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OBJECTIVE The insulin tolerance test (ITT) is usually regarded as the 'gold standard' for the assessment of the hypothalamic-pituitary axis (growth hormone (GH) and ACTH) but must be used with caution and is contra-indicated in certain groups of patients. The glucagon stimulation test (GST) has previously been shown to be a good alternative when the ITT is(More)
In a clinic population of 509 type 1 diabetic patients aged 16-45 years, 5.5% had received treatment for thyroid disorders (20 hypothyroid, three males; eight thyrotoxicosis, four males), and Addison's disease was present in four patients (0.8%, one male). In all patients, type 1 diabetes preceded the diagnosis of the other autoimmune disorder. The clinical(More)
OBJECTIVE The management of CSF rhinorrhoea following dopamine agonist (DA) treatment for invasive prolactinomas is difficult and there is no clear consensus for its treatment. Our objective was therefore to investigate the different treatments for this condition. DESIGN AND PATIENTS We examined the case notes of five patients with invasive prolactinomas(More)
Sera from seven patients with ovarian or colorectal carcinoma who had been given only single injections of 131I or 111In labelled IgG1, IgG2a or IgG2b monoclonal antibodies for immunoscintigraphy 2 weeks to 9 months earlier were tested for their ability to agglutinate sheep red blood cells coated with a mouse monoclonal antibody. Six showed agglutination,(More)
Obesity, particularly truncal obesity, is closely correlated to the prevalence of diabetes and cardiovascular disease. Plasma leptin, tumour necrosis factor-alpha and non-esterified fatty acid levels are all elevated in obesity and play a role in causing insulin resistance. Diabetic glycaemic control and insulin resistance improve with reductions in(More)
AIM It is known that patients with Type 1 diabetes mellitus are more prone to develop coeliac disease and that autoimmune thyroid disease occurs more frequently in patients with coeliac disease. We therefore assessed whether coeliac disease, either known or occult, occurs more frequently in young/middle aged adults with Type 1 diabetes and coexisting(More)
GH-deficient (GHD) patients have increased risk of cardiovascular death and may have cardiac structural abnormalities. In non-GHD patients these are associated with cardiac autonomic dysfunction, and it is possible that autonomic dysfunction is also present in GHD patients. Power spectral analysis (PSA) of heart rate variability (HRV) indirectly measures(More)
OBJECTIVE Growth hormone (GH) deficiency is associated with increased cardiovascular morbidity and mortality. Abnormalities in heart rate variability (HRV), a surrogate marker of cardiac autonomic tone, have also been found in untreated growth hormone deficient (GHD) patients. Similar abnormalities have been found in patients with complications(More)
OBJECTIVE This study investigated whether medically significant obesity (body mass index > 30 kg/m2) is recognised effectively in hospital outpatient departments and how those identified as obese are subsequently managed. DESIGN A retrospective analysis of patients' hospital records (rheumatology n = 108, cardiology n = 257, orthopaedic n = 250)(More)