Endocrine Abstracts

Osteoporosis and Fracture: The Role of the Endocrine NurseThe importance of osteoporosis lies in the increased fracture risk associated with reduced bone mineral density (BMD). Although osteoporosis is not painful, osteoporotic fractures are associated with significant morbidity and mortality; furthermore the occurrence of a fracture leads to an increased risk of subsequent fracture in both women and men.Identification of patients ...

A number of growth factors and their receptor signalling pathways are expressed in the embryonic and adult pancreas. Recent evidence from studies using murine gene-targeting strategies has implicated insulin and IGF-1 receptor and post-receptor signalling pathways in beta cell function. A number of roles for these signalling mechanisms have been reported in both beta cell development and survival and in regulating insulin gene expression and insulin secretion. Global and condi...

The advent of insulin almost 80 years ago revolutionised the treatment of diabetes and must be one of the great achievements of twentieth century medicine. Since then, there has been an increasing understanding of the need to attain and uphold near normoglycaemia to delay the onset and retard the progression of diabetic complications. Major advances in the understanding of the molecular assembly, biological activity and therapeutic properties of insulin have led to the many de...

Hypertension and diabetes are prevalent conditions. Population studies suggest that blood pressure in excess of 140/90 mmHg is found in nearly 30% of adults while type 2 diabetes occurs in 3-4%. However, both conditions are strongly age-dependent, and exhibit large geographical variations. Non-european populations typically have much higher prevalence rates. Worldwide, there has been a dramatic increase in the occurrence of type 2 diabetes. It has long been known that these co...

In diabetic pregnancy good outcomes can be achieved by meticulous glycaemic control prior to and during pregnancy. However, national and regional audits indicate the difficulties in getting optimal results in comparison to the background population. Despite great efforts by mothers and their diabetes care teams, the babies are often large for gestational age (Mean birthweight 3427g, 86 %> 50%ile, 55% > 90%ile) and are delivered early (Median gestational age 37weeks) by c...

During the past decade, few topics in medicine have been more controversial or clinically relevant than the effects of hormone replacement therapy (HRT) on risk for cardiovascular disease (CVD) in postmenopausal women. Based on extensive observational, animal model, and in vitro studies, many clinicians and patients were convinced that HRT lowered risk for CVD, a perception that helped make HRT use one of the most well-established treatment paradigms in American medicine. Howe...

The effect of Oestrogen on brain aging. Declan GM Murphy.The biological basis of human brain aging is poorly understood and there are few proven treatments for age-related brain disease. Recently, however, it has been suggested that HRT may have a 'neuroprotective' effect. Some studies report no beneficial effect of HRT on cognitive function in healthy older women though most show a significant benefit to memory and/or a general cognitive enhancement. There is perhaps grea...

Oestrogen replacement therapy remains one of the two licensed indications for the use of HRT. The rationale is sound. Oestrogen is from the time of puberty a major regulator of the resorption/formation balance and of the rate of recruitment of BMUs. Natural or surgical withdrawal of oestrogen results in acceleration of turnover, bone loss and potential osteoporosis. Similarly, in the postmenopause, restoration of oestrogen to premenopausal levels restrains turnover, inhibits r...

The low incidence of new cases of craniopharyngioma, 1-2 per million per year, and the great variability of morbidity at presentation, have made the evaluation of optimal tumour management extremely difficult. Two patterns of management have evolved over the last 3 decades, namely the performance of 'definitive' radical surgery at onset followed by the use of irradiation to deal with any later recurrence and subtotal tumour resection at onset followed by early irradiation to p...

Past studies in Pekin ducks have indicated that the sensitivity of the avian kidney to the antidiuretic action of arginine vasotocin (AVT), the avian antidiuretic hormone, differs with the osmotic status of the birds (1). The objective of this study was to determine whether this modulation involves an interaction with prostaglandins (PG's).The study was carried-out in vivo, using 8 unanaesthetized Pekin ducks given an intravenous maintenance infusion of either 200 mosmolal...