Endocrine Abstracts

Much has been written on the attributes of preoperative localisation and minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism. A recent 'summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century' (Bilezikian et al, 2002) suggested however that in experienced hands, conventional open parathyroidectomy with visualisation of all four glands was still the gold standard. In light of this we have carried o...

We report two ladies who presented with thyroid dysfunction associated with neck swelling. In both cases within ten days of consultation they developed rapid enlargement of their mass associated with marked swelling of an arm.Case 1. A 63 year old lady developed sudden onset of a thyroid swelling associated with a new diagnosis of primary hypothyroidism . She had lost weight and felt tired. On examination she had a moderately enlarged woody goitre, there was no associated ...

To dissect mechanisms which result in 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) insensitivity we have compared the antiproliferative actions of 1,25(OH)2D3 in a range of malignant breast cell lines (ZR-75-1, T-47D, MCF-7, MCF-7Res and MDA-MB-231) and the non-malignant breast epithelial cells MCF-12A cells. All the malignant cell lines displayed greater resistance than MCF-12A cells to 1,25(OH)2D3. For ex...

Background: The high prevalence of chronic disease urges for new ways of working with our patients as active members of the health care team to better design processes for ongoing supportive treatment. Our Division of Endocrinology & Metabolism at the University of Alberta prioritized the need to improve care for those living with adrenal insufficiency (AI). We have worked with AI patient partners to address learning needs and priorities of our patients, their caregivers, ...

Objective: The 250 µg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency (AI). There are challenges to the use of the SST in routine clinical practice, including staff and resource limitation in the current COVID-19 pandemic and Synacthen cost. We aimed to investigate the value of basal cortisol level for predicting AI in our selected cohort of patients at risk of secondary adrenal insufficiency from pitui...

In the clinic, glucocorticoids are widely used due to their anti-inflammatory properties. Despite their huge benefits, prolonged use is often associated with severe side effects as well as the development of glucocorticoid resistance in some cases. Mutations in an important SWI/SNF subunit, ARID1a, have previously been linked to glucocorticoid resistance and are associated with a vast number of human cancers. Determining the functional role of ARID1a...

In the clinic, glucocorticoids are widely used due to their anti-inflammatory properties. Despite their huge benefits, prolonged use is often associated with severe side effects as well as the development of glucocorticoid resistance in some cases. Mutations in an important SWI/SNF subunit, ARID1a, have previously been linked to glucocorticoid resistance and are associated with a vast number of human cancers. Determining the functional role of ARID1a...

Introduction: Effective transition care is vital to empower young people (YP) to optimally self-manage their diabetes. National data highlights the concern regarding poorer care outcomes due to lower completion of annual care processes and higher rates of DKA whilst transitioning to adult care. The Children and Young People’s Diabetes Team provides care for 170 YP aged 16–19 years. In April 2017, 19% of this age group had a HbA1c <58 mmol/mol, significantly lower...

First line screening for pheochromocytoma, as recommend by Endocrine Society guidelines, is to determine plasma free or urinary fractionated metanephrines. We routinely offer the latter. Although negative results rule out pheochromocytoma, it is not uncommon to see borderline results which require further investigation. In this situation we have historically relied on the measurement of plasma catecholamines in the clonidine suppression test (CST). Plasma metanephrines, howeve...

Aim: The short Synacthen test (SST) is an established test used to assess the hypothalamic-pituitary-adrenal axis. There remains debate whether a 30 minute or 60 minute cortisol sample has diagnostic superiority. Currently at the Queen Elizabeth University Hospital, Glasgow all tests arranged by endocrinology are performed by endocrine nurse specialists who utilise a 0 and 30 minute cortisol protocol. Performing a further 60 minute sample requires more nursing time and space r...