Endocrine Abstracts

Radioiodine treatment is the cornerstone of differentiated thyroid cancer (DTC) management. A number of thyroid cancers, however, become radioiodine-refractory (RAIR) and these represent about 60% of advanced DTCs and are responsible for the vast majority of DTC mortality. RAIR DTC has limited therapeutic options, mainly tyrosine kinase inhibitors that are associated with moderate efficacy and considerable toxicity. Reinducing NIS expression (redifferentiation) with the aim of...

Introduction: Somatostatin analogues (SSAs) are the mainstay of treatment for carcinoid syndrome (CS)-related symptoms. Controversy still exists regarding the extent of the efficacy of this intervention. The purpose of the systematic review and meta-analysis was to evaluate the percentage of patients achieving partial (PR) or complete response (CR) with the use of SSAs (lanreotide, octreotide, pasireotide) in patients with CS. Due to lack of uniformity and established criteria...

Purpose: HPA axis activation resulting in increased cortisol production by the adrenals is a crucial part of the response to critical illness. The action of cortisol may also be modulated at the tissue level, through changes in the availability of the free fraction and modifications of the glucocorticoid receptor activity. It has been proposed that tissue resistance to glucocorticoids may occur, at least in some patients, and relate to insufficient anti-inflammatory activity a...

Background: Adrenal masses are discovered in 5% of abdominal imaging scans. Work-up aims at exclusion of malignancy and hormone excess. However, estimates of these risks derive from retrospective studies only, mostly small and with significant selection bias.Methods: Prospective multi-centre study (2011–2016) in 14 centres (11 countries) of the European Network for the Study of Adrenal Tumours (ENSAT) with prospective consecutive enrolment of patien...

Background: Adrenal masses are discovered in 5% of cross-sectional abdominal imaging scans. Work-up aims at exclusion of malignancy and hormone excess. However, estimates of these risks presently derive from retrospective studies only, mostly small and with significant selection bias.Methods: Prospective multi-centre study (2011–2016) in 21 centres (17 countries) of the European Network for the Study of Adrenal Tumours (ENSAT) with consecutive enrol...

Patients with adrenal insufficiency require increased hydrocortisone (HC) replacement doses during surgery, trauma and infection to avoid life-threatening adrenal crisis. However, currently administered HC doses are chosen empirically rather than on rational grounds, with huge variability in administration modes, total dose and dosing intervals. To conclusively determine serum cortisol levels observed under stress conditions, we firstly collected blood samples from healthy con...

Objective: Somatic mutations in the GNAS1 gene, which encodes the alpha-subunit of G stimulatory proteins (gsp), are frequently detected in somatotroph pituitary tumors and have been associated to specific clinical-smaller and less invasive tumors occurring in older patients- and histopathological-densely granulated adenomas- characteristics. However, the question whether the presence of a somatic gsp mutation affects the response to somatostatin analogue treatment remains unr...

Patients with adrenal insufficiency (AI) require adjustment of hydrocortisone (HC) dose to avoid life-threatening adrenal crisis during illness, surgery and trauma. However, current dose recommendations are based on empirical grounds only and choice of dose and administration modes vary considerably. We designed the PACS study to compare cortisol levels achieved by currently recommended HC stress doses to those in i) healthy controls (n=85, 21–70 years), ii) mili...

Introduction: The hypothalamo-pituitary adrenal axis has been extensively investigated in sepsis. Most studies concentrated in the acute phase and in most the high-dose ACTH stimulation test has been applied. Studies extending in the post-acute phase by using the more physiological low-dose ACTH stimulation are scarce.We aimed to investigate the time course of cortisol levels before and after stimulation with 1μg Synacthen in mechanically ventilated...

Polycystic ovary syndrome (PCOS) affects 5–10% of the female population. It is characterised by androgen excess and anovulatory infertility; several studies have reported an increased incidence of the metabolic syndrome and enhanced 5α-reductase activity in PCOS. However, the contribution of obesity to these findings has yet to be clarified. Here we have analysed metabolic status and urinary steroid metabolite excretion in 114 patients with PCOS (median age 30 (range...