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It has been known for over 40 years that GH-deficient-children benefit from replacement with the hormone. But GH, essential for longitudinal growth, also plays a role after completion of final height. With the introduction of biosynthetic human GH 20 years ago, the use of GH was no longer restricted to severe growth retardation in hypopituitary children. This book will take the reader behind the myths of GH and into the real world of clinical endocrinology. The contributions stem from recognized clinicians and scientists who have been working in the field for decades. The contents encompass traditional end points of GH therapy such as body composition, bone biology and physical performance. Attention is also devoted to diagnostic aspects and side effects. Additional features range from clinical epidemiology to quality of life, and novel areas such as the impact of traumatic brain injury on pituitary function are also covered. The present volume of Frontiers of Hormone Research is essential reading for health care professionals interested in clinical endocrinology and GH.
For 20 years, KIGS (Pfizer International Growth Database) has provided an outstanding tool for monitoring the use, efficacy and safety of growth hormone (GH) treatment in children with short stature of varying origin. This volume offers a comprehensive update of the continuing experiences in KIGS and is based on data from more than 50 countries and more than 60,000 patients. International experts analyse in detail the basic auxological characteristics of patients and their response to GH treatment for a broad spectrum of growth disorders. These include idiopathic GH deficiency, organic GH deficiency due to a variety of causes such as congenital malformations and syndromes, genetic disorders or treatment for leukaemia or central nervous system tumours and short stature in children born small for gestational age, specific syndromes and systemic disorders. Each growth disorder is also covered by a review of relevant published data by international experts. KIGS has also established itself as a primary source of information about adverse events during long-term GH treatment in children. The recent analysis of KIGS data has revealed no new adverse drug reactions since the 10-year follow-up. Therefore, treatment with GH seems a low-risk intervention in children and adolescents with various growth disorders. The process of developing disease-specific growth response prediction models has been ongoing in KIGS for many years. The available models are accurate, precise and have a relatively high degree of predictive power, although further predictors of the growth response remain to be identified. The KIGS prediction models can be applied prospectively to new patients, enabling their GH therapy to be better tailored and monitored to achieve optimal growth, safety and cost outcomes. The future of KIGS within the era of evidence-based medicine will continue to depend upon the quality of the data reported. Therefore, the commitment of participating physicians will continue to be a decisive element. The ongoing recognition of the importance of valid safety and efficacy information in the practice of paediatric endocrinology is exemplified by this valuable international collaboration of clinicians and the pharmaceutical community.
Gigantism and Acromegaly brings together pituitary experts, taking readers from bench research, to genetic analysis, clinical analysis, and new therapeutic approaches. This book serves as a reference for growth hormone over-secretion and its diagnosis and treatment for endocrinologists, pediatricians, internists, and neurosurgeons, and for geneticists. Pharmaceutical companies may use it as a reference for drug development and research. Students, residents and fellows in medicine and endocrinology and genetics will also find it valuable as it provides a single up-to-date review of the molecular biology of gigantism and acromegaly as well as recommended approaches to evaluation and management. Acromegaly is a rare pituitary disorder that slowly changes its adult victim's appearance over time: larger hands and feet, bigger jaw, forehead, nose, and lips. Generally, a benign pituitary tumor is the cause and symptoms of acromegaly can vary from patient to patient, making a diagnosis difficult and prolonging suffering for years. Early detection is key in the management of acromegaly as the pathologic effects of increased growth hormone (GH) production are progressive and can be life-threatening as the result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies. - Accessible, up-to-date overview of the characteristics, state-of-the-art diagnostic procedures, and management of acromegaly and gigantism - Provides a unique compendium of endocrinology, genetics, clinical diagnosis and therapeutics - Contains contributions from internationally known experts who have treated patients with acromegaly and gigantism
This revised new edition reviews the substantial advances in our understanding of the vital role of growth hormone (GH) in maintaining adult health, and the resulting disorders from GH deficiency. The first edition, published in 1996, provided a pioneering overview of the subject; this new edition provides an even more comprehensive account, fully updated with the latest research, clinical applications, and references. The therapeutic benefits of GH treatment in GH deficiency are thoroughly evaluated, including effects on metabolism, cardiac function, exercise performance, psychosocial aspects, and aging and gender-specific effects. This compilation by the world's leading experts covers clinical investigation, diagnosis and treatment issues, and encompasses new knowledge of the control and action of GH secretion. This volume is the most authoritative, comprehensive, and detailed account available and will be an essential source of reference for all endocrinologists.
A multitude of new developments, not only in the rapidly advancing field of molecular genetics and steroid metabolism but in all traditional areas of pediatric endocrinology, have influenced the diagnostic approach in children and adolescents with endocrine disorders, thus warranting this 4th, revised and extended edition of 'Diagnostics of Endocrine Function in Children and Adolescents'. Several chapters have been revised completely and all have been thoroughly updated. In addition, new chapters dealing with the muscle-bone unit and bone metabolism have also been incorporated. The original format of the chapters, which are a combination of in-depth discussion of the diagnostic process, practical conclusions and expert advice based on extensive experience, was maintained. Easy-to-use tables and figures allow for quick reference. Flowcharts of possible diagnostic pathways lead to the most frequent diagnoses. Presenting a broad range of diagnostic approaches, test procedures, and normative data required for establishing diagnoses for a broad spectrum of endocrine disorders, this book is an indispensable reference tool not only for endocrinologists and pediatricians but also for professionals in other specialties seeking evidence-based, rapid diagnostic solutions as the basis of advice and therapy for their patients.
The pituitary, albeit a small gland, is known as the "master gland" of the endocrine system and contributes to a wide spectrum of disorders, diseases, and syndromes. Since the publication of the second edition of The Pituitary, in 2002, there have been major advances in the molecular biology research of pituitary hormone production and action and there is now a better understanding of the pathogenesis of pituitary tumors and clinical syndromes resulting in perturbation of pituitary function. There have also been major advances in the clinical management of pituitary disorders. Medical researchers and practitioners now better understand the morbidity and mortality associated with pituitary hormone hyposecretion and hypersecretion. Newly developed drugs, and improved methods of delivering established drugs, are allowing better medical management of acromegaly and prolactinoma. These developments have improved the worldwide consensus around the definition of a "cure" for pituitary disease, especially hormone hypersecretion, and hence will improve the success or lack of success of various forms of therapy. It is therefore time for a new edition of The Pituitary. The third edition will continue to be divided into sections that summarize normal hypothalamic-pituitary development and function, hypothalamic-pituitary failure, and pituitary tumors; additional sections will describe pituitary disease in systemic disorders and diagnostic procedures, including imaging, assessment of the eyes, and biochemical testing. The first chapter will be completely new – placing a much greater emphasis on physiology and pathogenesis. Two new chapters will be added on the Radiation and Non-surgical Management of the Pituitary and Other Pituitary Lesions. Other chapters will be completely updated and many new author teams will be invited. The second edition published in 2002 and there have been incredible changes in both the research and clinical aspects of the pituitary over the past 8 years – from new advances in growth hormones to pituitary tumor therapy. - Presents a comprehensive, translational source of information about the pituitary in one reference work - Pituitary experts (from all areas of research and practice) take readers from the bench research (cellular and molecular mechanism), through genomic and proteomic analysis, all the way to clinical analysis (histopathology and imaging) and new therapeutic approaches - Clear presentation by endocrine researchers of the cellular and molecular mechanisms underlying pituitary hormones and growth factors as well as new techniques used in detecting lesions (within the organ) and other systemic disorders - Clear presentation by endocrinologists and neuroendocrine surgeons of how imaging, assessment of the eyes, and biochemical testing can lead to new therapeutic approaches
This book analyzes in detail all aspects related to endocrine and metabolic late effects observed in patients treated for cancer, both in childhood and adulthood. The chapters focusing on the possible pathogenic mechanisms of late effects (i.e., premature aging and chronic inflammation) and on bone health in cancer survivors are particularly interesting and innovative. The volume also deals with hypothalamic-pituitary, thyroid and gonadal disorders, including infertility and how to prevent it. Finally, the relationship between metabolic alterations and cardiovascular diseases in cancer survivors is addressed. Thanks to advances in cancer treatment and supportive care, the five-year survival rate of cancer patients is constantly increasing. However, this undisputable success of medicine has a flip side: the late adverse effects of anticancer therapies. Pediatric oncologists were the first to cope with late complications of treatments, but today also adult oncologists and onco-hematologists recognize the relevance of this issue. Even though late effects observed in cancer survivors can affect any organ or system, endocrine and metabolic dysfunctions are the most frequently reported. Endocrine complications rarely influence life expectancy of cancer survivors, but they can significantly impact morbidity and quality of life. Among endocrine adverse effects, severe hypothalamic damage may be considered the most harmful in survivors, leading to morbid obesity, propensity to metabolic syndrome and cardiovascular disease. This book aims to disseminate the knowledge about endocrine and metabolic adverse effects of cancer therapies and about survivorship care. Since the number of cancer survivors is steadily growing in the general population, this publication is intended not only for endocrinologists but also for oncologists, onco-hematologists, internists, pediatric specialists in those areas and general practitioners, with the aim to better counsel and monitor cancer survivors.
When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.