in order to effectively attend to the course, il is needed the Knowledge of arguments studied in the courses of Human Anatomy, Physiology, and General Pathology

no specific co-requisite is needed

the course gives the cultural and scientific basis for the successive courses of Surgery and Internal Medicine 

the frequency of the lessons is mandatory. the lesson will be in the form of slide presentation or with movies. 

documents will be put in the webpage of the course (TEAMS platform)

besides individual study, group studying is encouraged 

Endocrinology

• Introduction to the endocrine and metabolic physiology: concept of hormone, feed-back and local and remote hormonal transport, receptors and second/intracellular messangers.
• Pathophysiology of the endocrine and metabolic systems: function of each endocrine gland.
• Hypothalamus and pituitary disease: functioning and non-functioning  pituitary adenoma, alterations of the neuro-pituitary gland (diabetes insipidus and SIADH), consequences of hyper and hypo-production of pituitary hormones both in children and adults.
• Diagnostics, symptoms and therapy of the goiter (from simple goiter to multinodular toxic goiter), of acute and chronic thyroiditis, of hyper and hypothyroidism both congenital and acquired, of  thyroid cancers both differentiated and undifferentiated.
• Diagnostics, symptoms and therapy of parathyroid diseases (from hyperplasia to adenomas and carcinomas), of  the hyper and hypo-functioning of parathyroid glands both congenital and acquired. Diagnostic and treatment of osteoporosis.
• Diagnostics, symptoms and therapy of the adrenal gland diseases, both hyper and hypofunctions of the  cortical and medullary portions.
• Congenital and acquired female hypogonadisms and alteration of menstrual cycle: Polycistic ovary syndrome.
• Congenital and acquired male hypogonadism and alteration of male fertility.
• Hypertricosis and hirsutism: causes and differential diagnosis. Intersex conditions and their causes.
• Multiple endocrine neoplasia type 1 and 2: genetics, clinical manifestations and diagnosis
• Endocrine paraneoplastic syndromes: causes and clinical manifestation of ectopic production of ACTH, PTHrP etc.
• Pluriglandular autoimmune syndromes (PGA) types 1-4 and their causes.
• Obesity, metaboolic ssyndrome. Tickness and lipodistrophy

Diabetology

• Pathophysiology of metabolism: anabolic and catabolic processes
• Alterations in glucose metabolism: diabetes mellitus and "prediabetes"
• Type 1 and type 2 diabetes mellitus; secondary diabetes and monogenic diabetes.
• Diabetes in pregnancy.
• The chronic complications of diabetes: microangiopathy and cardiovascular disease.
• Acute complications of diabetes and hypoglycaemic syndromes.
• Treatment of diabetes ad its complications: addressing the complexity.
• Alterations of lipid metabolism: dyslipidemia and their relationship with atherosclerosis.
• Insulin resistance and metabolic syndrome.

Urology

• Prostatic pathology: acute and chronic prostatitis, benign prostatic hyperplasia, prostate carcinoma. Disorders of the bladder emptying phase.
• Urolithiasis: correlated process to the development and growth of the stones. The concept of urinary stasis.
• Comorbidity. Renal colic: symptoms, diagnosis of the acute and chronic picture, medical and surgical treatment, monitoring of relapses.
• Urinary incontinence: type of incontinence, diagnosis and differential diagnosis, treatment.
• Neurologic bladder: neurologic bladder and hyperactive bladder. Disease of bladder filling phase and differential diagnosis with other pathology of the urogenital system and not; treatment.
• Urinary system trauma: Classification, diagnosis and symptoms. Therapeutic approach at the renal trauma. Clinical monitoring.
• Urogenital tuberculosis (ugtb) and bilharzia (schistosomiasis): framing in the third millennium. Migratory phenomenon and disease recurrence; diagnosis and treatment.
• Obstructive nephropaty. Malformations of the upper urinary tract. Diagnosis and treatment.
• Andrological surgery: erectile disfunction, hydrocele, varicocele, spermatocele, transsexualism: symptoms, diagnosis, differential diagnosis and treatment.
• Kidney cancer: framing and classification, diagnosis and differential diagnosis, symptoms, prognosis and therapy. Classification of kidney cystic lesions and kidney complex cystic lesions.
• Bladder neoplasia: ethiopatogenesis, classification, symptoms, diagnosis, differential diagnosis, prognosis, treatment. Urinary derivation.
• Upper urinary tract neoplasia: ethiopatogenesis, classification, symptoms, diagnosis, differential diagnosis, prognosis, treatment. Urinary derivation.
• Hematuria: micro and macro-hematuria: Meaning, ethiopathogenesis, classification, symptoms, diagnosis, differential diagnosis, prognosis, treatment.
• Urinary tract infection: post kidney cause, simple and complicated infection, recurrent cystis.
• Therapy of recurrent cystis during pregnancy and in postmenopausal age. Asymptomatic bacteriuria.
• Testis cancer: ethiopathogenesis, classification, symptoms, diagnosis, differential diagnosis, prognosis, treatment.

Nephrology

• Approach to the nephropathic patient: importance of history and physical examination; main elements of semeiotics.
• Diagnosis of kidney diseases: interpretation of the urine test, of the renal function indices and of the main blood and urinary parameters. notes on diagnostic imaging methods for use in nephrology.
• The alterations of the hydroelectrolytic balance: diagnosis and significance of hypernatremia or hyponatremia,  hypo and hyperkalaemia, and altered metabolism of calcium and phosphorus
• The alterations of the acid-base balance: definition of the acid-base imbalances; diagnosis and treatment of metabolic acidosis
• Hereditary kidney diseases: clinical aspect and diagnosis of non-cystic (Alport, Fanconi and Fabry syndromes, tubulopathies, glomerulopathies):
• Cystic kidney diseases: hereditary diseases (polycystic kidney of the childhood, polycystic kidney of the adult); classification of acquired renal cysts (bosniak)
• Tubulointerstitial diseases: description and diagnosis of acute and chronic forms of primary glomerulopathies: clinical description and histopathology of minimal lesion nephropathy; focal and segmental glomerulosclerosis; iga glomerulonephritis; membranous glomerulonephritis; membrano proliferative glomerulo nephritis; rapidly progressive glomerulo-nephritis: glomerular diseases in systemic disorders: diabetic nephropathy, multiple myeloma, sle, vasculitis
• Pathophysiology of kidney stones: pathophysiology of kidney stones in the different forms based on their chemical composition; medical treatment of kidney stones
• Acute renal injury: definition and classification; diagnosis and treatment of pre-renal, renal and post-renal forms
• Chronic kidney disease: classification and description of the main pathophysiological changes.
• medical therapy of chronic renal insufficiency: outline of pharmacological and dietetic-nutritional therapy
• Chronic renal failure: description of main clinical, blood chemistry and metabolic-nutritional aspects
• Hemodialysis: description and indications for treatment
• Peritoneal dialysis: descriptions and indications for treatment
• Kidney transplantation: description and knowledge of the indications and contra-indications for living and cadaveric kidney transplantation, possible complications and hints of pharmacological therapy

Suggested books:

• Testi consigliati 

  • HARRISON'S Principles of Internal Medicine,“Endocrinology and Metabolism”, 21st edition, 2022
  • WILLIAMS Textbook of Endocrinology, 14th edition, Elsevier, 2019.
  • Oxford Textbook of Endocrinology and Diabetes 3rd Edition, Oxford 2022
  •  GARIBOTTO G, PONTREMOLI R. Manuale di Nefrologia. II Edizione. Edizioni Minerva Medica, 2017.
  • RONCO  C. Nefrologia Medica. Piccin Nuova Libraria Ed., Padova. 2020 
  • COLLEGIO PROFESSORI ORDINARI DI UROLOGIA: “Manuale di urologia e Andrologia”. Pacini Editore, 2009.
  • F. LOMBARDO, A. LENZI   Manuale di Endocrinologia, Edises, 2017
  • HARRISON Principi di Medicina Interna 20° Edizione – Endocrinologia e Metabolismo – Casa Editrice Ambrosiana, Milano, 2021
   

Consultations:

• Textbook of Diabetes, 5th Edition, Richard I. G. Holt, Clive Cockram, Allan Flyvbjerg, Barry J. Goldstein (Editors) - Wiley-Blackwell, 2016
• Essential Endocrinology and Diabetes, 7th Edition - Richard I. G. Holt, Neil A. Hanley (Editors) - Wiley-Blackwell, 2021 
• International Textbook of Diabetes Mellitus, 2 Volume Set, 4th Edition - R. A. DeFronzo, E. Ferrannini, Paul Zimmet, George Alberti (Editors) - Wiley-Blackwell, 2015 
• Cardiovascular Endocrinology & Metabolism. Theory and Practice of Cardiometabolic Medicine. – AJ Krentz, Chilton RJ (Editors) – Academic Press, ELSEVIER – London 2023

There are no specific indications for non-attending students, as attendance to the courses is mandatory.

Oral examination with interactive discussion of the program topics.

No stage, practice or collaboration exist during the duration of the course

The professors receive the student by appointments that are taken by email:

Prof. Vincenzo Panichi    vincenzo.panichi@unipi.it

Prof. Piero Marchetti       piero.marchetti@unipi.it

Prof. Alessandro Zucchi   alessandro.zucchi@unipi.it

Prof. Ferruccio Santini     ferruccio.santini@unipi.it