Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0043
S. Bonnema, L. Hegedüs
Nuclear medicine techniques, like iodine uptake measurements, planar scintigraphy, and positron emission tomography (PET), are very helpful in the management of a number of thyroid disorders. The thyroid gland can trap radioactive iodine as well as the widely used 99mTc isotope. Non-iodine radioactive isotopes are also useful, primarily in the context of PET. The emission of γ -photons enables detection by a gamma camera, resulting in the generation of a two- or three-dimensional thyroid image. In contrast to most other imaging methods, nuclear medicine techniques reflect the functional status of the thyroid tissue. Among other advantages, this feature aids in the management of patients with thyroid nodular diseases in order to diagnose thyroid malignancy. In patients with established thyroid cancer, various techniques, like radioiodine whole-body scan or PET, are very sensitive for detection and localizing of residual malignant thyroid tissue. This chapter focuses on and discusses advantages and limitations of nuclear medicine techniques in thyroid diseases.
{"title":"Thyroid Imaging","authors":"S. Bonnema, L. Hegedüs","doi":"10.1093/med/9780198870197.003.0043","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0043","url":null,"abstract":"Nuclear medicine techniques, like iodine uptake measurements, planar scintigraphy, and positron emission tomography (PET), are very helpful in the management of a number of thyroid disorders. The thyroid gland can trap radioactive iodine as well as the widely used 99mTc isotope. Non-iodine radioactive isotopes are also useful, primarily in the context of PET. The emission of γ -photons enables detection by a gamma camera, resulting in the generation of a two- or three-dimensional thyroid image. In contrast to most other imaging methods, nuclear medicine techniques reflect the functional status of the thyroid tissue. Among other advantages, this feature aids in the management of patients with thyroid nodular diseases in order to diagnose thyroid malignancy. In patients with established thyroid cancer, various techniques, like radioiodine whole-body scan or PET, are very sensitive for detection and localizing of residual malignant thyroid tissue. This chapter focuses on and discusses advantages and limitations of nuclear medicine techniques in thyroid diseases.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122125621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0004
J. Danks, S. Richardson
Molecular biology advances have assisted comparative endocrinology. Previously the characterization of hormones in ‘lower’ vertebrates relied upon biological assays and protein chemistry, whereas now genes are readily revealed in whole genome sequences, and specific antibodies and other reagents for sensitive assays can rapidly be developed, enabling revealing physiological experiments. Comparative endocrinology only became a special field in the last 50 years as endocrinologists concentrated on rodents as their preferred animal model. In the past many of the known hormones were originally identified in ‘lower’ vertebrates. Two paradigmatic examples of the value of comparative endocrinology will be highlighted. Calcium regulating factors, both hypercalcaemic and hypocalcaemic, will be discussed before thyroid hormones. Both groups of hormones are essential for human life during development and in adulthood, and pivotal insights have been gained from non-mammalian vertebrates.
{"title":"Endocrinology and Evolution","authors":"J. Danks, S. Richardson","doi":"10.1093/med/9780198870197.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0004","url":null,"abstract":"Molecular biology advances have assisted comparative endocrinology. Previously the characterization of hormones in ‘lower’ vertebrates relied upon biological assays and protein chemistry, whereas now genes are readily revealed in whole genome sequences, and specific antibodies and other reagents for sensitive assays can rapidly be developed, enabling revealing physiological experiments. Comparative endocrinology only became a special field in the last 50 years as endocrinologists concentrated on rodents as their preferred animal model. In the past many of the known hormones were originally identified in ‘lower’ vertebrates. Two paradigmatic examples of the value of comparative endocrinology will be highlighted. Calcium regulating factors, both hypercalcaemic and hypocalcaemic, will be discussed before thyroid hormones. Both groups of hormones are essential for human life during development and in adulthood, and pivotal insights have been gained from non-mammalian vertebrates.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116869464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0219
R. Clarke, Alice Greenhalgh
Breast cancer is the most common form of cancer in women. In order to fully understand the molecular causes of breast cancer, it is critical to understand the underlying mechanisms which regulate and dictate normal breast development. Both pituitary and ovarian steroid hormones are required to regulate and govern breast development. Progesterone is an ovarian steroid hormone and is considered to be a major risk factor for the development of breast cancer, since it controls proliferation of stem and progenitor cells. The human breast is organized as an epithelial network of ducts opening at the nipple and these form a tree-like structure ending in lobuloalveolar glands located within the collagenous and adipose tissue of the mammary gland. Upon pregnancy, specialized luminal cells develop in the alveoli which go on to secrete milk proteins and lipids during lactation. Breast development occurs in three well-defined stages: embryonic, pubertal, and reproductive.
{"title":"The Breast","authors":"R. Clarke, Alice Greenhalgh","doi":"10.1093/med/9780198870197.003.0219","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0219","url":null,"abstract":"Breast cancer is the most common form of cancer in women. In order to fully understand the molecular causes of breast cancer, it is critical to understand the underlying mechanisms which regulate and dictate normal breast development. Both pituitary and ovarian steroid hormones are required to regulate and govern breast development. Progesterone is an ovarian steroid hormone and is considered to be a major risk factor for the development of breast cancer, since it controls proliferation of stem and progenitor cells. The human breast is organized as an epithelial network of ducts opening at the nipple and these form a tree-like structure ending in lobuloalveolar glands located within the collagenous and adipose tissue of the mammary gland. Upon pregnancy, specialized luminal cells develop in the alveoli which go on to secrete milk proteins and lipids during lactation. Breast development occurs in three well-defined stages: embryonic, pubertal, and reproductive.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125772036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0204
H. Vervenne, G. Berghe
The neuroendocrine responses to acute and prolonged critical illness are substantially different. In the acute phase, the adaptations are probably beneficial in the struggle for short-term survival, whereas the chronic alterations may be maladaptive and participate in the general wasting syndrome of prolonged critical illness. Thorough understanding of the pathophysiology underlying these distinct neuroendocrine alterations during acute and prolonged critical illness is vital when considering new therapeutic strategies to correct these abnormalities and, as such, open perspectives to improve survival. Indeed, adequate choice of hormone and corresponding dosage are crucial and depend on such insights. The concomitant administration of presumed deficient (hypothalamic) releasing factors holds promise as an effective and safe intervention to jointly restore the corresponding axes and to counteract the hypercatabolic state of prolonged critical illness.
{"title":"Endocrinology in the Critically Ill","authors":"H. Vervenne, G. Berghe","doi":"10.1093/med/9780198870197.003.0204","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0204","url":null,"abstract":"The neuroendocrine responses to acute and prolonged critical illness are substantially different. In the acute phase, the adaptations are probably beneficial in the struggle for short-term survival, whereas the chronic alterations may be maladaptive and participate in the general wasting syndrome of prolonged critical illness. Thorough understanding of the pathophysiology underlying these distinct neuroendocrine alterations during acute and prolonged critical illness is vital when considering new therapeutic strategies to correct these abnormalities and, as such, open perspectives to improve survival. Indeed, adequate choice of hormone and corresponding dosage are crucial and depend on such insights. The concomitant administration of presumed deficient (hypothalamic) releasing factors holds promise as an effective and safe intervention to jointly restore the corresponding axes and to counteract the hypercatabolic state of prolonged critical illness.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124659774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0490
A. Dobs, Swaytha Yalamanchi
Testosterone has been increasingly prescribed in recent years, particularly for middle-aged and older men with relatively non-specific symptoms that mimic androgen deficiency. There has thus been considerable interest in understanding the risk–benefit ratio of testosterone treatment in older men who may be particularly vulnerable to some of the adverse effects of exogenous testosterone. The exact risks and patient-important benefits are currently unknown due to lack of data from adequate randomized control trials, but some helpful inferences can be made based on available data. Erythrocytosis, the most commonly reported adverse effect of testosterone therapy, has been reported to be 3–4 times more likely in men treated with testosterone as compared to placebo; however, the form of therapy may play a role with the highest risk seen in men receiving intramuscular testosterone therapy as compared to transdermal formulations. Reassuringly, current data do not demonstrate that exogenous testosterone causes de novo or worsens mild to moderate lower urinary tract symptoms; insufficient data exist in men with severe lower urinary tract symptoms as such men have usually been excluded from testosterone trials. Testosterone has not been demonstrated to cause prostate cancer, but is not recommended presently in men who either have a history of prostate cancer or are otherwise at high risk. The effects of testosterone treatment on cardiovascular disease risk are unknown. The majority of presently available data do not suggest an increased risk, but in the absence of adequately powered randomized controlled trials, caution in men with pre-existing cardiovascular disease is recommended. Overall, further data are needed to better understand both the benefits and risks of exogenous testosterone in older men.
{"title":"Risks of Testosterone Treatment","authors":"A. Dobs, Swaytha Yalamanchi","doi":"10.1093/med/9780198870197.003.0490","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0490","url":null,"abstract":"Testosterone has been increasingly prescribed in recent years, particularly for middle-aged and older men with relatively non-specific symptoms that mimic androgen deficiency. There has thus been considerable interest in understanding the risk–benefit ratio of testosterone treatment in older men who may be particularly vulnerable to some of the adverse effects of exogenous testosterone. The exact risks and patient-important benefits are currently unknown due to lack of data from adequate randomized control trials, but some helpful inferences can be made based on available data. Erythrocytosis, the most commonly reported adverse effect of testosterone therapy, has been reported to be 3–4 times more likely in men treated with testosterone as compared to placebo; however, the form of therapy may play a role with the highest risk seen in men receiving intramuscular testosterone therapy as compared to transdermal formulations. Reassuringly, current data do not demonstrate that exogenous testosterone causes de novo or worsens mild to moderate lower urinary tract symptoms; insufficient data exist in men with severe lower urinary tract symptoms as such men have usually been excluded from testosterone trials. Testosterone has not been demonstrated to cause prostate cancer, but is not recommended presently in men who either have a history of prostate cancer or are otherwise at high risk. The effects of testosterone treatment on cardiovascular disease risk are unknown. The majority of presently available data do not suggest an increased risk, but in the absence of adequately powered randomized controlled trials, caution in men with pre-existing cardiovascular disease is recommended. Overall, further data are needed to better understand both the benefits and risks of exogenous testosterone in older men.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128603780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0006
W. Drake, B. Keevil, P. Trainer
Accurate assessment of anterior pituitary function requires a sound knowledge of its normal physiology together with careful integration of clinical and biochemical information. The optimum methods of testing anterior and posterior pituitary function and the interpretation of the results are subjects of continuing debate. The syndromes associated with and consequences of hypo- and hyperpituitarism; and the diagnosis and treatment of diabetes insipidus are all discussed elsewhere in this book. The intention of this chapter is to describe the physiological basis and evidence in favour of the various available tests of anterior pituitary function, while at the same time acknowledging their limitations and appreciating the importance of the clinical context of testing.
{"title":"Pituitary Assessment Strategy","authors":"W. Drake, B. Keevil, P. Trainer","doi":"10.1093/med/9780198870197.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0006","url":null,"abstract":"Accurate assessment of anterior pituitary function requires a sound knowledge of its normal physiology together with careful integration of clinical and biochemical information. The optimum methods of testing anterior and posterior pituitary function and the interpretation of the results are subjects of continuing debate. The syndromes associated with and consequences of hypo- and hyperpituitarism; and the diagnosis and treatment of diabetes insipidus are all discussed elsewhere in this book. The intention of this chapter is to describe the physiological basis and evidence in favour of the various available tests of anterior pituitary function, while at the same time acknowledging their limitations and appreciating the importance of the clinical context of testing.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127479378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0188
A. Rogol, J. Fuqua
Delayed puberty occurs when no signs of pubertal maturation are seen by 14 years of age in boys or 13 years in girls. Although constitutional delay of growth and puberty is commonly seen and is often regarded as benign, there are many other causes of pubertal delay that ultimately result in permanent hypogonadism, and these must be differentiated from self-limited delays in maturation. Causes of hypogonadism include disorders affecting the gonads (primary hypogonadism) and abnormalities of pituitary or hypothalamic function (hypogonadotropic hypogonadism). Hypogonadotropic hypogonadism may be part of a more global set of pituitary deficiencies or may be the only endocrine axis affected. A rapidly growing array of genetic disorders accounts for isolated hypogonadotropic hypogonadism. Treatment of delayed puberty often consists of short-term administration of sex steroids to those with constitutional delay, while individuals with permanent hypogonadism require long-term testosterone or oestradiol replacement.
{"title":"Pubertal Delay and Hypogonadism","authors":"A. Rogol, J. Fuqua","doi":"10.1093/med/9780198870197.003.0188","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0188","url":null,"abstract":"Delayed puberty occurs when no signs of pubertal maturation are seen by 14 years of age in boys or 13 years in girls. Although constitutional delay of growth and puberty is commonly seen and is often regarded as benign, there are many other causes of pubertal delay that ultimately result in permanent hypogonadism, and these must be differentiated from self-limited delays in maturation. Causes of hypogonadism include disorders affecting the gonads (primary hypogonadism) and abnormalities of pituitary or hypothalamic function (hypogonadotropic hypogonadism). Hypogonadotropic hypogonadism may be part of a more global set of pituitary deficiencies or may be the only endocrine axis affected. A rapidly growing array of genetic disorders accounts for isolated hypogonadotropic hypogonadism. Treatment of delayed puberty often consists of short-term administration of sex steroids to those with constitutional delay, while individuals with permanent hypogonadism require long-term testosterone or oestradiol replacement.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131952056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0267
J. Gunst, G. Van den Berghe
Critically ill patients and patients undergoing major surgery usually develop stress hyperglycaemia, which is associated with an increased morbidity and mortality risk. Randomized controlled trials interfering with elevated blood glucose during intensive care and the perioperative period have yielded mixed results, however. The optimal blood glucose target may depend on the context. Tight glucose control was shown to be effective and safe when performed with accurate glucose measurement tools and a reliable insulin infusion protocol in patients receiving early parenteral nutrition. Whether tight glucose control is beneficial in the absence of early parenteral nutrition, remains to be studied. In any case, hypoglycaemia and severe hyperglycaemia should be avoided. In patients with poorly controlled diabetes, the ideal blood glucose target may be higher than in non-diabetics.
{"title":"Care of Diabetes in ICU and Perisurgery","authors":"J. Gunst, G. Van den Berghe","doi":"10.1093/med/9780198870197.003.0267","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0267","url":null,"abstract":"Critically ill patients and patients undergoing major surgery usually develop stress hyperglycaemia, which is associated with an increased morbidity and mortality risk. Randomized controlled trials interfering with elevated blood glucose during intensive care and the perioperative period have yielded mixed results, however. The optimal blood glucose target may depend on the context. Tight glucose control was shown to be effective and safe when performed with accurate glucose measurement tools and a reliable insulin infusion protocol in patients receiving early parenteral nutrition. Whether tight glucose control is beneficial in the absence of early parenteral nutrition, remains to be studied. In any case, hypoglycaemia and severe hyperglycaemia should be avoided. In patients with poorly controlled diabetes, the ideal blood glucose target may be higher than in non-diabetics.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132150893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0201
C. D. Roo, G. T’Sjoen
Transgender persons inherently possess normal reproductive capacity, however, hormonal and surgical treatments for transgender people potentially impair the ability of these individuals to reproduce. Additionally, transgender people tend to start gender-affirming treatment at a young age, when reproductive wishes are not yet clearly defined nor fulfilled. The most recent Standards of Care of the World Professional Association for Transgender Health recommend to clearly inform patients on their future reproductive options prior to initiation of treatment. Where surgery definitely results in sterility, hormone therapy on the other hand also has an important, but partially reversible impact on fertility. However, thresholds for cross-sex hormone treatment to avoid permanent reproductive impairment have not been established. The current fertility preservation options for transgender men are embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. For transgender women, sperm cryopreservation, surgical sperm extraction, and testicular tissue cryopreservation are possible.
{"title":"Fertility Options for Transgender Persons","authors":"C. D. Roo, G. T’Sjoen","doi":"10.1093/med/9780198870197.003.0201","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0201","url":null,"abstract":"Transgender persons inherently possess normal reproductive capacity, however, hormonal and surgical treatments for transgender people potentially impair the ability of these individuals to reproduce. Additionally, transgender people tend to start gender-affirming treatment at a young age, when reproductive wishes are not yet clearly defined nor fulfilled. The most recent Standards of Care of the World Professional Association for Transgender Health recommend to clearly inform patients on their future reproductive options prior to initiation of treatment. Where surgery definitely results in sterility, hormone therapy on the other hand also has an important, but partially reversible impact on fertility. However, thresholds for cross-sex hormone treatment to avoid permanent reproductive impairment have not been established. The current fertility preservation options for transgender men are embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. For transgender women, sperm cryopreservation, surgical sperm extraction, and testicular tissue cryopreservation are possible.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131307280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780198870197.003.0040
P. Laurberg, I. B. Pedersen
Goitre and thyroid abnormalities are common in populations with both low and high iodine intake. A clinical investigation of the thyroid, including inspection, palpation, and auscultation of the thyroid gland, remains first-line evaluation for goitre and thyroid nodules. Clinical symptoms and signs of hyper- and hypothyroidism are many and may overlap considerably with complains and abnormalities commonly seen in other diseases and in apparently healthy people. The first-line test for thyroid dysfunction is measurement of thyroid-stimulation hormone (TSH) in serum. The diagnosis and evaluation of nosological type of thyroid disorder should be substantiated by further biochemical tests and imaging procedures. Interpretation of laboratory tests of thyroid function highly depend on information on medication and clinical conditions including pregnancy.
{"title":"Clinical Assessment of the Thyroid Patient","authors":"P. Laurberg, I. B. Pedersen","doi":"10.1093/med/9780198870197.003.0040","DOIUrl":"https://doi.org/10.1093/med/9780198870197.003.0040","url":null,"abstract":"Goitre and thyroid abnormalities are common in populations with both low and high iodine intake. A clinical investigation of the thyroid, including inspection, palpation, and auscultation of the thyroid gland, remains first-line evaluation for goitre and thyroid nodules. Clinical symptoms and signs of hyper- and hypothyroidism are many and may overlap considerably with complains and abnormalities commonly seen in other diseases and in apparently healthy people. The first-line test for thyroid dysfunction is measurement of thyroid-stimulation hormone (TSH) in serum. The diagnosis and evaluation of nosological type of thyroid disorder should be substantiated by further biochemical tests and imaging procedures. Interpretation of laboratory tests of thyroid function highly depend on information on medication and clinical conditions including pregnancy.","PeriodicalId":130301,"journal":{"name":"Oxford Textbook of Endocrinology and Diabetes 3e","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125568792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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