This instant gold standard title is a major contribution to the field of clinical medical ethics and will be used widely for reference and teaching purposes for years to come. Throughout his career, Mark Siegler, MD, has written on topics ranging from the teaching of clinical medical ethics to end-of-life decision-making and the ethics of advances in technology. With more than 200 journal publications and 60 book chapters published in this area over the course of his illustrious career, Dr. Siegler has become the pre-eminent scholar and teacher in the field. Indeed his work has had a profound impact on a range of therapeutic areas, especially internal medicine, pediatrics, surgery, oncology, and medical education. Having grown steadily in importance the last 30 years, clinical ethics examines the practical, everyday ethical issues that arise in encounters among patients, doctors, nurses, allied health workers, and health care institutions. The goal of clinical ethics is to improve patient care and patient outcomes, and almost every large hospital now has an ethics committee or ethics consultation service to help resolve clinical ethical problems; and almost every medical organization now has an ethics committee and code of ethics. Most significantly, clinical ethics discussions have become a part of the routine clinical discourse that occurs in outpatient and inpatient clinical settings across the country. This seminal collection of 46 landmark works by Dr. Siegler on the topic is organized around five themes of foundational scholarship: restoring and transforming the ethical basis of modern clinical medicine, the doctor-patient relationship, education and professionalism, end-of-life care, and clinical innovation. With introductory perspectives by a group of renowned scholars in medicine, Clinical Medical Ethics: Landmark Works of Mark Siegler, MD explains the field authoritatively and comprehensively and will be of invaluable assistance to all clinicians and scholars concerned with clinical ethics.

The European Workshop on Molecular and Cellular Endocrinology of the Testis was organized for the first time at Geilo, Norway, 8-11 April 1980. Since then, these meetings have been held in Holland, France, Italy, England, Sweden/Finland (Aland), Germany, and Bel- gium. This year the circle has been closed: The 9th European Testis Workshop is back in the Norwegian mountains where it all started. The Scientific Committee of the First European Testis Workshop included Dr. H.J. van der Molen (Rotterdam), Dr. V. Hansson (Oslo), Dr. B. Cooke (London), Dr. V. Monesi (Rome), Dr. E.M. Ritzen (Stockholm), and Dr. J.M. Saez (Paris). Since then, two of the founders have left the Scientific Committee. Dr. Monesi died suddenly on 29 December 1979, 3 1/2 months before the first workshop took place. Thus, in spite of being one of the founders, he never experienced a Eu- ropean Testis Workshop. Dr. Mario Stefanini, from the same research institute in Rome, replaced Dr. Monesi on the Scientific Committee. Another founder of this workshop series, Dr. H.J. van der Molen (Rot- terdam), is one of the pioneers in research on molecular endocrinology of the testis in Europe. He left the Scientific Committee due to a change in his scientific career and was replaced by Dr. F.F.G. Rom- merts, whose lectures on "Testomania" have been a characteristic fea- ture of these meetings.

An ideal reference for infertility specialists and reproductive endocrinologists alike, this comprehensive text discusses current natural and mild approaches to in vitro fertilization (IVF) and the development of in vitro maturation (IVM) as a clinical treatment. It is divided thematically into four sections. Part I presents the basic science of ovarian endocrinology and the mechanism of oocyte maturation, including follicular development and the importance of mitochondrial changes. The differences between natural cycle IVF and stimulated IVF are presented in part II, including the standard ovarian stimulation protocols and their outcomes and the etiology, prevention and management of ovarian hyperstimulation syndrome (OHSS). Minimal and mild stimulation for IVF is discussed in part III, including mild stimulation protocols for oncofertility patients and the new minimally invasive INVO procedure. In vitro maturation as a clinical treatment is the subject of part IV, discussing the methodology of immature oocyte retrieval as well as other laboratory aspects and congenital and obstetrical outcomes of babies born from IVM. Combining expertise from thought leaders around the world, Development of In Vitro Maturation for Human Oocytes will be a go-to resource for infertility researchers and practitioners and reproductive endocrinologists working with infertile couples looking for safer and more cost-effective options for treatment.

Reflecting the increasing interest in fertility management for pediatric and adolescent patients and fulfilling an urgent need to have a comprehensive guide to the management of these individuals, this is the first book of its kind to present a comprehensive discussion of pediatric and adolescent oncofertility. It carefully examines the impact of pediatric cancer and cancer therapy on fertility and presents both current and emerging fertility preservation techniques for both males and females, such as cryopreservation. Fertility concerns beyond cancer are also discussed, including disorders of sexual differentiation, gender dysphoria and thalassemia. Practical chapters on pediatric oncofertility in the clinic round out the book, covering setting up a practice, counseling and consent, disclosure and insurance considerations. Concluding chapters document fertility preservation techniques and outcomes internationally, with contributions from Portuguese, Brazilian and Japanese authors. Timely and wide-ranging, Pediatric and Adolescent Oncofertility is an ideal resource for reproductive medicine specialists, pediatric oncologists, and primary care physicians treating pediatric and adolescent cancer patients looking to protect fertility options.

This unique book is a comprehensive guide for healthcare providers who treat patients with complex medical conditions but lack the resources to address fertility and sexuality concerns and help patients navigate their fertility decision-making process. It presents up-to-date information concerning fertility preservation and restoration for patients with hereditary cancer syndromes, disorders of sex development, hematologic diseases, genetic disorders of gonadal dysfunction, immunologic diseases, gynecologic diseases, endocrine disorders, and autoimmune and inflammatory diseases. Utilizing a practical, user-friendly format, each chapter discusses the epidemiology, classification, risk factors and/or clinical manifestations, and diagnosis and treatment modalities specific to each condition, as well as the effect of it or its treatment on fertility and unique options that may exist. Complex medical conditions are inherently difficult to manage, and reproductive interventions are often not part of the conversation. As such, Fertility Preservation and Restoration for Patients with Complex Medical Conditions will be an excellent resource for primary care physicians, obstetrician/gynecologists, endocrinologists, oncologists, and other health professionals working with patients with fertility concerns. This book, together with Oncofertility: Fertility Preservation for Cancer Survivors; Oncofertility: Ethical, Legal, Social, and Medical Perspectives; Oncofertility Medical Practice: Clinical Issues and Implementation; Oncofertility Communication: Sharing Information and Building Relationships across Disciplines; and Pediatric and Adolescent Oncofertility: Best Practices and Emerging Technologies, provides scientific and medically relevant information on fertility preservation from all vantage points and is an indispensable series for those interested in fertility management in cancer or complex settings.

This book describes the life cycle of a unique endocrine gland that is absolutely essential for the establishment and maintenance of pregnancy in all mammalian species. The corpus luteum is unique because it is formed and destroyed every (non-fertile) reproductive cycle. When fertilization occurs, the corpus luteum is rescued or maintained. The processes that control corpus luteum formation, demise (luteolysis), or maintenance are just beginning to be unraveled in recent years; they involve diverse cell types and mechanisms. Some of these processes resemble tumor development-angiogenesis, for instance-but interestingly enough, this resemblance is only up to a point. The corpus luteum uses mechanisms that allow its normal, physiological growth and disappearance. Pulling together key research on the corpus luteum, this volume is of interest to both reproductive endocrinologists and comparative physiologists, with clinical relevance spanning comparative animal studies to women's health.

Based on the most novel approaches and cutting-edge clinical and scientific information regarding radionuclide imaging and therapies for neuroendocrine tumors, this clinical guidebook represents a unique collaborative effort between endocrinologists, nuclear physicians, oncologists, surgeons, physicists, radio-pharmacists and geneticists. It begins with the embryology, classification and molecular genetics of gastroenteropancreatic neuroendocrine tumors and carcinoids, chromaffin cell tumors, and MEN1- and MEN2-related tumors. Following a chapter on radiopharmaceuticals in neuroendocrine imaging, it turns to the physics and technology of current and cutting-edge radiology, including SPECT/CT and PET/CT and PET/MR. Discussing of radionuclide imaging covers the tumors mentioned above, as well as pulmonary and thymic neuroendocrine tumors and medullary thyroid carcinoma. A presentation of radionuclide therapies follows, including 131I-MIBG therapy, somatostatin receptor-based therapy, and alpha radionuclide therapy, as well as the role of nanoparticles. Comprehensive and up-to-date, Diagnostic and Therapeutic Nuclear Medicine for Neuroendocrine Tumors will assist and guide physicians who encounter patients with these conditions, either from a diagnostic or therapeutic standpoint, and particularly emphasizes the current and emerging medical devices and imaging and therapeutic options.

It is well-established, through extensive peer-reviewed published research, that physical activity and exercise training can impact the reproductive endocrine system of women. This ground-breaking, comprehensive title presents a range of unique insights into the opposite question: how the reproductive endocrine system of women affects their exercise ability. More precisely, the thematic question explored in this work is: if exercise affects reproductive hormones, conversely then could the reproductive hormones have physiological effects unrelated to reproduction that influence the capacity of women to exercise? In exploring this question, the goal is to better understand the unique physiology of women and whether female sex hormones might account for some of the variance in physiological performance between amenorrheic and eumenorrheic women, and within women across the age span as they experience menarche to menopause. Sex Hormones, Exercise and Women: Scientific and Clinical Aspects synthesizes the research by exploring the physiology and psychology behind these occurrences. This novel title will not only be of interest to researchers, exercise scientists, graduate students, and clinicians; it will also serve as a source of valuable information for female athletes and their trainers in the context of preparing for competitions.

Biology of Menopause presents the proceedings of an international symposium held from September 10-13, 1998 in Newport Beach, CA. The proceedings review current knowledge and explores future research directions on the biologic changes of the hypothalamic-pituitary-ovarian axis across the menopausal transition and the associated changes in physiologic systems outside of the HPO axis, including the brain, the musculoskeletal and cardiovascular systems. Additionally, chapters present new methods of study and emerging areas of research.

The gold-standard resource for evaluating bone health in children and adolescents, this practical and highly anticipated second edition offers a comprehensive, fully updated resource for addressing bone health in these populations. Developed by a renowned international panel of experts in measuring and analyzing bone density in the pediatric patient and reflecting the 2013 International Society for Clinical Densitometry (ISCD) Guidelines for Pediatric DXA assessment, interpretation and reporting, this indispensable reference covers all the important changes in the field over the last 9 years. Some highlights of this edition include: an entire chapter on the assessment of infants and toddlers, a chapter devoted to the assessment of children with disabling conditions, an in-depth discussion of vertebral fracture and its etiologies, and a thorough review of the advantages and limitations of densitometry techniques including DXA, pQCT, HRpQCT, and MRI. New fracture prediction software, including Trabecular Bone Score and Finite Element Analysis, is described. In this edition, the limitations of DXA are addressed as are the most recent strategies for handling them including proposed DXA adjustments such as height Z-score. Solidifying itself as the leading text in the field, Bone Health Assessment in Pediatrics: Guidelines for Clinical Practice, 2nd edition provides all of the critical basic analysis and evaluation tools, images, and calculations necessary for clinical practice.

Bringing together the latest knowledge on the growth and development of children and the most important abnormalities of puberty, this comprehensive text presents the current views on the pathogenesis, diagnostic possibilities and therapeutic options of the main deviations from the normal course of puberty (e.g., precocious and delayed puberty). The chain of physical and hormonal changes in the transitional years is carefully followed, including the regulation of the hypothalamic pulse generator as well as the timing of puberty. Further topics include growth disturbances, adolescent varicocele, adolescent gynecomastia, polycystic ovary syndrome, pubertal acne, and the psychosocial development of adolescents with pubertal abnormalities. Written and edited by internationally noted experts, Puberty will be an excellent resource for pediatricians, endocrinologists, gynecologists, andrologists, urologists, family practitioners, child psychologists and public health specialists - all those who will be challenged in their everyday practice with the problems of puberty.

Due to the resultant health consequences and considerable increase in prevalence, obesity has become a major worldwide health problem. "Obesity and Lipotoxicity" is a comprehensive review of the recent researches to provide a better understanding of the lipotoxicity-related mechanisms of obesity and the potential for the development of new treatment strategies. This book overviews the biochemical pathways leading to obesity-related metabolic disorders that occur subsequent to lipotoxicity. Chapters examine the deleterious effects of nutrient excess at molecular level including the cellular and molecular aspects of breast cancer, resistance to leptin, insulin, adiponectin, and interconnection between the circadian clock and metabolic pathways during high-fat feeding. "Lipotoxicity and Obesity" will be a useful resource for clinicians and basic science researchers, such as biochemists, toxicologists, immunologists, nutritionists, adult and pediatric endocrinologists, cardiologists, as well as students who are thought in this field.

This book reviews the growing literature that is consistent with the hypothesis that hormones can regulate auditory physiology and perception across a broad range of animal taxa, including humans. Understanding how hormones modulate auditory function has far reaching implications for advancing our knowledge in the basic biomedical sciences and in understanding the evolution of acoustic communication systems. A fundamental goal of neuroscience is to understand how hormones modulate neural circuits and behavior. For example, steroids such as estrogens and androgens are well-known regulators of vocal motor behaviors used during social acoustic communication. Recent studies have shown that these same hormones can also greatly influence the reception of social acoustic signals, leading to the more efficient exchange of acoustic information.

This book aims to equip readers with a better understanding of neuroendocrine tumors of the abdomen and explains how to manage them optimally by making use of novel therapeutic options that represent major advances on previous treatments. The most recent advances in epidemiology, genetics, molecular biology, biomarkers, pathology, diagnostics, clinical assessment, medical therapy, and surgical treatment are presented. The information and data provided will stimulate readers to develop their personal opinions on significant issues and assist in decision making in individual patients during routine clinical practice. The book features a multidisciplinary approach and is designed to meet the needs of all physicians seeking comprehensive guidance from experts on the management of patients with neuroendocrine tumors. It will also be of value for researchers wishing to acquaint themselves with the state of the art in the field and emerging research avenues. Abdominal Neuroendocrine Tumors is published in Springer's highly successful Updates in Surgery series, which now comprises more than 20 titles.

Cushings syndrome is a rare disorder that is associated with many co-morbidities such as systemic hypertension, diabetes, osteoporosis, impaired immune function, and psychiatric disease, all of which severely reduce quality of life and life expectancy. This book reviews the role of cortisol in the human body, focusing on the effects of excess cortisol due to Cushing's syndrome as well as the role of the HPA axis in metabolism, inflammation, and neuropsychiatric function. The volume will cover basic mechanistic data, clinical outcomes data, and novel therapies. Also discussed are everything from abnormalities of the HPA axis, to the role of the HPA axis in the development of neuropsychiatric disorders and metabolic disorders, to new definitions of Cushing's remission and recurrence. The Hypothalamic Pituitary Adrenal Axis in Health and Disease will provide a comprehensive and multi-disciplinary review of the pathophysiology and outcomes of excess cortisol in the human body and brain as well as the role of the HPA axis in other disease states.

Lifestyle - the manner in which people live - is fundamental to health, wellness, and prevention of disease. It follows that attention to lifestyle is critically important to effective and successful health care. But here's the challenge: health care professionals receive very little, if any, formal training about lifestyle counseling and therefore are ill equipped to incorporate lifestyle issues into clinical practice. In response, "Lifestyle Medicine" is evolving as a means to fill this knowledge gap. Lifestyle medicine approaches health and wellness by harnessing the power of lifestyle-related behaviors and influencing the environment we live in. It is a formal approach that promises to enhance and strengthen a re-invigorated health care system that is still outpaced by the epidemic proportions and complexity of chronic diseases like obesity, diabetes, depression, hypertension, and cancer, among others. Lifestyle Medicine: A Manual for Clinical Practice presents this formal approach in a pragmatic context. This unique and practical manual provides clear and succinct guidance on nearly all aspects of lifestyle medicine. The approach is both explanatory and pragmatic, providing case studies and bulleted translation of academic information into clinical practice recommendations. There is an emphasis on scientific evidence wherever possible as well as opinions by the expert chapter authors who practice lifestyle medicine. There is a "how-to" rationality to the book, consistent with a premise that any and all health care professionals should, and perhaps must, incorporate lifestyle medicine. A valuable checklist is included at the close of the book that summarizes key points and provides a practical tool for routine patient encounters.

This timely volume provides an overview to the causes, effects on systems and clinical approaches of metabolic acidosis. Beginning with a basic understanding of the physiology, pathophysiology and development of this disease, subsequent chapters cover the characteristics and context of the processes that can cause it and a thorough presentation of management strategies. Recommended treatments include those carried out by the health care provider as well as the individual patient, such as dietary management. Clinicians and healthcare professionals will find the tools needed to recognize, work up and manage patients with metabolic acidosis in this practical and concise resource.

Iodine is an essential micronutrient and an integral component of the thyroid hormones, which are required for normal growth and development. The iodine deficiency disorders (IDD) encompass a spectrum of adverse health effects including goiter, cretinism, hypothyroidism, growth retardation, and increased pregnancy loss and infant mortality. This volume summarizes the current understanding of the effects of iodine deficiency as well as iodine excess. It also discusses best practices for salt iodization, the mainstay of global IDD prevention efforts, and other forms of food fortification. The effectiveness of iodine supplementation for vulnerable populations, an evolving strategy in many regions, is also described. Low level environmental exposure to chemicals such as perchlorate and thiocyanate, which competitively block thyroidal iodine uptake, appears to be ubiquitous worldwide. There has been recent concern that such environmental exposures might pose a health hazard by inducing or aggravating underlying thyroid dysfunction. This up-to-date volume explores both the effects of iodine deficiency as well as the best strategies for IDD prevention.

This book provides a concise, focused and clinically relevant summary of complications and emergencies related to bariatric surgery. The first section of the text addresses general complications related to anesthesia and the stress of surgery, including issues such as deep vein thrombosis, pulmonary embolism, hemorrhage, pneumonia and cardiac complications. Additionally, this section addresses the workup of the bariatric patient with abdominal pain. The second portion of the text focuses on gastric bypass and sleeve-specific complications, including staple line and anastomotic leaks, internal hernia, marginal ulceration, GI obstruction, hernia formation and gallstone disease. The third portion of the book examines metabolic, nutritional and psychological complications after bariatric surgery. The text also covers management of weight loss failure. Bariatric Surgery Complications and Emergencies serves as a very useful resource for physicians and surgeons who are involved in any parts of evaluation or management of bariatric patients suffering from postoperative complications or emergencies including bariatric surgeons who perform these operations on a regular basis, non-bariatric general surgeons who cover such patients when on-call, surgical trainees, and primary care physicians.

Thyroid hormone plays an important role in development and functional maintenance in the central nervous system. Deficiency of thyroid hormone during fetal and early postnatal life induces abnormal development known as cretinism in humans. However, the molecular mechanism of thyroid hormone action has not yet been fully understood. Thyroid hormone action in the brain may be disrupted under various pathological conditions. In addition, environmental factors including endocrine-disrupting chemicals and bacterial endotoxins may disrupt thyroid hormone action in brain, causing abnormal brain development and functional disruption. This is a first book to comprehensively describe the effect of thyroid hormone disruption in the central nervous system. The first section deals with the disruption of thyroid hormone action at the molecular level. First the authors provide a summary of the possible molecular mechanisms of thyroid hormone action in the brain, then they discuss several factors that may disrupt thyroid hormone action. In the second section, animal models to study thyroid hormone action will be introduced. An interesting character of thyroid hormone deficiency is that, without thyroid hormone, the thyroid hormone receptor may act as a "repressor" of gene expression, causing more severe consequence than those of thyroid hormone receptor knockout animals. Thus, several different kind of animal models may be used to clarify the role of thyroid hormone and its receptor in the brain. In the third section, human studies on thyroid disease and neurodevelopment will be introduced. Although endemic cretinism induced by iodine deficiency and sporadic cretinism by various thyroid mutation are well known, the pathophysiological mechanisms that create each abnormal phenotype are not fully understood.

This long overdue title provides a comprehensive, up-to-date, state-of-the art review of approved biologic therapies, with coverage of mechanisms of action, Indications for therapy, immunogenicity and a detailed examination of adverse effects and safety of the many and diverse therapeutic agents presented in a total of 13 chapters. It is predicted that by 2016, biologics will make up half of the world's 20 top-selling drugs and by 2018, biologic medicine sales will account for almost half of the world's 100 biggest selling drugs. Recombinant proteins dominate the growing list of the more than 200 approved biotherapeutic agents with targeted antibodies, fusion proteins and receptors; cytokines; hormones; enzymes; proteins involved in blood-clotting, homeostasis and thrombosis; vaccines; botulinum neurotoxins; and, more recently, biosimilar preparations, comprising the majority of approved biologics. Written with clinicians, other health care professionals, and researchers in mind, Safety of Biologics Therapy examines, in a single volume, the full range of issues surrounding the safety of approved biologic therapies. A good understanding of the risks and safety issues of modern biologics therapy is increasingly being demanded of all those connected with their development, handling, prescribing, administration and subsequent patient management. In addition to being of great value to clinicians in all branches of medicine, and to nurses, pharmacists and researchers, this book will prove invaluable for students taking undergraduate and graduate courses in the above disciplines and in the biomedical sciences.

Providing the latest evidence-based information on etiology, evaluation and treatment, this unique text provides an in-depth, comprehensive discussion of the epidemiology, genetic and endocrinologic factors and medical and surgical management of recurrent pregnancy loss (RPL). Taking a multidisciplinary approach including psychological treatment and patient perspectives, all aspects of current RPL prevention and treatment are elucidated. Detailed chapters provide real-world illustrative material and cover the set-up and management of RPL clinics and databases, containing practical tips. Recurrent Pregnancy Loss will be an excellent resource for OB-GYN specialists, general and reproductive endocrinologists, radiologists, hematologists, psychiatrists, psychologists, and any other investigators or clinicians treating patients confronted with this emotionally and physically trying condition.

Presenting the most current and relevant information on the diagnosis and management of primary ovarian insufficiency, also known as premature ovarian failure (POI/POF), this book presents two equally important voices. The first is the scientific, evidence-based voice discussing the latest information on POI/POF in a concise and logical fashion: etiologies, symptoms, genetics, mechanisms, associated conditions, as well as psychological and lifestyle considerations. The second voice presents the first-person stories of affected women, who are often faced with a diagnosis of irreversible infertility at a very young age and who somehow learn to live with great uncertainty about their ability to create a family - a core identity issue for many women. It is thus not simply a clinical, case-based presentation, but a more collaborative effort between clinicians who are well-versed in the field and women who have POI/POF. Primary Ovarian Insufficiency: A Clinical Guide to Early Menopause will therefore be an excellent practical yet personal reference for OB/GYNs, reproductive medicine specialists, and any clinician, nurse or health care worker treating women living with POI/POF.