bluuebunny/crossref_metadata_2025_split huggingface dataset:
SAT-LB79 Biotin Depleting Procedure Does Not Impact the Reliability of TSH, LH and FSH Immunoassays
Authors: Gruson Damien , Pouplaert Marie 
Published: May 2020

Abstract
Background: Biotin interference has become a major problem with some laboratory immunoassays, leading to erroneous tests results and potentially harmful clinical consequences. There is therefore a clinical need to easily identify the interference and to overcome its effect to avoid harmful consequences for patients. The aim of this study was to demonstrate the VeraPrep BiotinTM procedure, a biotin depleting device, does not impact the immunoreactivity of TSH, LH and FSH immunoassays.Materials and methods: Nine samples (4 from women and 5 from men) were tested with two-sites electrochemiluminescent immunoassays (Cobas e602, Roche diagnostics) for the measurement of three pituitary hormones, TSH, LH and FSH. The samples were first measured without any treatment (baseline) and then retested after treatment with VeraPrep Biotin™ procedure. Percent (%) difference was calculated between post-treatment and baseline to determine if the biotin depleting device impact the immunoassays immunoreactivity.Results: The median baseline concentrations for TSH, LH and FSH were 2.3 mIU/L (standard deviation (SD): 1.5), 4.9 IU/L (19.0) and 5.3 IU/L (17.5), respectively. The median concentrations after treatment with the VeraPrep Biotin™ procedure for TSH, LH and FSH were 2.3 mIU/L (1.5), 4.9 IU/L (18.9) and 4.9 IU/L (16.5), respectively, and were not statistically different from baseline (P = 0.976). The mean recoveries after treatment were 99.5%, 98.6% and 95.4% for TSH, LH and FSH, respectively.Conclusions: The concentrations of the TSH, LH and FSH assays were not impacted by the pretreatment with the VeraPrep Biotin™ procedure, confirming its ability to help clinical laboratories to overcome biotin interference.
MON-LB004 Understanding the Influence of Endometrial Cancer Risk Factors Using Human Primary Endometrial Organoids
Authors: Murphy Alina R , Campo Hannes , Kim Julie 
Published: May 2020

Abstract
It is unclear how endometrial cancer risk factors such as obesity, high serum testosterone, and high serum levels of the endocrine-disrupting compound bisphenol-A (BPA) influence hormone action to promote carcinogenesis. We hypothesized that obesity, high testosterone, and BPA exposure alters the protective progesterone response in the benign endometrium. Primary human benign endometrial organoids, consisting of both epithelial and stromal cells, were exposed to each of these risk factors in vitro in the presence of cyclic levels of estradiol, progesterone, and testosterone for 14 days. Progesterone response genes HSD17B2, IGFBP1, PAEP, and PRL were measured by real-time qPCR and IHC. First, to simulate obesity, endometrial organoids were cocultured with increasing numbers of human adipocyte spheroids during the hormone treatment. Real-time qPCR analysis revealed dysregulation of expression of HSD17B2 and IGFBP1 by approximately 20% when cocultured with 30 adipocyte spheroids. In addition, PRL protein levels were significantly lower in the stroma of the endometrial organoids. Second, increasing concentrations of BPA and 3nM testosterone individually or in combination were added to endometrial organoids together with the 14-day menstrual cycle hormones. Treatment with 0.6 ng/mL of BPA decreased expression of HSD17B2, IGFBP1, and PAEP by 50% to 80%. However, this effect was not seen in the context of high testosterone, indicating that there may be crosstalk between these two risk factors. In summary, this study demonstrated that adipocytes, BPA exposure, and high testosterone directly alter progesterone action in benign endometrial organoids, suggesting a diminution of the protective effects of progesterone and an increased risk of endometrial cancer.
SAT-387 Testing for Parathyroid Hormone: Performances of a Novel Fully Chemiluminescent Automated Assay
Authors: Gruson Damien , Adamantidou Christina 
Published: May 2020

Abstract
Background: Parathyroid hormone (PTH) is one of the key regulators of the bone and mineral metabolism. Testing for PTH is essential for the management of hyper- or hypo calcemia. Measurement of PTH is also an important tool for the monitoring of patient with chronic kidney diseases. Our study objective was to determine the performances of a novel fully automated chemiluminescent assay for testing of intact PTH. Methods: We evaluated the Maglumi® (Snibe) PTH assay a fully automated two-sites immunoluminometric method based on a solid-phase, paramagnetic microbeads, coated with a monoclonal antibody targeting PTH epitopes. Assay imprecision was assessed with two levels of control materials. Reference values were determined with samples of 24 healthy volunteers. Method comparison was performed with an electrochemiluminescent immunoassay (ECLIA) (Roche diagnostics) with 24 patients’ samples. Results: The between-run coefficients of variation of the Maglumi® PTH assay were 5.1 and 3.7 % for concentrations of 33 and 992 pg/mL, respectively. The median PTH levels were 121 pg/mL (range: 18 - 369) with the Maglumi assay and 117 pg/mL with the ECLIA method (range: 10 - 482). The upper limit of the reference interval in the healthy volunteers was 63 pg/mL. The correlation between the both methods was good (r=0.87, p&lt;0,001). Passing-Bablok regression analysis showed a slope of 0.96 (95% confidence interval (CI): 0.83 to 1.35) and an intercept of -2.14 (95% CI: -20.49 to -10.47). Bland-Altman plot evidenced a bias between the methods with a mean bias of 4.6 pg/mL. Conclusions: Our preliminary data showed excellent concordance and analytical performances for the PTH fully automated immunoassay associated to perspectives of automation and reduction of turn-around time of analysis.
MON-LB035 Adrenal Venous Sampling in the Lateralization of Acth-Independent Cushing Syndrome With Bilateral Adrenal Masses: A Case With a 5-Year Follow-Up
Authors: Kang Yu Mi , Majumdar Sachin 
Published: May 2020

Abstract
Background Nearly 25% of adrenal Cushing syndrome (CS) patients with bilateral adrenal masses have unilateral hypercortisolism, making localization crucial for surgical planning. Since there is no standardized protocol for adrenal venous sampling (AVS) in lateralizing adrenal hypercortisolism, we share our experience with a case of CS with bilateral adrenal masses in which lateralization via AVS permitted unilateral adrenalectomy. Clinical Case A 59-year-old woman with hypertension, hyperlipidemia, and prediabetes was hospitalized for worsening back pain and hypertension. Her BMI was 26.5 kg/m2, BP 173/93 mmHg, HR 73/min, she was anxious, diaphoretic, and hirsute. Glucose was 118 mg/dL and HbA1c 6.6%. Abdominal computed tomography revealed a type B aortic dissection with both right (6.1 x 3.1cm and 3.6 x 2.4cm), and left (largest 1.7 cm) sided adrenal masses. Plasma and 24 hour-urine metanephrine, normetanephrine and catecholamines, as well as plasma renin and aldosterone levels, were normal. AM cortisol on three different occasions was 21.30, 20.70, and 21.30 mcg/dL. Midnight cortisol was 17.8 mcg/dL, and 24-hour urine free cortisol on two occasions was 163 mcg (urine volume 3.4L with creatinine 1.14) and 99.2 mcg (urine volume 1.15L). After 1mg dexamethasone her AM ACTH and cortisol were &lt;5 and 18.70 mcg/dL, respectively. Preoperative AVS was performed and 8mg of dexamethasone was administered the night prior to ensure ACTH suppression during the procedure, and epinephrine was measured to ascertain adequate adrenal vein cannulation. Cortisol levels (in mcg/dL) from the common iliac, right and left adrenal veins were 14.7, 61.5, and 23.5 at 0 minute and 15.2, 61.0, and 22.7 at 2 minutes, respectively. Epinephrine levels (in pg/dL) from the common iliac, right and left adrenal veins were 42, 577, and 3225 at 0 minutes, and 46, 718, and 2989 at 2 minutes. Despite higher epinephrine levels from the left adrenal, the cortisol ratio of the right adrenal vein to peripheral vein was 4.18 with the right-to-left ratio of 2.59 and 2.68 at 0 and 2 minutes, suggesting hypersecretion of cortisol from the right adrenal gland. Unilateral right adrenalectomy revealed a 5.6 cm adrenal adenoma arising in a background of adrenal cortical hyperplasia. Morning postoperative cortisol was 2.2 mcg/dL. She was placed on hydrocortisone and tapered over a 10-month period with remission maintained for more than 3.5 years post-operatively. Conclusion This case demonstrates the safety, usefulness, and necessity, of AVS in localizing cortisol production when bilateral adrenal masses are present. In addition, this case suggests that the use of high dose dexamethasone and measurement of catecholamines may be helpful for more accurate interpretation. More data on AVS in CS patients with bilateral adrenal masses is needed so a well-validated and standardized CS-specific ACS protocol can be developed.
SUN-LB79 Efficacy of the Percutaneus Administration, Guided by Ultrasound, of Polidocanol Ablation for Cystic Thyroid Nodules
Authors: Castillo Marlen Alejandra Alvarez , Palomo Antonio Segovia 
Published: May 2020

Abstract
Introduction: The cystic thyroid nodule is a variant of nodular disease presentation, it can condition compressive symptoms, drainage is an alternative for its management, but it presents an elevated rate of recurrence, injection of ethanol is an alternative for refractory cases but it requires multiple sessions and is not exempt for recurrence, on the other hand, polidocanol may represent a best alternative for treatment. Objective: Determine the efficacy of polidocanol administration for cystic thyroid nodule disease. Study Design: An experimental, prospective, comparative of before and after and analytical study was made. Period and Population: Patients older than 18 years were selected, with diagnosis of cystic thyroid nodule disease in whom drainage was made with subsequent ablation with polidocanol 1%, considering therapeutic efficacy a reduction of at least 50% in regard of initial volume. Results: 39 patients were studied, 33 (84-6%) were women, with an age of 49.0 (15.0) years old. All with palpable nodules, time of identification of 14.1 (11.69) months and a palpable size of 3.53 (2.02) cms. The predominant location was the right lobule (51.3%), 24 (61.5%) referred growth before the procedure conditioning compressive symptoms. The main cystic composition was pure and unique in 20 (51.3%). 10 (25.6%) referred important cosmetic problem/ dysphagia. TSH was 1.73 (1.22) mU/ ml. An initial volume was of 13.99 (11.72) ml and a final volume of 6.6 (12.1) ml, p 0.000 (IC 95% 4.4, 10.2). 3 (7.7%) presented hematoma and 2 (6.1%) pain. Time of follow- up was of 24 weeks. Reduction percentage 78.7 (32). 33 (84.6%) achieved a reduction ≥50% and 21 (53.8%) ≥85% of the initial volume. Conclusion: Polidocanol is effective and safe for cystic thyroid nodule disease treatment, its use should be proposed in patients with this pathology.
SUN-LB43 DLK1 Expressing Cells Contribute to the Zonation of the Adrenal Gland
Authors: Mariniello Katia , Rognoni Emanuel , Guasti Leonardo 
Published: May 2020

Abstract
The adrenal cortex is a dynamic organ that undergoes self-renewal and remodeling in response to the demand for steroids. In the mouse it is divided into two concentric layers, the outer zona glomerulosa and the inner zona fasciculata (ZF), that secrete aldosterone and corticosterone, respectively. Cell fate mapping studies have shown that the maintenance of the cortex relies on a pool of stem/progenitor cells located in the capsular and subcapsular compartments. Two interconnected cell populations have been identified, subcapsular undifferentiated cells secreting the morphogen Sonic Hedgehog (Shh) and capsular Gli1+ cells, which can transduce the Shh signal (1); both populations are precursors of steroidogenic cells and newly formed cells migrate in a centripetal fashion to repopulate the gland until they reach the juxtamedullary region where they undergo senescence and apoptosis. Moreover, our lab has shown that the Notch atypical ligand Delta-Like homologue 1 (Dlk1) is expressed in partially undifferentiated cells of the subcapsular region in rat (2)and human (3)adrenals, whilst it is mostly expressed in capsular cells in mice (4,5). To investigate whether Dlk1 expressing cells contribute to the zonation of the adrenal cortex we conducted lineage tracing analyses using a tamoxifen inducible Dlk1CreERT2mouse model carrying the R26tdTom reporter. Pregnant dames were injected with tamoxifen at embryonic day (e) 12.5 and pups were culled at postnatal day (p) 10 and p38. Analysis of tdTomato expression showed that 35% (p10) and 24% (p38) of Steroidogenic Factor 1(Sf1)+cortical cells were tdTomato+, revealing that capsular Dlk1+cells are steroidogenic precursors. On the other hand, postnatal tamoxifen injections (p0) showed tdTomato+/Sf1+ cells only in 1-2% in cortical cells after 24-months chase, suggesting that the contribution of Dlk1+cells to adrenocortical self-renewal is limited postnatally.However, the Dlk1+population could be reactivated in the adult mouse treated with dexamethasone and was shown to contribute to the regeneration of the ZF once dexamethasone treatment was ceased. 1. King P, et al. Shh signaling regulates adrenocortical development and identifies progenitors of steroidogenic lineages. Proc Natl Acad Sci(2009) 106:21185-211902. Guasti L, et al. Dlk1 Up-Regulates Gli1 Expression in Male Rat Adrenal Capsule Cells Through the Activation of β1 Integrin and ERK1/2. Endocrinology(2013) 154:4675-46843. Hadjidemetriou I, et al. DLK1/PREF1 marks a novel cell population in the human adrenal cortex. J Steroid Biochem Mol Biol(2019) 193:1054224. Guasti L, Candy Sze WC, McKay T, Grose R, King PJ. FGF signalling through Fgfr2 isoform IIIb regulates adrenal cortex development. Mol Cell Endocrinol(2013) 371:182-1885. Heikkilä M, et al. Wnt-4 Deficiency Alters Mouse Adrenal Cortex Function, Reducing Aldosterone Production. Endocrinology(2002) 143:4358-4365
MON-LB018 Paediatric Type 2 Diabetes in a Single Centre in East London in the Period 2009-2018
Authors: Gevers Evelien F , Giuffrida Anna 
Published: May 2020

Abstract
Background: The incidence of Paediatric type 2 diabetes is increasing, especially in areas of deprivation.
Aim: To describe the cohort of CYP with T2D in Royal London Hospital over the period 2009-2018.
Methods: Retrospective analysis of patient cohort.
Results: Number of new patients doubled from 2.6/year in 2009-2013 to 5.3/year in 2014-2018. Prevalence in our cohort is 7.5% (national average of 2.5%, NPDA 2017-2018). Fourty patients (25 female, 15 male) were diagnosed in 2009-2018, with a mean age at diagnosis of 13.9+/-1.7 yrs. Males had more frequently learning difficulties compared to females (40% vs 20%). Sixty % of patients were Asian compared to 28% in our T1D cohort.
BMI at presentation was 31.5 kg/m2 (23 females) and 33.85 kg/m2 (13 males). BMI remained stable for females for the first year after diagnosis but in males increased to 34.6 kg/m2 (n=10, non significant (ns)).
At diagnosis, Metformin was started in 38/40 patients although 7 patients reduced the dose and 6 stopped due to side effects. 12/36 patients started also on long-acting insulin (0.28+/-0.17U/kg), in 6 combined with prandial insulin (0.42+/-0.20U/kg). Seven patients started long-acting insulin at a later stage and 6 required prandial insulin too. 1 patient was treated with Sitagliptin.
HbA1c at diagnosis (n=27) was 75.2+/- 20mmol/mol, similar for males and females.HbA1c dropped to 55.0+/-17.4mmol/mol after 3 months (P&lt;0.0001), to increase again to 63.0+/-25.8 and 67+/-28 after one (n=25, ns) and 2 years (n=23, ns).
Nineteen of 38 patients achieved a HbA1c &lt; 48 at least once, but only 9 of 35 achieved an HbA1c &lt; 48 for a year. Of these, 3 continued to be on insulin and in 1 patient insulin was stopped. Two patients relapsed.
Complications were as follows: 11/21 hypertension, 6/28 sleep apnoea, 10/30 raised ALT and 9/24 fatty liver.
Conclusion: Learning difficulties in patients with T2D are frequent. Complications of obesity/T2D are common in this cohort. Current treatment does not achieve permanent reduction in BMI and HbA1c in most patients although temporary reduction of HbA1c is possible. New treatment approaches are needed to improve outcomes.
MON-LB108 Measurement Of Carotid Intima,hepatic Steatosis And Inflammatory Markers In Obese Children
Authors: Bazan Maria Cristina 
Published: May 2020

Abstract
Measurement of carotid intima,hepatic steatosis and inflammatory markers in obese children. Elevated levels of inflammatory factors and increased mean intimal carotid thickness (IMT) would increase the risk of atherothrombotic events and contribute to the progression of cardiovascular disease in obese children. Objectives: Evaluate inflammatory factors, metabolic syndrome and non-alcoholic liver steatosis and carotid IMT as an early cardiovascular risk marker. Patients and methods: Descriptive cross-sectional exploratory study. Consider 41 obese children both sexes between 6- 12 years old. Evaluated: anthropometry and determinations of lipid and liver profile, blood glucose, insulin, HOMA, ultrasensitive CRP, fibrinogen. Hepatic ultrasound and measurement of carotid IMT with ESAOTE Mylab 50 Exdicion equipment. . Results: From 41 studied patients, 57% were female. 51% presented MS and 68% elevated triglycerides. CRP&gt; 1 was found in 71% of cases. Hepatic steatosis was observed in 60%, which only 10% had altered transaminases. 12% presented high fibrinogen. Patients with MS had a significant positive difference in the IMTCC (X = 0.41 ± 0.12; p 0.024), HDL (X 37.89 ± 1.72; p 0.004) triglycerides (X 149.42 ± 10.69; p 0.002) in relation to patients without MS. Conclusion: CRP is an inflammatory risk factor associated with elevated BMI and MS. There was a higher prevalence of MS in our study. The increase in the average intimal thickness is significantly related to the presence of MS and RCP&gt;1. The determination of marker molecules of an inflammatory state and measurement of carotid IMT would contribute to the implementation of strategies to prevent cardiovascular, hepatic and metabolic risk since childhood.
SAT-LB88 Recurrent Dysphagia Due to an Esophageal Stricture in a Patient With Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy (APECED)
Authors: Johnson Timothy , Gabriely Ilan 
Published: May 2020

Abstract
Background: Chronic Mucocutaneous Candidiasis is one of the hallmark features of Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED). Untreated esophageal candidiasis may lead to complications such as esophageal stricture, rupture and or fistula formation1,2. Case Presentation:A 31-year-old man with a past medical history significant for APECED with involvement including hypoparathyroidism, hypothyroidism and adrenal insufficiency presented to the Emergency Department with dysphagia and globus sensation after eating. This was the fourth time in the last 2 years that the patient had presented with this chief complaint. The patient underwent emergent esophagogastroduodenoscopy (EGD) where a large meat bolus was identified at approximately 20 cm and removed. A discrete esophageal tear at 19-20 cm was identified and clipped. The esophagus was noted to be diffusely narrowed with mild corrugation, and biopsies showed evidence of esophageal candidiasis. A chest CT scan demonstrated diffuse pneumomediastinum and soft tissue emphysema throughout the esophagus, suspicious for a tear. Fluoroscopic Esophagogram showed mild narrowing of the upper third of the esophagus without evidence of gross extravasation. The patient was placed on NPO (nothing by mouth) diet, started total parenteral nutrition, and treated with IV Fluconazole, administered for 10 days and then transitioned to oral Fluconazole for a total of 21 days, with improvement. A subsequent repeat fluoroscopic esophagogram showed absence of extravasation at the previously identified level of the esophagus. The patient is currently scheduled for a repeat EGD in 3 months. Conclusion:This case demonstrates a significant complication of APECED involving esophageal candidiasis. Timely diagnosis and treatment of esophageal candidiasis in APECED may prevent life-threatening esophageal pathology.
References:1)Kim, Byung-Wook et al. Esophagomediastinal fistula and esophageal stricture as a complication of esophageal candidiasis: A case report. Gastrointestinal Endoscopy, Volume 52, Issue 6, 772 – 775.2)Hyun J, Chun H, Keum B et al. Candida esophagitis complicated by esophageal stricture. Endoscopy 2010; 42(S02): 180 - 181. doi:10.1055/s-0029-1244014.
OR25-03 The Effects of Crinecerfont (NBI-74788), a Novel CRF1 Receptor Antagonist, on Adrenal Androgens and Precursors in Patients with Classic Congenital Adrenal Hyperplasia: Results from A Multiple-Dose Phase 2 Study
Authors: Auchus Richard J , Sarafoglou Kyriakie , Fechner Patricia Y , Vogiatzi Maria , Giri Nagdeep , Roberts Eiry , Sturgeon Julia , Farber Robert 
Published: May 2020

Abstract
Introduction: Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD CAH) is a rare autosomal recessive disease that results in impaired cortisol synthesis and excess androgen production. Compounds that inhibit adrenocorticotropic hormone (ACTH) release could reduce adrenal androgen production and thus the amounts of exogenous glucocorticoids needed to decrease these androgen levels. This study evaluated the effect of crinecerfont (NBI-74788), a novel, non-steroidal, and selective corticotropin-releasing factor-1 (CRF1) receptor antagonist on adrenal androgens and precursors in adults with 21OHD CAH.
Methods: This open-label, multiple-dose study enrolled men and women (18–50 years old) with 21OHD CAH. A sequential-cohort design evaluated 4 crinecerfont oral dosing regimens: 50 mg QHS (Cohort 1); 100 mg QHS (Cohort 2); 100 mg QD (Cohort 3); and 100 mg alternative dosing (Cohort 4). Each regimen was administered for 14 consecutive days. ACTH, 17-hydroxy-progesterone (17OHP), and androstenedione (A4) were measured serially over a 24-hour period, at baseline and after 14 days of dosing.
Results: Analyses included 23 participants: Cohort 1 (4 women, 4 men: mean age 31.1 years); Cohort 2 (5 women, 2 men: mean age 32.9 years); and Cohort 3 (3 women, 5 men: mean age 30.9 years). Cohort 4 is ongoing. At baseline, median plasma ACTH, serum 17OHP, and serum A4 levels were as follows: Cohort 1 (ACTH, 151 pg/mL; 17OHP, 5352 ng/dL; A4, 270 ng/dL); Cohort 2 (ACTH, 232 pg/mL; 17OHP, 12821 ng/dL; A4, 597 ng/dL); and Cohort 3 (ACTH, 470 pg/mL; 17OHP, 6451 ng/dL; A4, 299 ng/dL). After 14 days of once-daily crinecerfont 50 mg, Cohort 1 patients had median percent reductions from baseline in plasma ACTH (-54%), serum 17OHP (-60%), and serum A4 (-21%). Median percent reductions were generally larger with 100 mg in Cohort 2 (ACTH, -67%; 17OHP, -75%; A4, -47%) and Cohort 3 (ACTH, -69%; 17OHP, -55%; A4, -43%), consistent with a dose-related response. Adverse events were mostly mild; no clinically significant findings from routine laboratory tests, vital signs, or electrocardiograms were noted.
Conclusions: Results of this Phase 2 study of crinecerfont, a novel, orally administered, selective CRF1-receptor antagonist, indicated clinically meaningful reductions of elevated ACTH, 17OHP, and A4 in adults with 21OHD CAH after 14 days of treatment. Further studies are warranted to evaluate the effects of chronic crinecerfont therapy on maintenance of adrenal steroid production, clinical endpoints of disordered steroidogenesis, and reductions in GC exposure in both adult and pediatric patients with 21OHD CAH.