SHINE study: Developing an intervention for safe hospital insulin use for older or frail adults with diabetes undergoing surgical hospital admission: Study protocol.

Aims: To present a study protocol for the development of an intervention to enhance safe insulin use for older or frail adults undergoing a surgical admission to hospital.

Design: Following the United Kingdom's Medical Research Council and National Institute for Health and Care Research Frameworks for development and evaluation of complex interventions; this qualitative study will use a co-design approach using design thinking, to develop a theoretical model for the intervention.

Methods: Non-participatory observations, interviews and co-design workshops will be conducted with older or frail individuals with diabetes, their caregivers and healthcare staff responsible for their care during surgical admissions at a single National Health Service hospital in England.

Impact of vitamin D replacement in patients with normocalcaemic and hypercalcaemic primary hyperparathyroidism and coexisting vitamin D deficiency.

Background: Vitamin D deficiency is increasingly recognized in patients with primary hyperparathyroidism but some clinicians are reluctant to replace vitamin D due to concerns with aggravating hypercalcaemia. We investigated the impact of vitamin D repletion in asymptomatic patients with normocalcaemic and hypercalcaemic primary hyperparathyroidism.

Methods: This is a retrospective analysis of 111 patients with elevated parathyroid hormone concentrations (>6.

Newer dopaminergic agents cause minimal endocrine effects in idiopathic Parkinson's disease.

Objective: We studied the prevalence of endocrine dysfunction in subjects with idiopathic Parkinson's disease (IPD) on newer dopaminergic agents (DA). DA are also used in endocrine hypersecretory states in small doses and we hypothesized that endocrine dysfunction was likely in IPD where DA were used in comparatively much higher dosage.

Patients And Methods: Twenty-five subjects with IPD, established on DA, were recruited to this cross-sectional study.

Late presentation of hyperandrogenism in pregnancy: clinical features and differential diagnosis.

Background: Hyperandrogenic states in pregnancy are rare but arise most commonly due to new-onset ovarian pathology in pregnancy. We describe the case of a young woman who presented in the latter half of her pregnancy with features of hyperandrogenism. We review the biochemical and imaging findings and discuss the differential diagnosis.