Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Bullosis diabeticorum is a spontaneous, non-inflammatory, blistering condition seen in patients with diabetes mellitus that can be diagnosed after excluding similar conditions. The lesions described in bullosis diabeticorum have been reported to typically resolve without any specific treatment or scarring and are often considered to be self-limiting.We report a case of a 49-year-old man with type 1 diabetes who presented with recurrent episodes of bullosis diabeticorum, complicated by infection and ultimately resulting in bilateral major amputations.This case highlights the fact that bullosis diabeticorum may not follow an uncomplicated self-limiting course and also the need for early recognition and prompt treatment of infection. Copyright (C) 2016 John Wiley & Sons.

Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP), described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting. He denied any significant history of trauma and serum amylase levels were normal. An admission computed tomography (CT) scan of the abdomen confirmed the presence of a PP in direct contact with the spleen. The CT also demonstrated a heterogenous hypodense area of the splenic hilum, along with perisplenic fluid. The patient was admitted for observation. His abdominal pain progressed, and he became haemodynamically unstable. An emergency ultrasound scan (USS) at this time revealed intra-abdominal haemorrhage. A subsequent CT confirmed splenic rupture, which was managed surgically with a full recovery. Few such cases are documented within the literature and more understanding of preempting such events is needed.

Background The Apnoea–Hypopnoea index (AHI) is regarded as a gold standard diagnostic marker of Obstructive Sleep Apnoea Syndrome (OSAS). However, a number of patients present with excessive daytime sleepiness (EDS), yet exhibit a raised Respiratory Disturbance Index (RDI), comprising of flow limited breaths in the presence of a normal AHI (<5 events/hr). We sought to evaluate the benefits of CPAP in this “Flow Limitation” cohort compared to a matched population of OSAS subjects. Results 27 subjects (Mean age 47 (SD 8) years; ESS 17(4); 48% male; BMI 35.60 (8.12)) presented to our Sleep Service with EDS and undertook a cardio-respiratory polysomnograph, demonstrating an RDI >15 and AHI <5 (Mean RDI 16 (4); AHI 3(2); ODI 5(3)) 25 subjects were subsequently treated with CPAP. At “6-week compliance” visits, 20 (80%) were deemed compliant with CPAP (mean nightly usage 6.03 (1.47) hrs; pre-CPAP ESS 18(3) falling to 9 (4) following CPAP. Within the Flow Limitation cohort, statistically significant associations were observed between CPAP compliance and Female gender (100 v 55%), higher BMI (36.61 v 31.56), higher pre-CPAP ESS (18 v13) and lower Pulse Transit Time PTT (300.90 v 316 ms). This “Flow Limitation” cohort was compared with an age/gender matched “OSAS “cohort (ESS 15(5); BMI 38.33 (7.80) AHI 58.16 (25.79) ODI 48 (23)). 26 OSAS subjects were treated with CPAP with 19 (70%) deemed compliant (nightly usage 5.25 (3.55) hrs; pre-CPAP ESS 16 (5) falling to 10(5) following CPAP. Whilst the mean PTT of the OSAS cohort was lower than the “Flow Limitation” cohort, this did not reach statistical significance (298.85(15.04) v 306.44 (18.36) ms; ANOVA; p = 0.1) yet the PTT Deceleration Index (DI), a surrogate of physiological arousal, was significantly higher in the OSAS cohort (59.05(29.33) v 36.32(23.69)/hour; ANOVA; p = 0.003). Conclusion “Sleepy” subjects exhibiting an elevated Flow Limitation Index in the presence of a normal AHI appear to demonstrate a response to CPAP therapy comparable to that observed in OSAS. Female gender and a higher BMI appear to predict compliance with therapy, whilst the utility of Pulse Transit Time in guiding decision making in “sleepy” subjects with a normal AHI merits further study.

Examining the system of Diophantine equations { f1(x) = x1 + ...x 2 n = ν1, f2(x) = λ1x1 + ...λnx 2 n = ν2, with λi 6= λj and νi, λi ∈ Z, we show that the singular series S(ν) converges if n ≥ 6.

This paper gives a formula for Weil’s Exponential Sums which depends entirely upon the singularities mod , similar to the purpose of the Stationary Phase Formula for Igusa Local Zeta Functions. The paper then shows why the the newly discovered formula for Generalized Exponential Sums does not correspond more closely with the Stationary Phase Formula for Igusa Local Zeta Functions by showing that the Stationary Phase Formula’s requirement that one consider points where the function evaulates to zero modulo is a result of the transformations and not necessarily the Exponential Sum itself. In proving this, the paper gives a simplication of the transformation necessary to

The Ehrenfest Urn Model (P. and T. Ehrenfest (1907)) has had application to heat exchange problems between two isolated bodies. The basic model can be described as an urn containing w/sub 0/ white and b/sub 0/ black balls. A ball is drawn at random from the urn and is replaced by a ball of opposite color. The interest is in the distribution of W/sub n/, the number of white balls in the urn after n drawings with replacement. A number of modifications and generalizations of the model are knwon. A further generalization of the model is given which permits replacement by a ball of either color with randomization before each replacement.