By Shlomo Melmed MBChB MACP, Kenneth S. Polonsky MD, P. Reed Larsen MD FRCP, Henry M. Kronenberg MD
The most recent version of Williams Textbook of Endocrinology edited via Drs. Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, and Henry M. Kronenberg, is helping you diagnose and deal with your sufferers successfully with up-to-the minute, useful information on all endocrine procedure issues. accomplished but obtainable, this largely revised twelfth variation updates you on diabetes, metabolic syndrome, weight problems, thyroid affliction, testicular issues, and masses extra so that you supplies your sufferers with the main profitable remedies. locate clinical perception and scientific facts interwoven in each bankruptcy, reflecting advances in either components of this always altering self-discipline, and awarded in a really obtainable structure. you will additionally entry useful contributions from a dynamic checklist of professional authors and approximately 2.000 full-color pictures that can assist you with each prognosis. besides handy on-line entry at www.expertconsult.com, this identify has every little thing you must deal with any and all of the medical endocrinopathies you'll encounter.Rely at the one reference that integrates speedily evolving simple and medical technology in a cohesive, hassle-free layout, definitively addresses each subject within the box, and has remained a regular for greater than part a century. replace your information and abilities to diagnose and deal with your sufferers so much successfully with exhaustively revised content material on diabetes, metabolic illness, thyroid melanoma, fertility difficulties, testicular difficulties, weight matters, and lots more and plenty extra. follow trustworthy counsel on endocrine stipulations of growing to be curiosity like hypothyroidism and testicular issues, with committed new chapters that expound at the most recent study findings. conquer any medical problem with complete and easy-to-use insurance of every little thing from hormone task, diagnostic strategies, imaging modalities, and molecular genetics, to overall care of the sufferer. follow the most recent practices with suggestions from specialist authors who give a contribution clean views on each subject. seek the whole contents on-line, obtain all of the photos, and entry hyperlinked references to PubMed at www.expertconsult.com. Your principal resource for authoritative endocrinology counsel.
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Example text
A sellar mass in a patient with diabetes insipidus is unlikely to be a simple pituitary adenoma; it is more likely to be a craniopharyngioma or the result of infiltrative disease. • Diffuse enlargement of the pituitary after pregnancy is most likely caused by lymphocytic hypophysitis. • Primary hypothyroidism can cause diffuse reversible pituitary enlargement and mild hyperprolactinemia. Serum TSH should therefore be measured in cases of diffuse pituitary enlargement and as part of an evaluation for hyperprolactinemia.
An important part of evaluating large goiters is CT imaging (without contrast) or MRI to exclude compression of local structures. Until recently, it was standard practice to obtain imaging studies of patients with primary hyperparathyroidism only if they were going to have surgery. But now clinicians sometimes image patients with “asymptomatic” primary hyperparathyroidism to help both the patient and the clinician decide whether surgery may be preferable to observation. , unexplained fatigue) that do not meet the guideline criteria or to prevent bone loss in the future.
Cinacalcet, an activator of the calcium-sensing receptor, is effective in lowering PTH levels in the secondary hyperparathyroidism of renal failure; it also lowers the calcium-phosphate product and is used as part of dialysis treatment. However, although this agent also lowers serum calcium and PTH in primary hyperparathyroidism, it does not improve bone density. The medical therapy for Cushing’s disease is still primitive. Although recurrent Cushing’s is often treated with drugs such a ketoconazole, normalization of cortisol is rarely achieved.
