Replacement Therapies in Adrenal Insufficiency


Book Description

Replacement Therapies in Adrenal Insufficiency provides a thorough understanding of the conditions which result in adrenal insufficiency. Never before has one source of information combined all updates on current causes and mechanisms of adrenal sufficiency to allow for quick reference and subsequent treatment decisions. Scientific data on this broad condition includes specific disease coverage of Addison’s disease, hypopituitarism, congenital adrenal hypoplasia and adrenalectomy. Practical points in diagnosis, dosing, drug interactions, replacement therapies and emergency situations are also provided as guidance for overall management. Provides available treatment means and how to apply them in varying situations, including use among the chronically ill and within emergency settings Includes "Clinical Messages" within each chapter that provide clinical applications for the latest research in each discipline area, with a specific disease focus Outlines practical points in the management of adrenal insufficiency, including daily maintenance therapy, illness, sick days, emergencies and travel




Cortisol Excess and Insufficiency


Book Description

Disorders associated with cortisol excess and insufficiency, although rare, deserve the attention of the entire medical community because of high associated morbidity and mortality. Both diagnosis and management of hypo- and hypercortisolism are challenging, and disease presentation, at both clinical and laboratory level is not always definite. New tools are available for non-invasive and early diagnosis, and the choice of treatment should be tailored to each patient to improve quality of life through the regulation of the levels and rhythm of hormonal secretion, while limiting complications associated with the disease and therapies. In this new volume, top experts have contributed chapters on the pathognomonic, epidemiological, clinical, radiological, and laboratory aspects of the various disorders associated with altered cortisol secretion. They also present information on still debated standpoints on management. Cortisol Excess and Insufficiency is a valuable reference book for those wishing to have a reasoned and broad overview of the pathophysiology and management of disorders associated with hypo- and hypercortisolism.




Congenital Adrenal Hyperplasia


Book Description

Congenital Adrenal Hyperplasia: A Comprehensive Guide addresses how hydrocortisone works, what can go wrong, and how to correct it, also explaining why the timing of doses and measurement of cortisol from a dose is extremely important. The book provides an in-depth analysis of this disorder for pediatric endocrinologists and primary care providers, allowing them to help patients with an updated model of care and appropriate treatment. Patients and family members will benefit from the trend-forward information that will empower them to approach their healthcare providers with the expectation of receiving individualized care and treatment for this disorder. - Outlines the basics of congenital adrenal hyperplasia and its interrelation with hormones and bodily functions - Presents the known cognitive and emotional aspects of the disease - Reviews multidisciplinary management as well as post-treatment management of the disease




Endocrine Hypertension


Book Description

Several genetic, biochemical and radiologic discoveries have impacted the management of endocrine hypertension, while surgical procedures have revolutionized treatment of patients with endocrine hypertension. This text contains the proceedings of a 2001 workshop on the topic.




Growth Hormone Deficiency in Adults


Book Description

It has been known for over 40 years that GH-deficient-children benefit from replacement with the hormone. But GH, essential for longitudinal growth, also plays a role after completion of final height. With the introduction of biosynthetic human GH 20 years ago, the use of GH was no longer restricted to severe growth retardation in hypopituitary children. This book will take the reader behind the myths of GH and into the real world of clinical endocrinology. The contributions stem from recognized clinicians and scientists who have been working in the field for decades. The contents encompass traditional end points of GH therapy such as body composition, bone biology and physical performance. Attention is also devoted to diagnostic aspects and side effects. Additional features range from clinical epidemiology to quality of life, and novel areas such as the impact of traumatic brain injury on pituitary function are also covered. The present volume of Frontiers of Hormone Research is essential reading for health care professionals interested in clinical endocrinology and GH.




SAFE USES OF CORTISOL


Book Description

The Third Edition of this popular book brings up to date the material that so many readers found helpful in the previous editions. The text has been revised and reorganized with current chapters focusing on the history of cortisol use, sources of confusion regarding cortisol therapy, the significance of normal adrenocortical function, generally accepted uses of physiological dosage, viral infections, miscellaneous clinical conditions, and future directions for research and therapy. The author provides explanation and confirmation of the rationale for the effectiveness and safety of the uses of physiological dosages of cortisol in the treatment, not only of patients with rheumatoid arthritis and other autoimmune disorders, but also of patients with chronic allergies, chronic fatigue syndrome, gonadal dysfunction, infertility, shingles, acne, hirsutism, respiratory infections, and other less common disorders. It is a known fact that the influenza virus attacks the human body by impairing the production of the adrenocorticotropic hormone (ACTH), which, in turn, impairs the production of cortisol; the only hormone that is absolutely essential for life. In addition, within the past two years, a new infection has developed in central China and has been labeled Severe Acute Respiratory Syndrome (SARS). The ACTH hormone and the SARS epidemic is addressed, and it is hoped that this type of cortisol therapy will not only be helpful in the treatment of the various disorders mentioned but will lead to a better understanding of the factors that contribute to the development of these disorders and ultimately contribute towards their prevention.




Endocrine and Metabolic Late Effects in Cancer Survivors


Book Description

This book analyzes in detail all aspects related to endocrine and metabolic late effects observed in patients treated for cancer, both in childhood and adulthood. The chapters focusing on the possible pathogenic mechanisms of late effects (i.e., premature aging and chronic inflammation) and on bone health in cancer survivors are particularly interesting and innovative. The volume also deals with hypothalamic-pituitary, thyroid and gonadal disorders, including infertility and how to prevent it. Finally, the relationship between metabolic alterations and cardiovascular diseases in cancer survivors is addressed. Thanks to advances in cancer treatment and supportive care, the five-year survival rate of cancer patients is constantly increasing. However, this undisputable success of medicine has a flip side: the late adverse effects of anticancer therapies. Pediatric oncologists were the first to cope with late complications of treatments, but today also adult oncologists and onco-hematologists recognize the relevance of this issue. Even though late effects observed in cancer survivors can affect any organ or system, endocrine and metabolic dysfunctions are the most frequently reported. Endocrine complications rarely influence life expectancy of cancer survivors, but they can significantly impact morbidity and quality of life. Among endocrine adverse effects, severe hypothalamic damage may be considered the most harmful in survivors, leading to morbid obesity, propensity to metabolic syndrome and cardiovascular disease. This book aims to disseminate the knowledge about endocrine and metabolic adverse effects of cancer therapies and about survivorship care. Since the number of cancer survivors is steadily growing in the general population, this publication is intended not only for endocrinologists but also for oncologists, onco-hematologists, internists, pediatric specialists in those areas and general practitioners, with the aim to better counsel and monitor cancer survivors.




Glucocorticoid Action


Book Description

Glucocorticoids regulate multiple metabolic and developmental processes and play a vital role in the maintenance of basal and stress-related homeostasis. For the last 50 years, pharmacologic doses of glucocorticoids have been used in the treatment of inflammatory, autoimmune, and lymphoproliferative diseases and in the prevention of allograft rejection, while substitution doses have been employed in the management of adrenocortical insufficiency. aspects of glucocorticoid action, in particular, (i) the impact of maternal and early life stress on stress-related gene regulation in the offspring; (ii) the importance of glucocorticoids and their receptors; (iii) further understanding of the mechanisms of GR action, including its effect on chromatin modulation, its interaction with coactivators and corepressors, and the genetic dissection of GR function in mice; (iv) The interaction of hGR with other transcription factors, such as NF-kappa-B, p53, transforming growth factor beta (TGF-beta) and the chicken ovalbumin upstream promoter transcription factor II (COUP-TFII); recycling, ubiquitination and degradation of the receptor, actions of the GR-beta isoform, a novel synthetic nonsteroidal target gene-specific agonist, the importance of target tissue activity of 11-beta-hydroxysteroid dehydrogenase type 1 in glucocorticoid action in health and disease, the interaction of the receptor with the nutrient carnitine, the anthrax products protective antigen (PA) and lethal factor (LF), and the human immunodeficiency virus type-1 (HIV-1)-encoded molecules Vpr and Tat; (vi) an update on the effects of glucocorticoids on the immune system; and (vii) the clinical implications of glucocorticoid action, including glucocorticoid resistance/hypersensitivity, familial and sporadic glucocorticoid resistance, and the effects of stress and depression.




Developmental Endocrinology


Book Description

Leading researchers comprehensively translate all the latest scientific information regarding endocrine physiology and development into an understanding of the clinical pathogenesis, diagnosis, and treatment of endocrine disease. Organized by endocrine system, each section of the book concisely describes the chronological development of the human organism, from the fetal/prenatal period through childhood, adolescence, and in some cases, into adulthood. The prenatal sections review recent discoveries concerning transcription factors, homeobox genes, and human molecular mutations-the basic processes governing prenatal development of the individual endocrine organs-and detail the pathophysiology, clinical characteristics, and treatment of pediatric endocrine disorders.




The Human Hypothalamus


Book Description

The Human Hypothalamus: Neuroendocrine Disorders, Volume 181 in the Handbook of Clinical Neurology series, provides comprehensive summaries of recent research on the brain and nervous system as they relate to clinical neurology. This volume summarizes the role of the hypothalamus in neuroendocrine disorders, identifying the mechanism of action, disorder etiology, and best practices for assessment and treatment. Disorders covered include pituitary hypothalamic disorders of development and growth, hypothalamic tumor related disorders, hypothalamic autoimmune disorders and infection, disorders of vasopressin, water and sodium homeostasis, eating disorders, and gonadotropic hormone regulation disorders. - Discusses the importance of the hypothalamus in human growth and development - Reviews hypothalamic related tumors, as well as pituitary, autoimmune, vasopressin and hormone regulation disorders - Includes metabolic and eating disorders - Identifies mechanisms of disease action and etiology - Provides best practice information for assessment and treatment