Endocrinology has been written to meet the requirements of today's trainee doctors and the demands of an increasing number of degree courses in health and biomedical sciences, and allied subjects. It is a truly integrated text using large numbers of real clinical cases to introduce the basic biochemistry, physiology and pathophysiology underlying endocrine disorders and also the principles of clinical diagnosis and treatment. The increasing importance of the molecular and genetic aspects of endocrinology in relation to clinical medicine is explained.

Contents

• Preface
• Chapter 1. Principles of endocrinology
  • Functions of hormones and their regulation
  • Chemical signalling - endocrine, paracrine, autocrine and intracrine mechanisms
  • Chemical classification of hormones and their synthesis
  • Hormone synthesis
  • Transport of hormones in the circulation and their half-lives
  • Hormone receptors - cell surface
  • Hormone receptors - intracellular
  • Hormones and gene transcription
  • Hormone receptor regulation
  • Neuroendocrine interactions
  • Hormones and the immune system
  • Hormones, growth promotion and malignancy
  • Genes, mutations and endocrine function
  • Clinical evaluation of endocrine disorders
• Chapter 2. The endocrine pancreas
  • Glucose turnover
  • Anabolic and catabolic phases of glucose metabolism
  • Actions of insulin and glucagon
  • Lipid metabolism - insulinopenia and diabetic ketosis
  • Protein metabolism and the anabolic actions of insulin
  • Definition and diagnosis of diabetes mellitus
  • Etiology of type 1 DM
  • Prevention of type 1 DM
  • Structure, synthesis and metabolism of insulin and glucagon
  • Anatomical features of pancreatic islets in relation to hormone secretion and its control
  • Control of insulin and glucagon secretion
  • Type 2 DM
  • Causes of DM
  • Genetic disorders of β-cell function
  • Counter-regulatory hormones and DM
  • Complications of DM
  • Macrovascular circulatory changes
  • Microvascular changes - diabetic retinopathy, nephropathy and neuropathy
  • Diabetes and the neuropathic foot
  • Diabetes and insulin resistance of pregnancy
  • Development of the pancreas: effects of DM on organogenesis
  • Treatment of DM - rationale and practical considerations
  • Hypoglycemia
  • Physiological responses to hypoglycemia and its treatment
  • Hypoglycemia and insulinoma
  • Hypoglycemia in infancy
  • Disorders of the α, γ and PP cells of the islets
  • Clinical case questions
• Chapter 3. The thyroid gland
  • Iodine intake
  • Anatomical features of the thyroid gland
  • Iodine trapping and thyroid function
  • Synthesis of thyroid hormones
  • Actions of thyroid hormones
  • Control of thyroid hormone synthesis and secretion
  • Hyperthyroidism — Graves' disease
  • Surgical anatomy and embryology of the thyroid gland
  • Primary hypothyroidism — Hashimoto's disease and myxedema
  • Secondary hypothyroidism
  • Hypothyroidism in infancy and childhood
  • Thyroid hormone resistance
  • Non-thyroid illness (‘sick euthyroid’ syndrome)
  • Transport and metabolism of thyroid hormones
  • Biochemical measurements of thyroid hormone status
  • Thyroid growth
  • Nodular thyroid disease
  • Thyroid cancer
  • Clinical case questions
• Chapter 4. The adrenal gland
  • Specificity of the biological effects of adrenal steroid hormones
  • Cholesterol and steroid synthesis in the adrenal cortex
  • Anatomical and functional zonation in the adrenal cortex
  • Glucocorticoid receptors
  • Actions of glucocorticoids and clinical features of Cushing's syndrome
  • Adrenal cortical androgens
  • Hypothalamic control of adrenocortical steroid synthesis - CRH and vasopressin
  • Pituitary control of adrenocortical steroids - ACTH
  • Feedback control of glucocorticoids
  • Excess glucocorticoids: biochemical investigation of Cushing's syndrome
  • Measurements of cortisol in blood, urine and saliva
  • Dynamic tests of endocrine function
  • Imaging the adrenal gland
  • Treatment of Cushing's syndrome
  • Nelson's syndrome
  • Excess adrenal androgens - congenital adrenal hyperplasia (CAH)
  • Deficiency of adrenocortical secretions - Addison's disease
  • Aldosterone and the control of salt and water balance
  • Transport and metabolism of adrenocortical steroids
  • Selective mineralocorticoid excess and deficiency
  • The adrenal medulla and pheochromocytoma
  • Catecholamine synthesis and secretion
  • Diagnosis and treatment of pheochromocytomas
  • Clinical case questions
• Chapter 5. The parathyroid glands and vitamin D
  • Calcium and phosphate in serum and its measurement
  • Intracellular calcium concentration
  • Calcium and phosphate balance
  • Hormonal control of serum Ca²⁺ and P_i concentrations
  • Sources, metabolism and transport of vitamin D
  • Classical actions of vitamin D on intestine and bone
  • Parathyroid glands and PTH synthesis
  • Control of PTH secretion
  • Actions of PTH
  • Hypercalcemia and primary hyperparathyroidism
  • Hyperparathyroidism and multiple endocrine neoplasia (MEN)
  • Hypercalcemia and vitamin D excess
  • Hypercalcemia and malignancy
  • Parathyroid hormone-related peptide (PTHrp)
  • Treatment of hypercalcemia
  • Mutations of the Ca²⁺ or PTH receptors
  • Hypocalcemia and its treatment
  • Pseudohypoparathyroidism
  • Vitamin D deficiency
  • Non-classical actions of vitamin D
  • Vitamin D resistance and rickets
  • Hormones and the skeleton
  • Structure, formation and function of bone
  • Osteoporosis
  • Paget's disease (osteitis deformans)
  • Calcitonin and calcitonin gene-related peptide
  • Clinical case questions
• Chapter 6. The gonad
  • Genetic determination of sexual differentiation
  • Sexual differentiation of the gonads and internal reproductive tracts
  • Sexual differentiation of the external genitalia
  • Control of steroid production in the fetal gonads
  • Puberty
  • GnRH and the control of gonadotrophin synthesis and secretion
  • The gonadotrophins - LH and FSH - and their actions
  • Endocrine changes in puberty
  • Precocious sexual development
  • Delayed puberty
  • Premature adrenarche
  • Acne, hair growth and hirsutism
  • The breast - premature development, hypoplasia and gynecomastia
  • Testicular function
  • Control of testicular function
  • Transport, metabolism and actions of androgens
  • Spermatogenesis
  • Erection and ejaculation
  • Ovarian control and the menstrual cycle
  • Transport, metabolism and actions of ovarian steroids
  • The ovary - folliculogenesis and oogenesis
  • Non-steroidal factors in the control of the hypothalamic-pituitary-gonadal axis
  • Ovulation, menstruation and its problems
  • Polycystic ovary syndrome (PCOS)
  • Contraception
  • Infertility
  • Ovulation induction and assisted conception
  • Ovarian failure, the menopause and andropause
  • Hormonal replacement therapy (HRT) and selective estrogen receptor modulators (SERMS)
  • Clinical case questions
• Chapter 7. The pituitary gland
  • Anatomical and functional connections of the hypothalamo-pituitary axis
  • Embryology of the pituitary gland
  • Craniopharyngioma
  • Blood supply of the hypothalamo-pituitary axis
  • Sheehan's syndrome
  • Growth and somatotrophin deficiency
  • Growth hormone - secretory patterns and control
  • Actions of growth hormone and insulin-like growth factors
  • GH replacement therapy
  • GH excess - gigantism and acromegaly
  • Pituitary adenomas - incidence and treatment
  • Prolactinomas
  • Prolactin and its control
  • Circadian rhythms and the suprachiasmatic nucleus
  • The pineal gland and melatonin
  • Autonomic functions of the hypothalamus
  • Obesity
  • The neural lobe of the pituitary gland - AVP and oxytocin
  • Clinical case questions
• Chapter 8. Cardiovascular and renal endocrinology
  • Endocrinology of heart failure
  • Paracrine and autocrine regulation of blood pressure: the endocrinology of sepsis
  • Hormones and blood cell production - erythropoietin
  • Carcinoid
  • Clinical case questions

The information contained within this book was obtained by BIOS Scientific Publishers Ltd from sources believed by us to be reliable. However, while every effort has been made to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to any person acting or refraining from action as a result of information contained herein can be accepted by the authors or publishers.

The reader should remember that medicine is a constantly evolving science and while the authors and publishers have ensured that all dosages, applications and practices are based on current indications, there may be specific practices which differ between communities. You should always follow the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which you are practising.