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1

National Kidney and Urologic Diseases Information Clearinghouse (U.S.) and National Institute of Diabetes and Digestive and Kidney Diseases (U.S.), eds. Diabetes insipidus. [Bethesda, Md.]: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2001.

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2

V. V. A. M. van Knoers. Nephrogenic Diabetes Insipidus. [s.l.]: [s.n.], 1990.

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3

International Symposium on Diabetes Insipidus in Man (1984 Paris, France). Diabetes insipidus in man. Edited by Czernichow P and Robinson A. G. Basel ; New York: Karger, 1985.

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4

Alter, Craig A., ed. Diabetes Insipidus in Children. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-83248-3.

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5

International Symposium on Diabetes Insipidus in Man (1984 Paris, France). Diabetes insipidus in man: International Symposium on Diabetes Insipidus in Man, Paris, January 18-19, 1984. Edited by Czernichow P. ed and Robinson Alan G. ed. Basel: Karger, 1985.

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6

Graham, Olive. Diabetes insipidus: What kind of diabetes is that? : study guide. [Bethesda, Md.?]: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, Clinical Center Communications, 1988.

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7

Patsy, McCabe, and National Institutes of Health (U.S.). Office of Clinical Center Communications, eds. Diabetes insipidus: What kind of diabetes is that? : study guide. [Bethesda, Md.?]: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Clinical Center Communications, 1988.

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8

Hamburg, Universität, ed. Heterologe Expression des normalen und eines mutanten Vasopressin-Neurophysin-Vorläufers in einer Hypophysentumorzellinie der Maus als Modellsystem für den familiären hypothalamischen Diabetes insipidus. [s.l.]: [s.n.], 1997.

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9

Diabetes Insipidus. Exon Publications, 2024. http://dx.doi.org/10.36255/diabetes-insipidus.

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Diabetes Insipidus is a rare condition characterized by an imbalance of water in the body, leading to excessive thirst and urination. This article is organized to provide an understanding of Diabetes Insipidus for patients, their loved ones, and the public. It begins with an introduction to the condition, explaining its types and the differences between them. The article discusses the risk factors and epidemiology of Diabetes Insipidus, followed by an exploration of its causes and symptoms. The pathophysiology section explains how the condition affects the body, while the complications section highlights potential risks if not managed properly. Diagnosis methods are described, along with the various treatment options available, including medications and lifestyle changes. The prognosis of living with Diabetes Insipidus is also covered, providing a complete overview of managing the condition. All information is presented in simple terms to ensure it is understandable for all readers.
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10

Kamoi, Kyuzi, ed. Diabetes Insipidus. InTech, 2011. http://dx.doi.org/10.5772/860.

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11

Central diabetes insipidus. BC Children's Hospital, 2005.

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12

Smith, Andrew Heermance. Diabetes: Mellitus and Insipidus. Creative Media Partners, LLC, 2018.

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13

Smith, Andrew Heermance. Diabetes: Mellitus and Insipidus. Creative Media Partners, LLC, 2018.

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14

Diabetes Insipidus in Man (Frontiers of Hormone Research). S. Karger AG (Switzerland), 1985.

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15

Alter, Craig A. Diabetes Insipidus in Children: A Pocket Guide. Springer International Publishing AG, 2021.

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16

Mitchell, Clifford. Diseases Of The Urinary Organs: Including Diabetes Mellitus And Insipidus. Kessinger Publishing, LLC, 2007.

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17

Younker, Katherine. America's Complete Diabetes Cookbook. Robert Rose, 2005.

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18

Publications, ICON Health. The Official Patient's Sourcebook on Diabetes Insipidus: Directory for the Internet Age. Icon Health Publications, 2005.

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19

Publications, ICON Health. Diabetes Insipidus - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. ICON Health Publications, 2004.

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20

Ippenberger, Jürgen. Diabetes insipidus im Kindesalter: Eine retrospektive Untersuchung anhand von 46 Fällen in den Jahren 1962-1989. 1992.

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21

Publications, ICON Health. The 2002 Official Patient's Sourcebook on Diabetes Insipidus: A Revised and Updated Directory for the Internet Age. Icon Health Publications, 2002.

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22

Bichet, Daniel G. Approach to the patient with polyuria. Edited by Robert Unwin. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0032.

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In a polyuric patient, first exclude osmotic diuresis, then differentiate between primary polydipsia, central, and nephrogenic diabetes insipidus, with clinical characteristics, simple blood and urine tests, and hypothalamic magnetic resonance imaging. Mammals are osmoregulators and osmolality is perceived by central and peripheral osmotic receptors and influencing thirst perception and vasopressin secretion. In congenital polyuric states it is useful to distinguish ‘pure’ polyuric states, that is, loss of water only but normal conservation of sodium, potassium, chloride, and calcium, from complex (water + sodium + calcium) polyuric states. For the latter, the triad polyuria/polyhydramnios/prematurity is a tell-tale sign of Bartter syndrome. We recommend sequencing of the nephrogenic diabetes insipidus and Bartter genes in all the affected congenital and hereditary polyuric patients. Acquired central and nephrogenic polyuric states are simpler to evaluate.
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23

Chazminare, Allex Sun. Symptoms of Diabetes Insipidus: Excess Thirst, Fever, over Fussiness, Excess Urination, Excessive Crying, Diarrhea, Vomiting, Lethargy, Weight Loss, Delayed Growth. Independently Published, 2021.

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24

McCall, Doctor Jane A. Reverse Diabetes: Step by Step Guide on How to Prevent Diabetes Mellitus and Insipidus with the Help of Insulin, Healthy Diet. a Better Approach to Cure Hypoglycemia and Hyperglycemia. Independently Published, 2017.

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25

Soto-Rivera, Carmen L., and Michael S. D. Agus. Endocrine Disorders in Pediatric Critical Care. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0016.

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This chapter focuses in pediatric endocrine disorders that can present acutely and warrant intensive care. Because most of the symptoms associated with endocrine diseases are nonspecific, a broad index of suspicion and knowledge of the details of hormonal regulation are essential for accurate diagnosis and timely management. The chapter includes important information on the pathophysiology, clinical manifestations, evaluation, and management of potentially life-threatening endocrine disorders, including diabetes insipidus, syndrome of inappropriate antidiuretic hormone secretion, acute primary and secondary adrenal insufficiency, disorders of calcium homeostatis, thyroid storm, and diabetic ketoacidosis. For treatment of these disorders, the authors discuss the use of vasopressin (aqueous pitressin), desmopressin, hydrocortisone, calcitonin, bisphosphonates, methimazole, iodide therapy, and insulin.
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26

Butler, Gary, and Jeremy Kirk. Endocrine emergencies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199232222.003.0097.

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Introduction 304Diabetic ketoacidosis 306Hypoglycaemia 314Adrenal insufficiency–adrenal crisis 316Hypocalcaemia 318Hypercalcaemia 320Acute diabetes insipidus 322Syndrome of inappropriate antidiuretic hormone secretion (SIADH) 324Hyperthyroid crisis 326Hypothyroid coma 327Unclear sex–ambiguous genitalia (Disorder of Sex Development) (DSD) 328This section is intended to be brief, with readily accessible information that is needed in an endocrine emergency in an infant, child, or adolescent. Endocrine emergencies are rare, but because of this they are usually unexpected. Always take a few moments to assess the situation....
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27

O’Neal, M. Angela. Acute Headache in Pregnancy. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0020.

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The case illustrates the characteristics of pituitary apoplexy. This anatomy of the pituitary, which predisposes to the condition, is described. The most common clinical feature is headache. Visual disturbance related to optic chiasm or optic nerve involvement is also common. Pituitary apoplexy is a neuroendocrine emergency. The most important hormone involved is adrenocorticotropic hormone, ACTH. However, there are often multiple hormonal deficiencies: growth hormone, hypothyroidism, and hypogonadotropic deficiency. A high prolactin level may reflect a prolactinoma or be due to hypothalamic inhibition. Diabetes insipidus (DI) is also common. The most urgent issue in treating pituitary apoplexy is prompt assessment of fluid and electrolyte imbalance and the replacement of corticosteroids.
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28

Sjoblom, Matthew D., Diane Gordon, and Lori A. Aronson. Hypopituitarism. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0041.

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Hypopituitarism is a decreased secretion of pituitary hormones. It is especially concerning during surgery and anesthesia if it results in adrenal insufficiency, hypothyroidism, or diabetes insipidus. Common causes in children include pituitary tumor and/or treatment, traumatic brain injury, and empty sella syndrome. Perioperative management includes recognition of clinical symptoms, such as hypotension, fatigue, polydipsia, and increased urine output. Unrecognized adrenal insufficiency may result in significant morbidity or mortality. Intraoperative treatment may involve stress-dose corticosteroids, careful fluid management, and desmopressin. This chapter uses the case study of a 9-year-old boy who presents for bilateral removal of tibial orthopedic hardware to illustrate the concepts.
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29

Jolly, Elaine, Andrew Fry, and Afzal Chaudhry, eds. Endocrine. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199230457.003.0007.

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Chapter 7 covers the basic science and clinical topics relating to the endocrine system which trainees are required to learn as part of their basic training and demonstrate in the MRCP. It covers endocrine physiology, acid-base balance, thyrotoxicosis, hypothyroidism, goitre and thyroid nodule, Cushing syndrome, acromegaly, hyperprolactinaemia, hypopituitarism, diabetes insipidus, adrenal incidentaloma, primary hyperaldosteronism, adrenal insufficiency, phaeochromocytoma and paraganglioma , male hypogonadism and Gynaecomastia, menstrual disorders and anovulation, hirsutism and the polycystic ovarian syndrome, multiple endocrine neoplasia and other genetic endocrine tumour syndromes, neuroendocrine tumours, acid-base disorders, sodium disorders, potassium disorders, hypocalcaemia, hypercalcaemia, hyperparathyroidism, osteoporosis, osteomalacia, Paget disease, dyslipidaemia, porphyria, adult inborn errors of metabolism, and obesity.
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30

Adam, Sheila, Sue Osborne, and John Welch. Neurological problems. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0008.

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This chapter provides an overview of the care and management of neurological disorders commonly seen in critical care, starting with an outline of the anatomy and physiology of the nervous system. The concepts of awareness, consciousness, and arousal, and the use of the Glasgow Coma Scale (GCS) to assess conscious level are discussed. The management and monitoring of raised intracranial pressure, cerebral perfusion pressure, and the impact on cerebral blood flow are detailed. The management of sodium and water balance, including diabetes insipidus, is outlined. There are overviews of the management and nursing of patients who have suffered traumatic brain injury, subarachnoid haemorrhage, status epilepticus, myasthenia gravis, Guillain–Barré syndrome, meningitis, encephalitis, and intracranial abcess. The concept, ethics, and testing of brainstem death, organ donation, and the care of the family are detailed.
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31

Abatzis, Vaia T., and Edward C. Nemergut. Transsphenoidal/Pituitary Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0004.

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Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic agents should be tailored to facilitate surgical exposure, preserve cerebral perfusion and oxygenation, and provide for rapid emergence and neurological assessment. Postoperatively, careful monitoring of fluid balance and serum sodium is essential to the early diagnosis of diabetes insipidus (DI). DI is most often transient but can require medical therapy. A thorough understanding of the preoperative assessment, intraoperative management, and potential complications are fundamental to successful perioperative patient care and avoidance of morbidity and mortality.
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32

Chakera, Aron, William G. Herrington, and Christopher A. O’Callaghan. Polyuria. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0057.

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Polyuria describes the passage of more than 3 l of urine a day. This is an arbitrary definition, and the term is commonly applied to patients who are complaining of passing larger than normal volumes of urine. As water excretion is tightly regulated by the body to maintain normal osmolality, water excretion varies greatly depending on intake. Polyuria may be physiological or pathological. A patient with polyuria often presents with nocturia, urination overnight that disturbs sleep. It is usually accompanied by polydipsia (to maintain normal fluid balance). In hospital the commonest causes of polyuria are diuretic therapy and recovery from an acute renal injury (e.g. acute tubular necrosis or obstruction). This polyuric phase can result in an impressive diuresis (8–10 l/day) before tubular cells recover their ability to concentrate urine. During this period, patients are vulnerable to dehydration and may require intravenous fluid replacement. Following pituitary surgery, the urine output should be closely monitored for evidence of new diabetes insipidus. This chapter covers the approach to diagnosis, diagnostic tests, therapy, and prognosis.
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33

Schiller, Adalbert, Adrian Covic, and Liviu Segall. Chronic tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0086_update_001.

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Chronic tubulointerstitial nephropathies (CTINs) are a group of renal diseases, characterized by variable interstitial inflammation and fibrosis and tubular atrophy, and a slow course towards end-stage renal disease (ESRD). The causes of CTIN are numerous, including nephrotoxic drugs and chemicals, infections, autoimmune diseases, obstructive uropathies, and metabolic disorders. Taken together, CTIN are responsible for less than 10% of all ESRD cases requiring renal replacement therapy. The clinical manifestations of CTIN typically comprise low-grade proteinuria, leucocyturia, and variably reduced glomerular filtration rate (GFR), whereas the blood pressure is usually normal or moderately increased. Tubular abnormalities are common, including type 2 (proximal) renal tubular acidosis, Fanconi syndrome, nephrogenic diabetes insipidus, and type 1 (distal) renal tubular acidosis, with hypokalaemia and nephrolithiasis. Radiology exams reveal shrunken kidneys, sometimes with irregular outlines. A renal biopsy is often required for the diagnosis of CTIN and its aetiology. The treatment of CTIN mainly involves discontinuation of exposure to nephrotoxins and specific therapy of renal infections, urinary tract obstruction, or underlying systemic diseases. Agents like ACE inhibitors and pirfenidone, which might reduce interstitial inflammation and fibrosis, are still under clinical evaluation.
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34

Debaveye, Yves, and Greet Van den Berghe. Pathophysiology and management of pituitary disorders in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0262.

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The pituitary gland plays a predominant role in the endocrine system. Consequently, patients with pituitary diseases or after pituitary surgery present unique challenges to the intensivist. Failure of the anterior pituitary gland to secrete one or more pituitary hormones results in a clinical syndrome known as hypopituitarism. While hypopituitarism is mostly encountered in patients in whom the diagnosis has already been made, acute exacerbation of an undiagnosed insufficiency may occasionally occur. Acute decompensated patients with suspected hypopituitarism should be admitted to an intensive care unit for haemodynamic stabilization, replacement of missing hormones, and identification and treatment of the causative stressor. Prompt administration of hydrocortisone is the single most important acute medical intervention in hypopituitaric patients. Failure of the posterior pituitary to secrete antidiuretic hormone results in diabetes insipidus (DI). DI is characterized by excess volumes of severely diluted urine, which can lead to hyperosmolality and hypernatraemia as many critically-ill patients do not have free access to oral fluids due to obtundation or sedation. Management of DI includes the correction of free water deficit and the reduction of polyuria with desmopressin. The post-operative care following pituitary surgery focuses on vigilant observation for neurosurgical complications (visual loss, meningitis, and cerebrospinal fluid leakage) and monitoring of neuroendocrinological perturbations (hypopituitarism and disorders of water balance, such as DI and SIADH). SIADH presents with hyponatremia, hypo-osmolality, and inappropriately concentrated urine in a setting of euvolaemia and can be managed in most cases by fluid restriction. Potential disruption of the pituitary-adrenal function is covered with peri-operative glucocorticoids.
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