Helen Wallace

Queen's University Belfast | QUB · Centre for Public Health

Patients undergoing systemic anti‐cancer treatment (SACT) often receive short courses of high dose steroids which may cause hyperglycaemia and potentially impact negatively on clinical outcomes. In this study we aimed to ascertain the prevalence of diabetes in a day‐case SACT cohort and secondly to compare practical methods of identifying patients...

Background: The global epidemic of type 2 diabetes (T2D) and obesity has been translated into pregnancy, with approximately 18% of women being diagnosed worldwide with Gestational Diabetes Mellitus (GDM). Whilst preventive strategies have proven effective in the non-pregnant context, attrition rates are high and there is an urgent need to develop...

Patients undergoing systemic anti-cancer treatment (SACT) often receive short courses of high doses of steroids this may cause hyperglycaemia and potentially impact negatively on clinical outcomes. We sought to ascertain the prevalence of hyperglycaemia (steroid-induced diabetes and steroid induced hyperglycaemia) in our local patient cohort underg...

Background: Observational studies have suggested an inverse association between low serum 25-hydroxyvitamin D [25(OH)D] concentrations and development of type 2 diabetes. High-quality trials are required to test the hypothesis that vitamin D is a direct contributor to type 2 diabetes pathogenesis. Objective: The purpose of this double-blind rand...

A case series of Ectopic ACTH production in malignancy - the morbidity and mortality associated with this.

We present three cases of Cushing’s syndrome due to ectopic ACTH in patients with malignancy. All three had hypokalaemia at presentation. Diagnosis was based on clinical features andmorning ACTH and cortisol concentrations. Case one presented with fatigue, hypokalaemia ([K+] 1.9 mmol/L) and a new diagnosis of diabetes mellitus (DM) on a background...

Acute kidney injury (AKI) is common in acute medical admissions. It is associated with increased mortality and prolonged length of stay. Advice to hold nephrotoxic medications at times of illness may not be getting through to patients. We retrospectively reviewed all 238 medical admissions in a 1 week period (20/11/17 – 27/11/17). AKI was present i...

Aims & Methods Patients with diabetes receiving haemodialysis are frail and have multiple complex co-morbidities, which require input from multiple specialist teams. We suspected that many patients were missing essential diabetes and screening assessments due to difficulties attending and organising appointments around dialysis sessions. In order t...

Aims The diabetic eye screening programme (DESP) offers all patients with diabetes an annual appointment at their general practice. Patients with diabetes who undergo maintenance haemodialysis have complex healthcare needs and we suspected that many patients missed their screening appointments. We sought to assess the frequency of missed screening...

Aims: Our regional oncology day-case facility provides chemotherapy to approximately 50 patients per day. Glucocorticoids, which almost every patient receives, are a major contributor to hyperglycaemia. Our unit had a small number of potentially avoidable hyperglycaemic crises in this cohort. We sought to improve recognition and management of stero...

The aryl hydrocarbon receptor interacting protein (AIP) founder mutation R304* (or p.R304*; NM_003977.3:c.910CtextgreaterT, p.Arg304Ter) identified in Northern Ireland (NI) predisposes to acromegaly/gigantism; its population health impact remains unexplored. We measured R304* carrier frequency in 936 Mid Ulster, 1000 Greater Belfast (both in NI) an...

Background: A founder mutated AIP allele, R304* was previously identified in several Irish familial isolated pituitary adenoma (FIPA) pedigrees from a small region within Mid Ulster, Northern Ireland, but the allele’s general population impact remains unknown. Aims: To estimate R304* prevalence in the general population and pituitary adenoma (PA)...

TSH-secreting pituitary adenomas (TSHomas) are rare. Previously, the reported prevalence was one case per million populations although this is probably an underestimate. A recently published study reported a prevalence of TSHomas in Sweden of 2.8/million inhabitants. Methods/design: Observational study conducted in four tertiary referral centres in...

Clinical and biochemical follow up after surgery for phaeochromocytoma is essential with long term studies demonstrating recurrence frequencies between 6% and 23%. To examine the characteristics and frequency of tumour recurrence in a regional endocrine referral centre, in patients with surgical resection of phaeochromocytoma (P) and abdominal para...

Vitamin D is a steroid hormone, which in active form binds to the vitamin D receptor. Expression of the vitamin D receptor in diverse cell types (pancreatic islet cells, myocytes, hepatocytes and adipocytes) raises the suspicion that vitamin D may be involved in multiple cellular processes, including the response to insulin. Insulin resistance is a...

Primary hyperparathyroidism (PHP) during pregnancy is associated with high risk of maternal, foetal and neonatal mortality. Maternal and foetal complications have been reported in 67 and 80% of cases respectively. Guidelines for the management of PHP in adults exist, but there is no clear consensus regarding optimal management of PHP during pregnan...

Phaeochromocytoma is a catecholamine producing tumour and an uncommon cause of hypertension. We present two cases of relatively asymptomatic individuals, in which previously undiagnosed phaeochromocytoma was unmasked by elective nonadrenal surgical procedures, manifesting as postoperative hypertensive crisis and subsequent cardiogenic shock. The in...

An 85-year-old lady with decreased mood and low energy was found to have an elevated serum corrected calcium concentration of 2.8 mmol/L (reference range: 2.1–2.6 mmol/L). Plasma parathyroid hormone concentration was elevated at 390 pg/mL (reference range: 10–85 pg/mL). She had a past history of renal calculi. Renal function, full blood picture, er...