hrp0082p3-d2-964 | Sex Development (1) | ESPE2014

An Ovulating Testis

Kothandapani Jaya Sujatha Gopal , Sachdev Pooja , Wright Neil

Background: Ovotesticular disorders of sexual development (DSD) are a rare form of DSD with co-existence of both ovarian and testicular tissue in one or both gonads.Case report: A term infant (weight +1.38 SDS) presented at birth with severe penoscrotal hypospadias, a small phallus and a right hemiscrotum with descended gonad (external masculinization score 1.5). Pelvic ultrasound revealed no Mullerian structures, a small right gonad with probable epidid...

hrp0084p2-477 | Growth | ESPE2015

BASIC: Bone Age Study in Children

Cockill Toby , Hewitt Amanda , Wright Neil , Elder Charlotte

Background: Bone age studies require X-ray of the left hand and wrist to assess skeletal maturity. The Tanner-Whitehouse 3 (TW3) scoring method provides an objective framework for calculating bone age and specifies exact placement of the hand. In our service we have noted a number of poor quality films, caused by difficulty with hand placement, e.g. scrunching of the fingers. This compromises the ability to score accurately and in a proportion necessitates re-X-ray, with time,...

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...

hrp0086p1-p10 | Adrenal P1 | ESPE2016

Current Dilution Methods Cause Large Variations and Inaccuracies when Making up 1 μg Synacthen Dose

Cross Alexandra S , Sachdev Pooja , Wright Neil P , Jabbar Imran , Elder Charlotte J

Background: The low-dose short Synacthen test is a popular diagnostic test of adrenal insufficiency in children. It is employed by 82% of UK paediatric endocrinologists. Although various dosing strategies exist, 1 μg is most commonly employed, however none of the low-dose forms are commercially available. A BSPED survey revealed 14 different methods for diluting 250 μg/ml ampoules.Objective and hypotheses: Do various dilution strategies result ...

hrp0086p1-p753 | Pituitary and Neuroendocrinology P1 | ESPE2016

The Intra- and Inter-User Reliability of Testicular Volume Estimation – A Simulation Study

De Silva Shamani , Akbarian-Tefaghi Ladan , Langley Joseph , Stanton Andrew , Wright Neil P , Elder Charlotte J

Background: Measuring testicular volume (TV) by orchidometer is a standard method of pubertal staging in boys. A paucity of evidence exists as to its inter and intra-user reliability and the impact of clinicians’ gender, training and experience on the accuracy of measurements.Objective and hypotheses: We engineered prosthetic models of different size testes to investigate the reliability of TV estimation.Method: The study was ...

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...

hrp0082fc1.4 | Adrenal | ESPE2014

A Novel Non-Invasive Short Synacthen Test

Elder Charlotte , Johnson Trevor , Loxley Martin , Keevil Brian , Wales Jerry , Wright Neil

Background: The short synacthen test (SST) is a popular diagnostic investigation for adrenal insufficiency (AI). Cannulation and blood sampling are required making it invasive, time-consuming and resource-intensive. Salivary cortisol is a well-established alternative to serum sampling.Objective and Hypotheses: To develop a non-invasive alternative to the 1 μg SST, using a novel formulation of Synacthen (with a nasal drug enhancer, chitosan) given na...

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...