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Book Details
Abstract
Essential reading for candidates for the MRCPath examination and similar postgraduate examinations in clinical biochemistry. The book gives an overview of the acquisition of data, as well as concentrating on clinical aspects of the subject, giving detailed coverage of all conditions where clinical biochemistry is used in diagnosis and management. In common with other diagnostic specialties clinical biochemistry now uses an increasing number of techniques involving the 'new biology': these are covered in this book. It is also increasingly common for medically qualified clinical biochemists to become involved in the clinical management of patients (eg nutritional support) and material on this will be included.
- Significant changes to content to reflect changes in how clinical chemistry services are organised and to reflect the advent of metabolic medicine as a recognised specialty.
- Chapter on Clinical biochemistry of nutrition to include new information on regulation of appetite and the clinical management of obesity.
- New chapter to bring together information on inborn errors of metabolism affecting adults.
- New chapter on clinical biochemistry of cardiovascular disease.
- The diabetes chapter has been split into two separate chapters to allow more detailed description of the practical clinical management of the disease.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Clinical Biochemistry: Metabolic and Clinical Aspects | iii | ||
| Copyright Page | iv | ||
| Contents | v | ||
| Preface | vii | ||
| Contributors | ix | ||
| Chapter 1. The uses of biochemical data in clinical medicine | 1 | ||
| INTRODUCTION | 1 | ||
| SPECIFIC USES OF BIOCHEMICAL TESTS | 2 | ||
| CONCLUSION | 5 | ||
| FURTHER READING | 6 | ||
| Chapter 2. The acquisition of biochemical data | 7 | ||
| INTRODUCTION | 7 | ||
| THE TEST REQUEST | 7 | ||
| FACTORS AFFECTING TEST RESULTS | 7 | ||
| CONCLUSION | 16 | ||
| FURTHER READING | 16 | ||
| Chapter 3. The interpretation of biochemical data | 17 | ||
| INTRODUCTION | 17 | ||
| THE QUALITY OF RESULTS | 17 | ||
| NORMAL AND ABNORMAL | 17 | ||
| THE INTERPRETATION OF RESULTS | 20 | ||
| THE PREDICTIVE VALUE OF TESTS | 22 | ||
| EVIDENCE-BASED CLINICAL BIOCHEMISTRY | 27 | ||
| CONCLUSION | 27 | ||
| FURTHER READING | 27 | ||
| Chapter 4. Sodium, water and potassium | 28 | ||
| PHYSIOLOGY | 28 | ||
| DISORDERS OF SODIUM METABOLISM | 34 | ||
| DISORDERS OF WATER METABOLISM | 41 | ||
| DISORDERS OF POTASSIUM METABOLISM | 54 | ||
| CONCLUSION | 64 | ||
| FURTHER READING | 64 | ||
| APPENDIX 4.1: FORMULAE | 65 | ||
| APPENDIX 4.2: DYNAMIC FUNCTION TESTS | 65 | ||
| Chapter 5. Hydrogen ion homoeostasis and tissue oxygenation and their disorders | 67 | ||
| INTRODUCTION | 67 | ||
| THE PHYSIOLOGICAL ROLE OF HYDROGEN IONS | 67 | ||
| HYDROGEN ION HOMOEOSTASIS | 68 | ||
| THE ASSESSMENT OF ACID–BASE STATUS | 75 | ||
| DISORDERS OF HYDROGEN ION HOMOEOSTASIS | 76 | ||
| TISSUE OXYGENATION | 89 | ||
| CONCLUSION | 94 | ||
| FURTHER READING | 94 | ||
| Chapter 6. Calcium, phosphate and magnesium | 95 | ||
| CALCIUM METABOLISM | 95 | ||
| PHOSPHORUS METABOLISM | 110 | ||
| MAGNESIUM METABOLISM | 119 | ||
| CONCLUSION | 124 | ||
| FURTHER READING | 124 | ||
| APPENDIX 6.1: CALCIUM ABSORPTION TEST | 124 | ||
| APPENDIX 6.2: ANALYSIS OF TUBULAR HANDLING OF CALCIUM | 125 | ||
| APPENDIX 6.3: CLASSIFICATION OF PSEUDOHYPOPARATHYROIDISM | 125 | ||
| APPENDIX 6.4: ESTIMATION OF TmP/GFR | 126 | ||
| APPENDIX 6.5: MAGNESIUM RETENTION TEST | 126 | ||
| APPENDIX 6.6: RENAL TUBULAR REABSORPTION OF MAGNESIUM | 126 | ||
| Chapter 7. The kidneys, renal function and renal failure | 128 | ||
| ANATOMY | 128 | ||
| RENAL FUNCTION | 131 | ||
| RENAL DISEASE AND ITS PRESENTATION | 134 | ||
| THE ASSESSMENT OF RENAL FUNCTION | 135 | ||
| ACUTE RENAL FAILURE | 141 | ||
| CHRONIC RENAL FAILURE | 147 | ||
| CONCLUSION | 154 | ||
| FURTHER READING | 155 | ||
| Chapter 8. Proteinuria | 156 | ||
| INTRODUCTION | 156 | ||
| PROTEIN CONSERVATION BY THE KIDNEYS | 156 | ||
| NORMAL URINARY PROTEIN CONTENT | 159 | ||
| PROTEINURIA IN RENAL DISEASE | 160 | ||
| MICROALBUMINURIA AS A MARKER OF RISK | 168 | ||
| CLINICAL INVESTIGATION OF PROTEINURIA | 170 | ||
| FURTHER READING | 172 | ||
| Chapter 9. Renal tubular disorders and renal stone disease | 174 | ||
| INTRODUCTION | 174 | ||
| RENAL TUBULAR DISORDERS | 174 | ||
| RENAL CALCULI | 180 | ||
| CONCLUSION | 185 | ||
| FURTHER READING | 185 | ||
| APPENDIX 9.1: DIAGNOSIS OF RENAL TUBULAR ACIDOSIS | 185 | ||
| Chapter 10. The clinical biochemistry of nutrition | 186 | ||
| INTRODUCTION | 186 | ||
| NUTRITIONAL REQUIREMENTS | 186 | ||
| ASSESSMENT OF NUTRITIONAL STATUS | 199 | ||
| CONCLUSION | 206 | ||
| FURTHER READING | 206 | ||
| Chapter 11. Nutritional disorders and their management | 207 | ||
| INTRODUCTION | 207 | ||
| GENERALIZED UNDERNUTRITION | 207 | ||
| OBESITY | 209 | ||
| EATING DISORDERS | 216 | ||
| DIET IN THE AETIOLOGY OF DISEASE | 217 | ||
| THERAPEUTIC DIETS, DIETARY SUPPLEMENTS AND NUTRACEUTICALS | 218 | ||
| PROVISION OF NUTRITIONAL SUPPORT | 220 | ||
| CONCLUSION | 224 | ||
| FURTHER READING | 224 | ||
| Chapter 12. The clinical biochemistry of the gastrointestinal tract | 225 | ||
| INTRODUCTION | 225 | ||
| MOUTH AND OESOPHAGUS | 226 | ||
| STOMACH | 226 | ||
| PANCREAS | 229 | ||
| SMALL BOWEL BACTERIAL OVERGROWTH | 231 | ||
| MALDIGESTION AND MALABSORPTION | 233 | ||
| INTESTINAL PERMEABILITY | 240 | ||
| FAECAL TESTS OF INTESTINAL INFLAMMATION | 245 | ||
| SMALL INTESTINAL TUMOURS AND HORMONES | 247 | ||
| THE ACUTE ABDOMEN | 250 | ||
| FURTHER READING | 252 | ||
| Chapter 13. The assessment of hepatic function and investigation of jaundice | 253 | ||
| INTRODUCTION | 253 | ||
| ANATOMY OF THE LIVER | 253 | ||
| HEPATIC REGENERATION | 256 | ||
| PHYSIOLOGICAL FUNCTIONS | 256 | ||
| LIVER FUNCTION TESTS | 259 | ||
| USES OF LIVER FUNCTION TESTS | 268 | ||
| ABNORMAL LIVER FUNCTION TESTS IN ASYMPTOMATIC PATIENTS | 270 | ||
| NORMAL LIVER FUNCTION TESTS IN THE PRESENCE OF OVERT LIVER DISEASE | 271 | ||
| ROLE OF LIVER FUNCTION TESTS IN ASSESSING PROGNOSIS | 271 | ||
| CONCLUSION | 272 | ||
| FURTHER READING | 272 | ||
| Chapter 14. Acute and chronic liver disease | 274 | ||
| CLASSIFICATION OF LIVER DISEASE | 274 | ||
| ACUTE HEPATITIS AND ITS SEQUELAE | 274 | ||
| ACUTE LIVER FAILURE | 277 | ||
| CHRONIC HEPATITIS | 277 | ||
| PRIMARY BILIARY CIRRHOSIS (PBC) | 281 | ||
| PRIMARY SCLEROSING CHOLANGITIS (PSC) | 281 | ||
| ALCOHOLIC LIVER DISEASE | 281 | ||
| THE CONCEPT OF CIRRHOSIS | 283 | ||
| DRUGS AND THE LIVER | 288 | ||
| NEOPLASTIC DISEASE OF THE LIVER AND BILIARY TRACT | 288 | ||
| TOTAL PARENTERAL NUTRITION | 289 | ||
| BACTERIAL INFECTIONS | 289 | ||
| REYE'S SYNDROME | 289 | ||
| INHERITED METABOLIC DISORDERS INVOLVING THE LIVER | 290 | ||
| LIVER TRANSPLANTATION | 295 | ||
| CONCLUSION | 296 | ||
| FURTHER READING | 297 | ||
| Chapter 15. Diabetes mellitus: pathophysiology and biochemical background | 298 | ||
| PHYSIOLOGY AND PATHOPHYSIOLOGY OF GLUCOSE HOMOEOSTASIS | 298 | ||
| DIAGNOSIS AND CLASSIFICATION OF DIABETES MELLITUS | 307 | ||
| ENDOCRINE ASSOCIATIONS WITH DIABETES | 320 | ||
| DIABETES, NUTRITION AND GROWTH | 321 | ||
| MECHANISMS OF DIABETIC TISSUE DAMAGE | 321 | ||
| CONDITIONS ASSOCIATED WITH INADEQUATELY CONTROLLED DIABETES MELLITUS | 323 | ||
| BIOCHEMICAL MEASUREMENTS IN DIABETES MELLITUS | 324 | ||
| CONCLUSION | 327 | ||
| FURTHER READING | 327 | ||
| Chapter 16. The clinical management of diabetes mellitus | 329 | ||
| INTRODUCTION | 329 | ||
| GENERAL ASPECTS OF MANAGEMENT | 329 | ||
| HYPOGLYCAEMIC TREATMENT IN DIABETES | 332 | ||
| OBSTACLES TO ACHIEVING GLYCAEMIC CONTROL | 339 | ||
| DIABETIC EMERGENCIES | 342 | ||
| MANAGEMENT OF SOME SPECIFIC COMPLICATIONS OF DIABETES | 347 | ||
| MANAGEMENT OF DIABETES IN THE HOSPITAL SETTING | 349 | ||
| FURTHER READING | 351 | ||
| Chapter 17. Hypoglycaemia | 352 | ||
| GLUCOSE HOMOEOSTASIS IN THE FED AND THE POSTABSORPTIVE STATES | 352 | ||
| HYPOGLYCAEMIA | 353 | ||
| CLASSIFICATION OF HYPOGLYCAEMIC DISORDERS | 355 | ||
| PRACTICAL APPROACH AND INVESTIGATION OF HYPOGLYCAEMIA | 355 | ||
| EMERGENCY TREATMENT OF HYPOGLYCAEMIA | 359 | ||
| CAUSES OF HYPOGLYCAEMIA | 359 | ||
| CONCLUSION | 367 | ||
| FURTHER READING | 367 | ||
| Chapter 18. Hypothalamic, pituitary and adrenal disorders | 368 | ||
| INTRODUCTION | 368 | ||
| CLINICAL ANATOMY OF THE PITUITARY AND HYPOTHALAMUS | 368 | ||
| PHYSIOLOGY OF HYPOTHALAMO–PITUITARY–END-ORGAN AXES | 369 | ||
| CLINICAL ANATOMY AND PHYSIOLOGY OF THE ADRENALS | 371 | ||
| ASSESSMENT OF NORMAL PITUITARY FUNCTION | 371 | ||
| OTHER DIAGNOSTIC TECHNIQUES IN PITUITARY DISEASE | 379 | ||
| PITUITARY HYPERSECRETION STATES | 380 | ||
| HYPOTHALAMIC AND PITUITARY DEFICIENCY STATES | 387 | ||
| ADRENAL DISEASE | 389 | ||
| MONITORING PITUITARY AND ADRENAL REPLACEMENT THERAPY | 390 | ||
| CONCLUSION | 391 | ||
| FURTHER READING | 391 | ||
| APPENDIX 18.1: TEST PROTOCOLS | 391 | ||
| Chapter 19. Thyroid dysfunction | 394 | ||
| INTRODUCTION | 394 | ||
| NORMAL THYROID PHYSIOLOGY | 394 | ||
| THE EVALUATION OF THYROID FUNCTION | 402 | ||
| HYPERTHYROIDISM | 408 | ||
| HYPOTHYROIDISM | 414 | ||
| THYROIDITIS | 418 | ||
| NEOPLASIA | 419 | ||
| SYNDROMES OF RESISTANCE TO THYROID HORMONES | 420 | ||
| SCREENING | 420 | ||
| FURTHER READING | 420 | ||
| Chapter 20. Hormonal aspects of non-endocrine disease | 422 | ||
| INTRODUCTION | 422 | ||
| THE METABOLIC RESPONSE TO STRESS | 422 | ||
| ENDOCRINE EFFECTS OF PSYCHOSOCIAL STRESS | 427 | ||
| RENAL DISEASE | 427 | ||
| LIVER DISEASE | 431 | ||
| AGEING | 433 | ||
| CONCLUSION | 435 | ||
| FURTHER READING | 435 | ||
| Chapter 21. Disorders of sex development | 436 | ||
| INTRODUCTION | 436 | ||
| DISORDERS OF SEX DEVELOPMENT | 436 | ||
| PUBERTY | 446 | ||
| INVESTIGATIONS | 451 | ||
| FURTHER READING | 452 | ||
| Chapter 22. The clinical biochemistry of female reproductive function, pregnancy, contraception and hormone replacement therapy | 453 | ||
| INTRODUCTION | 453 | ||
| PHYSIOLOGY | 453 | ||
| HORMONES REGULATING REPRODUCTIVE FUNCTION | 456 | ||
| REPRODUCTIVE STEROID HORMONES | 457 | ||
| OLIGO- AND AMENORRHOEA | 460 | ||
| INFERTILITY | 460 | ||
| HIRSUTISM AND VIRILISM | 461 | ||
| PREGNANCY | 462 | ||
| ORAL CONTRACEPTION AND HORMONE REPLACEMENT THERAPY | 467 | ||
| FURTHER READING | 470 | ||
| APPENDIX 22.1: ACTH STIMULATION TEST FOR THE DIAGNOSIS OF CONGENITAL ADRENAL HYPERPLASIA | 470 | ||
| Chapter 23. Reproductive function in the male | 471 | ||
| INTRODUCTION | 471 | ||
| THE TESTIS | 471 | ||
| EVALUATION OF TESTICULAR FUNCTION | 473 | ||
| MALE HYPOGONADISM | 474 | ||
| GYNAECOMASTIA | 476 | ||
| IMPOTENCE | 477 | ||
| FURTHER READING | 479 | ||
| APPENDIX 23.1: PROTOCOLS FOR ENDOCRINE INVESTIGATIONS | 480 | ||
| Chapter 24. Inherited metabolic disease | 481 | ||
| INTRODUCTION | 481 | ||
| CLINICAL PRESENTATION AND PATHOPHYSIOLOGY | 481 | ||
| NEWBORN SCREENING | 486 | ||
| INHERITANCE | 486 | ||
| DIAGNOSTIC STRATEGIES | 489 | ||
| PRENATAL DIAGNOSIS | 496 | ||
| MANAGEMENT | 497 | ||
| CONCLUSION | 504 | ||
| FURTHER READING | 504 | ||
| Chapter 25. Paediatric clinical biochemistry | 505 | ||
| INTRODUCTION | 505 | ||
| POSTNATAL INVESTIGATION OF THE SMALL FOR GESTATIONAL AGE NEWBORN | 505 | ||
| RESPIRATORY DISORDERS | 506 | ||
| RENAL FUNCTION | 508 | ||
| CARBOHYDRATE METABOLISM | 510 | ||
| CALCIUM AND PHOSPHORUS METABOLISM | 512 | ||
| DISORDERS OF LIVER FUNCTION | 514 | ||
| PARENTERAL NUTRITION | 519 | ||
| DISORDERS OF GROWTH | 520 | ||
| INHERITED METABOLIC DISEASES | 521 | ||
| FURTHER READING | 536 | ||
| Chapter 26. Biochemical aspects of anaemia | 538 | ||
| INTRODUCTION | 538 | ||
| RED CELL FORMATION, STRUCTURE, FUNCTION AND METABOLISM | 538 | ||
| ANAEMIA | 539 | ||
| ANAEMIAS DUE TO FAILURE OF CELL PRODUCTION | 541 | ||
| BLOOD LOSS OR HAEMORRHAGE | 547 | ||
| HAEMOLYTIC ANAEMIA | 547 | ||
| CONSEQUENCES OF HAEMOLYSIS | 551 | ||
| DIAGNOSIS OF HAEMOLYSIS | 551 | ||
| CONCLUSION | 557 | ||
| FURTHER READING | 557 | ||
| Chapter 27. The porphyrias: inherited disorders of haem synthesis | 558 | ||
| INTRODUCTION AND OVERVIEW | 558 | ||
| PORPHYRIAS PRESENTING WITH ACUTE ATTACKS | 563 | ||
| THE CUTANEOUS PORPHYRIAS | 568 | ||
| NEW APPROACHES TO TREATMENT | 574 | ||
| SECONDARY DISORDERS OF PORPHYRIN METABOLISM | 574 | ||
| CONCLUSION | 575 | ||
| FURTHER READING | 575 | ||
| APPENDIX 27.1: DRUGS THAT ARE CONSIDERED SAFE FOR USE IN PATIENTS WITH ACUTE PORPHYRIAS | 576 | ||
| Chapter 28. The haemo globino pathies | 578 | ||
| INTRODUCTION | 578 | ||
| THE THALASSAEMIAS | 580 | ||
| STRUCTURAL HAEMOGLOBIN VARIANTS | 582 | ||
| LABORATORY DIAGNOSIS OF HAEMOGLOBINOPATHIES | 585 | ||
| CONCLUSION | 587 | ||
| FURTHER READING | 587 | ||
| Chapter 29. Immunology for clinical biochemists | 588 | ||
| THE IMMUNE SYSTEM | 588 | ||
| DISEASES OF THE IMMUNE SYSTEM | 604 | ||
| LYMPHOID MALIGNANCIES | 616 | ||
| INFECTION AND SEPSIS | 626 | ||
| CONCLUSION | 628 | ||
| FURTHER READING | 628 | ||
| Chapter 30. Metabolic bone disease | 629 | ||
| BONE BIOLOGY | 629 | ||
| OSTEOPOROSIS | 638 | ||
| OSTEOMALACIA | 644 | ||
| RENAL OSTEODYSTROPHY | 648 | ||
| BONE DISEASE IN PRIMARY HYPERPARATHYROIDISM | 652 | ||
| PAGET'S DISEASE OF BONE | 653 | ||
| BONE TURNOVER AND BONE DISEASE IN CHILDREN | 656 | ||
| GENETIC BONE DISEASES | 656 | ||
| CONCLUSION | 658 | ||
| FURTHER READING | 659 | ||
| APPENDIX 30.1: INDICATIONS FOR DIAGNOSTIC TRANSILIAC BONE BIOPSY | 659 | ||
| APPENDIX 30.2: PROTOCOL FOR DESFERRIOXAMINE TEST IN DIALYSIS PATIENTS | 659 | ||
| Chapter 31. The biochemistry of articular disorders | 660 | ||
| INTRODUCTION | 660 | ||
| THE ARTICULAR SYSTEM | 660 | ||
| DISORDERS OF THE ARTICULAR SYSTEM | 661 | ||
| ARTICULAR INVOLVEMENT IN SYSTEMIC DISEASE | 665 | ||
| THE ARTICULAR SYSTEM AND ENDOCRINE DISORDERS | 666 | ||
| LABORATORY TESTING IN ARTICULAR DISEASE | 666 | ||
| CONCLUSION | 667 | ||
| FURTHER READING | 668 | ||
| Chapter 32. Muscle disease | 669 | ||
| INTRODUCTION | 669 | ||
| FUNCTIONAL ANATOMY AND PHYSIOLOGY OF MUSCLE | 669 | ||
| DISEASES OF MUSCLE AND THEIR INVESTIGATION | 673 | ||
| BIOCHEMICAL INVESTIGATION OF MUSCLE DISEASE | 674 | ||
| INVESTIGATION OF MUSCLE DISEASE | 676 | ||
| CONCLUSION | 682 | ||
| ACKNOWLEDGEMENT | 682 | ||
| FURTHER READING | 682 | ||
| APPENDIX 32.1:THE ISCHAEMIC EXERCISE TEST | 682 | ||
| Chapter 33. Investigation of cerebrospinal fluid | 683 | ||
| INTRODUCTION | 683 | ||
| CEREBROSPINAL FLUID PHYSIOLOGY | 683 | ||
| INVESTIGATIONS RELEVANT TO PHYSIOLOGY AND PATHOPHYSIOLOGY | 684 | ||
| BIOCHEMICAL INVESTIGATIONS IN CNS DISORDERS | 692 | ||
| CONCLUSION | 695 | ||
| FURTHER READING | 696 | ||
| Chapter 34. Biochemical aspects of psychiatric disorders | 697 | ||
| INTRODUCTION: PSYCHIATRY AS A CLINICAL DISCIPLINE | 697 | ||
| THE CLASSIFICATION OF PSYCHIATRIC DISORDERS | 698 | ||
| THE AETIOLOGY OF PSYCHIATRIC DISORDERS | 699 | ||
| BIOCHEMICAL INVESTIGATIONS IN PSYCHIATRIC DISORDERS | 699 | ||
| PSYCHIATRIC MANIFESTATIONS OF ORGANIC DISEASE | 699 | ||
| ENDOCRINE AND METABOLIC MANIFESTATIONS OF PSYCHIATRIC DISEASE | 703 | ||
| METABOLIC COMPLICATIONS OF PSYCHOTROPIC DRUGS | 704 | ||
| FUTURE DEVELOPMENTS | 705 | ||
| CONCLUSION | 705 | ||
| FURTHER READING | 705 | ||
| Chapter 35. Biochemical aspects of neurological disease | 706 | ||
| INTRODUCTION | 706 | ||
| ENCEPHALOPATHY AND SEIZURES | 706 | ||
| MOVEMENT DISORDERS | 709 | ||
| ATAXIA | 712 | ||
| SPINAL CORD DISORDERS | 715 | ||
| PERIPHERAL NEUROPATHY | 715 | ||
| CONCLUSION | 722 | ||
| FURTHER READING | 722 | ||
| Chapter 36. Biochemical aspects of mental retardation | 723 | ||
| INTRODUCTION | 723 | ||
| AETIOLOGY | 724 | ||
| CHROMOSOMAL DISORDERS | 724 | ||
| DISORDERS OF AMINO ACID METABOLISM | 731 | ||
| LYSOSOMAL STORAGE DISORDERS | 740 | ||
| OTHER SYNDROMES | 744 | ||
| CONCLUSION: FINAL CONSIDERATIONS ON DIAGNOSIS IN MENTAL RETARDATION | 747 | ||
| FURTHER READING | 748 | ||
| Chapter 37. Lipid metabolism, hyper- and hypolipidaemias | 749 | ||
| INTRODUCTION | 749 | ||
| LIPIDS | 750 | ||
| LIPOPROTEINS | 752 | ||
| APOLIPOPROTEINS | 754 | ||
| ASSEMBLY OF LIPOPROTEINS | 756 | ||
| CHOLESTEROL ABSORPTION | 757 | ||
| TRIGLYCERIDE DIGESTION | 757 | ||
| BILE ACID METABOLISM | 757 | ||
| LIPOPROTEIN METABOLISM | 758 | ||
| ENZYMES INVOLVED IN LIPOPROTEIN METABOLISM | 761 | ||
| TRANSFER PROTEINS INVOLVED IN LIPOPROTEIN METABOLISM | 763 | ||
| RECEPTORS INVOLVED IN LIPOPROTEIN METABOLISM | 764 | ||
| OTHER PROTEINS INVOLVED IN LIPOPROTEIN SYNTHESIS, TRANSPORT AND METABOLISM | 765 | ||
| CLASSIFICATION OF LIPOPROTEIN DISORDERS | 766 | ||
| THE PRIMARY DYSLIPOPROTEINAEMIAS | 767 | ||
| ACQUIRED HYPERLIPIDAEMIA | 775 | ||
| ACQUIRED HYPOLIPIDAEMIA | 778 | ||
| INVESTIGATION OF LIPID DISORDERS | 778 | ||
| TREATMENT OF HYPERLIPIDAEMIA | 780 | ||
| CONCLUSION | 780 | ||
| FURTHER READING | 782 | ||
| Chapter 38. The clinical biochemistry of the cardiovascular system | 783 | ||
| INTRODUCTION | 783 | ||
| ATHEROSCLEROSIS | 783 | ||
| CARDIOVASCULAR RISK FACTORS | 788 | ||
| ENDOTHELIAL FUNCTION AND ITS ASSESSMENT | 798 | ||
| MARKERS OF INSTABILITY OF CORONARY ARTERY LESIONS | 800 | ||
| CLINICAL ASSESSMENT OF CARDIOVASCULAR RISK | 800 | ||
| HYPERTENSION | 802 | ||
| HEART FAILURE | 807 | ||
| ACUTE CHEST PAIN | 808 | ||
| CONCLUSION | 813 | ||
| FURTHER READING | 813 | ||
| Chapter 39. Therapeutic drug monitoring | 814 | ||
| INTRODUCTION | 814 | ||
| USES OF THERAPEUTIC DRUG MONITORING | 819 | ||
| INDIVIDUAL DRUGS | 822 | ||
| PROVISION OF A THERAPEUTIC DRUG MONITORING SERVICE | 831 | ||
| QUALITY CONTROL | 832 | ||
| CLINICAL AUDIT | 833 | ||
| CONTINUING EDUCATION | 833 | ||
| CASE REPORTING | 833 | ||
| FURTHER READING | 834 | ||
| APPENDIX 39.1: CALCULATIONS FOR THE DETERMINATION OF DOSE REQUIREMENTS TO ACHIEVE STEADY-STATE CONCENTRATIONS | 835 | ||
| APPENDIX 39.2: METHOD of predicting dosage for phenytoin (assuming good compliance) (from Evans al 1992) | 835 | ||
| Chapter 40. Poisoning | 836 | ||
| INTRODUCTION | 836 | ||
| AETIOLOGY OF POISONING | 836 | ||
| TYPES OF LESION IN POISONING | 837 | ||
| DIAGNOSIS AND MANAGEMENT OF POISONING: GENERAL PRINCIPLES | 838 | ||
| SPECIFIC POISONS | 842 | ||
| CONCLUSION | 856 | ||
| FURTHER READING | 856 | ||
| APPENDIX 40.1: POISONS CENTRES | 856 | ||
| Chapter 41. Metabolic effects of tumours | 857 | ||
| INTRODUCTION | 857 | ||
| CARCINOID TUMOURS | 857 | ||
| INTRODUCTION | 862 | ||
| MEN1 | 863 | ||
| MEN2 | 868 | ||
| INTRODUCTION | 874 | ||
| THEORIES OF ECTOPIC HORMONE PRODUCTION | 874 | ||
| METABOLIC CHANGES IN MALIGNANCY | 878 | ||
| HAEMATOLOGICAL SEQUELAE OF MALIGNANCY | 883 | ||
| PARANEOPLASTIC SYNDROMES | 884 | ||
| ENDOCRINE SEQUELAE OF TUMOURS AND THEIR TREATMENT | 888 | ||
| CONCLUSION | 890 | ||
| FURTHER READING | 890 | ||
| Chapter 42. Tumour markers | 891 | ||
| INTRODUCTION | 891 | ||
| TUMOUR MARKERS IN THE MANAGEMENT OF SPECIFIC CANCERS | 898 | ||
| CONCLUSION | 912 | ||
| FURTHER READING | 912 | ||
| Chapter 43. Molecular clinical biochemistry | 914 | ||
| INTRODUCTION | 914 | ||
| GENES AND GENE EXPRESSION | 914 | ||
| THE TECHNIQUES OF GENETIC ANALYSIS | 922 | ||
| THE APPLICATIONS OF DNA ANALYSIS | 928 | ||
| DNA DIAGNOSTIC TESTS - SOME EXAMPLES | 931 | ||
| GENE THERAPY | 937 | ||
| CONCLUSION | 939 | ||
| ACKNOWLEDGEMENTS | 939 | ||
| GLOSSARY | 940 | ||
| FURTHER READING | 941 | ||
| Chapter 44. Free radicals | 942 | ||
| INTRODUCTION | 942 | ||
| DEFINITION AND SOURCES OF FREE RADICALS | 942 | ||
| FUNCTIONS OF FREE RADICALS | 944 | ||
| FREE RADICAL TOXICITY | 946 | ||
| DEFENCE AGAINST FREE RADICALS | 948 | ||
| METHODS FOR DETECTING FREE RADICALS | 951 | ||
| CONCLUSION | 951 | ||
| FURTHER READING | 951 | ||
| Index | 953 |