hrp0095p1-500 | GH and IGFs | ESPE2022

A patient-centric approach to connected health solutions in paediatric growth hormone therapy

Halabi Ammar , Martin Blaine , Koledova Ekaterina , Giunti Guido , Dimitri Paul

Background: There is a clear need for improved patient-centric approaches in the treatment of chronic conditions, including paediatric growth hormone deficiency (GHD). Greater understanding of the patient’s treatment journey has the potential to inform clinical decisions and to improve clinical- and patient-reported outcomes. Connected Health (CH) combines state-of-the-art technologies, tools, methodologies and analytics to create new patient-centric hea...

hrp0089p1-p009 | Adrenals and HPA Axis P1 | ESPE2018

The Relationship of Baseline, Incremental and Peak Cortisol Following a Short Synacthen Test – Single-centre Analysis of Three Years’ Data

Aji Apoorva , Colyer Sharon , Burn Sarah , Dimitri Paul , Wright Neil , Krone Nils , Elder Charlotte

Introduction: The Short Synacthen Test (SST) is the most popular diagnostic investigation of adrenal insufficiency (AI) amongst adult and paediatric endocrinologists. AI can present insidiously and symptoms may be non-specific. The number of medical indications for glucocorticoids is growing and SST usage is correspondingly increasing. There is evidence that an early morning plasma cortisol (EMC) of below ~100–150 nmol/l is highly predictive of failing the SST and the cor...

hrp0089p2-p021 | Adrenals and HPA Axis P2 | ESPE2018

Borderline Peak Plasma Cortisol Following Synacthen Stimulation – Single-centre Analysis of Three Years Data

Burn Sarah , Colyer Sharon , Dimitri Paul , Wright Neil , Krone Nils , Elder Charlotte

Introduction: The Short Synacthen Test (SST) is the most popular diagnostic investigation of adrenal insufficiency (AI) worldwide. Symptoms of AI are frequently non-specific, often delaying diagnosis, however fortunately cases of adrenal crisis remain relatively rare. Diagnostic cut-offs for plasma cortisol on SST are controversial, made more complicated by modern assays and paediatric normative values extrapolated from adult data. Some advocate a division between biochemical ...

hrp0086fc2.3 | Bone & Mineral Metabolism | ESPE2016

The Impact of Intragastric Balloon Placement Suppported by a Lifestyle Intervention Programme on Cortical and Trabecular Microstructure and Strength in Severely Obese Adolescents

Sachdev Pooja , Reece Lindsey , Copeland Rob , Wales Jerry , Dimitri Paul , Wright Neil

Background: The effect of profound weight loss following obesity surgery on skeletal microarchitecture and strength in adolescents has not been studied. Obese children are at an increased risk of fracture and childhood obesity leads to reconfiguration of trabecular bone without augmenting bone strength.Objective and hypotheses: To examine the impact of weight loss following 6 months treatment with an intragastric balloon supported by a lifestyle interven...

hrp0086lbp5 | (1) | ESPE2016

Development of Skeletal Microarchitecture and Biomechanics Over 2 Years Following 6 Month Intragastric Balloon Insertion in Obese Adolescents

Sachdev Pooja , Reece Lindsey , Copeland Rob , Thomson Mike , Wales Jerry , Jacques Richard , Dimitri Paul , Wright Neil

Background: A reduction in bone mass in adults and adolescents has been observed following Roux-en-Y bypass surgery with an increase in fracture risk reported in adults. However, the intragastric balloon (IGB) is a less invasive bariatric procedure.Objective and hypotheses: Given obese adolescents are at greater risk of fracture we studied the impact of a 6 month IGB insertion on skeletal mass, geometry and strength over 2 years.Me...

hrp0082p1-d3-52 | Bone (1) | ESPE2014

Opposing Effects of Childhood Obesity on Radial and Tibial Bone Microstructure

Dimitri Paul , Jacques Richard , Paggiosi Margaret , King David , Walsh Jennifer , Bishop Nick , Eastell Richard

Background: Bone mass is low in obese children when measured by conventional techniques. However, these imaging modalities cannot quantify alterations in bone microstructure and strength. High resolution peripheral quantitative computed tomography (HRpQCT – isotropic voxel size 82 mm) provides the resolution required to determine 3-dimensional in-vivo bone microstructure; microfinite element (microFE) analysis of HRpQCT images provides insight into skeletal biome...

hrp0082p2-d2-278 | Adrenals & HP Axis (1) | ESPE2014

Do Neonates Need a Short Synacthen Test to Investigate the Adrenal Axis?

Niranjan Usha , Franklin Victoria , Bashir Imran , Martin Sarah , Gibson Alan , Wright Neil , Dimitri Paul

Background: There is limited evidence regarding the most appropriate method to investigate adrenal dysfunction in neonates. Our unit in Sheffield, UK measures a series of three serum cortisol levels to determine the need for a short synacthen test (SST). Other units use the SST as the first-line investigation in suspected adrenal insufficiency in neonates; however SST is more invasive with anaphylactic risk.Objective and hypotheses: To determine the prop...

hrp0082p3-d1-903 | Pituitary | ESPE2014

Xanthogranulomatous Hypophysitis: a Rare but Mistaken Pituitary Lesion

Kothandapani Jaya Sujatha Gopal , Bagga Veejay , Wharton Stephen , Sinha Saurabh , Dimitri Paul

Introduction: Xanthogranulomatous hypophysitis (XGH) is a very rare form of pituitary hypophysitis that may present both clinically and radiologically as a neoplastic lesion or craniopharyngioma. Our case series compares the paediatric and adult presentations of XGH and the differential diagnoses considered.Case series: Patient 1: A 15-year-old female presented with refractory headache, lethargy, short stature, delayed growth (weight (−3.3...

hrp0084fc2.6 | Bone & Mineral Metabolism | ESPE2015

A Contextual Feature-Based Recognition Approach to Quantify Trabecular Microstructure Using 1.5T Axial-MRI: An Innovative Methodology

Dimitri Paul , Lekadir Karim , Hoogendoorn Corne , Armitage Paul , Whitby Elspeth , King David , Eastell Richard , Frangi Alejandro

Background: In-vivo skeletal MRI imaging remains challenging due to the extremely short MR relaxation times (<1 ms) of protons bound to water in bone. However, each MRI sequence contains properties identifiable through feature-based recognition, highlighting characteristics relating to skeletal configuration. We thus present a novel statistical method for clinical 1.5 Tesla (T) MRI in quantifying trabecular microstructure and use HRpQCT to determine its accuracy.<...

hrp0094p2-246 | Growth hormone and IGFs | ESPE2021

Massive Open Online Learning – accelerating knowledge in digital health in the management of children with growth disorders

Dimitri Paul , Fernandez-Luque Luis , Koledova Ekaterina , Bagha Merat , Shabbir Syed Abdul ,

Background: Over the last decade, and in light of the COVID-19 pandemic, there has been a substantial increase in the use of digital health tools to track growth and manage growth disorders in children. Paediatric endocrinologists acknowledge the usefulness of these tools in clinical decision making but lack confidence and skills to use them. Atique et al. designed a Massive Open Online Learning Course (MOOC) to increase digital health literacy, and identified...