Developed by renowned experts, this comprehensive and easy to read title offers a state-of-the-art description of the management of endocrine, diabetic, and metabolic emergencies and brings the field fully up to date, setting a high standard for diagnosis and treatment in each category. All chapters begin with a summary that presents, in concentrated form, what the physician needs to know to begin the evaluation and emergency treatment of the known endocrine emergencies. This is followed by an extended discussion of the pathophysiology that can be read after initial treatment has begun. Covering such areas as hypoglycemia, acute adrenal insufficiency, ovarian hyperstimulation syndrome, thyroid storm, and pituitary apoplexy, just to name several, Endocrine Emergencies: Recognition and Treatment is an invaluable, practical resource that will be of great interest to endocrinologists, internal medicine and emergency room physicians, fellows and residents.

It has been over 50 years since Hans Selye formulated his concept of stress. This came after the isolation of epinephrine and norepinephrine and after the sympathetic system was associated with Walter Cannon's "fight or flight" response. The intervening years have witnessed a number of dis coveries that have furthered our understanding of the mechanisms of the stress response. The isolation, identification and manufacture of gluco corticoids, the identification and synthesis of ACTH and vasopressin, and the demonstration of hypothalamic regulation of ACTH secretion were pivotal discoveries. The recent identification and synthesis of CRR by Willie Vale and his colleagues gave new impetus to stress research. Several new concepts of stress have developed as a result of advances in bench research. These include the concept of an integrated "stress sys tem," the realization that there are bi-directional effects between stress and the immune system, the suggestion that a number of common psychiatric disorders represent dysregulation of systems responding to stress, and the epidemiologic association of stress with the major scourges of humanity."

This volume represents the first attempt to present in one place the clinical syndromes and the pathophysiologic basis for the "resistance states" to each of the classes of steroid hormones. Glucocorticoids, mineralocorticoids, androgens, estrogens, progesterone and vitamin D have widely diverse roles ranging from the control of homeostasis to reproduction and bone formation. They are similar in that they share a chemical structure and that their action is in the cell nucleus where they induce transcription of specific genes leading to synthesis of function-specific proteins. Clinical syndromes of steroid hormone resistance to androgens (complete and partial testicular feminization), aldosterone (pseudo hypoaldosteronism) and vitamin D (vitamin D-dependent rickets type II) have been known for many years. Progesterone and glucocorticoid resistance syndromes have been described only recently. Resistance to estrogens has not been reported in man or in animals. It is hoped that a detailed reexamination of what is known about each of these conditions at the clinical and molecular levels will enhance our understanding of the function of these hormones and their mechanisms of action. New insight and research initiatives should result. G.P. Chrousos D.L. Loriaus M.B. Lipsett vii ACKNOWLEDGMENTS The contents of this volume are based in part on the proceedings of an International Conference held in Bethesda in the summer of 1984. This conference was sponsored by the National Institute of Child Health and Human Development, Bethesda, Maryland."

It has been over 50 years since Hans Selye formulated his concept of stress. This came after the isolation of epinephrine and norepinephrine and after the sympathetic system was associated with Walter Cannon's "fight or flight" response. The intervening years have witnessed a number of dis coveries that have furthered our understanding of the mechanisms of the stress response. The isolation, identification and manufacture of gluco corticoids, the identification and synthesis of ACTH and vasopressin, and the demonstration of hypothalamic regulation of ACTH secretion were pivotal discoveries. The recent identification and synthesis of CRR by Willie Vale and his colleagues gave new impetus to stress research. Several new concepts of stress have developed as a result of advances in bench research. These include the concept of an integrated "stress sys tem," the realization that there are bi-directional effects between stress and the immune system, the suggestion that a number of common psychiatric disorders represent dysregulation of systems responding to stress, and the epidemiologic association of stress with the major scourges of humanity."

Medical emergencies due to disorders of the endocrine system represent a unique category of clinical care. Hypotension, fever, palpitations, confusion, and electrolyte abnormalities are all signs of disparate endocrine emergencies that require immediate diagnoses and treatment. Recognition of endocrine emergencies will frequently lead to rapid improvement and stabilization of the patient. Now in a revised and expanded second edition including the latest clinical guidelines and protocols, Endocrine Emergencies serves as a handy single reference for any endocrinologist, internist, hospitalist, and emergency medicine physician to rapidly identify and initiate treatment. Topics covered include acute adrenal insufficiency, diabetic ketoacidosis, thyroid storm, hyponatremia, and myxedema coma, among many others. Each chapter opens with a precis that provides, in a single page, a presentation of symptoms, workup, and therapy. This serves as a rapid, "off the shelf" cue to immediately begin a differential diagnoses and therapy plan. The remainder of each chapter is an in-depth review of the pathophysiology, diagnoses, and management of the disease process. Book chapters are written by experts in the field and reflect the consensus and standard of care for specific endocrine emergencies. Updated with the latest clinical evidence and treatment options, Endocrine Emergencies remains a valuable resource for practitioners in endocrinology and internal medicine, as well as emergency room physicians, hospital support staff, fellows and residents.

Medical emergencies due to disorders of the endocrine system represent a unique category of clinical care. Hypotension, fever, palpitations, confusion, and electrolyte abnormalities are all signs of disparate endocrine emergencies that require immediate diagnoses and treatment. Recognition of endocrine emergencies will frequently lead to rapid improvement and stabilization of the patient. Now in a revised and expanded second edition including the latest clinical guidelines and protocols, Endocrine Emergencies serves as a handy single reference for any endocrinologist, internist, hospitalist, and emergency medicine physician to rapidly identify and initiate treatment. Topics covered include acute adrenal insufficiency, diabetic ketoacidosis, thyroid storm, hyponatremia, and myxedema coma, among many others. Each chapter opens with a precis that provides, in a single page, a presentation of symptoms, workup, and therapy. This serves as a rapid, "off the shelf" cue to immediately begin a differential diagnoses and therapy plan. The remainder of each chapter is an in-depth review of the pathophysiology, diagnoses, and management of the disease process. Book chapters are written by experts in the field and reflect the consensus and standard of care for specific endocrine emergencies. Updated with the latest clinical evidence and treatment options, Endocrine Emergencies remains a valuable resource for practitioners in endocrinology and internal medicine, as well as emergency room physicians, hospital support staff, fellows and residents.