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November 1985

Endocrine Aspects of Acute Illness

Arch Surg. 1985;120(11):1327. doi:10.1001/archsurg.1985.01390350103032

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In critical care medicine, "the greatest advances have come about through understanding the metabolic consequences of illness and injury and the methods of physiologic correction that can restore a patient to normal homeostasis." Underlying this statement from the "preface" there is a theme—"compensation in critical care"—that forms the core of this book.

Overall the authors have followed this theme. From "Thyroid Function in Critical Illness" to "Neuropeptides in Shock and Trauma," the chapters outline the physiologic changes that accompany critical illness, the body's compensating responses, and the treatments that best help these responses. Surgeons will find helpful the information given about calcium, phosphorus, glucose, and magnesium metabolism, about the "euthyroid-sick" syndrome, myxedema coma, and reverse-triiodothyronine, and there is an excellent discussion of thyrotropin-releasing hormone in the treatment of hemorrhagic and anaphylactic shock.

But sometimes the reading becomes a challenge. For example, in the chapter "An Introduction to Prostaglandins and

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