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Acute Endocrinology: From Cause to Consequence by Greet Van den Berghe MD, PhD (auth.)

By Greet Van den Berghe MD, PhD (auth.)

The integration of endocrinology in serious care drugs has ended in new experimental and medical facts at the complicated endocrine and metabolic derangements accompanying non-endocrine critical health problems. The becoming a member of of those disciplines has generated very important novel insights with major scientific implications. Acute Endocrinology: From reason to final result compiles those new findings into a massive and hugely proper new source. half one bargains with the classical life-threatening health problems attributable to fundamental endocrine illnesses reminiscent of thyrotoxicosis, hypothyroidism, acute adrenal difficulty, acute calcium issues, pheochromocytoma, serious hyper- and hypoglycemia. half seems to be at endocrinology from the ICU part, beginning with a basic evaluation of the dynamic neuroendocrine and metabolic pressure responses within the of extensive care-dependent, non-endocrine serious disorder. Acute Endocrinology: From reason to end result offers a special and up to date review of the becoming a member of of those disciplines and seeks to stimulate additional interdisciplinary examine during this very important and interesting field.

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Sample text

Endocr Rev 1993; 14:747–793. 10. Matovinovic J. Endemic goiter and cretinism at the dawn of the third millennium. Annu Rev Nutr 1983; 3:341–412. 11. Daniels GH. Thyroid nodules and nodular thyroids: a clinical overview. Compr Ther 1996; 22:239–250. 12. Day TA, Chu A, Hoang KG. Multinodular Goiter. Otolaryngol Clin N Am 2003; 36:35–54. 13. Okamoto T, Iihara M, Obara T. Management of Hyperthyroidism Due to Graves’ and Nodular Diseases. World J Surg 2000; 24:957–961. 14. Pacella CM, Bizzarri G, Spiezia S et al.

Careful blood glucose monitoring is imperative as the majority of hypothermic patients have depleted their glycogen stores, and hypothermia may mask hypoglycemic symptoms (33). To ultimately normalize core body temperature in myxedema coma, thyroid hormone administration is essential; however, restoration of body temperature by thyroid hormone may take several days. Hypotension Treatment of hypothermia with external warming should be initiated concurrently with intravenous hydration with 5% to 10% glucose in half-normal saline or with isotonic saline if hyponatremia is present.

Regardless, given the possible longstanding consequences, it seems prudent not only to treat hyperthyroidism, but also to monitor patients with a history of hyperthyroidism life-long for sequelae. A dose should be selected to cure hyperthyroidism and cause hypothyroidism within a three to six-month timeframe with the expectation for lifelong thyroid hormone replacement with periodic monitoring after treatment (79). Two different generally accepted dose calculation strategies exist: (1) Fixed dose (typically 185–555 MBq or 5–15 mCi) or (2) Calculated dose based on thyroid gland size and percentage uptake at 24 hours.

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