Practical Pediatric Endocrinology in a Limited Resource Setting - 1st Edition - ISBN: 9780124078222, 9780124079366

Practical Pediatric Endocrinology in a Limited Resource Setting

1st Edition

Editors: Margaret Zacharin
eBook ISBN: 9780124079366
Hardcover ISBN: 9780124078222
Paperback ISBN: 9780128102756
Imprint: Academic Press
Published Date: 10th May 2013
Page Count: 416
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Description

Practical Pediatric Endocrinology in a Limited Resource Setting provides a guide for managing pediatric endocrine problems in a limited resource setting, together with an outline of the bases for these disorders. The book outlines a plan for coming to a likely diagnosis in situations where resources are constrained, and suggests ways to access more sophisticated technologies for diagnostic confirmation and extension of available tools.

Further extending and complementing each chapter is a series of scenarios for use as teaching and learning tools. Together with a clinical question, all chapters include a suggested outline for assessment that assists readers facing similar situations in daily practice. Each scenario works through a typical series of deductive steps used to establish a working diagnosis, while considering both a differential diagnosis and reminding readers of current knowledge around the subject matter.

Key Features

  • Provides a working knowledge of pediatric endocrinology, from the viewpoint of practical application, for residents and clinicians practicing in settings with scarce material resources
  • Features clinically based chapters, empahsising workable diagnoses and management plans in limited resource situations
  • Includes information on Type 1 diabetes mellitus, given its increasing prevalence worldwide
  • Describes basic research techniques and planning, intended to foster collaboration between colleagues and other centers in clinical or basic research, which can inform clinical practice and drive innovation

Readership

Practicing clinicians or residents in endocrinology, pediatrics, family practice, and general medicine who work in developing countries or rural areas of developed countries with limited resources

Table of Contents

Contributors

Foreword

Preface

Chapter 1. Growth: Importance and Implications of Variations

Part 1: Normal Growth and Puberty

Part 2: Variations in Linear Growth

Specific Conditions Presenting with Short Stature and Growth Failure

Tall Stature

Specific Conditions Presenting with Tall Stature

References and Further Reading

Resources

Chapter 2. Puberty: Normal and Abnormal

Normal Puberty

Clinical Setting

Delayed Puberty

Growth Monitoring

Hypothalamic Pituitary Disorders (Secondary Hypogonadism)

Primary Hypogonadism

Precocious Puberty

Pathophysiology of Precocious Puberty

Management of Precocious Puberty

Gynaecomastia

Other Disorders of the Breast

References

Further Reading

Chapter 3. Thyroid Disorders

Hypothyroidism

Clinical Setting

Clinical Setting

Hyperthyroidism

Clinical Setting

Thyroid Nodules

Thyroid Cancer in Childhood

References

Chapter 4. Adrenal Disorders

Background: Pathophysiologic Considerations

Clinical Setting

Principles and Problems of Treatment Provision

Congenital Adrenal Hyperplasia

Diagnostic Approach to the Newborn with Suspected 21-Hydroxylase Deficiency (21-OHD)

11-Hydroxylase Deficiency (11β-OHD)

3β-Dehydrogenase Deficiency

17α-Hydroxylase Deficiency

Laboratory Investigations of CAH in the Neonatal Period

Diagnostic Approach to ‘Simple Virilising’ Forms of CAH Later in Childhood

Diagnostic Approach to Non-Classical CAH in Childhood

Management of a Child with Classical 21-OHD

Acquired Disorders of the Adrenal Cortex

Disorders of Mineralocorticoid Function

Hyperfunction of the Adrenal/Disorders of the Adrenal Cortex/Excessive Adrenal Steroid Production

Adrenal Tumours/Adrenal Carcinoma

Disorders of the Adrenal Medulla

Reference

Further Reading

Chapter 5. Disorders of Sexual Development in Resource-Limited Settings

Introduction

The Importance of the Local Setting

Sex Development

Clinical Assessment

Investigations

Management

Special Considerations in Africa

References

Chapter 6. Obesity in Developing Countries

Introduction

Anthropometric Data and Criteria for Diagnosis

Evaluation of Potential Underlying Causes

Systemic Review of Medical History

Physical Examination

Priorities for Laboratory Facilities

Imaging

Differential Diagnosis

Treating Obesity

Summary

References

Further Reading

Chapter 7. Disorders of Mineral and Bone Metabolism

Introduction

Normal Mineral Metabolism

Hypocalcaemia, Hypercalcaemia and Disorders of the Parathyroid Glands

Rickets

References

Chapter 8. Disturbances of Sodium and Water

Introduction

Pathophysiology

Clinical Features of Disturbed Salt and Water Balance

Aetiology and Investigations for Hyponatraemia

Clinical Conditions with Hypervolaemic Hyponatraemia

Clinical Conditions with Euvolaemic Hyponatraemia

Clinical Conditions with Hypovolaemic Hyponatraemia

Endocrine Disease

Management of Hyponatraemia: Fluid and Sodium Correction

Hyperkalaemia

Aetiologies and Investigations for Hypernatraemia

Treatment of Hypernatraemia

HIV and Derangements of Fluid and Sodium

Conclusion

References and Further Reading

Chapter 9. Bone Health

Introduction

Background

Tools for Assessment

Primary Bone Disorders

Fibrous Dysplasia

Secondary Osteoporosis

Bone Dysplasias

References

Chapter 10. Paediatric and Adolescent Gynaecology

Paediatric Gynaecology

Adolescent Gynaecology

Further Reading

Chapter 11. Endocrine Dysfunction and Disease in the Neonatal Period

Introduction

Fetal and Neonatal Glucose Physiology

Hypoglycaemia

Hyperglycaemia

The Adrenal Gland in the Perinatal Period

Thyroid Physiology in the Fetus and Newborn

Problems with Salt and Water Balance

Hypercalcaemia and Hypocalcaemia in the Newborn

Epigenetics

Conclusions

References and Further Reading

Chapter 12. Diabetes in Children and Adolescents: Basic Training for Healthcare Professionals in Developing Countries∗∗Based on the Changing Diabetes in Children (CDiC) Sub-Saharan African collaborative initiative of NovoNordisk, Roche Diagnostics and ISPAD

Introduction

Diagnosis

Diabetes Emergency Care: DKA, Severe Hypoglycaemia, Managing Surgical Emergencies

Regular T1DM Treatment

T1DM Chronic Complications Assessment and Prevention: Metabolic Control Matters!

Co-Morbid Conditions with Type 1 Diabetes Mellitus

Learning to Cope with Diabetes: Therapeutic Empowerment-Based Education

Psychosocial Issues

Conclusions

References

Appendix: International Study Group of Diabetes in Children and Adolescents Declaration of Kos

Chapter 13. Hypoglycaemia

Clinical Setting

Definition

Physiology

Symptoms

Causes

Diagnostic Approach

History

Examination

Investigations

Rationale for Management

Counselling and Education

References

Chapter 14. Clinical Scenarios

Bone Health

Calcium Disorders

Gynaecology

Salt and Water

Hypothalamic Pituitary Disorders and Growth

Adrenal/DSD

Conclusions

Disorders of Puberty

Thyroid Disorders

Long-Term Effects After Childhood Cancer

Hypoglycaemia

Chapter 15. Research in Medicine: Why do we Need It and How do (should) we Do It?

Introduction

Medical Literature

The Scientific Process

How do you Get Started with a Research Project? A Step-By-Step Approach

Concluding Remarks

References

Chapter 16. Molecular Biology and Molecular Genetics in Paediatric Endocrinology

Introduction

From Genome to Metabolome

Bioinformatic Tools

Structure of the Genome

Structure of a Gene

Analysis of Chromosomes and DNA: Methodological Aspects

Mutations and Endocrine Disorders

How to Approach a Patient with a Genetic Endocrine Disease

Genetic Counselling

Overview of Genetic Disorders in Paediatric Endocrinology

References and Further Reading

Index

Details

No. of pages:
416
Language:
English
Copyright:
© Academic Press 2013
Published:
Imprint:
Academic Press
eBook ISBN:
9780124079366
Hardcover ISBN:
9780124078222
Paperback ISBN:
9780128102756

About the Editor

Margaret Zacharin

A/Prof. Margaret Zacharin is a paediatric and adult endocrinologist, working at the Royal Children’s hospital, and the Peter MacCallum cancer hospital, Melbourne, Australia. Her clinical practice interests include disorders of puberty, bone health and long term effects of childhood cancer, with research in areas of primary and secondary bone disorders and hormone replacement. She has major teaching commitments in Europe, Africa and India and aims to help promulgate awareness of a need for improving access to and care of paediatric endocrine disorders in developing countries and in places where resources are constrained and reliance on clinical assessment and management strategies is paramount.

Affiliations and Expertise

Associate Professor, University of Melbourne; Pediatric and Adult Endocrinologist, Royal Children's Hospital, Parkville, Victoria, Australia