Cover -- Half-title -- Title -- Copyright -- Contents -- Preface -- Section 1 Perioperative care of patients with endocrine disease -- Chapter 1 Anaesthesia for patients with pituitary disease -- Introduction -- Clinical anatomy and physiology of the hypothalamo-pituitary-neuroendocrine axis -- Clinical features of pituitary disease -- Endocrine hyposecretion syndromes -- Hormone hypersecretion syndromes -- Cushing's syndrome/disease -- Acromegaly -- Pituitary apoplexy -- Management of patients undergoing trans-sphenoidal resection of a pituitary adenoma -- References -- Chapter 2 Thyroid disease -- Introduction -- Anatomy -- Physiology -- Hypothyroidism -- Hashimoto's disease -- Myxoedema coma -- Hyperthyroidism -- Graves' disease -- Thyroid eye disease -- De Quervain's thyroiditis -- Thyroid crisis -- Thyroidectomy -- Indications -- Preoperative assessment -- Imaging -- Anaesthetic technique -- Regional anaesthesia -- General anaesthesia -- Tracheal intubation -- Anticipated difficult intubation -- Awake fibreoptic intubation -- Fibreoptic intubation under anaesthesia -- Unexpected difficult intubation -- Positioning the patient -- Surgical technique -- Monitoring of the recurrent laryngeal nerve -- Postoperative care -- Special situations -- Graves' disease -- Thyroid cancer -- Multiple endocrine neoplasia -- Large goitres -- Lingual thyroid -- Retrosternal goitre -- Thoracic goitre -- Pregnancy -- Trophoblastic disease -- Radioiodine treatment -- Postoperative complications -- Extubation problems -- Haematoma -- Recurrent laryngeal nerve damage -- Tracheomalacia -- Laryngeal oedema -- Hypocalcaemia -- Wound complications -- Postoperative pain -- Future developments -- Conclusions -- Chapter 3 Parathyroid disease -- Anatomy and embryology of the parathyroid gland -- Physiology -- Calcium-sensing receptor and secretion of parathyroid hormone.

Effects of parathyroid hormone -- Action of parathyroid hormone on bone -- Renal effects -- Intestinal effects -- Effect on phosphate -- Vitamin D -- Parathyroid hormone-related peptide (PTHrP) -- Pathological disorders of the parathyroid glands -- Hypoparathyroidism -- Causes -- Genetic defects and congenital hypoparathyroidism -- Acquired hypoparathyroidism -- Clinical features of hypoparathyroidism -- Diagnosis -- Treatment -- Causes -- Genetic defects and congenital hypoparathyroidism -- Acquired hypoparathyroidism -- Clinical features of hypoparathyroidism -- Diagnosis -- Treatment -- Primary hyperparathyroidism -- Causes -- Multiple endocrine neoplasia (MEN) syndromes -- Clinical features -- Diagnosis -- Management of primary hyperparathyroidism -- Calcimimetics -- Bisphosphonates -- Other medical treatments and lifestyle modifications -- Causes -- Multiple endocrine neoplasia (MEN) syndromes -- Clinical features -- Diagnosis -- Management of primary hyperparathyroidism -- Calcimimetics -- Bisphosphonates -- Other medical treatments and lifestyle modifications -- Secondary hyperparathyroidism -- Renal hyperparathyroidism -- Fibroblast growth factor 23 (FGF23) and Klotho -- Medical management -- Renal hyperparathyroidism -- Fibroblast growth factor 23 (FGF23) and Klotho -- Medical management -- Parathyroidectomy -- Surgical approaches -- Preoperative localisation -- Intraoperative monitoring and localisation of the parathyroid glands -- Methylene blue -- Gamma probe -- Intraoperative identification of the recurrent laryngeal nerve -- Intraoperative monitoring of parathyroid hormone -- Anaesthetic considerations -- Surgical approaches -- Preoperative localisation -- Intraoperative monitoring and localisation of the parathyroid glands -- Methylene blue -- Gamma probe -- Intraoperative identification of the recurrent laryngeal nerve.

Intraoperative monitoring of parathyroid hormone -- Anaesthetic considerations -- Chapter 4 Adrenal disease: cortex and medulla -- Surgery for adrenal disease -- Phaeochromocytoma -- Presentation and diagnosis -- Preoperative preparation -- Preoperative drug therapy -- Alpha-adrenergic block -- Surgical management -- Perioperative management -- Surgical management -- Anaesthetic management -- Premedication -- Monitoring -- Maintenance -- Intraoperative problems -- Hypertension -- Hypotension -- Postoperative care -- Primary hyperaldosteronism (Conn's syndome) -- Anaesthetic management -- Excess glucocorticoid secretion (Cushing's syndrome) -- Anaesthetic considerations -- Steroid replacement therapy and surgery -- Chapter 5 Pancreatic neuroendocrine tumours including carcinoid -- Introduction and overview -- Islet cell tumours -- Carcinoid tumours -- General characteristics of the tumours -- Insulinoma -- Gastrinoma -- Non-functional neuroendocrine tumours -- Somatostatinoma -- Other islet cell tumours: VIPoma and glucagonoma -- Carcinoid tumours -- General considerations -- Chapter 6 Multiple endocrine neoplasia -- MEN 1: incidence, clinical features and diagnosis -- MEN 1, the MEN 1 gene and its protein, menin. -- MEN 2: incidence, clinical features and diagnosis -- The .Ret gene and MEN type 2 -- Screening and surveillance of MEN 2 -- Summary -- Acknowledgements -- Section 2 Perioperative care of the patient with diabetes mellitus -- Chapter 7 Diabetes: aetiology and pathophysiology -- Diagnosis of diabetes mellitus -- Type 1 diabetes -- Causation of type 1 diabetes -- Presentation of type 1 diabetes -- Management of type 1 diabetes -- Hypoglycaemia -- Complications of diabetes mellitus -- Microvascular complications -- Macrovascular -- Type 2 diabetes -- Hyperglycaemia in type 2 diabetes -- Insulin resistance in type 2 diabetes.

Insulin signalling -- β-cell dysfunction -- Insulin secretion -- Management of type 2 diabetes -- Management of cardiovascular complications -- References -- Chapter 8 Drugs used in diabetes mellitus -- Sulphonylureas -- Meglitinides -- Biguanides -- Thiazolidinediones -- Alpha-glucosidase inhibitors -- Incretins/GLP-1 mimetics -- Dipeptidyl peptidase-4 inhibitors -- Synthetic amylin analogues -- Insulin therapy -- References -- Chapter 9 Management of diabetes in surgical inpatients -- Preoperative assessment -- Metabolic challenge of surgery -- Aims of metabolic management -- Target glucose concentration perioperatively -- Perioperative glucose control -- Anaesthesia -- Regional anaesthesia -- General anaesthesia -- Intravenous fluids -- Monitoring of metabolism -- Postoperative care -- Conclusion -- Chapter 10 Management of diabetes in obstetric patients -- Epidemiology -- Risks associated with diabetes in pregnancy -- Preconception management -- Gestational diabetes -- Antenatal management -- Intrapartum management -- Glycaemic control in labour -- Analgesia for labour and vaginal delivery -- Acid-base status -- Haemodynamic control -- Neuropathy -- Obesity -- Anaesthesia for Caesarean section -- General principles -- Specific considerations in diabetics -- Neonatal management -- Neonatal hypoglycaemia -- Postnatal management -- Treatment and follow-up -- Breast or formula feeding -- Conclusions -- Chapter 11 Management of diabetes in paediatric surgery -- Introduction -- Type 1 diabetes -- Type 2 diabetes -- Maturity onset diabetes of youth -- Natural history -- Response to surgery -- Preoperative preparation -- General points -- Investigations -- Management of fasting -- Day care -- Peroperative management -- Minor surgery -- Morning surgery -- Postoperative care -- Afternoon surgery -- Continuous insulin pumps -- Major surgery.

Preoperative preparation -- Intravenous fluids -- Emergency surgery in the diabetic child -- Additional postoperative issues -- Antiemetics -- Analgesia -- Summary -- Chapter 12 Management of diabetes in ambulatory surgery -- Preoperative management -- Peroperative management -- Postoperative management -- Conclusions -- Section 3 Endocrine disorders in the critically ill -- Chapter 13 The endocrine response to critical illness -- Introduction -- Metabolic changes in the critically ill -- Ebb and flow -- Endocrine responses to critical illness: an overview -- The hypothalamo-pituitary-adrenal axis -- Etomidate and the cortisol response to stress -- The hypothalamo-pituitary-thyroid axis -- The hypothalamo-pituitary-gonadal axis -- The growth hormone, insulin-like growth factor (IGF), IGF-binding protein axis -- Metabolic and endocrine response in critical illness: adaptive or part of the problem? -- The problem of critical illness: if only life were simple -- What is critical illness? -- Critical illness: an evolving process -- Studying dynamic systems in an evolving process: the problem of too many variables -- Variable baselines: confounding co-morbidity -- Understanding sepsis: cellular stress as a model framework for the study of endocrine and metabolic changes in critical illness -- Cellular stress and critical illness -- Ebb and flow revisited: reflections on the past and directions for the future -- Chapter 14 Tight glucose control using intensive insulin therapy in the critically ill -- Introduction -- Effects of hyperglycaemia and insulin -- Tight glucose control by intensive insulin therapy -- Intensive insulin treatment protocols -- Hypoglycaemia -- How to measure glucose in the intensive care unit -- In search of the right targets -- Conclusions -- Chapter 15 Glucocorticoids in the critically ill -- Introduction.

Pharmacology of glucocorticoids.