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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 o… Read more
SUSTAINABLE DEVELOPMENT
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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.
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
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
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