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...

Introduction: Hypoglycaemia is an endocrine and medical emergency. It is usually due to the excessive dose of insulin or oral anti-diabetic agents. Although rare, hypoglycaemia can be a tumour–induced. Some of the other causes include renal and liver failure, hormonal deficiency, antibodies to insulin, infection, starvation, spontaneous hypoglycaemia and reactive hypoglycaemia.Case report: A 70-year-old man presented with 6 months’ history of r...

Aims: Vitamin B12 insufficiency has been linked with adiposity and insulin resistance. A clinical study from India showed that B12 insufficiency in pregnancy was associated with higher risk of gestational diabetes (GDM), mediated by maternal BMI. It is not known whether the same association exists among pregnant women in the UK.Methods: A retrospective study was done on women attending our antenatal clinic from 2010–2013. Information including mater...

Aim: The aim of our study was to assess the correlation between pre-operative fine needles aspiration based cytology with post-operative histology in patients with thyroid nodules.Methods: A retrospective analysis of patients who had thyroidectomy (hemi, subtotal, or total) was conducted and information on histology was obtained. Pre-operative FNA (done once or twice) was also obtained and compared with histology. Patients operated for Graves’ disea...

There are no established guidelines on the management of steroid induced diabetes (SID) in children. Steroids are commonly used to treat many chronic illnesses and as part of chemotherapy regimen in children. The hyperglycaemia caused by steroids is poorly recognised and can lead to adverse outcomes. Early recognition and appropriate management of hyperglycaemia is therefore crucial. Fasting blood glucose (BG) levels can be normal and the most sensitive time to test BG is 2 h ...

Introduction: Post-traumatic hypopituitarism (PTHP) is a recognised sequel of traumatic brain injury (TBI), occurring in 25–69% of adult patients, but there are few data on the prevalence or natural history in childhood. Our aim was to determine pituitary function in children at least 4 years after TBI requiring paediatric intensive care unit (PICU) admission. At the same time body composition was evaluated.Methods: Children discharged from the regi...

In the context of the cross-talk between the neuroendocrine and immune systems, it is well known that GH exerts physiological effects in central as well as peripheral compartments of the immune system. GH modulates a variety of thymic functions. For example, GH upregulates proliferation of thymocytes and thymic epithelial cells. Accordingly, GH-transgenic mice, as well as animals and humans treated with exogenous GH, exhibit an enhanced cellularity in the organ. GH also stimul...

Background: Hypopituitarism is an important sequela of traumatic brain injury (TBI) in adults. In paediatric practice, however, there are concerns that it may be under-recognised. Symptoms may be mistaken for post-concussion syndrome, which may result in delayed investigation and diagnosis. Furthermore, predictors of post-traumatic hypopituitarism (PTHP) in children have not been consistently identified. As normal pituitary function is required for growth, serial growth monito...

Sleep and cortisol cycles have a complex inter-relationship that is not fully understood. Slow wave sleep appears to have an inhibitory effect on cortisol production but the effect of other stages is not so clear. From diseases, such as Addisons disease and Cushings syndrome, we know that cortisol levels have an impact on the quality of sleep. In insomnia and depression, both sleep and cortisol is altered.To investigate this relationship properly a minim...

Defective signalling by insulin-like molecules is not only a fundamental characteristic of diabetes, but is also associated with the majority of human tumours, where signalling is typically hyperactivated. Although both these diseases have a significant genetic component, we are still some distance from identifying all the genes and cellular mechanisms affected.We and other groups use the powerful genetics of the fruit fly, Drosophila melanogaster...