Endocrine Abstracts

A number of factors have been associated with the apparent increase in children with vitamin D deficiency (VDD) in developed countries: increased awareness, increased migration, children living with chronic illness or disabilities, effects of medication (e.g. glucocorticoids, anticonvulsants), use of sunscreen, changes in lifestyles and a rise in childhood obesity. The clinical features of VDD vary with age and degree of deficiency and importantly, calcium deficiency is now re...

Over the past few years the number of children identified with vitamin D insufficiency/deficiency across the UK has increased. The Department of Health has recently reiterated the guidance for practitioners regarding at risk groups requiring surveillance and treatment recommendations. An audit in 2011 demonstrated that 30% of the children presenting to the paediatric orthopaedic service with musculoskeletal symptoms had vitamin D insufficiency or deficiency.<p class="abste...

Introduction: Clinical nurse specialists (CNS) practice at an advanced level of nursing. The Royal College of Nursing (RCN) competency framework for paediatric endocrine nurses sets out expected levels of practice and academic attainment for ‘competent, experienced and expert’ practitioners. This paper reports the findings of an initial scoping exercise undertaken to explore current roles, academic attainment and aspirations of this group of nurses in order to inform...

Background: The GST is commonly used in children and adolescents for the diagnosis of growth hormone (GH) deficiency. Evidence supports the use of sex steroid priming to improve diagnostic accuracy in GH provocation tests. This project, undertaken on behalf of the BSPED Clinical Committee, aims to identify current practice and develop consensus in sex hormone priming and GST protocols for the development of standardised UK protocols.Method: (1) Audit of ...

Background: There have been a number of drivers that have led nurses to take on extended roles that have been traditionally been the domain of doctors. Competency frameworks for specialist nurses have been developed in other paediatric specialities, such as diabetes, oncology and epilepsy. However, this has not been established for paediatric endocrine nurses.Aim: To establish a competency framework for paediatric endocrine nurse specialists.<p class...

Introduction: The insulin tolerance test (ITT) is the gold standard method to assess GH and/or ACTH deficiency. Safety concerns with the use of this test were raised more than 20 years ago from overtreatment of hypoglycaemia and consequent cerebral oedema, resulting in some centres using alternative tests. We have re-appraised use of the ITT in a contemporary setting and evaluated: i) timing of the glucose nadir, ii) time to resolution of hypoglycaemia, iii) adverse events and...