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This review will provide an overview of what is currently known about mechanisms linking poor glycaemic control with increased thrombotic risk. The leading causes of death in people with diabetes are strokes and cardiovascular disease. Significant morbidity is associated with an increased risk of thrombosis, resulting in myocardial infarction, ischaemic stroke, and peripheral vascular disease, along with the sequelae of these events, including loss of functional ability, heart failure, and amputations. While the increased platelet activity, pro-coagulability, and endothelial dysfunction directly impact this risk, the molecular mechanisms linking poor glycaemic control with increased thrombotic risk remain unclear. This review highlights the complex mechanisms underlying thrombosis prevalence in individuals with diabetes and hyperglycaemia. Post-translational modifications, such as O-GlcNAcylation, play a crucial role in controlling protein function in diabetes. However, the role of O-GlcNAcylation remains poorly understood due to its intricate regulation and the potential involvement of multiple variables. Further research is needed to determine the precise impact of O-GlcNAcylation on specific disease processes.

Abstract Disclosure: L. Batten: None. R. Akinyombojnr: None. S. Dixit: None. L. Baker: None. S. Mongolu: None. Introduction: Radiation treatment is used for patients with secreting and non-secreting pituitary adenomas, with residual pituitary adenomas, or recurrent pituitary adenomas to achieve long-term disease control. The side effects of radiotherapy may be acute toxicity (within weeks) and late toxicity occurring years after treatment. Pituitary hormone deficiencies are the most common late complication. Long-term endocrine evaluations are recommended in patients after cranial radiotherapy to identify new pituitary hormone deficiencies. The aim of this project was to determine whether patients who had not undergone a formal screening process exhibited undiagnosed, subclinical hypopituitarism. Methods: We collected data on all living patients with primary brain tumours who underwent brain radiotherapy between January 2018 and December 2022 at 2 sites within Hull University Teaching Hospitals (n=38). Patients were identified from multidisciplinary team meeting records. Patients with pituitary tumours were excluded, as they routinely receive endocrine follow-up.After applying exclusion criteria, 38 patients remained eligible for review. 9 patients were subsequently excluded from the final analysis: 4 were already receiving steroid replacement therapy, 2 were under active investigation by the endocrinology team, and 3 had undergone ad hoc screening tests. This resulted in a final cohort of 29 patients for data collection.Patients were contacted by telephone to obtain consent for blood sample collection. A common theme among patients was a lack of awareness regarding the potential of late complications from radiotherapy. Results:Baseline characteristicsAge33-79 years (median 51 years)Sex (male:female)16:13Radiotherapy dose54-60 GyRadiotherapy fractions28-33 fractions (median 30 fractions) CancerNumber Oligodendroglioma10 Astrocytoma8Meningioma7Ependymoma2Germinoma1Glioma1 Results from screeningTo date, data has been collected on 19 patients. 2 patients did not attend their scheduled screening blood test appointments. 9 patients exhibited suboptimal 9:00 AM cortisol levels (<320 mmol/L). Of these, 1 patient commenced palliative radiotherapy with dexamethasone supplementation, while the remaining 8 demonstrated adequate adrenal function during dynamic testing with an ACTH stimulation test.Additionally, 1 patient was found to have subclinical hypothyroidism. 1 patient was identified with secondary hypothyroidism. Conclusion: This analysis highlights the ad hoc nature of screening for late effects. Implementing an automated approach to identify and these patients for screening is essential.An important consideration is whether patients with a low 9:00 AM cortisol level should undergo insulin stress tests (IST) or glucagon stimulation tests. While these tests provide valuable diagnostic information, they are resource-intensive. Presentation: Saturday, July 12, 2025

During the coronavirus 2019 (COVID-19) pandemic, the implementation of non-contact infrared thermometry (NCIT) became an increasingly popular method of screening body temperature. However, data on the accuracy of these devices and the standardisation of their use are limited. In the current study, the body temperature of non-febrile volunteers was measured using infrared (IR) thermography, IR tympanic thermometry and IR gun thermometry at different facial feature locations and distances and compared with SpotOn core-body temperature. Poor agreement was found between all IR devices and SpotOn measurements (intra-class correlation coefficient <0.8). Bland–Alman analysis showed the narrowest limits of agreement with the IR gun at 3 cm from the forehead (bias = 0.19°C, limits of agreement (LOA): −0.58°C to 0.97°C) and widest with the IR gun at the nose (bias = 1.40°C, LOA: −1.15°C to 3.94°C). Thus, our findings challenge the established use of IR thermometry devices within hospital settings without adequate standard operating procedures to reduce operator error.

Disclosure: H. Deshmukh: None. E. Ssemmondo: None. K. Adeleke: None. L. Batten: None. M. Aye: None. T. Sathyapalan: None. Introduction: There are limited data on the effect of time to remission of acromegaly and survival in people living with acromegaly Methods: The UK Acromegaly Register collected routine biochemical and clinical data on patients with acromegaly. We defined remission of acromegaly as Growth hormone (GH) controlled at ≤2 μg/l following the diagnosis of acromegaly. Time to first remission was defined as the difference between the date of diagnosis and the first GH date ≤2 μg/l in the longitudinal follow-up data (following surgery and/or medical therapy). We used a t-test to compare the mean survival and used the cox-proportional hazard model to assess the effect of time to remission on survival in acromegaly. Results: The study consisted of 3750 participants in the UK acromegaly register with complete data, of which 2472 (65%) participants achieved remission of acromegaly. The mean time to remission with somatostatin analogs (SA) and dopamine agonist (DA) therapy was 4.5 yrs and 7.3 years, respectively (P<0.001). The mean survival was significantly higher in those who achieved remission of acromegaly as compared to those who did not (25.5 yrs vs 21.9yrs P<0.001) achieve remission. In those who achieved remission, (median follow-up period of 23.9 years), there was 15% mortality in those who achieved remission within 1 year and 23% mortality in those who needed more than 1 year to achieve remission. In the cox-proportional hazard model adjusted for, baseline GH, age at diagnosis, and gender, a shorter time to regression of acromegaly was associated with improved survival (HR=0.92(0.91-0.93) P<0.001). Conclusion: This large population-based study of acromegaly showed that a shorter time to remission is associated with improved survival. Presentation: Thursday, June 15, 2023

This quiet, pretty beach on the privately owned Palm Island makes it into Sarah Miller's top 10, largely because of its secluded location. There's a reef about 200ft out from the white-sand beach (which has some of the finest sand in the Caribbean) lapped by a deep-blue, sparkling sea. Perfect for honeymooners after unadulterated privacy. When to go: when Palm Island has rooms free (001 784 458 8824; palm@caribsurf.com). How to get there: fly to Barbados or St Lucia (British Airways: 0345 222111; pounds 629.90), then take an internal flight to Union Island and a boat (20mins) to Palm Island. How to get there: Coral Cay Conservation (0171-498 6248) will teach you to dive in Belize, in return for pounds 875 (plus air fares) and a fortnight's work for the Marine Research Centre. Get there via Houston on Continental Airlines, or on the direct Gatwick- Cancun flight with British Airways. Either will cost you around pounds 400 through discount agents. Belize is a six-hour bus ride away (around pounds 5).

Funny you should say that. Artists have long been drawn to Cornwall, especially the far western peninsula of West Penwith, with its vast expanse of sky, dramatic light and untamed landscape. St Ives may be packed with bucket-and-spade-wielding tourists who come for the surrounding beaches, but it has also been pulling in artists since the 1920s when potters Bernard Leach and Shoji Hamada moved in. The most famous artists' colony, of course, was that established by sculptor Barbara Hepworth, along with her husband Ben Nicholson, Bernard Leach and Naum Gabo in the 1930s. Thirty years later they were followed by the likes of Patrick Heron, Terry Frost and Peter Lanyon, and today the trend is continued by younger artists. If you're here to pay homage to the region's artistic heritage, there are two big attractions. The Tate St Ives at Porthmeor Beach (01736 796226, www.tate.org.uk; open 10am-5.30pm daily, entrance pounds 4.75 adults, free for under 18s) offers big-name shows in a big, blousy building; it is currently showing the Barbara Hepworth Centenary Exhibition which runs until 12 October. The more intimate Barbara Hepworth Museum & Sculpture Garden is on Barnoon Hill (01736 796226; open 10am-5.30pm daily, single entry prices pounds 4.25 for adults, free for children; a joint ticket including the Tate costs pounds 7.50). There's something magical about Hepworth's studio (set up with her old tools and raw materials to look as if she's just popped out) and sub-tropical garden scattered with the finished sculptures. On the north coast. The rugged Atlantic coastline is far wilder than the southern stretch bordering the calmer English Channel. Tacky, tawdry Newquay has been reborn as the centre of the Cornish surfing universe, but much of the coastline from St Agnes to Morwenstow is good surfing territory. Gone are the pasty white wannabes of a decade ago, replaced by an influx of barefoot, blonde dreadlocked dudes. Fat Willies Surf Shack (01637 852052), a stalwart of the Newquay scene, has been joined by a whole host of surfing schools and shops. Check out the Fistral Surf Company (01637 850520. www.fistralsurf.com) and the Newquay Surfing Centre (01637 850737, www.nationalsurfingcentre.com), which is run by the British Surfing Association (01637 876474, www.britsurf.co.uk). Newquay has three top surfing \"breaks\" - get the lingo - Little Fistral, North Fistral and South Fistral. For beginners, Towan is a good bet. For more information visit www.surfnewquay.co.uk. The Mists of Avalon by Marion Zimmer Bradley is just one of the wildly romantic renditions of the Legend of King Arthur and those Knights of the Round Table that's stocked in the gift shop at Tintagel on the north coast of Cornwall. The crumbling castle ruins on the windswept cliff are at their most atmospheric on a broodingly blustery day. Although Arthur is placed in other Celtic locations, the Cornish landscape lends itself particularly well to the legend. The castle at Tintagel (above) dates back to the 12th century, built by Earl Reginald of Cornwall, whose brother was the patron of Geoffrey of Monmouth, the scholar whose History of the British Kings launched the saga of King Arthur. According to legend, Merlin smuggled Uther Pendragon into Tintagel using magic to disguise him as the Duke of Cornwall so that he could make love to Igerna, the duke's wife. Arthur was conceived and a legend born.

This form-and-function attitude extends to the city's hospitality industry, too. Spend a night in almost any of the city's hotels and, as you step sleepily into your bathroom the following morning, the sleek, tiled floor will gently toast the bottoms of your feet. Likewise, the recently renovated Cafe Opera boasts a dramatic new bar that may look good propped up by the city's fashionistas but whose secondary purpose is to softly cast light up to the belle epoque ceiling above. And, at Nouveau Riche, one of the city's best- loved restaurants, designer Jonas Bohlin has maintained the glamorously high ceilings but given the atmosphere a softer edge by hanging Design Torget's quirky chandeliers from the ceiling; each one is a huge metallic globe supporting about 40 upturned wine glasses. Equally eccentric glasses can be bought (but sadly not kept) at the city's Ice Bar. Throw on a glamorous fur-lined poncho, stuff your hands into warm mittens and head into a room made of ice to neck vodka from frozen cocktail glasses for as long as your lips can stand the cold (or until your glass melts). The glasses are hewn from ice shipped in from the river Torne in northern Sweden, where the Ice Hotel is based. Hotel J at 1 Ellensviksvagen, Nacka Strand (00 46 8601 3000; www.hotelj.com) has double rooms from Skr950 (pounds 72) including breakfast. Nordic Light, Vasaplan (00 46 8505 63300, www.nordichotels.se) has rooms from Skr1,190 (pounds 91); all are comfortable, well-equipped and come with funky light effects and breakfast. For more traditional surroundings, try the Hotel Esplanade at 7a Strandvagen (00 46 8663 0740, www.hotelesplanade.se). Doubles here start at Skr1,695(pounds 130), including breakfast. There are various Wayne's Coffee branches across Stockholm (www.waynescoffee.se); Nitty Gritty is at 26 Krukmakargatan (00 46 824 0044; www.nittygritty.se); R.O.O.M is at 20 Alstromergatan (00 46 8692 5000; www.room.se); Design Torget at various locations (www.designtorget.se); Cafe Opera is on Kungstradgarden (00 46 8676 5807), Nouveau Riche is at 4 Birger Jarlsgatan (00 46 8545 03560), and the Ice Bar is at the Nordic Sea Hotel on Vasaplan (00 46 850 56 3000; www.nordichotels.se).

Needless to say, with this guide to finding Dublin's quintessential heavenly half (so what? I'm being honest, even if I am a lightweight!), the pints being served were pretty damn good. Smooth, fruity, not too cold (that's a sign of a good Guinness, as one Dublin drinker happily explained), and never more than pounds 1.65 a pint, I just wish I'd actually liked the stuff. RB I followed the Boys for the Black Stuff box in the 1999 Time Out Guide to Dublin (Penguin, pounds 10.99). The guide aimed to provide you with a swift shortcut to finding the perfect pint of porter in Ireland's capital. It also listed those pitfalls the \"misguided enthusiast\" should avoid (namely, those pubs that claim to serve the best Guinness in Dublin and standing at the bar waiting for your pint - \"the barman will call you when he thinks its ready. He is after all the expert\"). RB Only in Dublin would you find a pub crawl masquerading as a cultural tour. The Jameson Literary Pub Crawl is a combination of what Dublin does best - Guinness and (literary) Greats. Two actors lead you around some of Dublin's writers' favourite haunts - most of them, unsurprisingly, are pubs. Starting with a song in the Duke, just off Grafton Street, we took a quick commercial break for a Jameson's whisky (only the one) and then carried on supine to acted scenes from Beckett's Waiting for Godot and Joyce's A Portrait of the Artist as a Young Man. Much better than a night in front of the telly. LG

If you're a southerner, it's possibly the perfect day trip. But, if you really want to capitalise on your day in the French capital, you need to take a good guide-book with you. To help you choose, we put three of the latest through their paces. A Shopper's Guide to Paris Fashion by Alicia Drake (Metro, pounds 9.99) was tested by Lucy Gillmore; Walking Paris: 30 original walks in and around Paris by Gilles Desmons (New Holland, pounds 9.99) was tested by Sarah Barrell; and Lonely Planet's CitySync Guide to Paris (pounds 12 from citysync.com) was tested by Rhiannon Batten. Here are the results: Or rather, Moroccan. Galerie 88, described by the guide as \"beatnik and low-key fashionable\", is a Moroccan cafe near the Hotel de Ville, overlooking the Seine. The Shopper's Guide includes a number of cafes for foot-sore shopaholics so that you can grab a quick caffeine fix. Delicious, thick Turkish-style coffee with cardamom pods and a dish of raisins is served in small brass pots on a tray. The atmosphere is arty chic and the exposed stone walls, laid- back service and delicious food bear out the guide's verdict. LG Though Walking Paris is intended to be used in conjunction with another general guide-book (it has neither a map of the Metro nor of the city as a whole), it does make some recommendations for cafes, bars and restaurants. A good tip on the Ile St-Louis was Berthillon (31 rue St-Louis-en-l'Ile), which specialises in home-made sorbets. Weary walkers in need of a restorative caffeine hit should go for the yummy coffee flavour. SB

In the last fifty years Irish poets have produced some of the most exciting poetry in contemporary literature, writing about love and sexuality, violence and history, country and city. This book, first published in 2003, provides an introduction to major figures such as Seamus Heaney, and also introduces the reader to significant precursors like Louis MacNeice or Patrick Kavanagh, and vital contemporaries and successors: among others, Thomas Kinsella, Nuala Ní Dhomhnaill and Paul Muldoon. Readers will find discussions of Irish poetry from the traditional to the modernist, written in Irish as well as English, from both North and South. This Companion provides cultural and historical background to contemporary Irish poetry in the contexts of modern Ireland but also in the broad currents of modern world literature. It includes a chronology and guide to further reading and will prove invaluable to students and teachers alike.