By Anil Bhansali, Yashpal Gogate
This e-book covers attention-grabbing and but usually demanding circumstances between grownup sufferers in a distinct Question-Answer structure. Simulating the bed-side case discussions in the course of the ward rounds, one query logically results in one other query thereby producing interest and selling evidence-based medication. Taking the readers in the course of the complete spectrum ranging from etiology and pathophysiology to medical presentation to administration ideas, each one query addresses one key element of the affliction. defined in a very easy and lucid narrative, this booklet guarantees sound conceptual figuring out whereas protecting each one subject comprehensively. This quantity covers vital themes similar to acromegaly, Cushing syndrome, osteoporosis, hypercalcemia, pheochromocytoma, hyperaldosteronism, thyroid issues and diabetes in grownup sufferers. those circumstances aren't in basic terms obvious via endocrinologists, yet also are controlled through internists, orthopedic surgeons, obstetricians and gynecologists. much less universal issues comparable to adrenal problems and androgen extra have additionally been coated.
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Additional info for Clinical Rounds in Endocrinology: Volume I - Adult Endocrinology
As pegvisomant blocks GH receptors at hepatocytes and decreases hepatic glucose output, it is the preferred drug in this scenario. Addition of cabergoline to conventional treatment for preoperative control of blood glucose may be useful (unpublished observation). Cabergoline acts through dopamine subtype 2 receptor and resets the altered sympathetic tone leading to control of blood glucose level and decrease in GH–IGF1. 48. What is dopastatin? Dopastatin is a chimeric analogue combining somatostatin (SSTR 2 and 5) and dopamine subtype 2 agonist.
Treatment with cabergoline progressively improves gonadal function in up to 60% of patients with macroprolactinoma after 4–6 months of therapy. In our patient, hypothalamo–pituitary– gonadal axis is less likely to recover because of the presence of giant adenoma (>4 cm) and concurrent apoplexy.
However, in a patient with apoplexy, use of cabergoline is fraught with the risk of worsening of apoplexy. In addition, CSF rhinorrhea may occur with the use of cabergoline in patients with infrasellar extension of tumor. 5 mg twice weekly with close monitoring for CSF rhinorrhea and neurological status. Treatment with cabergoline progressively improves gonadal function in up to 60% of patients with macroprolactinoma after 4–6 months of therapy. In our patient, hypothalamo–pituitary– gonadal axis is less likely to recover because of the presence of giant adenoma (>4 cm) and concurrent apoplexy.