Handbook of Diagnostic Endocrinology (Contemporary by Janet E. Hall, Lynnette K. Nieman

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By Janet E. Hall, Lynnette K. Nieman

Skilled physicians concisely clarify the pathophysiology and medical manifestations of endocrine issues and survey the entire most up-to-date laboratory diagnostics. themes variety greatly from an summary of the analysis of diabetes and the long term tracking of its issues to the overview of menstrual disorder. assurance can be given to the prognosis of pituitary tumors, Cushing's syndrome, thyroid disorder, and hypoglycemia; the assessment of endocrine-induced high blood pressure; the overview of dyslipidemia and weight problems; and techniques to diagnosing hyper- and hypocalcemia. There also are discussions of osteoporosis, hypogonadism and erectile disorder, and hyperandrogenism in girls. The authors every one overview the complicated physiological foundation of the proper endocrine strategies and supply richly instructive innovations for followup and long term administration of sufferers.

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Hypoglycemia also stimulates AVP release in man, but to relatively low levels that are not consistent among individuals. As will be discussed in the clinical disorders, a variety of drugs also stimulate AVP secretion, including nicotine (17). However, despite the importance of these stimuli during pathological conditions, none of them is a significant determinant of physiological regulation of AVP secretion in man. Integration of Thirst and AVP Secretion A synthesis of what is presently known about the regulation of thirst and AVP secretion in man leads to a relatively simple but elegant system to maintain water balance.

Stimulation of AVP secretion at Posms below the threshold for subjective thirst acts to maintain an excess of body water sufficient to eliminate the need to drink whenever slight elevations in Posm occur. This system of differential effective thresholds for thirst and AVP secretion nicely complements many studies that have demonstrated excess unregulated, or need-free, drinking in both man and animals (6). Therefore, in summary, during normal day-to-day conditions, body water homeostasis appears to be maintained primarily by ad libitum, or unregulated, fluid intake in association with AVP-regulated changes in urine flow, most of 02/Verbalis/23-54/F 32 12/2/02, 8:36 AM Chapter 2/Water Metabolism Disorders 33 which occurs before the threshold is reached for osmotically stimulated, or regulated, thirst.

2. Ekins RP. Ligand assays: from electrophoresis to miniaturized microarrays. Clin Chem 1998;44:2015–2030. 3. Van Vunakis H. Radioimmunoassays: an overview. Methods Enzymol 1980;70:201–209. 4. Jaffe BM, Behram HR. Methods of Hormone Radioimmunoassay, 2nd ed. Academic Press, New York, 1978. 5. Yalow RS. Radioimmunoassay: a probe for the fine structure of biologic systems. Science 1978;200:1236. 6. Parker CW. Radioimmunoassay of Biologically Active Compounds. Prentice-Hall, Englewood Cliffs, NJ, 1976.

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