This volume focuses on challenging field in biomedicine that is the genetic control of central immune tolerance. It covers the thymus development, their cellular components and their respective function, the peculiar gene expression profiling (transcriptome) found in the medullary thymic epithelial cells (mTECs) that are implicated in the self-representation in the thymus, the Autoimmune regulator (Aire) gene, the mutations in this gene and manifestation of autoimmune diseases, and the role of cell-cell interactions within the thymus with implications in the negative selection (elimination) of nascent autoreactive T cells in preventing aggressive autoimmunity. The thymus gland is a lymphoid organ implicated in the maturation, differentiation and selection of T cells. This organ is gained more and more attention in different biomedical research labs worldwide due to its function that is associated with the control of immune homeostasis in the body, establishing the central immune tolerance and preventing the onset of autoimmune diseases.

The main focus of this book is on brown adipose tissue and its metabolic function. The book provides a timely update on the latest research and shows where the field is heading. Brown adipose tissue (BAT) dissipates energy and has received considerable attention in the last few years, having been re-discovered in adult humans in 2007/9. Moreover, BAT might offer a target for novel therapies to address obesity, a health condition that has reached pandemic dimensions.

This practice-oriented book provides a comprehensive and up-to-date review of the history, surgical anatomy, etiology, pathogenesis, clinical presentation and treatment of primary, secondary, and tertiary hyperparathyroidism. The coverage is wide ranging, encompassing, for example, innovations in both medical and surgical treatment, current indications for parathyroidectomy, the role and performance of minimally invasive surgery, the value of intraoperative parathyroid hormone monitoring and guidance on reoperations. Individual chapters are devoted to particular conditions and disease settings, including multiple endocrine neoplasia types 1 and 2 and parathyroid carcinoma, with provision of information on genetic testing, clinical manifestations and therapy. All aspects of secondary hyperparathyroidism in predialysis and dialysis patients are discussed. The book is endorsed by the Italian Society of Surgery. It will be of great value for endocrine surgeons and endocrinologists and will also be of interest to specialists in internal medicine, nephrologists, urologists, gynecologists and radiologists.

This book focuses on hormones, and on how they are produced in very diverse regions of the body in humans and animals. But hormones can be found not only in vertebrates, but also in insects, shellfish, spiders, mollusks, even at the origin of metazoan diversification and exhibit the same pathways of synthesis. The book addresses the different classes of hormones: protein/peptides hormones, steroids and juvenile hormones and hormones like catecholamines, thyroid hormones and melatonin. It also discusses the types of hormone receptors, the majority of which are heptahelical G-protein coupled receptors or nuclear receptors. Particular attention is paid to the organs where hormones are created, with specifics on hormonal production and release, while a dedicated chapter details hormonal regulation from very simple to highly complex schemes. The remarkable kinetics of hormones production are also shown, before the book is rounded out by chapters on evolution in the endocrine system, the genetics of endocrine diseases and doping.

Providing a comprehensive review of the most up-to-date evidence, this book presents the latest biology, diagnosis and management for pheochromocytomas, paragangliomas and related disorders of the sympathoadrenal system. Many new areas, including genetic syndromes, have evolved, and these are insufficiently appreciated among practitioners. A discussion of the basics of catecholamine biology sets the stage for presentations of the pathology, clinical features, and diagnosis of these tumors, including localization and imaging. Medical, anesthetic and surgical management of pheochromocytomas and paragangliomas follow, including case material. Additional chapters discuss pheochromocytoma in pediatrics and in pregnancy, both pure and hypoglycemia-associated autonomic failure, and the role of the sympathetic nervous system in hypertension. These diseases are relatively rare, but many, if not most, go undiagnosed during life: If promptly diagnosed and appropriately treated, they are usually completely curable; if undiagnosed or mistreated, they are typically terminal. Bringing the most current knowledge to bear, Pheochromocytomas, Paragangliomas and Disorders of the Sympathoadrenal System will be a valuable resource for practicing endocrinologists, endocrine surgeons, internists and endocrine fellows faced with diagnosing and managing these conditions.

This book offers ophthalmologists and medical practitioners a concise, data-driven review of the information that is most relevant in guiding the diagnosis and management of thyroid-associated eye diseases (TED). Thyroid-Associated Eye Disease can be read in its entirety to give a perspective of the field, but also considered as a reference as clinical questions arise. The goal is to deliver data- driven guidance and discreet approaches and suggestions useful for clinical practice and decision making. Advances in diagnostic evaluation, including autoantibody assessment, are reviewed, and the diagnostic features of euthyroid TED are also discussed. All relevant aspects of treatment are covered, from the use of radioactive iodine, long-term medical therapy, and surgical thyroidectomy through to the treatment of active TED by steroids and novel biologics and the role of minimally invasive surgery. Numerous supporting images are included, and helpful checklists will aid the practitioner in treatment decision making.

In the years since the publication of the third edition, awareness of the remarkable morphologic diversity of thyroid carcinoma has notably expanded, and great advances have been made in unravelling the molecular genetic features of thyroid and parathyroid tumours. There has also been an increased interest in the use of the fine-needle aspiration technique for the diagnosis and management of thyroid tumours, and in the role of the pathologist in the operative handling of the hyperfunctioning parathyroid gland. This volume documents the most significant advances that have taken place since the previous edition, emphasising those with a practical application at the clinical level. The format remains similar to that of the previous versions, but the two thyroid and parathyroid editions have been merged into one, and most of the black and white images and photomicrographs have been replaced with colour. The authors include a number of the most recent references, but have not ignored the classic works in the field, many of which have descriptions, illustrations, and insights that cannot be bettered. This edition fulfils the original goal of this series, which is that of helping the pathologist diagnose and anticipate the behavior of the tumours and tumour-like lesions included in this publication.

Schwangerschaft bei Diabetes? Dank neuer Therapien konnen sich Diabetikerinnen heutzutage ihren Kinderwunsch erfullen. Voraussetzung ist allerdings die kompetente, luckenlose Begleitung der Schwangerschaft. Experten bieten hierfur alle notwendigen Informationen (inkl. Gestationsdiabetes) - praxisbezogen, ubersichtlich und verstandlich. Exakt erlautern sie welche Massnahmen, wann und wie einzusetzen sind. Alles rund um die Pravention sowie Begleit- und Folgeerkrankungen: wichtige Parameter und deren Uberwachung, Diagnose, Therapie, medikamentose Intervention. Ein hilfreicher Ratgeber fur werdende Mutter sowie alle Fachleute, die sie betreuen."

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.

Sleep has recently been recognized as a critical determinant of energy balance regulating, restoration and repair of many of the physiologic and psychologic processes involved in modulating energy intake and utilization. In addition to having an impact on obesity, sleep abnormalities, both quantitative and qualitative, have now been shown to have significant effects on obesity associated comorbidities, including metabolic syndrome, premalignant lesions and cancer. Sleep problems and fatigue also constitute a significant challenge for the ever expanding group of cancer survivors. Moreover, circadian misalignment, such as that experienced by "shift workers" has been shown to be associated with an increased incidence of several malignancies including, breast, colorectal and prostate cancer, consistent with the increasing recognition of the role of clock genes in the metabolic processes. Of increasing concern is the accelerating incidence of sleep disorders in childhood, their association with childhood obesity and associated abnormalities of circulating cytokines, adipokines and metabolic factors, many of which are implicated as etiologic mediators of the connection between obesity and cancer. Extensive studies have now been initiated to investigate the mechanisms by which disturbances in sleep duration, sleep continuity and sleep related breathing affect circadian rhythm, central and peripheral tissue oxygenation and metabolism, quality and quantity of dietary intake and circulating inflammatory cytokines and regulatory hormones. This volume aims to present the latest research on sleep, sleep disturbance and its correlation to obesity and cancer.

This book is a practical guide to the diagnosis and management of endocrine disorders. Presented as a collection of 21 clinical cases, topics cover pituitary, thyroid, parathyroid and adrenal glands, testes, ovary, and diabetes. Each case follows a step by step, uniform approach, explaining history, examination and investigation, diagnosis, and treatment. The comprehensive text is further enhanced by clinical photographs, diagrams and tables to assist learning. Key points Practical guide to diagnosis and management of endocrine disorders Step by step approach presented as 21 clinical cases Seven sections cover pituitary, thyroid, parathyroid and adrenal glands, testes, ovary, and diabetes Photographs, diagrams and tables further enhance the comprehensive text

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.

This astute volume brings together the latest expert research on adamantinomatous craniopharyngiomas (ACPs). ACPs are histologically benign but clinically aggressive tumors exhibiting a high propensity for local invasion into the hypothalamus, optic and vascular structures. These tumors, as well as the current treatments, may result in pan-hypopituitarism, diabetes insipidus, morbid obesity followed by type II diabetes mellitus, blindness, as well as serious behavioral and psychosocial impairments. Exploring in detail advances in both the understanding of tumor biology as well as clinical advances in patient management are explored in detail, this book will also look towards potential new treatment approaches. Basic Research and Clinical Aspects of Adamantinomatous Craniopharyngioma is the first book compiling all current research on ACPs. Mouse and human studies have unequivocally demonstrated that mutations in CTNNB1 encoding -catenin underlie the etiology of the majority, if not all ACP tumors. Genetic studies in mice have shown that ACPs are tumors of the pituitary gland and not of the hypothalamus as previously thought, and are derived from Rathke's pouch precursors. In addition, a role for tissue-specific adult pituitary stem cells has been revealed as causative of ACP. Together, these studies have provided novel insights into the molecular and cellular etiology as well as the pathogenesis of human ACP. Finally, this volume covers new treatment approaches that have been shown to be effective both in reducing ACP burden as well as reducing the morbidity associated with therapy.

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.

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.

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 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.

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.

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.

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.

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.

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.

Providing a comprehensive review of the most up-to-date evidence, this book presents the latest biology, diagnosis and management for pheochromocytomas, paragangliomas and related disorders of the sympathoadrenal system. Many new areas, including genetic syndromes, have evolved, and these are insufficiently appreciated among practitioners. A discussion of the basics of catecholamine biology sets the stage for presentations of the pathology, clinical features, and diagnosis of these tumors, including localization and imaging. Medical, anesthetic and surgical management of pheochromocytomas and paragangliomas follow, including case material. Additional chapters discuss pheochromocytoma in pediatrics and in pregnancy, both pure and hypoglycemia-associated autonomic failure, and the role of the sympathetic nervous system in hypertension. These diseases are relatively rare, but many, if not most, go undiagnosed during life: If promptly diagnosed and appropriately treated, they are usually completely curable; if undiagnosed or mistreated, they are typically terminal. Bringing the most current knowledge to bear, Pheochromocytomas, Paragangliomas and Disorders of the Sympathoadrenal System will be a valuable resource for practicing endocrinologists, endocrine surgeons, internists and endocrine fellows faced with diagnosing and managing these conditions.

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.