinic visits, supported by written information, but ther...

Arginine and other aminoacids have been reported to induce GH discharge, even if their site of action has not been clearly established. The aim of this study was to determine the effects of different culture media on GH secretion by pig pituitary cells. Pituitary cells from adult female pigs were cultured for 72 h in the following media: DMEM-F12 (Group A), DMEM-F12 SALTS (Group B) and DMEM-F12 ARGININE FREE (Group C), in standard culture condition (0-48 h: FCS 10%; 48-72 h: F...

Adrenal incidentalomas are increasingly recognised with the use of abdominal imaging with prevalence ranging from 0.35-0.45%. The vast majority of these are benign adrenocortical adenomas. Increasingly, subclinical hypercortisolism is recognised in such cases.We describe a case of a 34-year-old asymptomatic primigravida with chance recognition of an adrenal mass during an obstetric ultrasound. Biochemical testing revealed consistently normal urinary catecholamine and eleva...

Over a third of women with polycystic ovarian syndrome (PCOS) display glucose intolerance and multiple risk factors for cardiovascular disease, including central obesity. Interleukin-6, a cytokine that is mainly derived from adipose tissue, has recently been implicated as an important link in the development of cardiovascular disease in obesity. We determined the relations between circulating Interleukin-6 levels and anthropometric, metabolic and hormonal parameters in 38 wome...

Background: Octreotide LAR is used in the treatment of Acromegaly and is effective in reducing growth hormone levels in the majority of patients. With the introduction of the Endocrine Specialist Nurse it has been possible to take their care into the community.Method: A questionnaire was administered for both patients and practice nurses, to enable us to highlight the benefits and identify any problems. It was sent to 27 patients who receive Octreotide LAR and 27 GP Surger...

The hypothalamo-pituitary-adrenal (HPA) axis is essential component of the physiological stress response. Functional hypoadrenalism is a hypothetical contributor to mortality in the critically ill, though biochemical evidence for this is conflicting. Most studies have shown that 'high' random plasma cortisol in the first 24 hours of illness is associated with a high mortality. However, these data may be confounded by increased severity of illness in high mortality cohorts. Giv...

Diabetes and impaired glucose tolerance are associated with increased risk of cardiovascular diseases. Criteria for high risk populations that should be screened for diabetes needs be revising.Hospital admissions are stressful events and abnormally high random blood glucose levels are not acted upon appropriately.We studied 100 consecutive admissions to coronary care unit to assess the incidence of hyperglycaemia/diabetes on admiss...

A gender-related bias in survival rates has been demonstrated in rodent models of critical illness. Sex steroids have differential effects on metabolic, immune and cardiovascular end points which may underlie these observations. The hypothalamo-pituitary-gonadal (HPG) axis response to critical illness in humans is poorly characterised. We have conducted a prospective study to characterise this response in the context of heterogeneous disease severity and disturbances in overal...

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, ...