Zeʾēv Hôḵberg Livres

Algorithms provide a logical, concise and cost-effective approach to medical reasoning: utilizing a concise, step-by-step approach based upon clues from the history, physical examination and laboratory studies, algorithms help avoid excessive unnecessary procedures and testing. The 3rd, revised edition of Practical Algorithms in Pediatric Endocrinology deals with practical issues of child growth, puberty, diseases of the endocrine glands, sexual differentiation, as well as aberrations of water, electrolyte, mineral and carbohydrate metabolism. Fifty-six clinical issues are covered by an algorithmic approach, breaking down long lists and tables of differential diagnosis into smaller, more manageable ones. Common clinical symptoms, signs and laboratory abnormalities are classified as they present themselves at the patient’s bedside. This book is aimed at general practitioners and pediatricians, in particular those who are not exposed to pediatric endocrine problems on a daily basis, and at trainees in endocrinology and pediatric endocrinology as they acquire familiarity with clinical problem solving to make rational choices when facing clinical dilemmas.

As a common concept 'bone age' is felt to be an expression of the biological maturity of a child. Inferring from bone maturity, the clinician can contemplate diagnostic considerations and evaluate height prediction. A radiogram of the hand and wrist may provide additional information that is not being evaluated by reading of a 'bone age'. Although it reveals only calcified elements it provides a glimpse into a whole variety of processes in bone and cartilage growth, differentiation and calcification which, in turn, are regulated by control mechanisms. Thyroid hormones, sex steroids, calcium regulating hormones are but a few of these control mechanisms, and their effect may become evident when radiograms are carefully examined. This book illustrates how to interpret the biological mechanisms of growth from hand and wrist x-rays reviewing at the same time the anatomical and histological maturation of long bones and cuboid bones. It summarizes the endocrine regulation.

Centuries ago, during the industrial revolution, rickets, known as 'the English disease', became widespread among impoverished city children due to vitamin D deficiency and lack of sunlight. Today, it appears to be endemic again, as rising vitamin D deficiency correlates with increased breastfeeding in Western societies. Key risk factors for rickets include breastfeeding, nutritional status, and dark skin. Understanding rickets, or 'rachitis', requires knowledge of mineral metabolism and its regulation in growing children. It is now recognized that rickets is not solely due to vitamin D deficiency; both vitamin D and calcium deficiencies are common in developing countries and affluent societies where children and mothers have limited sunlight exposure. Advances in molecular biology have facilitated the use of subcellular technologies to investigate vitamin D in human and animal studies. This volume presents the latest research on vitamin D and rickets from various perspectives, including a historical overview of bone metabolism, molecular genetics of vitamin D, and insights for disease prevention. It will particularly interest pediatricians, endocrinologists, and healthcare specialists working with at-risk children.