Endocrine Abstracts

In the rat hippocampus, corticosteroids modulate neuronal excitability. Glucocorticoid excess within the rat hippocampus results in a neurodegenerative effect, although corticosteroids also protect oligodendrocytes from cytokine-mediated apoptosis. Other studies have shown that systemically insignificant levels of aldosterone affect systemic blood pressure when administered icv. Previously, we have shown by RT-PCR and immunohistochemistry that the genes for 11beta-hydroxylase ...

Background: GH insensitivity (GHI) presents with growth failure, IGF-1 deficiency and normal/elevated GH (basal >5 μg/l and/or peak >10 μg/l). GHI encompasses a spectrum of clinical and biochemical abnormalities. Associations between phenotypic characteristics and genetic defects remain obscure.Objective: Identify phenotypic predictors of underlying genetic defects in GHI.Methods: In total of 102 children (62M) me...

Background: Education in diabetes is a fundamental component of self-management. Health care systems that have structured education from diagnosis have demonstrated improving trends in HbA1c. Within Wales, education for Children and Young People (CYP) was delivered informally and this deficiency was highlighted in the National Paediatric Diabetes Audit. While structured education is being delivered in some parts of the UK, there is no overarching programme covering the entire ...

Endocrine nursing practice has been changing, with the advent of more autonomous roles, involving nurse led clinics and independent prescribing, with more complex clinical case management. However, recent research highlights the emphasis on optimum patient care, but scope of practice is not always clear, leading to unequal balance in skills and capabilities, qualifications, and Agenda for Change (AfC) bandings. This study explored the remit, job components, and capabilities of...

Background: SEREN is an established, QISMET accredited structured education programme for children/young people (CYP) and their families with Type 1 diabetes mellitus (T1DM), developed in Wales. The first module ‘Diabetes at diagnosis’ has been in use in Wales since 2016. The resources and health care professional (HCP) training have also been used by some paediatric diabetes teams in England who have since embedded SEREN into their diabetes care. Th...

Background: A diagnosis Silver–Russell Syndrome (SRS) is important for early institution of appropriate management, access to therapy and reduces the burden of diagnostic uncertainty. SRS is molecularly heterogeneous and 11p15 LOM/upd(7)mat account for ~60% cases. Monogenic causes include variants in HMGA2, CDKN1C, IGF-2, PLAG1 and contribute to 5% cases. Clinical SRS diagnosis requires the fulfilment of ≥4/6 Netchine–Harbison Clinical Scoring ...

Background: Obesity is associated with complex multisystem pathology and significant psychosocial burden. Yet, despite its increasing prevalence, the commissioning of Specialist Weight Management Services remains limited.Methods: Retrospective service evaluation of a proportion of patients (n=179) engaging with the Central London Community Healthcare Specialist Weight Management Service for at least 6-months from 2012 onwards. Outcome measures, ...

Background: Growth monitoring identifies treatable conditions in apparently healthy children and prevents inappropriate referrals. Systematic growth monitoring is not currently a UK priority and growth disorders are frequently diagnosed late.Objectives: Develop and test the accuracy of a smartphone app which enables families to measure a child’s height at home as a cost-effective alternative to primary care growth monitoring.M...

Background: Turner syndrome (TS) comprises a group of sex chromosome anomalies affecting approximately 15,000 in the UK. TS affects every organ system in the body through haploinsufficiency of genes that are normally expressed by both X chromosomes. Common features include short stature, congenital heart diease and gonadal dysgenesis requiring long-term oestrogen replacement but the adult phenotype extends to excess risk of diabetes, hypertension and hepatosteatosis. UCLH has ...

Introduction: Hydrocortisone therapy in adrenal insufficiency and medical management of Cushing’s syndrome requires accurate monitoring of glucocorticoid status. Currently, this necessitates admitting patients to hospital for serial measurements of serum cortisol. From previous studies in Cushing’s, the goal of medical therapy is a mean (based on five samples) serum cortisol of 150–300 nmol/l, which is known to equate to a normal cortisol production rate. Saliva...