Historically, clinical decisions in renal medicine have been challenged by the scarce availability of robust supportive evidence. Not only are the number of randomized controlled trials (RCTs) in Nephrology the third lowest amongst the medical specialties but in many instances the trials themselves are of poor quality. In addition, practice has been further influenced by extrapolation from the outcomes of general population clinical trials which exclude renal patients. The difference between the ideal trial participant and real complex cases encountered in daily practice is well recognized and further compounded in renal patients with complex pathophysiology - this ultimately makes decision making in this subset of patients a real challenge. Recently, there has been a growing interest in conducting well designed RCTs in different areas of renal medicine. However, though clinical guidelines are helpful in providing the clinicians with a frame of best available evidence for a clinical condition, it denies the unique nature of each individual patient. This book offers a thorough and critical appraisal and evaluation of the key published clinical trials that have shaped current practice in nephrology, dialysis and transplantation. It will help the practicing physician close the gap between the inflexible and generalized nature of clinical guidelines and the day-to-day clinical decision-making for individual patients. It will provide the clinician with the tools required to investigate and extract the appropriate guidance to apply to individual cases in daily practice. Moreover, it will help improve the ability of junior colleagues to appraise available evidence in a systematic way when there is lack of local guidelines or when the guidelines are difficult to apply due to logistic constraints or barriers. Lastly, this book will serve as a reference for key clinical trials in different areas of renal medicine together with literature and authors views of these trials and their impact on changing practice.​ 

Any surgical intervention, elective or acute, may lead to postoperative complications. Moreover, the pertaining approach - laparoscopic or open - will probably not differ in the morbidity rate after surgery. Complications that occur after a surgical intervention can be classified as major or minor. Major complications to the digestive tract after surgery imply in most of cases a leakage of an anastomosis, bleeding in the abdominal cavity or in the tract, the appearance of intraperitoneal abscesses, or surgical site infections and wound dehiscence. These complications, depending on the organ affected, upper GI, HPB tract or colorectal, are associated with high morbidity and mortality. Early suspicion and diagnosis, followed by an early and effective treatment is imperative in order to reduce the morbidity and mortality. Adequate treatment will involve a good coordination of the three disciplines involved in treatment: the surgeon, the intervention radiologist, and the gastroenterologist. Approach of these postoperative complications is changing constantly and these changes are not properly known by general and more specialized digestive surgeons daily involved in the treatment of these diseases. The proposal for this book is to offer a systematic description of the most frequent complications occurring in the three above mentioned parts of the digestive tract. In this way, the reader will have access to a practical book in which every current complication can be easily recognized, along with relevant information as guide for an adequate treatment.

This volume offers an up-to-date overview on the major areas of gynecological endocrinology, presenting the latest advances in adolescent gynecological endocrinology, assisted reproduction, menstrual-related disorders, sexuality and transsexualism, polycystic ovary syndrome, myometrial pathology and adenomyosis, obesity and metabolic syndrome, hormonal contraception, premature ovarian failure and menopause. In each chapter the recent advances deriving from basic science and clinical investigations are related to the practical management of the condition under consideration, taking into account the need for individualized therapies. The book is published within the ISGE Book Series, a joint venture between the International Society of Gynecological Endocrinology and Springer and is based on the 2014 International School of Gynecological and Reproductive Endocrinology Winter Course. It will be an important tool for obstetricians and gynecologists, endocrinologists and experts in women's health as well as interested GPs.

​This book provides up-to-date information on all aspects of autoimmune pancreatitis, a unique form of pancreatitis characterized clinically by frequent presentation with obstructive jaundice and dramatic response to steroids, histologically by a lymphoplasmacytic infiltrate with fibrosis, and radiologically by pancreatic enlargement. Current concepts regarding the disease and its classification into subtypes 1 and 2 are explained, and clinical, serological, and histopathological findings are carefully described. Imaging features on all the relevant modalities are illustrated, covering both the pancreas and other involved organs. Current and emerging therapeutic strategies, including steroids, immunomodulatory drugs, and rituximab, are then discussed. The reader will find the book to be an excellent aid to the diagnosis of autoimmune pancreatitis and its differentiation from pancreatobiliary malignancies, as well as a clear guide to treatment.

The world is beset by a pandemic of obesity and type 2 diabetes and the need for new drugs is startlingly clear; recent years have seen a huge increase in research activity to fill this gap. The development of new drugs for diabetes and obesity must be founded upon a sound appreciation of the pathophysiology of these common disorders. The dual defects of insulin resistance and impaired insulin secretion are fundamental to the pathogenesis and progression of obesity-associated type 2 diabetes. There is a need to explain how new drugs can counter insulin resistance and insulin deficiency to a broad range of professionals, from clinical scientists active in early (and later) phase drug development to specialist physicians and increasingly primary care doctors who must tailor drug regimens to the individual patient. Clinical research methods for measuring insulin action and insulin secretion have become well-established in proof-of-mechanism studies; however, selection of the best techniques is by no means straightforward. The purpose of the book is to aid the selection of the most appropriate techniques for assessing insulin action, insulin secretion and body composition in humans (with particular reference to new drugs) in phase 1 and 2 studies and aid the understanding of drug effects and non-drug treatment strategies on key biochemical-hormonal defects of obesity and type 2 diabetes. The book will assume a working knowledge of human physiology relating to glucose metabolism and will be of interest to biomedical scientists, pharmacologists, academics involved in metabolic research and clinicians practicing in these specialties.

This new volume provides a plethora of new information about potential medicinal herbs and their usefulness in treating diabetes and neurological diseases. Most large multinational companies are interested and engaged in the commercialization of herb-based formulations, and consumers continue to seek natural-based therapies. Herbs for Diabetes and Neurological Disease Management provides insight into plant-based novel molecules targeted for diabetes and neurological disorders. It looks at a selection of herbs that have proven effective in the management of diabetes and neurological disorders, including migraine, epilepsy, memory disorders, depression, and more. Divided into ten chapters focusing on diabetes and its macro- and microvascular complications (migraine, epilepsy, memory disorders, depression and other neuropsychiatric disorders), this book is structured to provide a source of reliable information and enrich the knowledge of readers. Each chapter briefly explains the epidemiology and pathophysiology of the disease state and the possible role of herbal drugs in the prevention of the particular disease. The reported pharmacological activities and possible mechanism of action of herbal drugs are also discussed in detail, which makes this book informative and unique. This new volume will be a reliable reference complementing the substantial information on the use of herbal drugs in diabetes and neurological disorders that serve as the pillars of drug discovery and development.

Primary Aldosteronism (PA) is a disease caused by the overproduction of aldosterone hormone from the adrenal glands. PA causes hypertension and the majority with this disease are undiagnosed for PA. There are new insights into this matter by using biochemistry as well as advanced radiology. In 2011, a breakthrough in the genetic derangements came, identifying a mutated potassium channel gene - KCNJ5 - in about 40% of PA with adenoma. Chapters in this book include a history of the disorder, epidemiology, genetics derangements, the KCNJ5 mutations and phenotype and more.

The purpose of the The Active Female: Health Issues Throughout the Lifespan, 2nd Edition is twofold: (1) to increase the awareness of wellness and fitness issues for active females and their family members; and (2) to provide an avenue for medical practitioners, allied health professionals, health educators, and certified individuals in sports medicine to gain critical, updated knowledge of a field specific to active females. Part I of the book offers a foundation to help the reader understand the interrelationship among body image concerns, the female reproductive cycle, and musculoskeletal anatomy/physiology of females that makes their health risks and concerns unique. Reproductive health is discussed by a prominent researcher in reproduction/endocrinology. An overview of the Female Athlete Triad which is a syndrome of three interrelated conditions (isordered eating, menstrual disturbances and bone loss) is presented in Part II. Physicians and certified professionals in sports medicine discuss the individual components of the triad, relating not only to the athletic female but also to the recreationally active woman throughout the lifespan. In Part III, Prevention and management of common musculoskeletal injuries is addressed by a female orthopedic surgeon who sub-specializes in treating female athletes. Finally, appropriate exercise and nutritional guidelines for active females are discussed in Parts IV-V of the book by certified professionals and licensed physicians in sports medicine. An invaluable addition to the literature, The Active Female: Health Issues Throughout the Lifespan, 2nd Edition will be of great interest to physicians, allied health care practitioners, medical/other wellness educators, and students who are interested in advancing women's health issues. Sports medicine specialists, family practitioners, gynecologists, team physicians, residents in sports medicine, athletic trainers, health educators, nurses, physicians assistants, physical therapists, sport psychologists, counselors, athletic trainers, and other members of the sports medicine team should also find this title of significant interest.

Studies on Diabetes examines how increased oxidative and nitrosative stress - one of the leading causes of diabetes complications - pathologically affects multiple tissues in the body. The volume editors and chapter authors are leading investigators in the field of basic and clinical research in diabetes and vascular disease. Their contributions represent a wealth of knowledge on and research into how diabetes triggers metabolic abnormalities that lead to hyperactivation of cellular and mitochondrial pathways that ultimately result in oxidative and nitrosative stress that left un-neutralized, results in tissue damage. Each chapter provides the reader with invaluable insight to the complicated mechanisms responsible for diabetes complications and vascular disease. Potential treatments for diabetes complications from animal models to the patient will also be discussed. This is essential reading for researchers and clinicians in endocrinology, diabetes, vascular disease and oxidative stress.

Endocrinology, and diabetes care in particular, is a dynamic field where clinicians must translate new evidence into clinical practice at a rapid pace. Designed in an engaging, case-based format, Endocrinology and Diabetes: A Problem Oriented Approach offers a wide range of thought-provoking case studies that reflect contemporary, challenging, hands-on clinical care. Further, by providing a list of specific clinical problems, this format offers the reader a more convenient and pointed way to solve precise clinical problems in a timely manner. Developed by a renowned, international group of experts, this comprehensive title covers the most common clinical problems in endocrinology and diabetes and should be of great interest to endocrinologists, diabetologists, internal medicine physicians, family physicians, fellows, and residents.

Androgens play a critical role in the development and maintenance of the male reproductive system and affect important physiological processes and pathological conditions, including the homeostasis of the normal prostate and prostate cancer. Androgen Action: Methods and Protocols is designed to provide a tool box to study various phases of androgen action, from its entry to the cell to the phenotypic response that the cell mounts, with up-to-date techniques for biochemists, molecular biologists, cell biologists, geneticists, and pathologists. The volume opens with a brief review of the research history on androgen action and prostate carcinogenesis, followed by chapters that cover state-of-the-art methods to determine androgen levels in biological tissues and fluids, experimental procedures to study the various aspects of androgen receptor activity, and methodology to study salient examples of interactions between androgen signalling and other major signalling pathways in cells. Written in the successful Methods in Molecular Biology (TM) series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and easily accessible, Androgen Action: Methods and Protocols provides a comprehensive overview of, and practical guidance on, the diverse methodologies that are propelling androgen action research forward, both for normal physiology as well as in disease states.

Darwinian medicine looks at the ecological and evolutionary roots of disease. A disease is an interaction between a genome and its biotic or abiotic environment and therefore a disease is essentially an ecological process. Good understanding of ecology and a Darwinian way of thinking can give us novel and useful perspectives on health and disease. If we understand the disease process better, we can certainly prevent, control as well as treat diseases in a better way. Although the thought that the origins of obesity and type 2 diabetes (T2D) might lie in our hunter gatherer adaptations is not new, research over the last decade makes us rethink many of the classical concepts. Brain and behavior is increasingly being recognized as central to all the endocrine, metabolic and immunological changes that earmark type 2 diabetes and other metabolic syndrome disorders. A major change in paradigm appears to be on the horizon and the proposed book intends to speed up the paradigm shift by raising important questions, pointing out flaws and inadequacies in the prevalent paradigm and stimulating radical rethinking which would redirect and refine the line of research as well as bring some fundamental changes in drug discovery and clinical practice.

Recent Advances in Prolactin Research summarizes the current knowledge of prolactin (PRL), PRL receptor, PRL-dependent signaling pathways, the role of PRL in oncogenesis and PRL crosstalk with other oncogenic factors. The chapters are written by experts in these fields and focus on identifying and reviewing timely experimental findings that provide new insights into the expanding role of PRL in the pathophysiology associated with a variety of human conditions. Prolactin is a peptide hormone that is best known for its role in lactation. Prolactin also has an influence on hematopoiesis and angiogenesis, and is involved in the regulation of blood clotting through several pathways. Although PRL was discovered more than 80 years ago, the understanding of PRL signaling and its relationship to various pathologies is still very incomplete. PRL is not only a pituitary hormone with an important role in reproduction, but PRL also acts as a cytokine, modulating a wide variety of physiological processes. For example, data gathered during the last decade have demonstrated that locally produced PRL acts as the autocrine/paracrine factor and plays a contributory role during breast oncogenesis. In fact, the scientific and clinical communities have suggested that the manipulation of the PRL axis may lead to the successful treatment of breast cancer. However, recent work has demonstrated that the role of the PRL axis is much more complex than first envisaged.

Defining and understanding cellular and molecular mechanisms that are relevant to women's health has become a critical area of scientific pursuit. Until recently, very little effort has been place on defining or understanding critical differences between women and men that may be critical to the overall health of the woman. In 1990, the National Institutes of Health recognized this gap in knowledge resulting in the creation of the Office of Research on Women's Health. One of the purposes of this office was to advance the understanding of health issues from the women's perspective from both a basic and clinical scientific perspective. From a scientific evolution of understanding, the existence of this office is new and thus there has not been enough time for new information to integrate itself in our current scientific thought process. This book will seek to capture and disseminate our current understanding of scientific advancements relevant to women's health and provide the information to a broad audience. The purpose of this work is to discuss recent advancements in basic science across three areas of concern for women's health. In addition, the book will provide "translational" chapters that attempt to place the basic science work in context within our current understanding of the human. Although it is well acknowledge that gender differences exist across organ function which translates into differences in whole body function, until recently little effort has been made to define basic mechanisms within various tissues within the woman. This work will focus on recent scientific findings that are relevant to women's health and to provide novel and relevant information to interested scientists and clinicians.

The sustained skin research efforts over the past decades has led to the accumulation of a significant collection of information on skin structure and physiology as well as on the pathogenesis of cutaneous diseases. In Molecular Dermatology: Methods and Protocols, leading experts in the field provide a collection of state-of-the-art reliable protocols covering a wide spectrum of techniques and experimental models, specific molecular assays and disease models, as well as overviews of diagnostic and research areas relevant to molecular dermatology. As a volume in the highly successful Methods in Molecular Biology (TM) series, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Comprehensive and authoritative, Molecular Dermatology: Methods and Protocols emphasizes the vital importance of skin research and collects the methodologies necessary to aid scientists in moving forward in this valuable field.

This volume presents key topics of current interest with regard to several pathophysiological conditions including (a) the basic and clinical aspects of bradykinin receptor antagonists, (b) the kallikrein-kinin pathways in hypertension and diabetes, (c) tissue kallikrein-kinin therapy for hypertension and organ damage, (d) the renal (tissue) kallikrein-kinin system in the kidney and novel potential drugs for salt-sensitive hypertension, (e) the kallikrein-kinin system in diabetes retinopathy, and (f) genetic manipulation and genetic variation of the kallikrein-kinin system and their impacts on cardiovascular and renal disease. Written by internationally reputed scientists, the book provides an essential overview of the latest developments in the field of kinin research, making it a valuable asset for endocrinologists, nephrologists, cardiologists, pharmacologists, physiologists, ophthalmologists and rheumatologists. Furthermore, it is also intended for postgraduate students in the fields of medicine, pharmacy, physiology and pharmacology, and those working at research organizations.

This book outlines risk assessments for 28 diseases and medical conditions including the following aspects: genetics, biochemistry, serology, past medical history, family history, co-morbidities, age, gender, ethnicity, nutrition and lifestyle. Recommendations are made for how to avoid, eliminate or mitigate risks. Preventing measures concerning chemical compound intake, lifestyle and nutrition are proposed. The unique content and approach of the book to chronic disease management make it a state-of-the-art reference work, addressing a missing component of medical care and reflecting the cutting edge of preventive medicine.

Understanding the influence and interaction between physical activity and the endocrine system are of paramount importance in dealing with a multitude of health problems. In Endocrinology of Physical Activity and Sport, renowned physicians and researchers provide a comprehensive and expanded update on the scientific, clinical and practical components of endocrinology as related to sport and exercise. The authors thoroughly review what is known about how such activity effects the endocrine system and how in turn these hormonal responses affect many other organs and systems of the body. In addition, aspects of endocrinology in non-glandular tissue which have endocrine actions are addressed; for example, adipocytes and the release of leptin and related adipocytokines. Further, a wide range of clinically related topics such as athletic amenorrhea, osteopenia, sarcopenia, and hypogonadism are included. This new edition critically integrates what is known about the complex interaction of the endocrine system in the sports context and will again prove immensely valuable to all physicians and clinical investigators treating those active in sports today.

In recent years, human studies have made enormous contributions towards an understanding of the genetic basis of diabetes mellitus; however, most of the experimentation needed for the invention and testing of novel therapeutic approaches cannot be performed in humans. Thus, there is no alternative to appropriate animal models. In Animal Models in Diabetes Research, expert researchers explore the current status of the most important models and procedures in order to provide a timely resource in experimental diabetology. The first half of the volume serves as a comprehensive overview on our current knowledge of the pathogenesis and pathophysiology of diabetes in animal models through a series of reviews in model strains. The book then continues with vital, established protocols that are employed in the characterization and study of animal models of diabetes. As a volume in the highly successful Methods in Molecular Biology (TM) series, this work contains the type of detailed description and key implementation advice necessary to achieve successful results. Authoritative and cutting-edge, Animal Models in Diabetes Research delivers essential content that will be an important resource to advance diabetes research in the years to come.

The book covers areas of cellular physiology and metabolism that are of interest to scientists involved in research in diabetes and metabolic diseases. Some chapters of the book are specifically research-oriented, as all the authors are actively practicing either bench or clinical research in the area. Nonetheless, since the work is fully comprehensive of the discipline, it is also suitable for university classes of graduate and undergraduate students. In particular, the book discusses classical aspects of cellular physiology and the metabolism of physical exercise, as well as novel topics like exercise in transplantation and exercise in beta-cell failure, which mark the frontiers of research in sport-related sciences and research. Exercise physiologists, biologists and physicians are the specific professional and academic targets of this work. The team of authors together with the editor are world-renowned experts in the field of physiology and metabolism applied to sport sciences.

It is a pleasure to introduce this new book, Clinical and Pathological Aspects of Skin Diseases in Endocrine, Metabolic, Nutritional, and Deposition Disease, edited by two of my friends and respected colleagues, Franco Rongioletti and Bruce R. Smoller. In fact, I was very ent- siastic when I learned that they were preparing this work. Although endocrine, metabolic, w, and deposition diseases are regularly included in general textbooks of dermatology and d- matopathology, one gains the general impression that these topics receive little emphasis and are mainly included for completeness. The prospect of having all of this information in one volume, lovingly described and detailed by experts in the feld, should be of great interest not only to dermatologists, pathologists, and dermatopathologists but also to internists and en- crinologists, who may well gain a different perspective on these disorders. As a derma- pathologist, I am also pleased that this project has been organized and undertaken by two distinguished authorities in cutaneous pathology. This assures a close integration of histo- thology and other laboratory techniques with the clinical aspects of these disorders, which will make it possible - perhaps for the frst time - to view these conditions in a truly comprehensive way. So I invite you, the reader, to open this volume and dig in; be prepared for an eye-catching, intellectually stimulating, and ultimately rewarding experience! Charlottesville, VA James W. Patterson v w Foreword II Dermatopathology is a bridge between Dermatology and Pathology.

The increasing prevalence of morbid obesity has led the World Health Organization to coin the descriptive term "globesity" to reflect the worldwide nature of the problem. Providing health care to these patients, especially when surgery is required, can be extremely challenging owing to the specific needs in respect of logistics, facilities, and professional expertise. Appropriate care has to date often been unachievable and unaffordable outside of established bariatric centers, but such centers themselves usually have insufficient capacity and resources to cope with the demand among the general population. This book therefore provides a wealth of guidance and helpful tips and tricks on how to deal with obese patients within a general surgery setting. Importantly, it highlights the need for global rethinking on public health as regards resource allocation and patterns and standards of care, with the ultimate goal of improving outcomes through greater affordability.

This book serves as a comprehensive resource on toxicants that can be released from food packaging materials and household plastics. Chapters include sources and levels of chemical exposure, known and suspected health effects and the identification of data gaps with recommendations for further research. In addition, regulatory approaches and risk assessment challenges in the United States and Europe are discussed. Chapters cover both the more widely known chemicals that can migrate from food packaging (bisphenol A, perfluorinated chemicals), and household plastics (lead, phthalates, brominated flame retardants), as well as chemicals that are just entering use in food packaging (nanomaterials in polymer food packaging) and chemicals recently identified as migrating from food packaging to food stuffs (phthalates, benzophenones, antimony, methylnaphthalene and the alkylphenols nonylphenol and octylphenol). Chapters on phthalates and brominated flame retardants discuss challenges that arise with the use of replacement chemicals. The health effect sections of chapters have drawn on a wide variety of toxicological endpoints and recommend approaches to better assess toxicological risks in vulnerable human populations. Reflecting the global nature of our food supply and household consumer goods, contributions have been drawn from international experts. A wide range of scientists will find this book to be useful, including toxicologists, environmental health scientists, food scientists, and regulators.

This is a timely and informative updated edition for all health care providers challenged with helping patients manage weight. Similar to the well-reviewed first edition, this updated title is directed toward individuals who wish to read further about targeted topics, rather than find an introduction to the field. This second edition again provides insights into recent scientific advances in obesity research and provides the most up-to-date instruction about current treatment issues and strategies for both adults and children. While several of the chapters are no longer relevant from the first edition, other topics have emerged as interesting and current. This edition will keep the two-section format of Physiology and Pathophysiology and Clinical Management, but it increases the first section to 10 chapters and reduces the second section to 12 chapters. The plan is to keep this edition in the range of about 350 to 400, maximum, printed pages. The volume is again divided into two parts. Part 1 covers new discoveries in the physiological control of body weight, as well as the pathophysiology of obesity. Expert authors discuss pathways that control food intake, energy expenditure and peripheral nutrient metabolism, including a look at the emerging evidence of the role of adipose tissue as an endocrine organ. Part 2 covers all the key issues central to clinical management, including recent developments in the epidemiology of obesity, assessment of the obese patient, behavioral strategies in weight management, dietary modification as a weight management strategy, physical activity as a weight management strategy, weight loss drugs, surgical approaches to obesity and other important clinical topics. An essential, practical text that sorts, synthesizes and interprets the latest information on obesity-related topics, this second edition will be an essential resource for clinical endocrinologists and other health care providers across a broad spectrum of specialties.