Essential Endocrinology and Diabetes (eBook)

Richard I. G. Holt, Neil A. Hanley (Autoren)

eBook Download: EPUB

2021 | 7. Auflage
John Wiley & Sons (Verlag)
978-1-118-76412-1 (ISBN)

Infos

Essential Endocrinology and Diabetes provides the accurate and up-to-date knowledge required for treating all areas of endocrinology and diabetes, covering the latest research, clinical guidelines, investigational methods, and therapies. This classic text explains the vital aspects of endocrine physiology in a succinct and easy-to-use format, with full-colour illustrations, clinical images, and case studies to assist readers in applying theory to practice. 

The text covers the principles of endocrinology, clinical endocrinology, and clinical diabetes and obesity, and has been revised throughout to present the most recent developments in the field. The seventh edition includes new and updated material on the latest molecular techniques, approaches to clinical investigation and diagnostics, next generation sequencing technology, and positron emission tomography (PET). The treatment of type 1 diabetes and type 2 diabetes has been updated with clinical algorithms and reflects significant advances such as incretin-based therapies, SGLT2 inhibitors, the development of better insulins, and technologies that support self-management. 

• Provides students and practitioners with comprehensive and authoritative information on all major aspects of endocrine physiology 
• Covers diagnosis, management, and complications of clinical disorders such as endocrine neoplasia, and type 1 diabetes and type 2 diabetes 
• Explains the core principle of feedback regulation, which is vital for the correct interpretation of many clinical tests 
• Features case histories, learning objectives, 'recap' links to chapter content, cross-referencing guides, key information boxes, and chapter summaries 

Essential Endocrinology and Diabetes, Seventh Edition is the ideal textbook for medical and biomedical students, junior doctors, and clinicians looking to refresh their knowledge of endocrine science. 

Richard Holt is Professor in Diabetes and Endocrinology at the University of Southampton, UK, and Honorary Consultant in Diabetes at University Hospital Southampton NHS Foundation Trust.  

 

Neil Hanley is Professor of Medicine at the University of Manchester, UK, and Honorary Consultant in Endocrinology at the Manchester University NHS Foundation Trust. 

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The Essentials are an international, best-selling series of textbooks, all of which are designed to support lecture series or themes on core topics within the health sciences. See www.wiley.com for further details. Essential Endocrinology and Diabetes provides the accurate and up-to-date knowledge required for treating all areas of endocrinology and diabetes, covering the latest research, clinical guidelines, investigational methods, and therapies. This classic text explains the vital aspects of endocrine physiology in a succinct and easy-to-use format, with full-colour illustrations, clinical images, and case studies to assist readers in applying theory to practice. The text covers the principles of endocrinology, clinical endocrinology, and clinical diabetes and obesity, and has been revised throughout to present the most recent developments in the field. The seventh edition includes new and updated material on the latest molecular techniques, approaches to clinical investigation and diagnostics, next generation sequencing technology, and positron emission tomography (PET). The treatment of type 1 diabetes and type 2 diabetes has been updated with clinical algorithms and reflects significant advances such as incretin-based therapies, SGLT2 inhibitors, the development of better insulins, and technologies that support self-management. Provides students and practitioners with comprehensive and authoritative information on all major aspects of endocrine physiology Covers diagnosis, management, and complications of clinical disorders such as endocrine neoplasia, and type 1 diabetes and type 2 diabetes Explains the core principle of feedback regulation, which is vital for the correct interpretation of many clinical tests Features case histories, learning objectives, recap links to chapter content, cross-referencing guides, key information boxes, and chapter summaries Essential Endocrinology and Diabetes, Seventh Edition is the ideal textbook for medical and biomedical students, junior doctors, and clinicians looking to refresh their knowledge of endocrine science. For more information on the complete range of Wiley medical student and junior doctor publishing, please visit: www.wiley.com To receive automatic updates on Wiley books and journals, join our email list. Sign up today at www.wiley.com/email All content reviewed by students for students Wiley Medical Education books are designed exactly for their intended audience. All of our books are developed in collaboration with students. This means that our books are always published with you, the student, in mind. If you would like to be one of our student reviewers, go to www.reviewmedicalbooks.com to find out more. This title is also available as an e-book. For more details, please see www.wiley.com/buy/9781118763964

Inhalt

Preface vii

List of abbreviations ix

Part 1: Foundations of Endocrinology 1

1 Overview of endocrinology 3

2 Basic cell biology and hormone synthesis 12

3 Molecular basis of hormone action 22

4 Investigations in endocrinology and diabetes 39

Part 2: Endocrinology - Biology to Clinical Practice 51

5 The hypothalamus and pituitary gland 53

6 The adrenal gland 80

7 Reproductive endocrinology 103

8 The thyroid gland 134

9 Calcium and metabolic bone disorders 155

10 Pancreatic and gastrointestinal endocrinology and endocrine neoplasia 175

Part 3: Diabetes and Obesity 193

11 Overview of diabetes 195

12 Type 1 diabetes 213

13 Type 2 diabetes 239

14 Complications of diabetes 265

15 Obesity 293

Index 311

Textauszug

CHAPTER 1
Overview of endocrinology

Key topics

• A brief history of endocrinology and diabetes
• The role of hormones
• Classification of hormones
• Control systems regulating hormone production
• Endocrine disorders
• Key points

Learning objectives

• To be capable of defining endocrinology
• To understand what endocrinology means as a basic science and a clinical specialty
• To appreciate the history of endocrinology
• To understand the classification of hormones into peptides, steroids and amino acid derivatives
• To understand the principle of how feedback mechanisms regulate hormone levels in the circulation

This chapter introduces endocrinology and diabetes including some of the basic principles that underpin the following chapters

Box 1.1 The endocrine and nervous systems are the two main communication systems in the body

Monitor internal and external environments

Ensure homeostasis

Allow appropriate adaptive changes

Communicate via chemical messengers

Figure 1.1 Chemical signalling in the endocrine and neural systems. (a) In endocrine communication, the producing cell secretes hormone into the blood vessel, where it is carried, potentially over large distances, to its target cell. (b) Sometimes hormones can act on the cell that produces them (autocrine, A) or nearby cells (paracrine, P) without the need for transport via the circulation. For instance, glucagon from α‐cells and somatostatin from δ‐cells can regulate insulin secretion by adjacent β‐cells within the pancreatic islet. (c) In neuroendocrine communication, neurons can secrete hormones into the surrounding blood vessels to reach a more distant target. A good example is hypothalamic regulation of the anterior pituitary. (d) In pure neural communication, neurons activate other neurons via neurotransmitters released from axonic terminals into the synaptic space. Conceptually, neurotransmitters are similar to hormones and in some instances, such as for norepinephrine/noradrenaline, can actually be the same chemical.

All organisms need to be able to analyze and respond to their surroundings in order to provide a constant internal environment. Maintaining this internal constancy is called homeostasis. For an organism comprised of a single or a few cells homeostasis is relatively easy as no cell is more than a short diffusion distance from the outside world or its neighbours. This simplicity has been lost with the evolution of more complex, larger, multicellular organisms. Diffusion alone is inadequate in larger animal species where discrete functions localize to specific organs. In humans, there are ∼1014 cells of more than 200 different types. With this compartmentalized function comes the need for effective communication to disseminate information throughout the whole organism – only a few cells face the outside world, yet all need to respond to it. Two communication systems facilitate this: the endocrine and nervous systems (Box 1.1).

Whereas gastrointestinal cells tend to secrete chemicals into ducts, the specialized cells that make up the glands and tissues of the endocrine system release their chemical messengers, called hormones, into the extracellular space, from where they enter the bloodstream. Historically, this blood‐borne transit of hormones was what defined ‘endocrinology’; however, the principle is identical for hormone action on a neighbouring cell (called a paracrine effect) or, indeed, the endocrine cell itself (an autocrine or intracrine effect) (Figure 1.1).

The nervous and endocrine systems interact. Endocrine glands can be under nervous control; the adrenal medulla is an excellent example (Chapter 6). Conversely, neural cells can themselves release hormones into the bloodstream. This is particularly relevant in the hypothalamus (Chapter 5). Indeed, this interplay between the body's two main communication systems has led to the composite specialty of ‘neuroendocrinology’ (Figure 1.1).

A brief history of endocrinology and diabetes

The term ‘hormone’, derived from the Greek word ‘hormaein’ meaning ‘to arouse’ or ‘to excite’, was first used in 1905 by Sir Ernest Starling in his Croonian Lecture to the Royal College of Physicians. However, endocrinology is built on foundations that are far older. Although Aristotle described the pituitary, gigantism, caused by excess growth hormone (GH) from the somatotrophs of the anterior pituitary, was referred to in the Old Testament. It was only two millennia or so later in the 19th century that the gland’s anterior and posterior components were appreciated by Rathke, and Pierre Marie connected GH‐secreting pituitary tumours to acromegaly and excess growth.

Diabetes was recognized by the ancient Egyptians. Areateus later described the disorder in the second century AD as ‘a melting down of flesh and limbs into urine’. Consequently, diabetes comes from the Greek word meaning ‘siphon’. The pancreas was only implicated relatively recently when Minkowski realized in 1889 that the organ’s removal in dogs mimicked diabetes in humans.

The roots of reproductive endocrinology are equally long. The Bible refers to eunuchs and Hippocrates recognized that mumps could result in sterility. Oophorectomy in sows and camels was used to increase strength and growth in ancient Egypt. The dependence of endocrinology on technology is also long standing. It took the invention of the microscope in the 17th century for Leeuwenhoek to visualize spermatozoa and later, in the 19th century, for the mammalian ovum to be discovered in the Graafian follicle.

During the last 500 years, many endocrine organs and systems (‘axes’) have been identified and characterized. In 1564, Bartolomeo Eustacio noted the presence of the adrenal glands. Almost 300 years later (1855), Thomas Addison, one of the forefathers of clinical endocrinology, described the consequences of their inadequacy. Catecholamines (epinephrine/adrenaline and norepinephrine/noradrenaline) were identified at the turn of the 19th century, in parallel with Oliver and Schaffer’s discovery that these adrenomedullary substances raised blood pressure. This followed shortly after the clinical features of myxoedema were linked to the thyroid gland, when, in 1891, physicians in Newcastle‐upon‐Tyne treated hypothyroidism with sheep thyroid extract. This was an important landmark, but long after the ancient Chinese recognized that seaweed, as a source of iodine, held valuable properties in treating swelling of the thyroid gland (‘goitre’).

These early aspects of clinical endocrinology and diabetes tended to rely on recognition and description. Since then our understanding has advanced through:

• Successful quantification of circulating hormones
• Molecular unravelling of complex hormone action
• Mechanistic identification of pathophysiology underlying endocrine dysfunction
• Molecular genetic diagnoses

Some of the landmarks from the last 100 years are shown in Box 1.2. Endocrinology and diabetes is notable for researchers who have been awarded the Nobel Prize for Medicine, Physiology or Chemistry for their landmark discoveries (Table 1.1).

Box 1.2 Some landmarks in endocrinology over the last century or so

1905	First use of the term ‘hormone’ by Starling in the Croonian Lecture at the Royal College of Physicians

1909	Cushing removed part of the pituitary and saw improvement in acromegaly

1914	Kendall isolated an iodine‐containing substance from the thyroid

1921	Banting and Best extracted insulin from islet cells of dog pancreas and used it to lower blood glucose

Early 1930s

Pitt‐Rivers and Harrington determined the structure of the thyroid hormone, thyroxine

1935–1940

Crystallization of testosterone

1935–1940

Identification of oestrogen and progesterone

1940s

Harris recognized the relationship between the hypothalamus and anterior pituitary in the ‘portal‐vessel chemotransmitter hypothesis’

1952	Gross and Pitt‐Rivers identified tri‐iodothyronine in human serum

1955	The Schally and Guillemin laboratories showed that extracts of hypothalamus stimulated adrenocorticotrophic hormone (ACTH) release

1950s

Adams and Purves identified thyroid stimulatory auto‐antibodies

Gonadectomy and transplantation experiments by Jost led to the discovery of the role for testosterone in rabbit sexual development

1955	Marcel Janbon and colleagues...

Produkt-Details

• Erscheint lt. Verlag: 2.3.2021
• Reihe/Serie: Essentials
• Reihe/Serie: Essentials
• Reihe/Serie: Essentials
• Sprache: englisch
• Themenwelt: Sachbuch/Ratgeber ► Gesundheit / Leben / Psychologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Innere Medizin
• Schlagworte: Diabetes • endocrinology • Endokrinologie • medical education • Medical Science • Medizin • Medizinstudium
• ISBN-10: 1-118-76412-9 / 1118764129
• ISBN-13: 978-1-118-76412-1 / 9781118764121