Endocrine Abstracts

The SIGN guideline group recently suggested a fracture risk threshold of 10% as an indication for DXA. Patients who do not have a 10 year fracture probability of 10% or more would therefore not meet the criteria for direct access to DXA. In order to assess whether implementing these guidelines would impact overall management, we undertook a prospective audit of our direct access DXA and health promotion service. Charts from 61 consecutive patients were reviewed (54F/7M, Mean a...

AimsThe premixed insulin analogue, biphasic insulin aspart 30/70 (BIAsp 30, 30% insulin aspart, 70% protaminated aspart) has a more physiological absorption profile than conventional premixed insulin, biphasic human insulin 30/70 (BHI 30, 30% soluble human insulin, 70% NPH), but no studies have previously tested how a switch from BHI 30 to BIAsp 30 can be done safely using a simple guideline. We investigated the occurrence of low interstitial glucose (IG...

Hyponatraemia is commonly encountered in neurosurgical units. Salt wasting syndrome is rare, and thought to occur due to ANP- and BNP-mediated natriuresis, leading to hypovolemic hyponatraemia. A 31 year old male was transferred to the National Neurosurgical Unit with a 12 hour history of back pain, progressive lower limb weakness and sensory loss. MRI demonstrated an epidural haematoma, extending from C7 to T3, and he underwent emergency decompressive laminectomy. Vasopressin...

Introduction: Studies have reported a rising incidence of congenital hypothyroidism (CHT) although the pathophysiology of most cases is unknown. A rising incidence is not simply a reflection of changing assay methodology and environmental factors may have an aetiological role. If so, then cases may exhibit space-time clustering, where cases occur at similar times and close proximities to other cases.Methods: We investigated whether there is evidence of s...

Background: Environmental factors play a role in the aetiology of type 1 diabetes. A particular role for infectious exposures has been postulated. Temporal variation in incidence would be consistent with this hypothesis. We specifically aimed to test predictions of increasing incidence occurring among cases of type 1 diabetes in children (aged 0–14 years) that might arise as a result of an environmental mechanism.Subjects and methods: The study anal...

Background: Growth hormone (GH) and Insulin like growth factor 1 (IGF-1) discordance in patients with acromegaly is a well-recognised phenomenon. It is unclear whether this is associated with increased mortality and morbidity compared to patients with concordant normal results.Methodology: A retrospective study was conducted on the United Kingdom Acromegaly Registry (UKAR). A comparison of mortality and morbidity was performed among four groups categoris...

Investigations of bone disorders which are often inherited have yielded important insights in the molecular mechanisms of bone development, osteoporosis and osteoarthritis. However, these studies have been hampered by the lack of available patients and affected families. To overcome this limitation, we have investigated mice treated with the chemical mutagen N-ethyl-N-nitrosourea (ENU) for hereditary bone disorders. Mice were kept in accordance with national welf...

We are investigating mice treated with the chemical mutagen N-ethyl-N-nitrosourea (ENU) to establish models for hereditary bone disorders such as osteoporosis, osteoarthritis and skeletal dysplasias. We report on one such mouse model designated Longpockets (Lpk). Mice were kept in accordance with national welfare guidelines and project license restrictions. Lpk/+ mice are viable and fertile, present with short humeri by two weeks of birth and have a...

Acromegalic congestive cardiac failure (CCF) is a serious and late complication of untreated acromegaly with associated high morbidity and mortality.1 Spontaneous recovery of end stage acromegalic CCF following autoinfarction of a somatotroph adenoma has not been previously reported.We report the case of a 61-year-old woman who presented with features of severe biventricular CCF and an acromegalic phenotype. Echocardiography revealed poor LV f...