Objective Measurement of salivary glucocorticoids is an accepted method for testing adrenal function but there is little data on stability during home collection. Current salivary collection techniques require active participation or present a choking hazard and are unsuitable for young children. We sought to: compare different salivary collection methods; assess stability of salivary glucocorticoids under conditions replicating home collection; assess patient tolerability and caregiver acceptability of a salivary collection device for young children, a swab encased in an infant pacifier (SaliPac™). Methods Six healthy adults collected salivary samples using a Salivette® Cortisol, passive drool and SalivaBio at night, waking and 3pm for five days. Time to collect 1ml saliva using the SalivaBio and SaliPac and caregiver acceptability were assessed in 30 children <6 years. Saliva was stored at 4°C, room temperature and 50°C for 24, 48, 72 hours and a week to replicate potential postage conditions. Salivary cortisol and cortisone concentrations were measured by mass spectrometry. Results There was no difference in salivary glucocorticoid concentrations using the three collection methods. Salivary cortisol and cortisone were stable for 72 hours at room temperature and 4°C, and repeated freeze-thaw cycles did not cause significant degradation. In children <6 years the SalivaBio and SaliPac were well tolerated and collected sufficient saliva for salivary steroid analysis in <4 minutes. Conclusions Salivette, passive drool and SalivaBio collect samples with comparable salivary cortisol and cortisone concentrations, which are stable under conditions replicating home collection. SaliPac is an acceptable device for salivary sampling in young children.
Charlotte (2018). Using a testicular simulation model as an educational tool to improve testicular volume estimations. Endocrine Abstracts, 58.
ObjectivesMeasuring testicular volume (TV) by orchidometer is routine in the clinic when staging male puberty. We have developed a simulation model for TV estimation and investigated whether training medical students, using a workshop with simulation models, could improve the accuracy and reliability of TV estimation.MethodsAll participating medical students watched a video representing standard undergraduate training in male pubertal assessment. Volunteers were then randomised directly to assessment or to attend a workshop consisting of a further video and four stations contextualising and practising the skills required for TV estimation, prior to assessment. Three child mannequins displaying testes of 3 mL, 4 mL (twice), 5, 10 and 20 mL were used for assessment. Participants were asked to return a fortnight later for repeat assessment to assess intra-observer reliability, the effect of repeated examinations on accuracy and time on skill retention.ResultsNinety students participated (55F), 46 attended the workshop and were considered “trained”. There was no difference between the groups in numbers of correct estimations (29% trained, 27% untrained, p=0.593). However, the trained group’s estimations were closer to the true volume, with more from the trained group one bead away (p=0.002) and fewer more than three beads away from the true volume (p<0.001), compared to the untrained group. Trained participants were more accurate at the second assessment (n=80) (p<0.001) and had greater intra-observer reliability (p=0.004).ConclusionsOverall TV estimation accuracy was poor. Workshop-style training improved accuracy, reliability and retention of skill acquisition and could be considered as a useful learning tool.
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