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This open access book presents the history, pharmacokinetics and pharmacodynamics of levothyroxine, discussing its role in the thyroid pathophysiology of patients of various ages and during pregnancy. It also describes the influence of levothyroxine on heart, bone and in cancer. When it was first synthesized in 1949, levothyroxine represented a significant advance in the treatment of hypothyroidism, providing a safe and effective treatment option for millions of hypothyroid patients around the globe. This synthetic form of thyroxine is now one of the most prescribed drugs in the world. Levothyroxine was first introduced by Merck KGaA,Darmstadt, Germany, in 1972, and since then the company has remained actively engaged in research on this mainstay of hypothyroidism treatment. This book is intended for healthcare professionals.
Both thyroid dysfunction and heart failure show a high prevalence in the adult population. Frequently, in clinical practice, a multidisciplinary approach is useful to optimize the management of patients with these conditions. Although there is no doubt regarding the close link between cardiovascular pathophysiology and thyroid homeostasis, our understanding of this association is far from being exhaustive. Thyroid hormone regulates the expression of cardiac-specific functional contractile and structural proteins and plays a pivotal role in modulating both diastolic and systolic function as well as peripheral vascular resistance. The close relationship between thyroid and heart dysfunction is strongly supported by recent evidence demonstrating that an altered thyroid profile is a negative prognostic predictor in patients with heart failure. The treatment of chronic heart failure, especially in advanced stages of the disease, continues to be an open and challenging field. The potential of novel thyroid hormone therapies that address the molecular biology of thyroid dysfunction and heart failure thus represents an attractive area of multidisciplinary scientific interest. This book is a readable, integrated, and highly up to date presentation of the clinical, pathophysiological, and basic science aspects of thyroid–heart failure interactions. It addresses a complex subject in an approach that targets a large audience of readers.
When the Medicare program was established in 1965, it was viewed as a form of financial protection for the elderly against catastrophic medical expenses, primarily those related to hospitalization for unexpected illnesses. The first expansions to the program increased the eligible population from the retired to the disabled and to persons receiving chronic renal dialysis. It was not until 1980 that an expansion of services beyond those required "for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member" was included in Medicare. These services, known as preventive services, are intended either to prevent disease (by vaccination) or to detect disease (by diagnostic test) before the symptoms of illness appear. A Committee was formed "to conduct a study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries under Title XVIII of the Social Security Act for some or all Medicare beneficiaries."
In recent years, several scientific papers have highlighted the role of the thyroid system in cardioprotection, and several clinical studies – including multicenter studies – have identified the role of thyroid hormones (TH) in the development and progression of cardiovascular disease, making an update of TH and heart relationship both necessary and timely. This second edition of Thyroid and Heart failure provides a careful and updated review of the experimental, clinical and epidemiological results in the field of TH and heart failure, with a particular focus on the translational - bench to bedside - significance of the obtained results. It discusses topics such as the molecular, structural, functional, cellular and histological cardiac changes; the reversibility of these changes with TH replacement therapy; the systemic effects – kidney, hormonal pathways systems, brain, muscle, etc – of altered TH metabolism in HF, as well as the clinical and prognostic implications. The section devoted to the potential therapeutic treatments has been expanded. Thanks to its translational approach to this highly complex subject, the book will be of interest to a broad readership, including cardiologists, endocrinologists and internists.
A user-friendly, pocket-sized reference for all physicians faced with endocrine care and challenges in hospitalized patients, this handbook covers the most common issues leading to an inpatient endocrine consult, providing differential diagnoses, a reasonable and practical approach to investigating and managing the condition, and advice for follow-up. Conditions discussed include thyrotoxicosis and thyroid storm, calcium disorders, osteoporosis, Cushing's syndrome, pheochromocytoma and paraganglioma, primary hyperaldosteronism, hypoglycemia in diabetic and non-diabetic patients, and endocrine issues during pregnancy, among others. Suggestions for further reading are included, providing more context for well-established clinical approaches. Written by experts with years of experience providing endocrinology consultations in a hospital setting, Handbook of Inpatient Endocrinology is a valuable, high-yield resource for endocrine residents and fellows, but it will be equally useful for any busy hospitalist or primary care physician when endocrinology consults are not available.
Both thyroid dysfunction and heart failure show a high prevalence in the adult population. Frequently, in clinical practice, a multidisciplinary approach is useful to optimize the management of patients with these conditions. Although there is no doubt regarding the close link between cardiovascular pathophysiology and thyroid homeostasis, our understanding of this association is far from being exhaustive. Thyroid hormone regulates the expression of cardiac-specific functional contractile and structural proteins and plays a pivotal role in modulating both diastolic and systolic function as well as peripheral vascular resistance. The close relationship between thyroid and heart dysfunction is strongly supported by recent evidence demonstrating that an altered thyroid profile is a negative prognostic predictor in patients with heart failure. The treatment of chronic heart failure, especially in advanced stages of the disease, continues to be an open and challenging field. The potential of novel thyroid hormone therapies that address the molecular biology of thyroid dysfunction and heart failure thus represents an attractive area of multidisciplinary scientific interest. This book is a readable, integrated, and highly up to date presentation of the clinical, pathophysiological, and basic science aspects of thyroid–heart failure interactions. It addresses a complex subject in an approach that targets a large audience of readers.
Dr. Robert Volpé and his distinguished contributors comprehensively review the latest thinking about the theoretical, experimental, and clinical aspects of autoimmune endocrine disorders. These world-renowned experts examine the pathogenesis and immunogenetics of these diseases, discuss the role of sex hormones in autoimmunity, and elucidate the nature of autoantigens. They also provide clinical detail on a wide variety of autoimmune endocrinopathies, including autoimmune thyroid disease, Graves' ophthalmopathy and dermopathy, human insulin-dependent diabetes mellitus, and autoimmune adrenocortical failure. Postpartum autoimmune endocrine syndromes, autoimmune hypophysitis, and the polyglandular autoimmune syndromes are also discussed in detail. Comprehensive and authoritative, Autoimmune Endocrinopathies provides today's most up-to-date understanding of the etiology and pathogenesis of autoimmune endocrine diseases.
"As the magnitude of cardiovascular diseases (CVDs) continue to accelerate globally, the pressing need for increased awareness and for stronger and more focused international and country responses is increasingly recognized. This atlas on cardiovascular disease prevention and control is part of the response to this need. It documents the magnitude of the problem, using global cardiovascular mortality and morbidity data. It demonstrates the inequities in access to protection, exposure to risk, and access to care as the cause of major inequalities between countries and populations in the occurrence and outcome of CVDs. The report has graphs showing mortality rates of CVDs by age, by country/region, and is divided into three main sections: Section A: Cardiovascular diseases due to atherosclerosis -- Section B: Other cardiovascular diseases -- Section C: Prevention and control of CVDs: Policies, strategies and interventions."--Provided by publisher.
The significant progress in the understanding of the pathogenesis and the treatment of Graves’ orbitopathy (GO) has warranted a second edition of this book within three years of the first. Now also fully incorporated is the EUGOGO consensus statement on management of GO, which since has been accepted worldwide as a useful guideline. Furthermore all chapters have been thoroughly updated. Subjects covered include the pathology of GO and the controversial views on its pathogenesis; assessment of changes using reliable measuring techniques; medical management of GO including established and alternative treatment options; technical explanations and illustrations of various surgical procedures and finally, the molecular, immunologic, and clinical aspects of this complex disorder. Two new chapters have been added: one describing the socioeconomic impact of the disease and the other outlining the Amsterdam Declaration on Graves’ Orbitopathy. The successful question-and-answer format facilitates its use as a reference guide for medical practitioners and surgeons working in the fields of ophthalmology, internal medicine, endocrinology, pediatrics, immunology, as well as otorhinolaryngology.