Endocrine Abstracts

Background: Acromegaly has until now been managed almost entirely in tertiary care. Introduction of nurses specialising in endocrinology has enabled us to take their care into the community.Method: 39 patients (P) mean age 57y(29-82) with active acromegaly, required Octreotide LAR treatment, and lived 5-173(median 38) miles from the endocrine unit. A shared care (SC) protocol was approved whereby the patient's first injection was given at the hospital, ...

Heterotrimeric G proteins mediate signalling from 7 transmembrane domain receptors to a variety of intracellular effectors. Regulators of G protein signalling (RGS) are a novel family of proteins, that act as GTPase activating proteins. In the human myometrium signalling via G proteins may be altered during pregnancy and labour, suggesting a physiological role of G proteins in human gestation. Our aim was to investigate the expression of RGS proteins in the human myometrium. E...

Case history: A previously asymptomatic 58-year-old gentleman presented following an out-of-hospital cardiac arrest, precipitated by multiple, bilateral pulmonary emboli.Investigations: In the course of investigation, a 35 mm, MIBG-negative, right adrenal lesion was discovered. Functional adrenal tests revealed significantly elevated normetanephrine and 3-methoxytyramine levels. Severe hypertension and type 2 diabetes were concurrently diagnosed.<p c...

Background: Pre-pituitary surgery, patients attend a ‘Pre-Pituitary Surgery Clinic’ (PPSC), to discuss management options and risks. Clinicians in attendance are; pituitary surgeon (1) registrar (1) endocrine team consultants (1–3), registrars (1–2) nurses (1) senior house officer (1) visiting doctors/medical students (4–6). Patients are informed a number of clinicians attend the clinic due to the multidisciplinary nature (MDT) and unit teaching respon...

Objective: The aim of our study is to evaluate the current practice, resources available and barriers to primary and secondary professionals providing care for children who are overweight or obese.Methods: A questionnaire was sent to primary and secondary care providers including General Practitioners (GP), Practice Nurses (PN), Health visitors, school nurses and community nurses in a selected Primary Care Trust and hospital doctors in Pennine Acute Trus...

Introduction: The concept of life-long medical therapy for acromegaly has recently been challenged. Hormonal remission for up to 48 months after stopping somatostatin analogues in acromegalic patients has recently been reported. Herein, we present a further case showing the longest remission yet in growth hormone levels after somatostatin analogue treatment.Case: In 1987, a 43 year old man was diagnosed with acromegaly [nadir GH on oral glucose tolerance...

Background: Insulin-induced hypoglycaemia (ITT) is considered the gold standard method for the evaluation of the hypothalamo-pituitary-adrenal axis. The standard short Synacthen test (SST) has been proposed as an alternative, but it may be associated with falsely reassuring results and potentially serious sequelae.Aim: To compare the serum cortisol response achieved in the SST with the one obtained during the ITT in patients with hypothalamo-pituitary di...

Oestrogens can prevent or delay the age-related deterioration of the skin. Post-menopausal women have a reduced rate of wound healing, which can be reversed by oestrogen therapy. However, the mechanisms underlying these effects remain poorly understood. To understand more fully the role of oestrogen in the cutaneous wound healing process we have measured migration, proliferation and the secretion of mitogenic factors by cultured dermal fibroblasts in response to17β-oestra...

Background:Long acting somatostatin analogues are an effective treatment for acromegaly but require administration by nurses.To improve patient convenience we have taken care into the community with endocrine specialist nurse education of practice nurses in administration of injections.Methods:After an initial pilot study, a questionnaire was administered to patients receiving, and practice nurses administering, Somatuline Autogel(SA) n=10 and Sandostati...

The role of oestrogens on the regulation of human hair growth is poorly understood. Using whole human scalp hair follicle organ culture, we have recently demonstrated, that human hair growth is inhibited by 17beta-oestradiol, but not by the biologically inactive isomer 17alpha-oestradiol. Using immunohistochemistry, we have also demonstrated the presence of both ERalpha and ERbeta in the pilosebaceous unit and the dermal papilla, a mesenchymal structure that controls the diffe...