Endocrine Abstracts

Background: Measuring testicular volumes by orchidometer is a standard method of pubertal staging in boys. A paucity of evidence exists as to its inter and intra-observer reliability and the impact of clinicians gender, experience and training on the accuracy of measurements. We are developing specifically engineered models with different testicular volumes to investigate inter and intra-observer reliability of testicular volume estimation for simulation training.<p class=...

Background: Currently we investigate children with possible GH deficiency, but who are healthy, with a normal short stature screen, and without suspicion of other pituitary dysfunction (‘simple short stature’), with full dynamic anterior pituitary function tests (APFT). An abnormal GH peak leads to a second GH stimulation test. We studied the cost implications of only performing a GH stimulation test initially, followed by full APFT if the initial GH peak was low, to...

Obesity and the metabolic syndrome are chronic inflammatory states that are now understood to be involved in the development type 2 Diabetes. Hypothalamic cytokine signalling is thought to influence neuroendocrine networks critical to the dynamic maintenance of glucose homeostasis. Interleukin 6 (IL6) is a cytokine that displays tissue-specificity and is instrumental in the mounting of the acute phase response, as well as in the subsequent resolving and adaptive phase. IL6 is ...

Introduction: In the presence of atherogenic plaque, estrogens may be potentially harmful. Among the key vessel wall components in the later stages of atherogenic process are endothelial cells (ECs). During the stages of plaque instability/rupture, metalloproteinases (MMP2 and MMP9), their inhibitors (TIMP2 and TIMP1), RANK, RANKL, OPG, MCP1, lysyl oxidase (LOX), PDGF, and ADAMTS4 play critical role. We aimed to investigate i) the effect of oestrogens on the expression of the ...

Background: Limited evidence exists regarding the effect of antenatal prednisolone (ANP) on neonatal adrenal function. Our regional neonatal unit screens these babies by measuring three random serum cortisol levels 8 h apart on day 3 of life. Adrenal function is considered adequate if two cortisol levels are >100 nmol/l. Those with inadequate random cortisol levels undergo a low-dose Synacthen test (LDST). Our survey of UK tertiary Paediatric Endocrinology centres revealed...

Introduction: There is evidence that an early morning plasma cortisol (EMC) below <160 nmol/l is predictive of failing the SST and the corollary is seen with an EMC above >340 nmol/l. Using an EMC to screen patients for AI has been advocated, although there is a paucity of paediatric studies. Modern sensitive and specific cortisol assays make deriving local diagnostic thresholds important. We analysed our SST data since the introduction of a new cortisol assay to deriv...

Introduction: Diagnostic cut-offs for plasma cortisol on Short Synacthen Test (SST) are controversial, made more complicated by modern assays and paediatric normative values extrapolated from adult data. Some advocate a division between biochemical and clinical AI, with different cut-offs and management strategies. For asymptomatic children, with a low-index of suspicion, and borderline SST results our department has evolved a tendency to advise hydrocortisone replacement in t...

Introduction: Treatment of β thalassemia major results in excessive iron deposition in most tissues including the endocrine glands.Aim: To find out the prevalence of endocrine complications in our thalassemia-endocrine clinic as set out by the UK thalassemia society guidelines.Methods: Clinic notes and electronic results of all patients attending Birmingham City Hospital for the 2-monthly thalassemia-endocrine MDT clinic (2010...

Background: Training is adolescent health and transition is lacking in medical education. Clinicians working in diabetes and endocrinology across paediatric and adult services need to have the skills to work effectively with this age group. Our aim was to identify the current state of training and to ascertain training needs in trainees.Methods: A questionnaire was developed based on existing questionnaires. Using trainee representatives all paediatric a...

The commonest cause of acquired hypopituitarism is a benign pituitary adenoma. However, in patients with non-pituitary malignancy different diagnoses need to be considered. We describe three oncology patients presenting with hypopituitarism and/or a pituitary mass where the cause was related either to malignant disease or its treatment.Case 1: A 56-year-old man with known metastatic melanoma presented with increasing lethargy. Investigation showed a larg...