Programme Book - British Society for Paediatric Endocrinology

Transcription

40th Meeting of the British Society for
Paediatric Endocrinology and Diabetes
7 - 9 November 2012
Including the CME Training Day on 7 November
Leeds Town Hall, Leeds, UK
Programme & Abstracts Book
CPD approval has been sought from the Royal College of Paediatrics and Child Health of the UK for the main meeting.
40th Meeting of the British Society for
Paediatric Endocrinology and Diabetes
7 - 9 November 2012
Including the CME Training Day on 7 November
Leeds Town Hall, Leeds, UK
www.bsped.org.uk
Welcome to Leeds
2012 will be remembered for many anniversaries - the 200th birthday of Charles
Dickens, the 100th anniversary of the Titanic tragedy, the Queen’s Diamond
Jubilee, the British Olympics, and of course the Ruby anniversary of the British
Society for Paediatric Endocrinology and Diabetes.
It is a special year for paediatrics in Leeds too, as we officially opened the Leeds
Children’s Hospital in the spring, and we are proud to be hosting this prestigious
meeting in Yorkshire’s capital city. We have planned a diverse, informative and
entertaining programme of events in the city which brought the world the likes
of Peter O’Toole, Alan Bennett, Jane Tomlinson and Harry Ramsden (of fish and
chips fame!)
Leeds is a popular destination with lots to offer visitors. It is the only English
city outside London with its own repertory theatre, opera house and ballet
companies and the city is also home to the Royal Armouries and the Thackray
medical museum. There are more listed buildings in Leeds than in any English
city outside London, with highlights including the Victoria Quarter, Leeds Corn
Exchange and Harewood House.
The Rough Guide to Britain named shopping in Leeds as one of the top thirty
things to do in the UK, and a great sporting heritage is built around worldfamous stadia like Headingley and Elland Road.
Leodensians are justly proud of our venue for the fortieth meeting of the
BSPED - the Leeds Town Hall. This stunning hybrid of classical Greek and
baroque styles built by Charles Broderick between 1853 and 1858 houses a
world famous organ, and is centrally located within walking distance of many
of Leeds’ historical and cultural landmarks. Take the time to explore the nearby
City Museum, Henry Moore Institute, Leeds Cathedral, or wander around the city
markets - perhaps you could simply catch a film at the Leeds International Film
Festival, which is showing many new releases at the Town Hall itself.
LOCAL CONVENORS
Sabah Alvi and Talat Mushtaq
BENEFACTORS
Ferring Pharmaceuticals Ltd
Ipsen Ltd
Merck Serono
Novo Nordisk Ltd
Pfizer Ltd
Sandoz Biopharmaceuticals
Sanofi Diabetes
Also supported by
BBI Healthcare
Diasend/Aidera AB
Eli Lilly & Company Ltd
Roche Diabetes Care
Siemens
The 40th Annual BSPED meeting will start with a CME day on Wednesday
7th – with themes of pituitary and thyroid disorders. The following day the
endocrine programme will focus on themes of genes, gender identity and, in the
spirit of Olympic year, the impact of sport on health and disease. There will, as
always, be opportunities for oral and poster presentation of new research, and
a parallel endocrine nurse specialist session, but in response to feedback from
our members, we are this year holding a single, fully integrated diabetes day
with speakers from all disciplines - nursing, psychology and dietetics as well as
paediatric and adult medicine-rather than parallel medical and nursing sessions.
We have a list of nationally and internationally renowned speakers, and we aim
to deliver a first class programme with talks to please all diabetes professionals,
closing the meeting with a keynote lecture from one of the most renowned
British diabetologists of our time.
The conference dinner will be held at The Metropole Hotel, just a short walk from
the Town Hall and city centre hotels. A highlight of the evening will be a short
after dinner talk on the history and origins of the BSPED, delivered by one of the
stalwarts of our Society…but you will need to attend to find out more!
We look forward to welcoming you to Leeds for what promises to be a
stimulating and educational anniversary meeting.
Sabah Alvi and Talat Mushtaq
40th Meeting of the British Society for Paediatric Endocrinology and Diabetes
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GENERAL INFORMATION
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Date and place of Meeting
The 40th Meeting of the British Society
for Paediatric Endocrinology and
Diabetes and CME Training Day will be
held on 7 - 9 November 2012 at Leeds
Town Hall, The Headrow, Leeds, LS1
3AD Telephone: 0113 247 6647.
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POSTER TOURS
The poster session will take place during the lunch break on Thursday 9 November
from 12.45-13:30.
Category Poster Tour Leader(s)
Adrenal Dr Li Chan
Adrenal, Gonadal, DSD and reproduction Prof Faisal Ahmed
Bone Dr Nick Shaw, Dr Jeremy Allgrove
and Dr Paul Arundel
Diabetes Dr Rakesh Amin
and Dr Tabitha Randell
Diabetes Nurse Mrs Marie Marshall
and Ms Louise Collins
Late effects of cancer treatment and Other / Misc
Dr Liz Crowne
Hyperinsulinism and Other / Misc Dr Indi Banerjee
Other / Misc & Thyroid Dr Fiona Ryan
Pituitary & growth Dr John Barton
and Dr Sarah Ehtisham
The Annual General Meeting
of the BSPED
The Annual General Meeting of the
BSPED will be held on Thursday 9
November from 17.15-18.00 in the
Victoria Hall.
Nurse Sessions
The Endocrine Nurse sessions will
take place on Friday 9 November
in the Albert Room.
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4 Leeds Museum Discovery Centre
[email protected]
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Endocrine Nurses
Business Meeting
This will take place on Friday 9
November from 09:00 – 09:45 in the
Albert Room.
GENERAL INFORMATION
3 Leeds Industrial Museum
[email protected]
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LEEDS CITY
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2 Leeds City Museum
[email protected]
Social Programme
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Badges
Name badges will be provided at the
registration desk on arrival and must
be worn at all times for admission to
the scientific sessions. Stewards will
be checking badges on entrance to
sessions.
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A detailed programme can be found
on page 7.
PA R
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BSPED CME Training Day
The BSPED CME Training Day will take
place on Wednesday 7 November 2012
from 09:30 – 16:30. This is the eighth
annual BSPED CME day approved
event and is part of a four year course
aimed to cover the entire syllabus of
paediatric endocrinology. This year’s
course content will focus on pituitary
and thyroid disorders.
W
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Hospital
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1 Leeds Art Gallery
[email protected]
5 Leeds Town Hall
Welcome Reception
[email protected]
The welcome reception and opening
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Parking
If travelling by car, there are a number
of large car parks located nearby. The
closest to Leeds Town Hall is Q-Park St
Johns Centre, Merrion Street, LS2 8LQ.
Hull & east
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Location
Leeds Town Hall is conveniently located
in the centre of Leeds, next to Leeds W E
ST S
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Central Library and Leeds City Art
Gallery. It is a five minute walk from
both the rail and bus stations and a 10
minute drive from the M1 and M62
motorways.
Newcastle&
north eas
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symposium are generously supported by
Pudsey Civic Hall
Ferring Pharmaceuticals Ltd. These will
[email protected]
take place on Wednesday 7 November
at 19:00
in the Leeds City Museum. All
Temple Newsam
House
delegates
are invited to join us.
[email protected]
8 The Carriageworks
Speakers Dinner
[email protected]
Supported by Novo Nordisk Ltd.
The Speakers Dinner will take place on
Wednesday 7 November at 19:45, by
invitation only. Located at The Leeds
Club, 3 Albion Place, Leeds, West
Yorkshire LS1 6JL.
Conference Dinner
The Conference Dinner will take place at
20:00 on Thursday 8 November 2012
at The Metropole Hotel, King Street,
Leeds, West Yorkshire LS1 2HQ. A three
course dinner will follow along with
entertainment. There may be a limited
number of tickets available for purchase,
please check at the registration desk.
Exhibitors and Sponsors
The exhibition is located in The Sullivan
Room, Elgar Room, Walton Room
and along the rear corridor of Leeds
Town Hall.
Exhibiting companies at this meeting
are: Diasend/Aidera AB, Eli Lilly &
Company Ltd, Ferring Pharmaceuticals
Ltd, Ipsen Ltd, Merck Serono, Novo
Nordisk Ltd, Pfizer Ltd, Roche Diabetes
Care, Sandoz Biopharmaceuticals,
Sanofi Diabetes.
We would also like to thank Novo
Nordisk Ltd for the speakers dinner.
Disabled Facilities
Leeds Town Hall is fully accessible with
a lift to the first floor, disabled toilet
facilities and disabled parking next to
the entrance.
Taxis
A list of taxi numbers can be found at
the registration desk.
Benefactors
We are grateful to the
following benefactors for
their support of the BSPED:
Ferring
Pharmaceuticals Ltd
Ipsen Ltd
Merck Serono
Novo Nordisk Ltd
Pfizer Ltd
Sandoz
Biopharmaceuticals
Sanofi Diabetes
Catering
A packed lunch will be available on
each day of the meeting, along with
refreshments during designated breaks
in the Exhibition Halls (The Sullivan
Room, Elgar Room and Walton Room).
Prayer Room
This is located in the Waterman Room.
Symposium
Ferring Pharmaceuticals are holding
a satellite symposium entitled
Regulation of Salt and Water Balance
on Wednesday 7 November 2012
from 17:30 – 19:00 in Leeds City
Museum, Millennium Square, Leeds,
West Yorkshire LS2 8BH. All delegates
are invited to attend this satellite
symposium and entrance is included in
the registration fee. Further details can
be found on page 8.
CPD approval
CPD approval has been sought for
this meeting.
03
DAy PLAnNer WEDNESDAY 7 November 2012
VICTORIA Hall
THURSDAY 8 November 2012 Day PLANNER
Leeds City Museum
07.30
VICTORIA Hall
07.30
CME Training Day
MAIN MEETING
08.00
08.00
08.30
08.30
09.00
09.00
09.30
10.00
10.30
11.00
12.00
TEA & COFFEE
11.00
11.30
The surgical management of pituitary
tumours
Symposium 1
Gender Identity Development Care and Controversies
12.00
Pituitary cases x2
13.00
13.00
14.30
Oral Communications 1
10.30
Causes, diagnosis and management of
pituitary dysfunction
12.30
14.00
MAIN MEETING WELCOME
10.00
Physiology and developmental disorders
of the pituitary
12.30
13.30
REGISTRATION OPENS
09.30
REGISTRATION
Albert Hall
TEA & COFFEE
11.30
ALBERT ROOM
LUNCH AND POSTER TOUR
LUNCH
13.30
Thyroid - physiology and developmental
biology
14.00
Hyperthyroidism and its management
Symposium 2
Controversies in Paediatric Endocrinology
14.30
15.00
Hypothyroidism and its management
15.00
15.30
15.30
TEA & COFFEE
16.00
TEA & COFFEE
16.00
Thyroid cases x2
16.30
16.30
CLOSE
17.00
17.30
18.00
REGISTRATION
Leeds City Museum, Leeds
Ferring Pharmaceuticals
Satellite Symposium
Symposium 3
The Olympiad!
17.00
17.30
BSPED Annual General Meeting
18.00
18.30
19.00
19.30
18.30
Welcome Reception
20.00
04
19.00
19.30
20.00
Pre-Dinner Welcome Reception
Conference dinner
05
DAY PLANNER FriDAY 9 November 2012
VICTORIA Hall
ALBERT ROOM
MAIN MEETING
Endocrine Nurse Day
07.30
08.00
08.30
09.00
09.30
10.00
10.30
11.00
Registration Opens
Registration Opens
09:55 - 10:00 Welcome
Paediatric Endocrine Nurses Business
Meeting (incorporating relaunch of the
BSPED GH Audit)
10:00 - 11:00 CME Session 1
Welcome
Ipsen Award Winners
TEA & COFFEE
TEA & COFFEE
11.30
Nurse Session 1
12.00
12.30
13.00
13.30
14.00
14.30
15.00
Symposium 5
Diabetes and Education
NOVO NORDISK AWARD WINNER
Case presentation: endocrinology in sport
Nurse Session 2
BSPED Prizes
LUNCH & POSTERS
S1 Physiology and developmental disorders of
the pituitary
M Dattani (London)
S2 Causes, diagnosis and management of pituitary
dysfunction
M Maghnie (Genoa, Italy)
11:00 - 11:30 Tea & Coffee
11:30 - 12:00 CME Session 2
S3 The surgical management of pituitary tumours
S Sinha (Sheffield)
12:00 - 13:00 Pituitary cases x2
13:00 - 13:45 Lunch
13:45 - 15:30 CME Session 3
LUNCH
Symposium 6
Diabetes and Sport
Keynote Lecture
15.30
16.00
CME training Day - Pituitary and Thyroid
VICTORIA HALL
09:30 - 16:30 REGISTRATION OPENS
Symposium 4
Hot topics In Diabetes
WEDNESDAY 7 November 2012 SCIENTIFIC PROGRAMME
CLOSE
13:45S4
Thyroid - physiology and developmental biology
N Schoenmakers (Cambridge)
14:15S5
Hyperthyroidism and its management
T Cheetham (Newcastle)
14:45 S6 Hypothyroidism and its management
M Donaldson (Glasgow)
15:30 - 16:00 Tea & Coffee
16.30
16:00 - 16:30 17.00
16:30 17.30
Thyroid cases x2
Close of meeting
18.00
18.30
19.00
19.30
20.00
06
07
SCIENTIFIC PROGRAMME WEDNESDAY 7 November 2012
THURSDAY 8 November 2012 SCIENTIFIC PROGRAMME
Leeds City Museum
Main meeting – VICTORIA Hall
16:45 - 19:45 Registration
17:30 - 19:00 Ferring Pharmaceuticals Satellite Symposium
Chair: T Cheetham (Newcastle upon Tyne)
Diabetes Insipidus and Pituitary Stalk Abnormalities
Other Forms of Salt and Water Disturbance
S Ball (Newcastle)
19:00 - 19:45 Welcome Reception
08
08:15 - 08:45 Registration Opens
08:45 - 09:00 Welcome
09:00 - 10:30 Oral Communications 1
Chairs: S Kanumakala (Brighton)
& L Metherell (London
OC1.1
Iodine status in UK pregnant women and implications for fetal brain development
Presenter: S Bath (Surrey)
S Bath, C Steer, J Golding, P Emmett, M Rayman
OC1.2
Disease- and treatment-related factors implicated in late neuroendocrine morbidity after paediatric optic pathway gliomas: a preliminary multivariate analysis of 96 patients treated over 30 years
Presenter: HW Gan (London)
HW Gan, H Spoudeas
OC1.3
Potential novel insights into the control of the feto-
placental unit by kisspeptin
Presenter: H Katugampola (London)
H Katugampola, L Dunkel, P King, J Achermann,
A Duncan, U Sankilampi, H Storr
OC1.4
Skeletal effects of hypothyroidism are mediated by thyroid hormone receptor alpha
Presenter: M Cheung (London)
M Cheung, A Boyde, H Evans, D Bassett, G Williams
OC1.5
Ethnic differences in vascular growth factor levels in early life in relation to arterial stiffness in The Manchester Heart And Growth Study
Presenter: S Khan (Manchester)
S Khan, S Anderson, A Whatmore, P Pemberton, A Vyas,
K Cruikshank, P Clayton
OC1.6
A novel syndrome characterized by hypothalamic hormonal insufficiency, neonatal seizures, congenital abnormalities of the kidneys and urinary tract and obesity due to mutation in a gene regulating hypothalamic development
Presenter: E Webb (London)
E Webb, D Kelberman, A Al Mutair, C Andoniadou,
C Bacchelli, E Chanudet, R Kleta, F Lescai, E Stupka,
P Beales, J Sowden, JP Martinez, M Dattani
09
SCIENTIFIC PROGRAMME THURSDAY 8 November 2012
THURSDAY 8 November 2012 SCIENTIFIC PROGRAMME
OC1.7
Novel therapies herald novel diseases:
The first paediatric case series of Graves’ immune reconstitution disease
Presenter: A Sinha (Newcastle upon Tyne)
A Sinha, M Abinun, T Cheetham
OC1.8
Loss-of-Function Mutations in IGSF1 Cause a Novel, X-Linked Syndrome of Central Hypothyroidism and Testicular Enlargement
Presenter: N Schoenmakers (Cambridge)
N Schoenmakers, B Bak, Y Sun, P van Trotsenburg,
W Oostdijk, P Voshol, L Persani, T Davis, P le Tissier,
N Gharavy, N Appelman-Dijkstra, A Pereira,
J den Dunnen, M Breuning, R Hennekam,
V Krishna Chatterjee, M Dattani, D Bernard, JM Wit
10:30 - 11:00 Tea & Coffee
Chair: P Dimitri (Sheffield)
11:00 - 12:00 Symposium 1 - Gender Identity Development - Care and Controversies
Chairs: S Alvi (Leeds) & G Butler (London)
11:00S7
The development of sexual identity and understanding of GID
P Carmichael (London)
11:30S8
12:00 - 13:30 Gender reassignment surgery in GID
J Bellringer (London)
Lunch
12:45 - 13:30 Poster Tour
13:30 - 14:30 Symposium 2 - Controversies in
Paediatric Endocrinology
Chairs: M Dattani (London) & H Storr (London)
13:30S9
Growth Hormone in transition
14:00S10
MEN Syndromes- genetics and the ethics
of screening
C Chu (Leeds)
10
OC2.1
Assessment of adrenal function in female to male adolescents with Gender Identity Dysphoria (GID).
Presenter: M Ajzensztejn (London)
M Ajzensztejn, M Gopalakrishnamoorthy, A Dawnay,
R Viner, C Brain, G Butler
OC2.2
Deficiency of the triple A syndrome gene product, ALADIN, renders human adrenal cells susceptible to oxidative stress with subsequent impact on steroidogenesis
Presenter: R Prasad (London)
R Prasad, A Clark, H Storr
OC2.3
Does Vitamin D modulate mitochondrial oxidative phosphorylation?
Presenter: A Sinha (Newcastle upon Tyne)
A Sinha, S Ball, K Hollingsworth, T Cheetham
OC2.4
Prenatal dexamethasone for treatment of congenital adrenal hyperplasia: a possible association with late gestational fetal demise
in two cases.
Presenter: A Peacock (Leeds)
A Peacock, I Abbey, S Alvi, C Bennett, J Dwyer,
T Glanville, T Mushtaq
OC2.5
Abnormal neurological and developmental outcomes in children with persistent and spontaneously resolving congenital hyperinsulinism
Presenter: B Avatapalle (Manchester)
B Avatapalle, S Shah, M Pryce, J Nicholson, L Rigby,
L Caine, M Didi, S Ehtisham, L Patel, M Skae, R Padidela, I Banerjee, P Clayton
OC2.6
Childhood body composition is associated with maternal plasma polyunsaturated fatty acids status in late pregnancy
Presenter: R Moon (Southampton)
R Moon, NC Harvey, G Ntani, JH Davies, HM Inskip,
K Godfrey, EM Dennison, P Calder, C Cooper
OC2.7
Growth, GH-IGF-I status and response to
r-hGH therapy in 3-M Syndrome, related to mutation status
Presenter: F Sakhinia (Manchester)
F Sakhinia, D Hanson, P Murray, J Kirk, T Cole, M Skae,
I Banerjee, R Padidela, L Patel, P Clayton
11
SCIENTIFIC PROGRAMME THURSDAY 8 November 2012
OC2.8
Genetic screening in a large cohort of patients with congenital hypopituitarism; current knowledge and future directions
Presenter: KS Alatzoglou (London)
KS Alatzoglou, JPG Turton, D Kelberman, MJ McCabe,
LC Gregory, EA Webb, DEG McNay, KS Woods, A Mehta, MT Dattani
OC2.9
Growth hormone (GH) neuro-secretory dysfunction following traumatic brain injury (TBI) in childhood
Presenter: N Daskas (Bristol)
N Daskas, P Sharples, E Crowne
OC2.10
When is it justifiable to await venous thyroid function tests before starting thyroxine treatment in infants referred with capillary TSH elevation?
Presenter: T Pokrovska (Glasgow)
T Pokrovska, J Jones, G Shaikh, M Donaldson
15:30 - 16:00 Tea & Coffee
16:00 - 17:00 Symposium 3 - The Olympiad!
Chairs: T Mushtaq (Leeds) & J Wales (Sheffield)
16:00S11
Beyond reasonable doubt – catching the GH cheats
R Holt (Southampton)
16:30S12
17:15 - 18:00 Physical activity and athletic training in children and adolescents
A Rogol (Virginia, USA)
19:15 - 20:00 Pre-Dinner Welcome Reception
20:00 - BSPED Annual General Meeting
Conference Dinner
FRIDAY 9 November 2012 SCIENTIFIC PROGRAMME
Main meeting – VICTORIA Hall
08:15 - Registrations Opens
09:00 - 10:00 Symposium 4 - Hot topics In Diabetes
Chairs: F Campbell (Leeds) & T Barrett (Birmingham)
09:00S13
Improving outcomes in teenagers and young adults with Type 1 diabetes
S Heller (Sheffield)
09:30S14
10:00 - 10:30 Continuous age appropriate structured education for children and young people with diabetes
K Lange (Hanover, Germany)
Chairs: C Acerini (Cambridge) & N Wright (Sheffield)
OC3.1
HbA1c league tables: Does selection policy
encourage foul play to support promotion to the “premier league”?
Presenter: M Wassef (Sheffield)
M Wassef, C Elder, N Wright
OC3.2
Audit of management of diabetic ketoacidosis
in children
Presenter: A Shetty (Cardiff)
J A Shetty, J Warner
OC3.3
Quality of Life and HbA1c outcomes in children and young people commencing insulin pump therapy
Presenter: J Cropper (London)
J Cropper, L Kanchi, M Ford-Adams, T Hulse,
C Buchanan, E Barker
OC3.4
Continuous Glucose Monitoring - Are there more barriers than benefits?
Presenter: C Gelder (Leeds)
C Gelder
OC3.5
Childhood Type I diabetes education at time of diagnosis- what patients want to know
Presenter: E Holloway (Chertsey)
E Holloway, D Wilkinson, Y Squire, J Holzmann,
A Lyddall, S Bahl
10:30 - 11:00 Tea & Coffee
Chairs: C Acerini (Cambridge) & N Wright (Sheffield)
OC4.1
Metformin in Obese Children and Adolescents:
the MOCA trial
Presenter: D Kendall (Manchester)
D Kendall, R Amin, T Barrett, P Dimitri, F Ivison,
M Kibirige, V Mathew, K Matyka, A McGovern, H Stirling, L Tetlow, A Vail, J Wales, N Wright, P Clayton, C Hall
12
13
SCIENTIFIC PROGRAMME FriDAY 9 November 2012
OC4.2
Patterns of presentation and initial management of type I diabetes mellitus in the UK: the Early Care Survey
Presenter: O Lokulo-Sodipe (Southampton)
O Lokulo-Sodipe, RJ Moon, J Edge, JH Davies
OC4.3
White UK children are older, more obese and more insulin resistant than non-White UK children at diagnosis of type 2 diabetes: baseline results of the UK national Type 2 diabetes cohort
Presenter: T Barrett (Birmingham)
T Barrett, Z Gray, E Ilsley, C Cotter, L Makusha, A Ford,
K Turner, J Heywood, A Barnett, D Dunger,
J Hamilton-Shield, J Wales
OC4.4
Vacuolar-type H+-ATPase V1A subunit is a molecular partner of Wolfram syndrome 1 (WFS1) protein, which regulates its stability and expression
Presenter: S Gharanei (Birmingham)
S Gharanei, M Zatyka, D Astuti, J Fenton, A Sik, Z Nagy, T Barrett
OC4.5
The effect of insulin intensification on glycaemic control and lipid levels in children and young persons
with type 1 diabetes differs in relation to ethnic group
Presenter: R Dias (Birmingham)
R Dias, F Brown, C Wyatt, S Cheema, J Allgrove, R Amin
12:00 - 12:45 Symposium 5 - Diabetes AND Education
Chairs: C Gelder (Leeds) & G Parfitt (Newport)
S15
NOVO NORDISK AWARD WINNER
Structured Knowledge and Information Programme-
the SKIP course
N Lovell (Bristol)
S16
How paediatric diabetes nurse specialists support schools
M Marshall (Manchester)
12:45 - 13:00 BSPED Prizes
13:00 - 14:00 Lunch
14:00 - 15:00 Symposium 6 - Diabetes and Sport
Chairs: F Annan (Liverpool) & J Edge (Oxford)
14:00S17
Physiology of exercise and endurance sport in type 1 diabetes
R Andrews (Taunton)
FriDAY 9 November 2012 SCIENTIFIC PROGRAMME
Endocrine Nurse Day – Albert ROOM
Generously supported by Sandoz Biopharmaceuticals
08:30 - 09:00 Registration Opens
09:00 - 09:55 Paediatric Endocrine Nurses Business Meeting
(incorporating relaunch of the BSPED GH audit)
09:55 - 10:00 Welcome
Chairs: J Walker (Leeds) & A Whitehead (Leeds)
10:00 - 10:30 Ipsen Award Winners
10:00S20
Congenital hyperinsulinism: The American experience
L Rigby (Manchester)
10:15S21
The DSD Clinic
N Nicoll (Bristol)
10:30 - 11:00 Tea & Coffee
OC5.1
Adolescent Transition Clinic: A review of the young person’s self-confidence and future concerns.
Presenter: A Whitehead (Leeds)
A Whitehead, J Walker, T Mushtaq, NS Alvi
OC5.2
Comparison of patient experiences of the glucagon and insulin pituitary provocation tests: time for a reappraisal
Presenter: H Katugampola (London)
H Katugampola, C Bulwer, HA Spoudeas
OC5.3
A comparison of patient’s preferences for attributes of growth hormone delivery devices: children starting versus children established on growth hormone treatment
Presenter: S How Yaw (Leeds)
S How Yaw, T Mushtaq, NS Alvi, J Walker, A Whitehead
OC5.4
The role of the paediatric endocrine nurse in supporting the information needs of girls with Turner syndrome and their parents
Presenter: J Collin (Manchester)
J Collin
14:30S18
Optimising sports performance in Type 1 diabetes
G Regan (Newport)
15:00 - 15:45 Keynote Lecture
Chair: J Gregory (Cardiff)
15:00S19
Insulin pumps and continuous monitoring: evidence for their role in the management of diabetes
J Pickup (London)
15:45 - 15:50 Closing remarks
14
15
SCIENTIFIC PROGRAMME FriDAY 9 November 2012
11:40 - 12:20 FriDAY 9 November 2012 SCIENTIFIC PROGRAMME
and
Nurse Session 1
11:40S22
The Bare Bones
P Arundel (Sheffield)
12:20 - 12:30
Case Presentation: Endocrinology in Sport
12:20S23Running High
R Mayers (Bristol)
12:30 – 13:15 Nurse Session 2
12:30 S25 Egg and Ovarian Tissue Preservation. What Can we Offer to Preserve Fertility Options for the Future?
S Nicholas (Leeds)
ZN/271/2010/UKc. Date of preparation of item: June 2011.
Made for each other
16
ZOMACTON® 10mg/ml Powder and Solvent for Solution for Injection in Prefilled Syringe.
ZOMACTON® 4mg INJECTION Please consult the full Summary of Product Characteristics
before prescribing.
Zomacton® 10mg/ml Injection (Somatropin, INN). Zomacton® 4mg Injection (Somatropin, INN).
Presentation: Zomacton 10mg/ml: Each vial contains 10mg Somatropin and is supplied with
a prefilled syringe of solvent for solution for injection. Zomacton 4mg: Each vial contains 4mg
Somatropin and is supplied with an ampoule of diluent Uses: The long-term treatment of children
who have growth failure due to inadequate secretion of growth hormone and for the long-term
treatment of growth retardation due to Turner’s syndrome confirmed by chromosome analysis.
Dosage and administration: Zomacton Injection is administered as a subcutaneous injection.
Growth Hormone Deficiency: The dosage and schedule of administration should be individualised
for each patient. Generally a dose of 0.17 - 0.23mg/kg bodyweight per week divided into 6 - 7
subcutaneous injections is recommended (corresponding to a daily injection of 0.02 - 0.03mg/kg
bodyweight). Turner’s Syndrome: Generally a dose of 0.33 mg/kg bodyweight per week divided
into 6 - 7 s.c. injections is recommended (corresponding to a daily injection of 0.05 mg/kg/
bodyweight). The required dose Zomacton 10mg is administered with a ZOMAJET VISION X
needle free device. The required dose Zomacton 4mg is administered with a ZOMAJET 2 VISION
needle free device. Both forms of Zomacton may be administered using conventional needle
and syringe. Contraindications: Use in children with closed epiphyses. Patients with acute
illness suffering complications. Evidence of tumour activity or if anti-tumour therapy is ongoing.
Known sensitivity to somatropin or any excipient. Zomacton 4mg injection must not be given to
premature babies or neonates as the solvent contains benzyl alcohol. Zomacton Injection should
not be used during pregnancy or lactation. Special warnings and precautions for use: Therapy
should be supervised by an appropriately qualified and experienced clinician. Very rare cases
of myositosis have been observed and may be due to the metacresol preservative in Zomacton
10mg/ml. If a patient using Zomacton 10mg/ml develops myalgia or disproportionate injection
site pain, Zomacton 4mg injection should be used. Patients should be observed for evidence of
glucose intolerance. Use with caution in children with diabetes mellitus or a familial predisposition
to the disease. In children with growth hormone deficiency and diabetes mellitus, glycaemic
control must be monitored and insulin needs adjusted accordingly. Patients with growth hormone
deficiency secondary to an intracranial lesion should be monitored frequently. Therapy should
be discontinued if progression or recurrence of the lesion occurs. Fundoscopic examination for
papilloedema is recommended at the initiation and periodically during the course of treatment,
especially if the patient reports recurrent headache, visual problems, nausea and/or vomiting
which may indicate intracranial hypertension. Hypothyroidism may develop during treatment with
growth hormone and inadequate treatment may prevent optimal response to growth hormone.
Growth failure due to Prader Willi syndrome is contraindicated unless GH deficiency is diagnosed.
Zomacton should be discontinued at renal transplantation. Signs of scoliosis should be monitored
during treatment. Caution must be taken in patients with central subclinical hypothyroidism
and in patients on thyroxin replacement therapy. Slipped capital femoral epiphysis may occur,
a patient developing a limp or hip or knee pain should be evaluated by a physician. The safety
of ongoing GH replacement in patients with critical illness has not been determined and
benefit needs to weighed against risk. Side effects: Please consult the full Summary of Product
Characteristics for further information about side effects. Injection site reactions and transient
headache have been reported. Infrequently, a slight transient oedema may occur during
treatment. Formation of antibodies against somatropin have been observed but binding capacity
of these is low and no clinical changes have been reported. Hypoglycaemia is a common event.
Leukaemia has been reported very rarely, the rate is similar untreated patients. In rare cases a
benign intracranial hypertension, and diabetes mellitus have been reported. Symptoms usually
are headache, nausea and/or vomiting and visual problems. Pharmaceutical precautions:
Zomacton 10mg/ml: Store at 2 - 8*C and protect from light. After reconstitution it is stable for
28 days when stored upright in the refrigerator at 2 - 8*C and protected from light. Zomacton
4mg: Store at 2 - 8*C and protect from light. After reconstitution it is stable for 14 days when
stored in the refrigerator at 2 - 8*C and protected from light. Legal category: POM. Package
quantity: Zomacton 10mg/ml: Carton containing one vial of Zomacton® 10mg/ml Injection and
one prefilled syringe of solvent for solution for injection. Zomacton 4mg: Carton containing
one vial of Zomacton 4mg Injection and one ampoule of diluent. Basic NHS price: Zomacton
10mg/ml: £199.23, Zomacton 4mg: £79.69. Product Licence number: Zomacton 10mg/ml:
PL 3194/0104. Zomacton 4mg: PL 3194/0052. Product Licence holder: Ferring Pharmaceuticals
Ltd., Drayton Hall, Church Road, West Drayton, UB7 7PS. Date of preparation: March 2011.
Zomacton is a registered trade mark.
Adverse events should be reported. Reporting forms and information
can be found at www.yellowcard.gov.uk. Adverse events should also be
reported to: Medical Information, Ferring Pharmaceuticals Ltd., Drayton Hall,
Church Road, West Drayton, UB7 7PS. Tel: 0844 931 0050.
Email: [email protected].
Ferring Pharmaceuticals Ltd., Drayton Hall, Church Road,
West Drayton, UB7 7PS. Telephone: 0844 931 0050,
Fax 0844 931 0057 www.ferring.co.uk
ZomaJet® and Zomacton® are registered trademarks.
17
Novo Nordisk was founded in 1923 out of a
passion to help people with diabetes. With
our strong commitment to patients and by
offering the largest portfolio of products in
the industry, we look to defeat diabetes by
improving awareness, prevention, detection,
and treatment of this chronic disease.
The
Greener
Choice
N
In addition, Novo
Nordisk has a leading
position within areas such as growth
hormone therapy, as well as haemostasis
management and hormone replacement
therapy.
Novo Nordisk manufactures and markets
pharmaceutical products and services that
make a significant difference to patients, the
medical profession and society.
For more information, please visit:
www.novonordisk.co.uk
UK/NC/0910/0010 Date of preparation September 2010
Ipsen is now working with international conservation
organisation, the World Land Trust (WLT) to protect and
reforest threatened ecosystems through tree planting,
initially in Brazil and Ecuador. Ipsen is also promoting
WLT’s work to help improve understanding of the
world’s most biologically important habitats.
h ie
y fo r
a h e alt
r
to
i ng
da
mo
r ro w
THE
G
G ro w
to
ICE
HO
ENER C
RE
October 2012 BSPED – UK/NUT08376
Refer to the Summary of Product Characteristics for
full information, particularly in relation to dosing,
precautions and side effects, before prescribing.
Abbreviated Prescribing Information for Omnitrope
(somatropin). Produced by recombinant DNA technology in
Escherichia coli. Presentation: 5 mg/1.5 ml (15IU) solution for
injection and 10 mg/1.5 ml (30IU) solution for injection.
Indications: Children: growth disturbance due to insufficient
secretion of growth hormone (pGHD) or associated with Turner
syndrome (TS) or associated with chronic renal insufficiency (CRI) or
in short children/adolescents born small for gestational age (SGA),
with a birth weight and/or length below -2 standard deviations,
who failed to show catch-up growth by 4 years of age or later.
Prader-Willi Syndrome (PWS): for improvement of growth and body
composition. Adults: pronounced growth hormone deficiency
(GHD). Dosage and Administration: Subcutaneous
injection. Rotate sites to avoid lipoatrophy. The maximum
recommended daily dose should not be exceeded. pGHD: 0.025
- 0.035 mg/kg body weight/day. PWS: 0.035 mg/kg body
weight per day, do not exceed 2.7 mg/day. TS: 0.045 - 0.050
mg/kg body weight/day. CRI: 0.045 - 0.050 mg/kg body
weight/day. Higher doses can be needed if growth velocity is too
low. SGA: 0.035 mg/kg body weight/day until final height
reached. Adult GHD: Start with low dose 0.15 - 0.3 mg/day.
Elderly: Experience in patients above 60 years is limited. Renal
impairment: In CRI, renal function should be below 50 percent of
normal before institution of therapy. Discontinue at renal
transplantation. Contraindications: Hypersensitivity to
somatropin or excipients; growth promotion in patients with closed
epiphyses; acute critical illness following open heart surgery,
abdominal surgery, multiple accidental trauma, acute respiratory
®
NOTES
Grow with us
failure or similar conditions. Somatropin must not be used when
there is any evidence of activity of a tumour. Intracranial tumours
must be inactive and antitumour therapy must be completed prior to
starting GH therapy. Treatment should be discontinued if there is
evidence of tumour growth. Precautions: May induce a state of
insulin resistance and hyperglycaemia: observe for glucose
intolerance. In patients with existing diabetes mellitus, anti-diabetic
therapy may require adjustment. Monitor thyroid function. Optimise
corticosteroid therapy prior to initiation. Signs of relapse of
malignant disease should be monitored for. Slipped epiphyses of
the hip may occur more frequently. Monitor for benign intracranial
hypertension. Refer paediatric patients with PWS and concomitant
risk factors for thorough evaluation due to risk of fatality; monitor
weight and restrict calorie intake; monitor for scoliosis. Not
recommended to initiate treatment in SGA patients near onset of
puberty. In acute, critically ill adult patients, somatropin may
increase mortality. Omnitrope 5 mg/1.5 ml solution for injection:
includes benzyl alcohol and must not be given to premature babies
or neonates. May cause toxic and anaphylactoid reactions in
infants and children up to 3 years old. Interactions: Somatropin
may increase the clearance of compounds resulting in lower
plasma levels known to be metabolised by cytochrome P450
isoenzymes, especially CYP 450 3A4 e.g. sex steroids,
corticosteroids, anticonvulsants and ciclosporin. Clinical
significance is unknown. Pregnancy: Do not use in pregnancy.
Lactation: Use with caution. Side effects: Common: formation
of antibodies; common in adults, uncommon in children paraesthesia, stiffness in the extremities, arthralgia, myalgia,
peripheral oedema. Common in children - transient local injection
site reactions. Rare: Diabetes mellitus Type II, benign intracranial
hypertension. Very rare: leukaemia. Pack sizes/cost: (excl VAT): 5
mg/1.5 ml, 5 vial pack - £433.82. 10 mg/1.5 ml, 5 vial pack £867.64. Legal Category: CD Anab POM. MA Holder:
Sandoz GmbH, Biochemiestrasse 10, A-6250 Kundl, Austria.
Distributed by Sandoz Ltd, Frimley Business Park, Camberley,
Surrey, GU16 7SR. MA No: 5mg/1.5ml -EU/1/06/332/005,
10mg/1.5ml - EU/1/06/332/008. UK/MKT/OMN/120028 April 2012.
A lifetime
commitment
®
Convenience and
1
simplicity
Well-established
2
safety profile
Least expensive
somatropin
3
on the NHS
Proven long-term
2
efficacy
Established
2
bioquivalence
Adverse events should be reported.
Reporting forms and Information can be
found at www.mhra.gov.uk/yellowcard.
Adverse events should also be reported
to Sandoz Ltd, 01276 698020 or
[email protected].
25 years in Endocrinology
Individualised Treatment – Our focus for the future
References: 1. Data on file, 2008; Sandoz Int. 2. Romer T et
al. Seven years of safety and efficacy of the recombinant human
growth hormone Omnitrope in the treatment of growth hormone
deficient children: results of a phase III study. Horm Res. 2009;
72(6): 359-69. 3. MIMS October 2012.
Date of preparation: October 2012.
Code: UK/MKT/OMN/12-0073.
Specialty Care
Endocrine
Grow with us
Biopharmaceuticals
Date of preparation: August 2012 GEN 3402
NOTES
NOTES
.
This meeting has in part, been organised and funded by SANOFI
Date of Preparation: October 2012 GBIE.GLA.11.10.22
22
PRESCRIBING INFORMATION - UK AND IRELAND Please refer to the Summary of
Product Characteristics for further information. SAIZEN® 8 mg click.easy®powder
and solvent for solution for injection SAIZEN 5.83 mg/ml solution for injection
SAIZEN 8 mg/ml solution for injection Somatropin (recombinant human growth
hormone) Presentation: SAIZEN® 8 mg click.easy®powder and solvent for solution
for injection: Each multi-dose vial of SAIZEN® contains Somatropin 8 mg as a
powder, accompanied by a cartridge of solvent containing 1.37 ml of 0.3% w/v
metacresol in water for injections. SAIZEN 5.83 mg/ml solution for injection: Each
cartridge contains 1.03 ml solution (6 mg somatropin) SAIZEN 8 mg/ml solution for
injection: Each cartridge contains either 1.50 ml solution (12 mg somatropin), or
2.50 ml solution (20 mg somatropin), Indications: The treatment of growth failure
in children caused by decreased or absent secretion of endogenous growth hormone;
Growth failure in girls with gonadal dysgenesis (Turner Syndrome); Growth failure
in prepubertal children due to chronic renal failure; Growth disturbance (current
height SDS < -2.5 and parental adjusted height SDS < -1) in short children born
small for gestational age (SGA) with a birth weight and/or length below – 2 SD, who
failed to show catch-up growth (HV SDS < 0 during the last year) by 4 years of age
or later; Replacement therapy in adults with pronounced growth hormone deficiency
who must also fulfil the following criteria: Childhood onset: Patients diagnosed as
growth hormone deficient during childhood must be re-tested and deficiency
confirmed before start of replacement therapy with Saizen. Adult onset: Patient
must be growth hormone deficient as a result of hypothalamic or pituitary disease
and have at least one other hormone deficiency diagnosed (except for prolactin) and
adequate replacement therapy instituted before treatment with growth hormone.
Dosage and Administration: Saizen 8mg click.easy, Saizen 5.83 mg/ml solution for
injection and Saizen 8 mg/ml solution for injection when used with the appropriate
auto-injector are all for multiple dose use. The dose for each is given by subcutaneous administration and under no circumstances should the daily dose be exceeded.
It is recommended that Saizen is administered at bedtime. Growth failure due to
inadequate secretion of endogenous growth hormone: 0.7-1.0 mg/m2 body surface
area (BSA) per day or 0.025-0.035 mg/kg body weight per day. Growth failure due to
Turner Syndrome: 1.4 mg/m2 BSA per day or 0.045-0.050 mg/kg body weight per day.
Concomitant therapy with non-androgenic anabolic steroids can enhance growth
response. Growth failure in prepubertal children due to chronic renal failure: 1.4
mg/m2 BSA per day, approximately equal to 0.045-0.050 mg/kg body weight per day.
Growth failure in short children born small for gestational age (SGA): The
recommended daily dose is 0.035 mg/kg body weight (or 1 mg/m2/day, equal to 0.1
IU/kg/day or 3 IU/m2/day). Treatment should be discontinued when the patient
reaches a satisfactory adult height or the epiphyses are fused. For growth
disturbance in short children born SGA treatment is usually recommended until final
height is reached. Growth Hormone Deficiency in adults: Low daily doses of 0.15-0.3
mg are recommended initially. Dosage should be adjusted stepwise, controlled by
Insulin-like Growth Factor 1 (IGF-1) values. The lowest efficacious dose is
recommended, this seldom exceeds 1.0 mg/day. In older or overweight patients,
Date of Preparation: October 2012
lower doses may be necessary. Contraindications: Epiphyseal fusion in children.
Somatropin must not be used in patients with active tumours. Intracranial tumours
must be inactive and anti-tumour therapy must be completed prior to starting GH
therapy. Treatment should be discontinued if there is evidence of tumour growth.
Known hypersensitivity to any ingredients in the injection or solvent; critically ill
patients. Treatment should be discontinued at the time of renal transplantation.
Precautions: Treatment should be carried out under regular specialist medical
supervision. Patients with intra or extracranial neoplasia in remission or those with
growth hormone deficiency secondary to an intracranial tumour should be examined
frequently whilst receiving growth hormone. Cases of leukaemia have been reported
in growth hormone deficient (GHD) patients. However a causal relationship to
somatropin has not been established. Somatropin may reduce insulin sensitivity so
patients should be monitored for evidence of glucose intolerance. Diabetic patients
may need to adjust insulin doses after somatropin treatment is initiated and regular
glucose monitoring may be required. Treatment should be discontinued in cases of
proliferative retinopathy. Pregnancy: Not recommended during pregnancy or in
women of child-bearing potential not using contraception. Lactation: Caution
should be exercised when somatropin is administered to breast feeding women.
Thyroid function tests should be monitored in all patients. In case of severe or
recurrent headache, visual problems, nausea and/or vomiting, funduscopy for
papilloedema is recommended. If papilloedema is confirmed a diagnosis of benign
intracranial hypertension should be considered and growth hormone discontinued. If
growth hormone treatment is restarted careful monitoring for signs of benign
intracranial hypertension is required. In children with growth failure secondary to
chronic renal failure, renal function should have decreased to below 50% of normal
before treatment. Conservative treatment for renal insufficiency should have been
established and maintained during treatment. During treatment patients should be
examined for progression of renal osteodystrophy. Growth spurts may increase risk
of joint related problems e.g. slipped capital femoral epiphysis. Physicians and
parents should be alert to the development of a limp and knee or hip pain in children
treated with somatropin. In patients with chronic renal failure hip x-ray is
recommended prior to starting somatropin therapy. Testing for antibodies should be
carried out on any patient who fails to respond to therapy. In short children born
SGA, other medical reasons or treatments that could explain growth disturbance
should be ruled out before starting treatment. For SGA patients it is recommended
to measure fasting insulin and blood glucose before start of treatment and annually
thereafter. In patients with increased risk for diabetes mellitus oral glucose tolerance
testing should be performed. If overt diabetes occurs, growth hormone should not be
administered. For SGA patients it is recommended to measure IGF-I level before start
of treatment and twice a year thereafter. If on repeated measurements IGF-I levels
exceed +2 SD compared to references for age and pubertal status, the IGF-I/IGFBP-3
ratio could be taken into account to consider dose adjustment. Experience in
initiating treatment in SGA patients near onset of puberty is limited and therefore
not recommended. Experience with SGA patients with Silver-Russel syndrome is
limited. Some of the height gain obtained with treating short children born SGA
with Somatropin may be lost if treatment is stopped before final height is reached.
Cases of sleep apnoea and sudden death in paediatric patients with Prader-WilliSyndrome under treatment with Somatropin have been reported. Saizen is not
indicated for treatment of paediatric patients with Prader-Willi-Syndrome, unless
they have been diagnosed as GHD. Varying injection site can prevent lipoatrophy. In
adults fluid retention is expected during somatropin therapy. In persistent oedema or
severe paraesthesia, decrease the dosage in order to prevent carpal tunnel syndrome.
Adult growth hormone deficiency should be treated as a lifelong condition.
Experience is limited in patients over 60. Concomitant corticosteroid therapy may
inhibit the response to somatropin. Side-effects: Antibodies to Somatropin can
form in some patients, the clinical significance is unknown. Common side effects:
Injection site reactions, localised lipoatrophy, fluid retention in adults (peripheral
oedema, stiffness, joint swelling, arthralgia, myalgia, paresthesia), and headache
(isolated). Serious: Hyperglycaemia, hypothyroidism, slipped capital femoral
epiphysis, avascular necrosis of the femoral head, idiopathic intracranial
hypertension. Please consult the Summary of Product Characteristics in relation to
other side effects. Additional information is available on request. Legal Category:
POM Basic NHS price: SAIZEN® 8mg click.easy®: Each carton contains 1 vial of
SAIZEN® 8mg and 1 solvent cartridge. Cost: £185.44; SAIZEN 5.83 mg/ml and Saizen
8 mg/ml solution for injections Each carton contains either; 1 cartridge with 1.03ml
of SAIZEN 5.83 mg/ml solution equivalent to 6.0mg. Cost: £139.0; 1 cartridge with
1.5ml of SAIZEN 8 mg/ml solution equivalent to 12.0mg. Cost: £278.16; 1 cartridge
with 2.5ml of SAIZEN 8 mg/ml solution equivalent to 20.0mg. Cost: £463.60;
Marketing Authorisation Holder and Numbers: SAIZEN® 8mg click.easy®: Serono
Limited, Bedfont Cross, Stanwell Road, Feltham, Middlesex, TW14 8NX, United
Kingdom; PL 03400/0079,
PA 285/5/4. Bacteriostatic solvent cartridge, PL
03400/0076. SAIZEN 5.83 mg/ml and Saizen 8 mg/ml solution for injections: MA
Holder and Numbers for the UK: Serono Limited, Bedfont Cross, Stanwell Road,
Feltham, Middlesex, TW14 8NX, United Kingdom. Saizen 5.83 mg/ml: PL
03400/0087, Saizen 8 mg/ml: PL 03400/0088 MA Holder and Numbers for Ireland:
Merck Serono Limited, Bedfont Cross, Stanwell Road, Feltham, Middlesex, TW14
8NX, United Kingdom; Saizen 5.83 mg/ml: PA 654/18/1, Saizen 8 mg/ml: PA
654/18/2. For further information, including price queries, contact: UK: Merck
Serono Ltd, Bedfont Cross, Stanwell Road, Feltham, Middlesex, TW14 8NX, Tel: 020
8818 7373. Republic of Ireland: Merck Serono, 4045 Kingswood Road, Citywest
Business Campus, Dublin 24, Tel: 01 4687590. Date of Preparation: May 2012
Adverse events should be reported and reporting forms and information can be
found at www.mhra.gov.uk/yellowcard. In the Republic of Ireland information
can be found at www.imb.ie. Adverse events should also be reported to Merck
Serono Limited – Tel: +44 (0)20 8818 7373 or email:
[email protected]
SAI12-0055
23
NOTES
24
NOTES
25
r
British Society fo
e
th
f
o
g
n
ti
e
e
M
41st
d Diabetes
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a
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Paediatric E
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2013 | Brighton D
13-15 November
.
held for
discussions will be
presentations and
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var
the
ere
wh
D 2013
and Hove and BSPE
BSPED 2013.
the city of Brighton
to
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eting will provide
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Bri
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research in paediat
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The Brighton get-t
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and basic science
o provide opportu
On 14 and 15 Nove
practice. It will als
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od
Nu
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The British
of
alis
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and sha
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all 3 days.
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be opportunities for
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(later King George
Brighton
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his leisure time in
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.uk
www.bsped.org
Conference Secretariat
BioScientifica Ltd
Euro House
22 Apex Court
Contact: Conference Secretariat
WoodlandsTel:
+44 (0) 1454 642240
Bradley Stoke
Fax:
+44 (0) 1454 642222
Bristol Email:
[email protected]
BS32 4JTWebsite: www.bsped.org.uk

Programme Book - British Society for Paediatric Endocrinology

Transcription

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