Verfügbarkeit: Greenspan's Basic & clinical endocrinology

Greenspan's Basic & clinical endocrinology:

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Format:	Buch
Sprache:	English
Veröffentlicht:	New York [u.a.] MacGraw-Hill Medical 2007
Ausgabe:	8. ed.
Schriftenreihe:	A Lange medical book
Schlagworte:	Endocrinología Enfermedades de las glándulas endocrinas Glándulas endocrinas - Fisiología Hormonas - Fisiología Physiologie Endokrinologie Endokrinium Endokrinopathie Einführung
Online-Zugang:	Inhaltsverzeichnis Klappentext
Beschreibung:	XIV, 1010 S. Ill., graph. Darst.
ISBN:	9780071440110 0071440119

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650		4	\|a Enfermedades de las glándulas endocrinas
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650		4	\|a Hormonas - Fisiología
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Datensatz im Suchindex

_version_	1804137299819102208
adam_text	Contents Authors ........................................................................... x Preface ...........................................................................xiv 1. Introduction to Endocrinology ...................................................1 Paul Webb, PhD, &John D. Baxter, MD The Endocrine System 2 Evolution of Multiple Hormone Response Systems 19 Hormones: Endocrine, Paracrine, Autocrine, Juxtacrine, Evolution of Endocrine Glands 19 & Intracrine Actions 3 Integrative Networks 20 Endocrine Organs 3 Endocrine & Nervous System Relationships: Target Organs 3 Neuroendocrinology 20 Hormone Receptors 3 Actions of Hormones 21 Chemical Composition of Hormones 3 Fetal Development 21 Relationships between Hormones & Other Signaling Cell Growth & Cancer 21 Molecules 4 Intermediary Metabolism 21 Neurotransmitters & Hormones 4 Mineral & Water Metabolism 21 Vitamins & Hormones 5 Cardiovascular & Renal Function 22 Eicosanoids: Prostaglandins & Related Compounds 5 Skeletal Function 22 Metabolites б Reproductive Function 22 Oncogenes & Hormones 6 Immune System 22 The Immune System & Hormones 6 Central Nervous System 23 Modulation of Hormone Levels б Recent Advances in Technology & Endocrinology 23 Regulation of Hormone Production б Sequencing the Human Genome 23 Molecular Mechanisms Regulating Hormone Release 7 Genomics & Patterns of Transcription 23 Hormone Transport in the Circulation 9 Proteomics 23 Transport of Hormones across the Membrane 10 Manipulating the Genome 24 Metabolism & Elimination of Hormones 10 RNA Interference (RNAi) 24 Mechanisms of Hormone Action 12 Stem Cells 24 Hormone Receptors 12 Molecular Basis of Genetic Endocrine Disease 25 Hormone Binding 14 Disorders of the Endocrine System 25 Hormone Effects on Receptor Activity 14 Endocrine Hypofunction 26 Classes of Hormone Action 14 Endocrine Hyperfunction 27 Classification of Hormone Action by Receptor Type 14 Defects in Sensitivity to Hormones 27 Classification of Hormone Action by Ligand Type 15 Syndromes of Hormone Excess Due to Exogenous Regulation of Hormone Responsiveness 16 Hormone 29 Regulation of Receptor Levels & Activities 1 б Nonendocrine Problems Associated with Endocrine Hormone Responsiveness Is Regulated by Postreceptor Disease 29 Influences 17 Approach to the Patient with Endocrine Disease 29 Combinatorial Interactions Influence Hormone History & Physical Examination 29 Signaling in DifřerenťWays 17 Laboratory Studies 29 Selective Modulation 17 Screening for Endocrine Diseases 32 Evolution of the Endocrine System 18 Treatment of Endocrine Diseases 32 The Origins of Regulatory Chemicals & the Metabolic Uses of Hormones & Selective Modulators in Therapy of Code 18 Nonendocrine Disease 33 Evolution of Hormones & Receptors 19 2. Mechanisms of Hormone Action ............. David G Gardner, MD, & Robert A. Nissenson, PhD Receptors 36 Neurotransmitter & Peptide Hormone Receptors 37 G Protein-Coupled Receptors 37 G Protein Transducers 39 Effectors 39 .35 Disorders of G Proteins and G Protein-Coupled Receptors 41 Growth Factor Receptors 44 Cytokine Receptors 47 Guanylyl Cyclase-Linked Receptors 47 iii iv / CONTENTS Nuclear Action, of Peptide Hormones 49 Nuclear Receptors 49 Steroid Receptor Family 49 Thyroid Receptor Family 52 Nongenomic Effects of the Steroid Hormones 56 Steroid & Thyroid Hormone Receptor Resistance Syndromes 57 3. Endocrine Autoimmunity ......... Juan Carhs Jaume, MD Basic Immune Components & Mechanisms 60 Immune Recognition & Response 61 Tolerance 64 Autoimmunity Is Multifactorial 69 Genetic Factors in Autoimmunity 69 Environmental Factors in Autoimmunity 70 Single Gland Autoimmune Syndromes 70 Autoimmune Aspects of Thyroid Disease 71 59 Autoimmune Aspects of Type 1 Diabetes 73 Autoimmune Aspects of Other Endocrinopathies 75 Autoimmune Polyglandular Syndromes 76 Autoimmune Polyglandular Syndrome I (APS-I) 77 Autoimmune Polyglandular Syndrome II (APS-II) 78 Management of Autoimmune Polyglandular Syndromes 78 POEMS Syndrome (Osteosderotic Myeloma) 79 4. Evidence-Based Endocrinology & Clinical Epidemiology ..............................80 David С Aron, MD, MS Clinical Epidemiology 80 Step One: Translation of the Clinical Problem into Diagnostic Testing: Test Characteristics 80 Answerable Questions 93 An Approach to Diagnosis in Practice 86 Step Two: Finding the Best Evidence 96 Clinical Epidemiologie Principles Applied to Treatment Step Three: Appraising the Evidence for Its Validity & Decisions 88 Usefulness 96 Decision Analysis 89 Steps Four and Five: Applying the Results in Practice & Other Aspects of Clinical Epidemiology 93 Evaluating Performance 97 Evidence-Based Endocrinology 93 5. Hypothalamus & Pituitary Gland ...............................................101 David С Aron, MD, MS, James W Findling, MD, &J. Bkke Tyrrell, MD Hypothalamic Hormones 106 Anterior Pituitary Hormones 113 Adrenocortícotropic Hormone & Related Peptides 113 Growth Hormone 114 Prolactin 118 Thyrotropm 120 Gonadotropins: Luteínizing Hormone & Follide- Stimulating Hormone 121 Endocrinologie Evaluation of the Hypothalamic-Pituitary Axis 123 Evaluation of Adrenocortícotropic Hormone (ACTH) 123 Evaluation of Growth Hormone (GH) 127 Evaluation of Prokain (PRL) 127 Evaluation of Thyroid-Stimulating Hormone (TSH) 127 Evaluation of LH&FSH 127 Problems in Evaluation of the Hypothalamic-Pituitary Axis 128 Effects of Pharmacologie Agents on Hypothalamic- Pituitary Function 128 Endocrine Tests of Hypothalamic-Pituitary Function 129 Neuroradiologic Evaluation 129 Pituitary & Hypothalamic Disorders 131 Empty Sella Syndrome 132 Hypothalamic Dysfunction 133 Hypopkuitarism 134 Pituitary Adenomas 140 6. Posterior Pituitary (Neurohypophysis) . Alan G. Robinson, MD Review of Normal Anatomy & Physiology 157 Vasopressin Insufficiency: Diabetes Insipidus 160 Excess Vasopressin: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) 165 157 Oxytocin 169 Parturition 169 Lactation 169 7. Growth ........... Dennis Slyne, MD Normal Growth 171 Intrauterine Growth 171 The Placenta 172 171 Classic Hormones of Growth & Fetal Growth 172 Growth Factors & Oncogenes in Fetal Growth 172 CONTENTS / v Insulin-Like Growth Factors, Receptors, & Binding Skeletal (Bone) Age 186 Proteins 172 Disorders of Growth 186 Insulin 172 Short Stature Due to Nonendocrine Causes 186 Epidermal Growth Factor 173 Short Stature Due to Endocrine Disorders 193 Fetal Origins of Adult Disease 174 Diagnosis of Short Stature 204 Postnatal Growth 174 Tall Stature Due to Nonendocrine Causes 205 Measurement of Growth 183 Tall Stature Due to Endocrine Disorders 206 8. The Thyroid Gland ..........................................................209 DavidS. Cooper, MD, Francis S. Greenspan, MD, FACE & PaulW. Ladenson, MA (Oxon.J, MD Embryology, Anatomy, & Histology 210 Thyroid Imaging 237 Physiology 210 Thyroid Ultrasonography & Other Imaging Structure & Synthesis of Thyroid Hormones 210 Techniques 238 Iodine Metabolism 212 Thyroid Biopsy 238 Thyroid Hormone Synthesis & Secretion 212 Test of Peripheral Thyroid Hormone Actions 239 Abnormalities in Thyroid Hormone Synthesis & Measurement of Thyroid Autoantibodies 239 Release 216 Disorders of the Thyroid 239 Metabolism of Thyroid Hormones 219 Hypothyroidism 240 Control of Thyroid Function & Hormone Action 221 Hyperthyroidism & Thyrotoxicosis 248 Physiologic Changes in Thyroid Function 229 Thyroid Hormone Resistance Syndromes 260 Thyroid Autoimmunity 231 Non toxic Goiter 260 Tests of Thyroid Function 232 Thyroiditis 263 Tests of Thyroid Hormones in Blood 232 Effects of Ionizing Radiation on the Thyroid Gland 266 Assessment of Thyroid Iodine Metabolism & Thyroid Nodules & Thyroid Cancer 267 Biosynthetic Activity 236 9. Metabolic Bone Disease .......................................................281 Dolores Shoback, MD, Deborah Sellmeyer, MD, & Daniel D. Bikle, MD, PhD Cellular & Extracellular Calcium Metabolism 281 Structure of Bone 317 Parathyroid Hormone 282 Bone Remodeling 319 Calcitonin 288 Osteoporosis 320 Vitamin D 288 Treatment of Osteoporosis 325 How Vitamin D & PTH Control Mineral Glucocorticoid-Induced Osteoporosis 330 Homeostasis 297 Osteomalacia & Rickets 331 Medullary Carcinoma of the Thyroid (MCT) 297 Nephrotic Syndrome 334 Hypercalcemia 299 Hepatic Osteodystrophy 335 Disorders Causing Hypercalcemia 300 Drug-Induced Osteomalacia 335 Treatment of Hypercalcemia 310 Hypophosphatemic Disorders 335 Hypocalcemia 310 Calcium Deficiency 337 Causes of Hypocalcemia 312 Primary Disorders of the Bone Matrix 337 Treatment of Hypocalcemia 316 Inhibitors of Mineralization 338 Bone Anatomy & Remodeling 317 Paget s Disease of Bone (Osteitis Deformans) 338 Functions of Bone 317 Renal Osteodystrophy 342 10. Glucocorticoids & Adrenal Androgens ...........................................346 David С Aron, MD, MS, James W Findling, MD, drJ. Bkke Tyrrell, MD Embryology & Anatomy 346 Secondary Adrenocortical Insufficiency 372 Biosynthesis of Cortisol & Adrenal Androgens 348 Diagnosis of Adrenocortical Insufficiency 373 Circulation of Cortisol & Adrenal Androgens 354 Treatment of Adrenocortical Insufficiency 375 Metabolism of Cortisol & Adrenal Androgens 354 Prognosis of Adrenocortical Insufficiency 378 Biologic Effects of Adrenal Steroids 356 Cushing s Syndrome 378 Glucocorticoids 356 Hirsutism & Virilism 390 Adrenal Androgens 363 Incidental Adrenal Mass 390 Laboratory Evaluation 363 Glucocorticoid Therapy for Nonendocrine Disorders of Adrenocortical Insufficiency 367 Disorders 391 Primary Adrenocortical Insufficiency (Addison s Disease) 367 ví / CONTENTS 11. Endocrine Hypertension ............... Burl R. Don, MD, ájoan C. Lo, MD Hypertension of Adrenal Origin 396 Synthesis, Metabolism, & Action of Mineralocorticoid Hormones 396 Pathogenesis of Mineralocorticoid Hypertension 398 Aldosterone & the Heart 398 Primary Aldosteronism 399 Syndromes Due to Excess Deoxycorticosterone Production 404 Cushing s Syndrome 406 Pseudohyperaldosteronism 406 Type II Pseudohypoaldosteronism (Arnold-Healy- Gordon Syndrome) 409 396 Hypertension of Renal Origin 410 The Renin-Angiotensin System 410 The Renin-Angiotensin System & Hypertension 413 Other Hormone Systems & Hypertension 417 Insulin 417 Natriuretic Peptides 418 Nitric Oxide 418 Endothelin 419 Kallikrein-Kinin System 419 Other Hormones & Autacoids 419 Sympathetic Nervous System 419 12. Adrenal Medulla & Paraganglia ........... Paul A. Fitzgerald, MD History 422 Anatomy 423 Hormones of the Adrenal Medulla 424 Catecholamines 424 Other Hormones Secreted by the Adrenal Medulla 435 Disorders of Adrenal Medullary Function 435 Adrenal Medullary Hypofunction (Epinephtme Deficiency) 435 Adrenal Medullary Hyperfunction 437 Pheochromocytoma 437 421 13. Testes........................... Glenn D. Braunstein, MD Anatomy & Structure-Function Relationships 470 Testes 470 Accessory Structures 472 Physiology of the Male Reproductive System 472 Gonadal Steroids 472 Control of Testicular Function 475 Evaluation of Male Gonadal Function 476 Clinical Evaluation 476 Laboratory Tests of Testicular Function 477 Pharmacology of Drugs Used to Treat Male Gonadal Disorders 479 Androgens 479 Gomdotropins 481 Gonadotropin-Releasing Hormone 481 470 Clinical Male Gonadal Disorders 481 Klinefelter s Syndrome (XXY Seminiferous Tubule Dysgenesis) 482 Bilateral Anorchia (Vanishing Testes Syndrome) 484 Leydig Cell Aplasia 485 Cryptorchidism 485 Noonan s Syndrome (Male Turner s Syndrome) 487 Myotonie Dystrophy 488 Adult Seminiferous Tubule Failure 488 Adult Leydig Cell Failure (Andropause) 490 Male Infertility 490 Erectile Dysfunction (Impotence) 493 Gynecomastia 495 Testicular Tumors 497 14. Female Reproductive Endocrinology & Infertility ..................................502 Mitchell P. Rosen, MD, & Marcelle I. Cedars, MD Menopause 537 Oocyte Depletion 538 508 Embryology & Anatomy 502 Ovarian Steroidogenesis 505 Physiology of Folliculogenesis & the Menstrual Cycle Menstrual Disturbances 517 Amenorrhea 517 Hypothalarnic Amenorrhea 520 Pituitary Amenorrhea 522 Ovarian Amenorrhea 524 Anovulation 527 Obesity 534 Outflow Tract Disorders 536 p Endocrine System Changes with Aging 539 Menopausal Consequences 540 Infertility 543 Diagnosis of Infertility 543 Management of the Infertile Couple 545 Contraception 546 Oral Contraceptives 546 Contraception: Long-Acting Contraceptives 552 Emergency Contraception 559 15. Disorders of Sexual Determination & Differentiation ...............................562 Felix A. Conte, MD, & Melvin M. Grumbach, MD Normal Sex Differentiation 562 Atypical Sex Differentiation 574 Testicular & Ovarian Differentiation 568 Klinefelter s Syndrome and Its Variants: Seminiferous- Psychosaual Differentiation 574 Tubule Dysgenesis 574 CONTENTS / vii Syndrome of Gonadal Dysgenesis: Turner s Syndrome & Its Variants 577 Individuals with Both Ovarian and Testicular Tissue (True Hermaphroditism) 583 Female Pseudohermaphroditism 584 P450 Aromatase Deficiency 590 Maternal Androgens & Progestogens 591 Male Pseudohermaphroditism 591 Unclassified Forms of Abnormal Sexual Development in Males 602 Unclassified Forms of Abnormal Sexual Development in Females 603 Management of Patients with Intersex Problems 603 ló.Puberty .................... Dennis Styne, MD Physiology of Puberty 611 Delayed Puberty or Absent Puberty (Sexual Infantilism) 620 .611 Precocious Puberty (Sexual Precocity) 631 17. The Endocrinology of Pregnancy ...............................................641 Robert N. Taylor, MD, PhD, &Dan I. Lebovic, MD, MA Conception & Implantation 641 Endocrinology of the Puerperium 653 Fetal-Placental-Decidual Unit 642 Endocrine Disorders & Pregnancy Pituitary Disorders 655 Polypeptide Hormones 645 Pregnancy & Breast Cancer 656 Steroid Hormones 646 Hypertensive Disorders of Pregnancy 657 Maternal Adaptation to Pregnancy 647 Hyperthyroidism in Pregnancy 658 Fetal Endocrinology 651 Hypothyroidism in Pregnancy 659 Endocrine Control of Parturition 652 18. Pancreatic Hormones & Diabetes Mellitus ........................................661 Umesh Masharani, MB, BS, MRCPfUK), & Michael S. German, MD The Endocrine Pancreas 662 Oral Glucose Tolerance Test 687 Anatomy & Histology 662 Insulin Levels 687 Hormones of the Endocrine Pancreas 662 Intravenous Glucose Tolerance Test 687 Diabetes Mellitus 672 Diet 692 Classification 672 Agents for the Treatment of Hyperglycemia 693 Type 1 Diabetes Mellitus 673 Insulin 701 Type 2 Diabetes 675 Steps in the Management of the Diabetic Patient 707 Other Specific Types of Diabetes 677 Hypoglycemia 713 Clinical Features of Diabetes Mellitus 680 Coma 715 Type 1 Diabetes 681 Specific Chronic Complications of Diabetes Mellitus Type 2 Diabetes 681 727 Urinalysis 682 Diabetic Patients Regulated by Diet Alone 734 Blood Glucose Testing 683 Diabetic Patients Taking Oral Hypoglycémie Serum Ketone Determinations 685 Agents 734 Glycated Hemoglobin Assays 685 Diabetic Patients Taking Insulin 734 Lipoproteins in Diabetes 686 19. Hypoglycémie Disorders ......................................................748 Umesh Masharani, MB, BS, MRCPÇUK), & Stephen E. Gitelman, MD Pathophysiology of the Counterregulatory Response to Symptomatic Fasting Hypoglycemia without Neuroglycopenia 748 Hyperinsulinism 762 Classification of Hypoglycémie Disorders 753 Nonfasting Hypoglycemia (Reactive Clinical Presentation of Hypoglycemia 754 Hypogiycemia) 763 Specific Hypoglycémie Disorders 755 Congenital Hyperinsulinism 764 Symptomatic Fasting Hypoglycemia with Hyperinsulinism 755 20. Disorders of Lipoprotein Metabolism ............................................770 Maryj. Malby, MD, &John P. Kane, MD, PhD Atherosclerosis 770 Clinical Descriptions of Primary & Secondary Disorders of Overview of Lipid Transport 771 Lipoprotein Metabolism 777 Differentiation of Disorders of Lipoprotein Metabolism 775 Primary Hypertrigiyceridemia 777 Secondary Hypertrigiyceridemia 781 viii / CONTENTS Familial Hypercholesterolemia 783 Familial Combined Hyperlipidemia 784 Lp(a) Hyperlipoproteinemia 784 Familial Ligand-Defective Apo Б 784 Cholesterol 7-<X-Hydroxylase Deficiency 784 Hypothyroidism 784 Nephrosis 784 Immunoglobulin Disorders 785 Anorexia Nervosa 785 Cholestasis 785 Primary Hypolipidemia Due to Deficiency of High- Density Lipoprotems 785 Primary Hypolipidemia Due to Deficiency of Apo B- Containing Lipoproteins 787 The Lipodystrophies 788 Rare Disorders 788 Treatment of Hyperlipidemia 789 Bile Acid Séquestrants 791 Niacin(NicotinicAcid) 792 Fibric Acid Derivatives 792 HMG-CoA Reducíase Inhibitors 793 Cholesterol Absorption Inhibitors 793 Combined Drug Therapy 794 21. Obesity & Overweight .......................................................796 Marc К Hellerstein, MD, PhD, á Elizabeth J. Parks, PhD Type 2 Diabetes Mellitus 813 Hyperlipidemia 813 Polycystic Ovarian Syndrome 813 Hypertension 813 Gallstones 815 Sleep Apnea 815 Osteoarthritis & Other Weight-Sensitive States 815 A Systematic Approach to the Treatment of Obesity 815 Clarification of Uncertainties Regarding the Pathogenesis of Obesity 807 Survey of Treatment Approaches & Their Efficacy 808 Diet 8c Exercise 808 Exercise 810 Surgical Treatment of Obesity 810 Pharmacologie Therapies 810 Other Conditions Affected by Treatment of Obesity or Overweight 813 22. Humoral Manifestations of Malignancy ..........................................817 Dolores Shoback, MD, & Janet L. Funk, MD Ectopie Hormone & Receptor Syndromes 817 Non-Islet Cell Tumors & Hypoglycemia 825 Hypercalcemia of Malignancy 818 Other Hormones Secreted by Tumors 826 Ectopie Cushing s Syndrome 821 Oncogenic Osteomalacia 827 Syndrome of Inappropriate Antidiuretic Hormone Gut Hormones 828 Secretion 824 23. Multiple Endocrine Neoplasia ........, David G. Gardner, MD Multiple Endocrine Neoplasia Type 1 (MEN 1) 831 Multiple Endocrine Neoplasia Type 2 (MEN 2) 836 831 Other Disorders Characterized by Multiple Endocrine Organ Involvement 841 24. Geriatric Endocrinology .................. Susan L. Greenspan, MD, &NeilM. Resnick, MD Thyroid Function & Disease 844 Disorders of the Thyroid Gland 845 Carbohydrate Intolerance & Diabetes Mellitus 849 Aging & the Physiology of Carbohydrate Intolerance 849 Diabetes Mellitus 849 Nonketotic Hyperosmolar Coma 852 Osteoporosis & Calcium Homeostasis 853 Osteoporosis 853 Hyperparathyroidism 860 844 Changes in Water Balance 861 Hypematremia 861 Hyponatremia 861 Hyporeninemic Hypoaldosteronism 862 Glucocorticoids & Stress 862 Disorders of the Hypothalamic-Pituitary-Adrenal Axis 862 Changes in Reproductive Function in Men 863 Benign Prostatic Hyperplasia 865 25. Endocrine Emergencies ....... David G. Gardner, MD MyxedemaComa 868 Thyroid Storm 870 Thyrotoxic Periodic Paralysis 871 Amiodarone-Induced Thyrotoxicosis 872 868 Acute Adrenal Insufficiency 873 Pituitary Apoplexy 874 Diabetic Ketoacidosis 875 Nonketotic Hyperosmolar Coma 879 CONTENTS / ix Hyponatremia 886 Diabetes Insipidus 889 .894 Pituitary Disorders 901 Lipid Disorders 904 Conclusion 908 .911 The Adrenal (Suprarenal) Gland 923 Embryology & Anatomy 923 Primary Hyperaldosteronism 924 Hypercortisolism 924 Adrenal Cortical Carcinoma 925 Sex Steroid Excess 925 Pheochromocytoma 925 Adrenal Incidemaloma 926 Technique of Adrenalectomy 927 The Endocrine Pancreas 927 Embryology & Anatomy 927 Insulinoma 927 Gastrinoma (Zollinger-Ellison Syndrome) 929 VIPoma (Verner-Morrison) Syndrome 930 Głucagonoma 930 Somatostatinoma 930 Nonfunctioning Pancreatic Tumors 930 933 958 Hypercalcemic Crisis 882 Acute Hypocalcemia 884 26. AIDS Endocrinopathies .............. Grace Lee, MD, & Carl Grunfeld, MD, PhD Thyroid Disorders 894 Adrenal Disorders 896 Bone & Mineral Disorders 898 Gonadal Disorders 900 27. Endocrine Surgery .................. Geeta Lai, MD, & Orlo H. Clark, MD The Thyroid Gland 911 Embryology & Anatomy 911 Developmental Thyroid Abnormalities 911 Hyperthyroidism 912 Thyroiditis 913 Goiter (Non toxic) 913 Thyroid Nodules 913 Thyroid Cancer 914 Conduct of Thyroidectomy 916 The Parathyroid Gland 917 Embryology & Anatomy 917 Primary Hyperparathyroidism (PHPT) 919 Persistent & Recurrent Primary Hyperparathyroidism 922 Secondary Hyperparathyroidism 922 Special Consideration: Familial Hyperparathyroidism 923 Complications of Parathyroid Surgery 923 Appendix: Normal Hormone Reference Ranges Index ................................. THE #1 ALL-INCLUSIVE ENDOCRINOLOGY REFERENCE TEXT—COMPLETELY REVISED AND UPDATED Edition after best-selling edition, Greenspan s Basic & Ciinical Endocrinology succeeds in delivering the scientific principles of endocrinology and in matching those to the clinical management of patients with endocrine-related diseases and disorders. Step by step, Greenspan s provides clinically relevant perspectives on metabolic bone disease, pancreatic hormones and diabetes mellitus, hypoglycemia, obesity, geriatric endocrinology, and many other diseases and disorders. Supporting this essential coverage is a handy appendix of normal hormone reference ranges. New to the Eighth Edition: ► Recent advances in motecufer endocrinology ► Current concepts in en¬ docrine pathophysiology to aid clinical decision- making ► Updated with the most practical, current insights into diagnostic testing ► Important new approaches to the medical management of endocrine disorders, in- recommenda-tíoris
adam_txt	Contents Authors . x Preface .xiv 1. Introduction to Endocrinology .1 Paul Webb, PhD, &John D. Baxter, MD The Endocrine System 2 Evolution of Multiple Hormone Response Systems 19 Hormones: Endocrine, Paracrine, Autocrine, Juxtacrine, Evolution of Endocrine Glands 19 & Intracrine Actions 3 Integrative Networks 20 Endocrine Organs 3 Endocrine & Nervous System Relationships: Target Organs 3 Neuroendocrinology 20 Hormone Receptors 3 Actions of Hormones 21 Chemical Composition of Hormones 3 Fetal Development 21 Relationships between Hormones & Other Signaling Cell Growth & Cancer 21 Molecules 4 Intermediary Metabolism 21 Neurotransmitters & Hormones 4 Mineral & Water Metabolism 21 Vitamins & Hormones 5 Cardiovascular & Renal Function 22 Eicosanoids: Prostaglandins & Related Compounds 5 Skeletal Function 22 Metabolites б Reproductive Function 22 Oncogenes & Hormones 6 Immune System 22 The Immune System & Hormones 6 Central Nervous System 23 Modulation of Hormone Levels б Recent Advances in Technology & Endocrinology 23 Regulation of Hormone Production б Sequencing the Human Genome 23 Molecular Mechanisms Regulating Hormone Release 7 Genomics & Patterns of Transcription 23 Hormone Transport in the Circulation 9 Proteomics 23 Transport of Hormones across the Membrane 10 Manipulating the Genome 24 Metabolism & Elimination of Hormones 10 RNA Interference (RNAi) 24 Mechanisms of Hormone Action 12 Stem Cells 24 Hormone Receptors 12 Molecular Basis of Genetic Endocrine Disease 25 Hormone Binding 14 Disorders of the Endocrine System 25 Hormone Effects on Receptor Activity 14 Endocrine Hypofunction 26 Classes of Hormone Action 14 Endocrine Hyperfunction 27 Classification of Hormone Action by Receptor Type 14 Defects in Sensitivity to Hormones 27 Classification of Hormone Action by Ligand Type 15 Syndromes of Hormone Excess Due to Exogenous Regulation of Hormone Responsiveness 16 Hormone 29 Regulation of Receptor Levels & Activities 1 б Nonendocrine Problems Associated with Endocrine Hormone Responsiveness Is Regulated by Postreceptor Disease 29 Influences 17 Approach to the Patient with Endocrine Disease 29 Combinatorial Interactions Influence Hormone History & Physical Examination 29 Signaling in DifřerenťWays 17 Laboratory Studies 29 Selective Modulation 17 Screening for Endocrine Diseases 32 Evolution of the Endocrine System 18 Treatment of Endocrine Diseases 32 The Origins of Regulatory Chemicals & the Metabolic Uses of Hormones & Selective Modulators in Therapy of Code 18 Nonendocrine Disease 33 Evolution of Hormones & Receptors 19 2. Mechanisms of Hormone Action . David G Gardner, MD, & Robert A. Nissenson, PhD Receptors 36 Neurotransmitter & Peptide Hormone Receptors 37 G Protein-Coupled Receptors 37 G Protein Transducers 39 Effectors 39 .35 Disorders of G Proteins and G Protein-Coupled Receptors 41 Growth Factor Receptors 44 Cytokine Receptors 47 Guanylyl Cyclase-Linked Receptors 47 iii iv / CONTENTS Nuclear Action, of Peptide Hormones 49 Nuclear Receptors 49 Steroid Receptor Family 49 Thyroid Receptor Family 52 Nongenomic Effects of the Steroid Hormones 56 Steroid & Thyroid Hormone Receptor Resistance Syndromes 57 3. Endocrine Autoimmunity . Juan Carhs Jaume, MD Basic Immune Components & Mechanisms 60 Immune Recognition & Response 61 Tolerance 64 Autoimmunity Is Multifactorial 69 Genetic Factors in Autoimmunity 69 Environmental Factors in Autoimmunity 70 Single Gland Autoimmune Syndromes 70 Autoimmune Aspects of Thyroid Disease 71 59 Autoimmune Aspects of Type 1 Diabetes 73 Autoimmune Aspects of Other Endocrinopathies 75 Autoimmune Polyglandular Syndromes 76 Autoimmune Polyglandular Syndrome I (APS-I) 77 Autoimmune Polyglandular Syndrome II (APS-II) 78 Management of Autoimmune Polyglandular Syndromes 78 POEMS Syndrome (Osteosderotic Myeloma) 79 4. Evidence-Based Endocrinology & Clinical Epidemiology .80 David С Aron, MD, MS Clinical Epidemiology 80 Step One: Translation of the Clinical Problem into Diagnostic Testing: Test Characteristics 80 Answerable Questions 93 An Approach to Diagnosis in Practice 86 Step Two: Finding the Best Evidence 96 Clinical Epidemiologie Principles Applied to Treatment Step Three: Appraising the Evidence for Its Validity & Decisions 88 Usefulness 96 Decision Analysis 89 Steps Four and Five: Applying the Results in Practice & Other Aspects of Clinical Epidemiology 93 Evaluating Performance 97 Evidence-Based Endocrinology 93 5. Hypothalamus & Pituitary Gland .101 David С Aron, MD, MS, James W Findling, MD, &J. Bkke Tyrrell, MD Hypothalamic Hormones 106 Anterior Pituitary Hormones 113 Adrenocortícotropic Hormone & Related Peptides 113 Growth Hormone 114 Prolactin 118 Thyrotropm 120 Gonadotropins: Luteínizing Hormone & Follide- Stimulating Hormone 121 Endocrinologie Evaluation of the Hypothalamic-Pituitary Axis 123 Evaluation of Adrenocortícotropic Hormone (ACTH) 123 Evaluation of Growth Hormone (GH) 127 Evaluation of Prokain (PRL) 127 Evaluation of Thyroid-Stimulating Hormone (TSH) 127 Evaluation of LH&FSH 127 Problems in Evaluation of the Hypothalamic-Pituitary Axis 128 Effects of Pharmacologie Agents on Hypothalamic- Pituitary Function 128 Endocrine Tests of Hypothalamic-Pituitary Function 129 Neuroradiologic Evaluation 129 Pituitary & Hypothalamic Disorders 131 Empty Sella Syndrome 132 Hypothalamic Dysfunction 133 Hypopkuitarism 134 Pituitary Adenomas 140 6. Posterior Pituitary (Neurohypophysis) . Alan G. Robinson, MD Review of Normal Anatomy & Physiology 157 Vasopressin Insufficiency: Diabetes Insipidus 160 Excess Vasopressin: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) 165 157 Oxytocin 169 Parturition 169 Lactation 169 7. Growth . Dennis Slyne, MD Normal Growth 171 Intrauterine Growth 171 The Placenta 172 171 Classic Hormones of Growth & Fetal Growth 172 Growth Factors & Oncogenes in Fetal Growth 172 CONTENTS / v Insulin-Like Growth Factors, Receptors, & Binding Skeletal (Bone) Age 186 Proteins 172 Disorders of Growth 186 Insulin 172 Short Stature Due to Nonendocrine Causes 186 Epidermal Growth Factor 173 Short Stature Due to Endocrine Disorders 193 Fetal Origins of Adult Disease 174 Diagnosis of Short Stature 204 Postnatal Growth 174 Tall Stature Due to Nonendocrine Causes 205 Measurement of Growth 183 Tall Stature Due to Endocrine Disorders 206 8. The Thyroid Gland .209 DavidS. Cooper, MD, Francis S. Greenspan, MD, FACE & PaulW. Ladenson, MA (Oxon.J, MD Embryology, Anatomy, & Histology 210 Thyroid Imaging 237 Physiology 210 Thyroid Ultrasonography & Other Imaging Structure & Synthesis of Thyroid Hormones 210 Techniques 238 Iodine Metabolism 212 Thyroid Biopsy 238 Thyroid Hormone Synthesis & Secretion 212 Test of Peripheral Thyroid Hormone Actions 239 Abnormalities in Thyroid Hormone Synthesis & Measurement of Thyroid Autoantibodies 239 Release 216 Disorders of the Thyroid 239 Metabolism of Thyroid Hormones 219 Hypothyroidism 240 Control of Thyroid Function & Hormone Action 221 Hyperthyroidism & Thyrotoxicosis 248 Physiologic Changes in Thyroid Function 229 Thyroid Hormone Resistance Syndromes 260 Thyroid Autoimmunity 231 Non toxic Goiter 260 Tests of Thyroid Function 232 Thyroiditis 263 Tests of Thyroid Hormones in Blood 232 Effects of Ionizing Radiation on the Thyroid Gland 266 Assessment of Thyroid Iodine Metabolism & Thyroid Nodules & Thyroid Cancer 267 Biosynthetic Activity 236 9. Metabolic Bone Disease .281 Dolores Shoback, MD, Deborah Sellmeyer, MD, & Daniel D. Bikle, MD, PhD Cellular & Extracellular Calcium Metabolism 281 Structure of Bone 317 Parathyroid Hormone 282 Bone Remodeling 319 Calcitonin 288 Osteoporosis 320 Vitamin D 288 Treatment of Osteoporosis 325 How Vitamin D & PTH Control Mineral Glucocorticoid-Induced Osteoporosis 330 Homeostasis 297 Osteomalacia & Rickets 331 Medullary Carcinoma of the Thyroid (MCT) 297 Nephrotic Syndrome 334 Hypercalcemia 299 Hepatic Osteodystrophy 335 Disorders Causing Hypercalcemia 300 Drug-Induced Osteomalacia 335 Treatment of Hypercalcemia 310 Hypophosphatemic Disorders 335 Hypocalcemia 310 Calcium Deficiency 337 Causes of Hypocalcemia 312 Primary Disorders of the Bone Matrix 337 Treatment of Hypocalcemia 316 Inhibitors of Mineralization 338 Bone Anatomy & Remodeling 317 Paget's Disease of Bone (Osteitis Deformans) 338 Functions of Bone 317 Renal Osteodystrophy 342 10. Glucocorticoids & Adrenal Androgens .346 David С Aron, MD, MS, James W Findling, MD, drJ. Bkke Tyrrell, MD Embryology & Anatomy 346 Secondary Adrenocortical Insufficiency 372 Biosynthesis of Cortisol & Adrenal Androgens 348 Diagnosis of Adrenocortical Insufficiency 373 Circulation of Cortisol & Adrenal Androgens 354 Treatment of Adrenocortical Insufficiency 375 Metabolism of Cortisol & Adrenal Androgens 354 Prognosis of Adrenocortical Insufficiency 378 Biologic Effects of Adrenal Steroids 356 Cushing's Syndrome 378 Glucocorticoids 356 Hirsutism & Virilism 390 Adrenal Androgens 363 Incidental Adrenal Mass 390 Laboratory Evaluation 363 Glucocorticoid Therapy for Nonendocrine Disorders of Adrenocortical Insufficiency 367 Disorders 391 Primary Adrenocortical Insufficiency (Addison's Disease) 367 ví / CONTENTS 11. Endocrine Hypertension . Burl R. Don, MD, ájoan C. Lo, MD Hypertension of Adrenal Origin 396 Synthesis, Metabolism, & Action of Mineralocorticoid Hormones 396 Pathogenesis of Mineralocorticoid Hypertension 398 Aldosterone & the Heart 398 Primary Aldosteronism 399 Syndromes Due to Excess Deoxycorticosterone Production 404 Cushing's Syndrome 406 Pseudohyperaldosteronism 406 Type II Pseudohypoaldosteronism (Arnold-Healy- Gordon Syndrome) 409 396 Hypertension of Renal Origin 410 The Renin-Angiotensin System 410 The Renin-Angiotensin System & Hypertension 413 Other Hormone Systems & Hypertension 417 Insulin 417 Natriuretic Peptides 418 Nitric Oxide 418 Endothelin 419 Kallikrein-Kinin System 419 Other Hormones & Autacoids 419 Sympathetic Nervous System 419 12. Adrenal Medulla & Paraganglia . Paul A. Fitzgerald, MD History 422 Anatomy 423 Hormones of the Adrenal Medulla 424 Catecholamines 424 Other Hormones Secreted by the Adrenal Medulla 435 Disorders of Adrenal Medullary Function 435 Adrenal Medullary Hypofunction (Epinephtme Deficiency) 435 Adrenal Medullary Hyperfunction 437 Pheochromocytoma 437 421 13. Testes. Glenn D. Braunstein, MD Anatomy & Structure-Function Relationships 470 Testes 470 Accessory Structures 472 Physiology of the Male Reproductive System 472 Gonadal Steroids 472 Control of Testicular Function 475 Evaluation of Male Gonadal Function 476 Clinical Evaluation 476 Laboratory Tests of Testicular Function 477 Pharmacology of Drugs Used to Treat Male Gonadal Disorders 479 Androgens 479 Gomdotropins 481 Gonadotropin-Releasing Hormone 481 470 Clinical Male Gonadal Disorders 481 Klinefelter's Syndrome (XXY Seminiferous Tubule Dysgenesis) 482 Bilateral Anorchia (Vanishing Testes Syndrome) 484 Leydig Cell Aplasia 485 Cryptorchidism 485 Noonan's Syndrome (Male Turner's Syndrome) 487 Myotonie Dystrophy 488 Adult Seminiferous Tubule Failure 488 Adult Leydig Cell Failure (Andropause) 490 Male Infertility 490 Erectile Dysfunction (Impotence) 493 Gynecomastia 495 Testicular Tumors 497 14. Female Reproductive Endocrinology & Infertility .502 Mitchell P. Rosen, MD, & Marcelle I. Cedars, MD Menopause 537 Oocyte Depletion 538 508 Embryology & Anatomy 502 Ovarian Steroidogenesis 505 Physiology of Folliculogenesis & the Menstrual Cycle Menstrual Disturbances 517 Amenorrhea 517 Hypothalarnic Amenorrhea 520 Pituitary Amenorrhea 522 Ovarian Amenorrhea 524 Anovulation 527 Obesity 534 Outflow Tract Disorders 536 p Endocrine System Changes with Aging 539 Menopausal Consequences 540 Infertility 543 Diagnosis of Infertility 543 Management of the Infertile Couple 545 Contraception 546 Oral Contraceptives 546 Contraception: Long-Acting Contraceptives 552 Emergency Contraception 559 15. Disorders of Sexual Determination & Differentiation .562 Felix A. Conte, MD, & Melvin M. Grumbach, MD Normal Sex Differentiation 562 Atypical Sex Differentiation 574 Testicular & Ovarian Differentiation 568 Klinefelter's Syndrome and Its Variants: Seminiferous- Psychosaual Differentiation 574 Tubule Dysgenesis 574 CONTENTS / vii Syndrome of Gonadal Dysgenesis: Turner's Syndrome & Its Variants 577 Individuals with Both Ovarian and Testicular Tissue (True Hermaphroditism) 583 Female Pseudohermaphroditism 584 P450 Aromatase Deficiency 590 Maternal Androgens & Progestogens 591 Male Pseudohermaphroditism 591 Unclassified Forms of Abnormal Sexual Development in Males 602 Unclassified Forms of Abnormal Sexual Development in Females 603 Management of Patients with Intersex Problems 603 ló.Puberty . Dennis Styne, MD Physiology of Puberty 611 Delayed Puberty or Absent Puberty (Sexual Infantilism) 620 .611 Precocious Puberty (Sexual Precocity) 631 17. The Endocrinology of Pregnancy .641 Robert N. Taylor, MD, PhD, &Dan I. Lebovic, MD, MA Conception & Implantation 641 Endocrinology of the Puerperium 653 Fetal-Placental-Decidual Unit 642 Endocrine Disorders & Pregnancy Pituitary Disorders 655 Polypeptide Hormones 645 Pregnancy & Breast Cancer 656 Steroid Hormones 646 Hypertensive Disorders of Pregnancy 657 Maternal Adaptation to Pregnancy 647 Hyperthyroidism in Pregnancy 658 Fetal Endocrinology 651 Hypothyroidism in Pregnancy 659 Endocrine Control of Parturition 652 18. Pancreatic Hormones & Diabetes Mellitus .661 Umesh Masharani, MB, BS, MRCPfUK), & Michael S. German, MD The Endocrine Pancreas 662 Oral Glucose Tolerance Test 687 Anatomy & Histology 662 Insulin Levels 687 Hormones of the Endocrine Pancreas 662 Intravenous Glucose Tolerance Test 687 Diabetes Mellitus 672 Diet 692 Classification 672 Agents for the Treatment of Hyperglycemia 693 Type 1 Diabetes Mellitus 673 Insulin 701 Type 2 Diabetes 675 Steps in the Management of the Diabetic Patient 707 Other Specific Types of Diabetes 677 Hypoglycemia 713 Clinical Features of Diabetes Mellitus 680 Coma 715 Type 1 Diabetes 681 Specific Chronic Complications of Diabetes Mellitus Type 2 Diabetes 681 727 Urinalysis 682 Diabetic Patients Regulated by Diet Alone 734 Blood Glucose Testing 683 Diabetic Patients Taking Oral Hypoglycémie Serum Ketone Determinations 685 Agents 734 Glycated Hemoglobin Assays 685 Diabetic Patients Taking Insulin 734 Lipoproteins in Diabetes 686 19. Hypoglycémie Disorders .748 Umesh Masharani, MB, BS, MRCPÇUK), & Stephen E. Gitelman, MD Pathophysiology of the Counterregulatory Response to Symptomatic Fasting Hypoglycemia without Neuroglycopenia 748 Hyperinsulinism 762 Classification of Hypoglycémie Disorders 753 Nonfasting Hypoglycemia (Reactive Clinical Presentation of Hypoglycemia 754 Hypogiycemia) 763 Specific Hypoglycémie Disorders 755 Congenital Hyperinsulinism 764 Symptomatic Fasting Hypoglycemia with Hyperinsulinism 755 20. Disorders of Lipoprotein Metabolism .770 Maryj. Malby, MD, &John P. Kane, MD, PhD Atherosclerosis 770 Clinical Descriptions of Primary & Secondary Disorders of Overview of Lipid Transport 771 Lipoprotein Metabolism 777 Differentiation of Disorders of Lipoprotein Metabolism 775 Primary Hypertrigiyceridemia 777 Secondary Hypertrigiyceridemia 781 viii / CONTENTS Familial Hypercholesterolemia 783 Familial Combined Hyperlipidemia 784 Lp(a) Hyperlipoproteinemia 784 Familial Ligand-Defective Apo Б 784 Cholesterol 7-<X-Hydroxylase Deficiency 784 Hypothyroidism 784 Nephrosis 784 Immunoglobulin Disorders 785 Anorexia Nervosa 785 Cholestasis 785 Primary Hypolipidemia Due to Deficiency of High- Density Lipoprotems 785 Primary Hypolipidemia Due to Deficiency of Apo B- Containing Lipoproteins 787 The Lipodystrophies 788 Rare Disorders 788 Treatment of Hyperlipidemia 789 Bile Acid Séquestrants 791 Niacin(NicotinicAcid) 792 Fibric Acid Derivatives 792 HMG-CoA Reducíase Inhibitors 793 Cholesterol Absorption Inhibitors 793 Combined Drug Therapy 794 21. Obesity & Overweight .796 Marc К Hellerstein, MD, PhD, á Elizabeth J. Parks, PhD Type 2 Diabetes Mellitus 813 Hyperlipidemia 813 Polycystic Ovarian Syndrome 813 Hypertension 813 Gallstones 815 Sleep Apnea 815 Osteoarthritis & Other Weight-Sensitive States 815 A Systematic Approach to the Treatment of Obesity 815 Clarification of Uncertainties Regarding the Pathogenesis of Obesity 807 Survey of Treatment Approaches & Their Efficacy 808 Diet 8c Exercise 808 Exercise 810 Surgical Treatment of Obesity 810 Pharmacologie Therapies 810 Other Conditions Affected by Treatment of Obesity or Overweight 813 22. Humoral Manifestations of Malignancy .817 Dolores Shoback, MD, & Janet L. Funk, MD Ectopie Hormone & Receptor Syndromes 817 Non-Islet Cell Tumors & Hypoglycemia 825 Hypercalcemia of Malignancy 818 Other Hormones Secreted by Tumors 826 Ectopie Cushing's Syndrome 821 Oncogenic Osteomalacia 827 Syndrome of Inappropriate Antidiuretic Hormone Gut Hormones 828 Secretion 824 23. Multiple Endocrine Neoplasia ., David G. Gardner, MD Multiple Endocrine Neoplasia Type 1 (MEN 1) 831 Multiple Endocrine Neoplasia Type 2 (MEN 2) 836 831 Other Disorders Characterized by Multiple Endocrine Organ Involvement 841 24. Geriatric Endocrinology . Susan L. Greenspan, MD, &NeilM. Resnick, MD Thyroid Function & Disease 844 Disorders of the Thyroid Gland 845 Carbohydrate Intolerance & Diabetes Mellitus 849 Aging & the Physiology of Carbohydrate Intolerance 849 Diabetes Mellitus 849 Nonketotic Hyperosmolar Coma 852 Osteoporosis & Calcium Homeostasis 853 Osteoporosis 853 Hyperparathyroidism 860 844 Changes in Water Balance 861 Hypematremia 861 Hyponatremia 861 Hyporeninemic Hypoaldosteronism 862 Glucocorticoids & Stress 862 Disorders of the Hypothalamic-Pituitary-Adrenal Axis 862 Changes in Reproductive Function in Men 863 Benign Prostatic Hyperplasia 865 25. Endocrine Emergencies . David G. Gardner, MD MyxedemaComa 868 Thyroid Storm 870 Thyrotoxic Periodic Paralysis 871 Amiodarone-Induced Thyrotoxicosis 872 868 Acute Adrenal Insufficiency 873 Pituitary Apoplexy 874 Diabetic Ketoacidosis 875 Nonketotic Hyperosmolar Coma 879 CONTENTS / ix Hyponatremia 886 Diabetes Insipidus 889 .894 Pituitary Disorders 901 Lipid Disorders 904 Conclusion 908 .911 The Adrenal (Suprarenal) Gland 923 Embryology & Anatomy 923 Primary Hyperaldosteronism 924 Hypercortisolism 924 Adrenal Cortical Carcinoma 925 Sex Steroid Excess 925 Pheochromocytoma 925 Adrenal Incidemaloma 926 Technique of Adrenalectomy 927 The Endocrine Pancreas 927 Embryology & Anatomy 927 Insulinoma 927 Gastrinoma (Zollinger-Ellison Syndrome) 929 VIPoma (Verner-Morrison) Syndrome 930 Głucagonoma 930 Somatostatinoma 930 Nonfunctioning Pancreatic Tumors 930 933 958 Hypercalcemic Crisis 882 Acute Hypocalcemia 884 26. AIDS Endocrinopathies . Grace Lee, MD, & Carl Grunfeld, MD, PhD Thyroid Disorders 894 Adrenal Disorders 896 Bone & Mineral Disorders 898 Gonadal Disorders 900 27. Endocrine Surgery . Geeta Lai, MD, & Orlo H. Clark, MD The Thyroid Gland 911 Embryology & Anatomy 911 Developmental Thyroid Abnormalities 911 Hyperthyroidism 912 Thyroiditis 913 Goiter (Non toxic) 913 Thyroid Nodules 913 Thyroid Cancer 914 Conduct of Thyroidectomy 916 The Parathyroid Gland 917 Embryology & Anatomy 917 Primary Hyperparathyroidism (PHPT) 919 Persistent & Recurrent Primary Hyperparathyroidism 922 Secondary Hyperparathyroidism 922 Special Consideration: Familial Hyperparathyroidism 923 Complications of Parathyroid Surgery 923 Appendix: Normal Hormone Reference Ranges Index . THE #1 ALL-INCLUSIVE ENDOCRINOLOGY REFERENCE TEXT—COMPLETELY REVISED AND UPDATED Edition after best-selling edition, Greenspan's Basic & Ciinical Endocrinology succeeds in delivering the scientific principles of endocrinology and in matching those to the clinical management of patients with endocrine-related diseases and disorders. Step by step, Greenspan's provides clinically relevant perspectives on metabolic bone disease, pancreatic hormones and diabetes mellitus, hypoglycemia, obesity, geriatric endocrinology, and many other diseases and disorders. Supporting this essential coverage is a handy appendix of normal hormone reference ranges. New to the Eighth Edition: ► Recent advances in motecufer endocrinology ► Current concepts in en¬ docrine pathophysiology to aid clinical decision- making ► Updated with the most practical, current insights into diagnostic testing ► Important new approaches to the medical management of endocrine disorders, in- recommenda-tíoris
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spelling	Greenspan's Basic & clinical endocrinology ed. by David G. Gardner .... Greenspan's Basic and clinical endocrinology Basic & clinical endocrinology Basic and clinical endocrinology 8. ed. New York [u.a.] MacGraw-Hill Medical 2007 XIV, 1010 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier A Lange medical book Endocrinología Enfermedades de las glándulas endocrinas Glándulas endocrinas - Fisiología Hormonas - Fisiología Physiologie (DE-588)4045981-0 gnd rswk-swf Endokrinologie (DE-588)4014663-7 gnd rswk-swf Endokrinium (DE-588)4152176-6 gnd rswk-swf Endokrinopathie (DE-588)4113435-7 gnd rswk-swf (DE-588)4151278-9 Einführung gnd-content Endokrinologie (DE-588)4014663-7 s DE-604 Endokrinium (DE-588)4152176-6 s Physiologie (DE-588)4045981-0 s Endokrinopathie (DE-588)4113435-7 s 1\p DE-604 Gardner, David G. Sonstige oth Greenspan, Francis S. Sonstige oth Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016265013&sequence=000003&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016265013&sequence=000004&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA Klappentext 1\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk
spellingShingle	Greenspan's Basic & clinical endocrinology Endocrinología Enfermedades de las glándulas endocrinas Glándulas endocrinas - Fisiología Hormonas - Fisiología Physiologie (DE-588)4045981-0 gnd Endokrinologie (DE-588)4014663-7 gnd Endokrinium (DE-588)4152176-6 gnd Endokrinopathie (DE-588)4113435-7 gnd
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title	Greenspan's Basic & clinical endocrinology
title_alt	Greenspan's Basic and clinical endocrinology Basic & clinical endocrinology Basic and clinical endocrinology
title_auth	Greenspan's Basic & clinical endocrinology
title_exact_search	Greenspan's Basic & clinical endocrinology
title_exact_search_txtP	Greenspan's Basic & clinical endocrinology
title_full	Greenspan's Basic & clinical endocrinology ed. by David G. Gardner ....
title_fullStr	Greenspan's Basic & clinical endocrinology ed. by David G. Gardner ....
title_full_unstemmed	Greenspan's Basic & clinical endocrinology ed. by David G. Gardner ....
title_short	Greenspan's Basic & clinical endocrinology
title_sort	greenspan s basic clinical endocrinology
topic	Endocrinología Enfermedades de las glándulas endocrinas Glándulas endocrinas - Fisiología Hormonas - Fisiología Physiologie (DE-588)4045981-0 gnd Endokrinologie (DE-588)4014663-7 gnd Endokrinium (DE-588)4152176-6 gnd Endokrinopathie (DE-588)4113435-7 gnd
topic_facet	Endocrinología Enfermedades de las glándulas endocrinas Glándulas endocrinas - Fisiología Hormonas - Fisiología Physiologie Endokrinologie Endokrinium Endokrinopathie Einführung
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016265013&sequence=000003&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016265013&sequence=000004&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA
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