Endocrine Abstracts

LH hyper-secretion, driven by increased GnRH pulsatility, underpins excess testosterone secretion – a key clinical feature of PCOS.The kisspeptin-neurokinin B (NKB)-GnRH pathway has emerged as the pivotal regulator of reproduction. We hypothesised that pharmacologic blockade of NKB may address the central pathophysiology of LH hyper-secretion and hyperandrogenism in PCOS. We undertook a randomised, double blind, placebo-controlled multi-centre Phase...

Background: Fetal glucocorticoid overexposure is associated with low birthweight and increased cardiovascular disease risk in the offspring. Such ‘programmed effects’ can be transmitted across generations through both male and female lines. Disruption of a germline epigenetic reprogramming pathway, characterised by genome-wide erasure and subsequent re-establishment of DNA methylation, may underpin the intergenerational transmission of programmed effects. We used a r...

Fetal Leydig cell (LC) dysfunction leads to human male reproductive disorders (‘testicular dysgenesis syndrome’; TDS) that manifest at birth (cryptorchidism, hypospadias) or in young adulthood (low sperm count, testicular germ cell cancer). The factors regulating fetal LC function in early gestation are unknown, but can be disrupted in rats by environmental chemicals (e.g. dibutyl phthalate (DBP)). We identify a novel repressor mechanism that explains this vulnerabil...

Background: Endocrine disruption in the human fetal testis by environmental agents has been proposed as a possible cause of testicular dysgenesis syndrome (TDS) comprising male reproductive disorders such as testicular germ cell tumours (TGCT), cryptorchidism, hypospadias and low sperm counts. Exposure of fetal rats to the widely used plasticizer di(n-butyl) phthalate (DBP) results in a TDS-like syndrome due to a reduction in testosterone production. Whether such effects also ...

Context: Thyroid eye disease is disabling and disfiguring and has a substantial negative impact on quality of life. Medical therapies to reduce inflammation are widely used, but there is limited data from clinical trials beyond 6 months of follow-up. Methods: 3 year follow-up of a subset of the CIRTED trial (n = 68) which randomized patients to receive high-dose oral steroid with azathioprine/placebo and radiotherapy/sham radiotherapy. We compar...

Background: Vitamin D deficiency (VDD) has been implicated in the pathophysiology of respiratory infections, including Coronavirus Disease 2019 (COVID-19). We assessed vitamin D levels of patients who died from COVID-19 during or following admission to Newcastle-upon-Tyne Hospitals.Methods: We performed a retrospective survey of electronic patient records for 2,355 patients admitted to our institution between 04/02/2020 and 19/01/2021, who had a positive...

Obesity and metabolic syndrome are highly prevalent in horses and ponies worldwide. Equine Metabolic Syndrome (EMS) shares much of the same pathophysiology with its human counterpart including adipose tissue dysfunction and insulin dysregulation. Vitamin D deficiency is strongly associated with obesity and insulin resistance in humans and supplementation is often recommended. In horses our understanding of vitamin D biology is limited and its association with EMS unknown. The ...

Introduction: Risk of thyroid cancer is 17-32% in cold nodules and <1 % in hot nodules. Hot nodules are usually associated with Thyrotoxicosis. Patients with thyroid carcinoma are usually euthyroid but may be associated with hypothyroidism. We report 3 patients with hyperthyroidism and associated thyroid carcinoma.Case 1: A 17 years old lady presented with a lump in the neck and examination revealed prominent nodule on the right. TFTs were suggestive...

Background: Distress tolerance (DT) has been proposed as a possible contributor to the ability to successfully adhere to difficult behaviour changes, such as stopping problematic substance and cigarette use. A number of measures of DT have been used in attempts to predict behaviour change outcomes. Findings however, have been inconclusive and no one measure has shown consistent results. Importantly, no work has yet assessed the predictive value of DT measures in successful wei...

The treatment of patients with carcinoid heart disease (CHD) presents substantial challenges due to the advanced multisystem nature of their disease. Intensive multidisciplinary collaboration and innovative techniques are often required in order to manage these patients. Here we describe two such cases from our institution. A 59-year old gentleman with metastatic NET and CHD was referred to our centre. Transoesophageal echocardiography demonstrated severe tricuspid regurgitati...