Clinical and internal medicine Books
John Wiley and Sons Ltd Pathys Principles and Practice of Geriatric
Book Synopsis
£413.06
John Wiley and Sons Ltd Fundamentals of Applied Pathophysiology
Book SynopsisTable of ContentsPreface Acknowledgements Contributors About the companion website Chapter 1 Learn the language Chapter 2 Cell and body tissue physiology Chapter 3 Homeostasis Chapter 4 Cancer Chapter 5 Inflammation, immune response and healing Chapter 6 Shock Chapter 7 The nervous system and associated disorders Chapter 8 The heart and associated disorders Chapter 9 The vascular system and associated disorders Chapter 10 The blood and associated disorders Chapter 11 The renal system and associated disorders Chapter 12 The respiratory system and associated disorders Chapter 13 The gastrointestinal system and associated disorders Chapter 14 Nutrition and associated disorders Chapter 15 The endocrine system and associated disorders Chapter 16 The reproductive systems and associated disorders Chapter 17 Pain and pain management Chapter 18 The musculoskeletal system and associated disorders Chapter 19 Fluid and electrolyte balance and associated disorders Chapter 20 The skin and associated disorders Chapter 21 The ear, nose and throat, and eyes, and associated disorders Appendix Reference values in venous serum (adults) Index
£35.95
Wiley-Blackwell Fundamentals of Molecular Virology
Book Synopsis
£103.46
Wiley-Blackwell Cancer Systems and Control for Health
Book Synopsis
£47.49
Wiley-Blackwell Urgent Care Emergencies
Book Synopsis
£37.99
Not Stated The Clinical Encounter
a huge range and FREE tracked UK delivery on ALL orders.
£31.34
Wiley-Blackwell PeopleCentred Pharmacy
Book Synopsis
£37.99
Wiley-Blackwell Exploring Symptoms an evidencebased approach to
Book Synopsis
£38.00
John Wiley & Sons Inc Cardiovascular Hemodynamics for the Clinician
Book SynopsisConcise, reliable, and useful handbook for understanding the practical application of hemodynamics in clinical medicine Cardiovascular Hemodynamics for the Clinician is a concise, straightforward handbook to help practicing clinicians and physicians in training better understand and interpret hemodynamic data. This book contains useful and practical information that will be helpful in making specific diagnoses, determining prognosis, and guiding therapy. The text provides a basic overview of cardiac and circulatory physiology followed by detailed discussion of pathophysiological changes in various disease states. Topics covered include the basics of hemodynamics, nuts and bolts of right heart catheterization, coronary artery disease, cardiomyopathies, cardiogenic shock, valvular heart disease, arrhythmias, mechanical circulatory support devices, and pericardial disease. Numerous pressure tracings and comprehensive information on the other hemodynamic data including cardiac output, intr
£59.84
Wiley-Blackwell Understanding Heart Stents A Guide for Patients a nd Families
£23.74
John Wiley & Sons Inc Acute Psychiatric Emergencies
Book SynopsisAn essential guide to the emergency treatment of mental health crises Hospital emergency departments are encountering increasing numbers of patients in mental health crises and the number continues to rise year on year. Despite these challenges, very few practitioners are trained specifically to deal with mental health crises. Acute Psychiatric Emergencies (APEx) meets this need with a course designed jointly by leading psychiatry and emergency medicine specialists with years of practical experience. It provides a structured approach for the assessment and management of acute mental health emergencies, discusses common presentations, as well as legal frameworks and human factors. Now fully updated to reflect new guidelines and expanded treatment of key subjects, it is an invaluable resource for any practitioner involved in the provision of psychiatric care at any point in the healthcare pathway. Readers of the second edition of Acute Psychiatric Emergencies will also find: Detailed di
£49.35
Johns Hopkins University Press Eating Disorders
Book SynopsisTable of ContentsPreface, by Philip S. Mehler and Arnold E. Andersen1. Diagnosis and Treatment of the Eating Disorders Spectrum in Primary Care Medicine, by Arnold E. Andersen2. The Role of the Multidisciplinary Team and Levels of Care in the Treatment of Eating Disorders, by Craig Johnson, Jeana Cost, Russell Marx, Kenneth Weiner, Nathalia Trees, and Philip S. Mehler3. Medical Evaluation of Patients with Eating Disorders, by Kristine Walsh and Philip S. Mehler4. Nutritional Rehabilitation: Practical Guidelines for Refeeding Patients with Anorexia Nervosa, by Meghan Foley, Shelby Sitko, and Philip S. Mehler5. Evaluation and Treatment of Electrolyte Abnormalities, by Dennis Gibson and Philip S. Mehler6. Gastrointestinal Complications, by Dennis Gibson, Leah Puckett, and Philip S. Mehler7. Cardiac Abnormalities and Their Management, by Katherine V. Sachs, Philip S. Mehler, and Mori Krantz8. Obstetric-Gynecologic Endocrinology and Osteoporosis, by Philip S. Mehler9. General Endocrinology, by Philip S. Mehler10. The Dual Diagnosis of Eating Disorder and Diabetes Mellitus, by Ovidio Bermudez, Jennifer McBride, and Philip S. Mehler11. Oral, Dental, Ear, and Eye Complications, by Jeffrey Hollis and Philip S. Mehler12. Athletes and Eating Disorders, by Arnold E. Andersen and Jeana Cost13. Males with Eating Disorders, by Arnold E. Andersen14. Special Considerations for Eating Disorders in Children and Young Adolescents, by Anna B. Tanner and Michael Spaulding-Barclay15. Atypical Anorexia Nervosa, by Neville Golden16. Eating Disorders in Transgender Individuals, by Arnold E. Andersen17. Using Medical Information Psychotherapeutically, by Arnold E. Andersen18. Ethical and Medicolegal Considerations in Treating Patients with Eating Disorders, by Patricia Westmoreland and Jessica Tse19. Medical Information for Nonmedical Clinicians and Educators, by Arnold E. Andersen20. Innovative Psychological Treatments of Eating Disorders, by Arnold E. Andersen21. Family-Based Treatment for Eating Disorders, by Daniel Le Grange and Sasha GorrellList of ContributorsAcknowledgmentsIndex
£37.35
John Wiley and Sons Ltd UICC Manual of Clinical Oncology
Book SynopsisThe Manual of Clinical Oncology, Ninth Edition, published with the International Union Against Cancer (UICC), provides a concise, accessible and feasible reference covering state of art multidisciplinary clinical oncology in order to meet the needs of clinicians caring for cancer patients throughout the world. Edited by world-renowned practising oncologists and written by key opinion leaders, this book contains authoritative and up-to-date information on cancer detection, diagnosis and treatment alongside topics such as survivorship, special populations and palliative care. Remodelled and revised for the ninth edition to provide practical information to oncology workers, the UICC Manual of Clinical Oncology is structured in two parts. Part 1 covers general principles of cancer diagnosis and management with additional attention to special settings in oncology, including supportive care and survivorship, and Part 2 covers site-specific multidisciplinary canTable of ContentsForeword x Preface xi About the Editors xiii Contributors xvi PART 1 General principles of cancer diagnosis and management 1 Principles of knowledge generation and translation 1 – Cancer epidemiology 3 2 – Levels of evidence, guidelines and standards 12 3 – Prognosis and classification of cancer 23 4 – Principles of cancer staging 34 5 – Assessment of treatment outcome 40 6 – Cancer informatics 53 Principles of cancer diagnosis 7 – Imaging 63 8 – Pathology 83 Principles of treatment 9 – Principles of surgery 98 10 – Principles of radiotherapy 108 11 – Principles of systemic therapy 124 Special settings, supportive care and survivorship 12 – Treatment in pregnancy 134 13 – Treatment in the elderly 139 14 – Oncology emergencies 145 15 – Supportive care during curative treatment 155 16 – Pain management in cancer 168 17 – Palliative care 174 18 – Survivorship 184 19 – Rehabilitation 194 PART 2 Site-specific multidisciplinary cancer management 203 Thoracic malignancies 20 – Lung 205 Breast 21 – Breast 221 Gastrointestinal malignancies 22 – Liver 241 23 – Biliary tract and pancreas 263 23.1 – Biliary tract 263 23.2 – Pancreas 270 24 – Oesophagus 280 25 – Stomach 297 26 – Colon, rectum and anus 308 26.1 – Colon and rectum 308 26.2 – Anus 327 Genitourinary malignancies 27 – Prostate 333 28 – Bladder and other urothelium 343 29 – Kidney 354 30 – Testicular germ cell tumours 368 31 – Penis 384 Haematological malignancies 32 – Lymphoma 392 33 – Myeloma 415 34 – Leukaemia 427 Gynaecological cancers 35 – Cervix 449 36 – Uterus 467 37 – Ovary and fallopian tube 479 Head and neck cancer 39 – General principles of head and neck cancer management 503 40 – Nasopharynx 512 41 – Oral cavity 524 42 – Larynx and hypopharynx 542 43 – Oropharynx 559 44 – Major salivary glands 571 45 – Nasal cavity and paranasal sinus 586 46 – Head and neck unknown primary 597 Endocrine tumors 47 – Pituitary 609 48 – Thyroid 626 49 – Adrenal tumours 641 50 – Neuroendocrine tumours 656 Dermatological cancer 51 – Skin: Basal cell carcinoma, squamous cell carcinoma and Merkel cell carcinoma 674 52 – Melanoma 689 Central nervous system and ocular cancers 53 – Central nervous system 706 54 – Eye: Choroidal melanoma, retinoblastoma, ocular adnexal lymph Sarcoma 55 – Bone (osteosarcoma) 745 56 – Soft tissue 754 Childhood malignancies 57 – Paediatric tumors 768 Specific cancer situations 58 – Cancer of unknown primary (no 59 – HIV and transplant-related neoplasms 797 59.1 – HIV-related neoplasms 797 59.2 – Post-transplantation lymphoproliferative disease 809 59.3 – Cancer following solid organ transplantation 812 Index 815
£130.45
Springer London Ltd Hearing Loss in the Elderly
Book SynopsisIn their preface, the authors highlight the great social and medical importance of hearing loss in the elderly, an ever-increasing prob lem. It is, therefore, most appropriate that a monograph, devoted to research in this field, features as an addition to the Bloomsbury Series in Clinical Science. Written by two leading authorities, the book reviews the past and present literature, details the clinical aspects and considers the electrophysiological and histopatho logical issues basic to the overall problem. It continues the high standard and excellence fostered by previous issues in the Series. London, August 1990 Jack Tinker Preface The number of very old people in the community is steadily increasing so the hearing loss that many of them endure has become a disorder of social and medical importance. Only by a greater scientific knowledge of old age deafness can there be any posTable of Contents1 Review of Literature.- Up to the Early Twentieth Century.- Recent Times.- Localization of the Disturbance.- Central.- Peripheral.- Aetiological Basis for the Disturbance.- Role of Exogenous Factors.- Summary.- Localization.- Aetiological Basis.- 2 Clinical Diagnosis and Audiometric Studies.- Clinical Dignosis.- History.- Examination of the Ear.- Clinical Speech Tests.- Tuning Fork Methods.- Audiogram.- Tympanometry.- X-Rays.- Electrophysiology.- Calorics and Electronystagmography.- Disorders of the External Ear.- Disorders of the Middle Ear.- Disorders of the Inner Ear.- Presbyacusis.- Noise Induced Hearing Loss.- Ototoxicity.- Bone Lesions of the Otic Capsule.- Acoustic Neuroma.- Tinnitus.- Audiometric Studies.- Personal Investigations.- Hearing Levels in a Large Group of Elderly People.- Comparison of Hearing Levels in Different Medical and Environmental Conditions.- 3 Electrophysiology.- (In collaboration with S.M. Mason).- Extratympanic Electrocochleography.- Detailed Investigation of ABR; Preliminary Investigation of ECochG.- Procedure.- Results.- Discussion.- Summary.- Simultaneous Recordings of ABR and ECochG; Detailed Investigation of ECochG Components.- Procedure.- Results.- Discussion.- Conclusions.- Summary.- Stimulus Rate Effects.- Procedure.- Results.- Discussion.- 4 Histopathological Changes.- Perfusion-Fixation and Slicing of Inner Ear.- Staining of Surface Preparations.- Preliminary Survey of Morphological Changes in Elderly Cochleas.- Procedure.- Results.- Discussion.- Quantitative Analysis of Hair Cell Changes.- Procedure.- Results.- Discussion.- Summary of Histopathological Changes.- 5 Summing-up.
£40.49
Springer-Verlag New York Inc. Chronic Ambulatory Peritoneal Dialysis CAPD and Chronic Cycling Peritoneal Dialysis CCPD in Children
Book SynopsisDuring the past decade, there has been a renaissance of interest in the use of peritoneal dialysis as a primary dialytic modality for the treatment of children with end stage renal disease (ESRD). The development of the technique of continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) has markedly changed the approach to children requiring dialytic therapy. The availability of these techniques has facilitated prolonged dialysis in infants and has for the first time given pediatric nephro logists in many areas of the world an opportunity to consider dialysis in chil dren afflicted with ESRD. I have enlisted the collaboration of colleagues from Europe, South America, Canada, and the United States in compiling this multidisciplinary text, which hopefully contains the most up-to-date, comprehensive information regarding the use of CAPD/CCTable of Contents1. The use of peritoneal dialysis in Europe for treatment of children with end stage renal disease—EDTA registry data.- 2. Demographic data on the use of CAPD/CCPD as a primary dialytic therapy in children in the United States.- 3. Pediatric CAPD in developing countries.- 4. Developmental aspects of peritoneal dialysis kinetics.- 5. Peritoneal dialysis kinetics in children.- 6. Kinetics of CCPD in children.- 7. CAPD in infants.- 8. Technical aspects of CAPD/CCPD.- 9. Peritoneal catheter: technique, logevity, complications.- 10. Continuous ambulatory peritoneal dialysis in children; biochemical control of uremia, anemia, hypertension, lipid metabolism, glucose tolerance, and endocrine abnormalities.- 11. The role of the nurse in CAPD/CCPD training.- 12. Complications of CAPD/CCPD in pediatric patients.- 13. Peritonitis in infants and children on CAPD/CCPD.- 14. Loss of ultrafiltration and sclerosing encapsulating peritonitis in children undergoing CAPD/CCPD.- 15. Long-term function of the peritoneal membrane.- 16. Nutritional recommendations for children treated with CAPD/CCPD.- 17. The role of the dietitian in the management of children undergoing CAPD/CCPD.- 18. Supplemental (NG) feedings of infants undergoing continuous peritoneal dialysis.- 19. Protein losses during CAPD in children: the role of dialysates containing amino acids.- 20. Control of renal bone disease by high-dose calcitriol and the use of calcium carbonate as a phosphate-binding agent in children on CAPD/ CCPD.- 21. Growth in children on CAPD.- 22. Comparison of CAPD and hemodialysis in children.- 23. Comparison of CAPD and CCPD in children.- 24. Transplantation in children undergoing CAPD and CCPD.- 25. Promoting psychosocial adaptation to continuous ambulatory peritoneal dialysis/continuous cylcing peritoneal Dialysis in Children and Adolescents.
£116.99
Springer-Verlag New York Inc. Manual of Tropical Dermatology
Book SynopsisWe live today in a world densely populated by human beings living in close commu nication with one another all over the surface of the planet. Viewed from a certain distance it has the look of a single society, a community, the swarming of an intensely social species trying to figure out ways to become successfully independent. We obvi ously need, at this stage, to begin the construction of some sort of world civilization. The final worst-case for all of us has now become the destruction, by ourselves, of our species. I Although this warning is often repeated, we must not forget its paramount importance and the commitment that each sector of society has to make a world civilization possible. Tropical dermatology is a good example of an important area of our spe cialty that has never caught the proper attention of the leading centers of research in the developed countries, even though it comprehends major infec tious, parasitic, and nutritional problems of one-half of the world's land aTable of ContentsI Introduction.- 1 Introduction to Tropical Dermatology.- 2 Clinical Index.- II Bacterial Diseases.- 3 Anthrax.- 4 Yaws.- 5 Tuberculosis of the Skin.- 6 Leprosy.- 7 Buruli Ulcer (Mycobacterium Ulcerans).- 8 Tropical Ulcers.- III Fungal Diseases.- 9 Tropical Tineas.- 10 Chromomycosis.- 11 Madura Foot and Other Mycetomas.- 12 Sporotrichosis.- 13 Actinomycosis.- 14 Botryomycosis.- 15 Rhinosporidiosis.- 16 Rhinoscleroma.- 17 North American Blastomycosis.- 18 Paracoccidioidomycosis.- 19 Lobo’s Disease.- IV Parasitic Diseases.- 20 Leishmaniasis.- 21 Amebiasis.- 22 Toxoplasmosis.- 23 Onchocerciasis.- 24 Filariasis.- 25 Dracunculosis.- 26 Schistosomiasis.- V Other Dermatoses.- 27 Lichen Planus Tropicus.- 28 Dietary Deficiencies.- 29 Phrynoderma.- 30 Brazilian Pemphigus Foliaceous.- 31 Chronic Arsenical Poisoning.- Appendix One Useful Techniques.- Appendix Two Useful Addresses.
£999.99
Springer-Verlag New York Inc. Suki and Massrys Therapy of Renal Diseases and Related Disorders
Book Synopsisstories of postwar nephrology and metabolism. Postwar Uremia is to the nephrologist what the baby is to the nephrology rushed to the fore and supplied nephrologists pediatrician, for it is the final common pathway of literally with such wonderful tools as the flamephotometer, electro- hundreds of disease processes that lead to scarring and destruction of nephrons. . phoresis, microchemistry, immunoassay, sonography, renal biopsy, immunofluorescence, electron microscopy, and un- We estimate that there are well in excess of 300,000 clear magnetic resonance, and permitted a total integration patients in the world living on the varied methodologies of form, histologic structure, and function. Clinical represented by the three basic forms of substituted kidney nephrology became indeed the real fusion of biochemistry, function-hemodialysis, peritoneal dialysis, and renal physiology, immunology, renal endocrinology, and the transplantation: over 100,000 persons in the United States focus of nTable of ContentsPart One: Disorders of Fluid, Electrolyte, and Acid-Base Balance. Part Two: Intrinsic Parenchymal Disease. A: Glomerular. B: Tubulointerstitial. Part Three: Renal Involvement in Systemic Disease. Part Four: Hereditary and Congenital Diseases. Part Five: Neoplasia. Part Six: Chemical and Physical Injuries. Part Seven: Chronic Renal Failure. A: Medical Therapy. B: Peritoneal Dialysis. C: Hemodialysis. D: Transplantation. Part Eight: Hypertension. Part Nine: Urologic Disorders. Index.
£40.49
Springer-Verlag New York Inc. Mens Health
Book SynopsisThis book covers issues of men's health, including screening, diagnosis and management of common disorders and opportunities for prevention and health maintenance. Each chapter pertains to a component of the physical exam and/or organ system. Examples include appropriate survey and screening of the integument, the significance of buccal/dental integrity, tailoring cardiovascular remedies and balancing prostate cancer screening with quality of life. The book follows the methodical approach of a comprehensive wellness visit, including inventory of psychosocial factors, which significantly impact physical well-being. Justification for often overlooked topics in the review of systems, such as sexual history and satisfaction, relationship issues, and vocational fulfillment are provided. This book is written in the spirit of the rich bedside acumen and the art of healing, we must strive to protect. While informative and stimulating, this text serves to remind us of the specialized diagnosTable of ContentsChapter 1. His Occupation: Safety and FulfillmentKathleen Fagan, MD, MPH, Rosemary Sokas, MD, MOH Chapter 2. Sunscreens & Ultraviolet light: What you need to knowShilpi Khetarpal, MD, Kenneth Tomecki, MD Chapter 3. His MouthGary K. Roberts, DDS Chapter 4:Screening and Management for Pulmonary and Sleep IssuesLoutfi S. Aboussouan, MD Chapter 5. His Upper GI TractDan E. Azagury, MD, Lyen Camille Huang, MD, MPH Chapter 6. His Lower GI TractCindy Kin, MD Chapter 7. Cardiovascular Prevention in MenRony Lohoud, MD, Irving Franco, MD Chapter 8.Metabolic Syndrome: The Vicious CycleJeannette M. Potts, MD Chapter 9. Andrology: Puberty-Fertility-AndropauseDavid P. Guo, MD, Michael L. Eisenberg, MD Chapter 10. Genital DermatologyAlok Vij, MD, Sarah C Vij, MD, Kenneth J Tomecki, MD Chapter 11. Male Sexual ConcernsJeannette Potts, MD Chapter 12. Benign Prostatic Hyperplasia and LUTSHarcharan Gill, MD Chapter 13. Prostate Cancer ScreeningJeannette. M. Potts, MD Chapter 14. Men Have Bladders, TooChristopher K. Payne, MD Chapter 15. Chronic Pelvic Pain in Men is NOT prostatitis!Jeannette. M. Potts, MD Chapter 16. Male Mental Health: A Peek Inside The Black BoxDean A. Tripp, Ph.D, Hayley Yurgan BScH
£999.99
iUniverse White Shadow: Walking with Janet Mentgen
Book Synopsis
£19.90
Brush Education Inc Vancouver Notes for Internal Medicine: High-Yield
Book SynopsisA point-of-care guide for internal medicine trainees. When students and residents begin a new rotation in internal medicine, they often start from scratch, relying on their own research to prepare for consultations. What questions are crucial during history taking? What should the physical examination and investigations focus on? What should the consultation write-up include? Now, physician learners can turn to Vancouver Notes for Internal Medicine for guidance on conducting consultations in each of the core internal medicine subspecialties. Vancouver Notes provides learners with an organized approach to common presentations in internal medicine. For each subspecialty, it lays out the process for identifying key information and communicating findings and management recommendations to a patient’s health-care team. Developed through the efforts of more than 90 resident physicians and faculty members at the University of British Columbia, Vancouver Notes combines valuable clinical pearls in a single, accessible resource to give students and residents the tools they need to succeed from day one.
£40.00
Thieme Medical Publishers Inc Vascular Lesions of the Head and Neck: Diagnosis and Management
Book SynopsisThieme congratulates Milton Waner on being chosen by New York magazine for its prestigious 'Best Doctors 2017' list. Vascular Lesions of the Head and Neck provides readers with an up-to-date review of the pathology, basic science, classification, radiologic features, and treatment modalities for vascular lesions of the head and neck. It covers all recent developments in medical and surgical treatment, laser technology, endovascular techniques, and appropriate radiation protocols that dramatically affect the evaluation and management of patients with vascular lesions. Key Features: Written by leading experts on the diagnosis and treatment of vascular lesions in the fields of otolaryngology, plastic surgery, radiology, dermatology, pathology, and pediatrics Emphasizes a multidisciplinary approach to the diagnosis and treatment of vascular lesions More than 200 full-color illustrations help clarify information in the text This book is an excellent desk reference for all otolaryngologists, plastic surgeons, vascular interventional radiologists, pediatricians, dermatologists, pathologists, and general pediatric surgeons involved in the treatment of patients with vascular lesions of the head and neck. Table of Contents1 Classification of Vascular Anomalies 2 Congenital Vascular Tumors 3 Pathology of Congenital Vascular Lesions 4 The Natural History, Physical Findings, and Evaluation of Hemangiomas 5 Hemangioma Syndromes 6 Radiologic Evaluation of Hemangiomas 7 Medical Management of Hemangiomas 8 Treatment of Infantile Hemangiomas 9 Radiologic Evaluation of Vascular Malformations 10 The Role of Endovascular Surgery in the Management of Vascular Lesions of the Head and Neck 11 Treatment of Port-Wine Stains 12 The Surgical Management of Vascular Malformations 13 Evaluation and Treatment of Vascular Neoplasms 14 Pathology of Acquired Vascular Neoplasms of the Head and Neck
£73.15
JP Medical Ltd Short and OSCE Cases in Internal Medicine
Book SynopsisThe second edition of this book is a practical revision guide for postgraduate students preparing for clinical examinations in internal medicine. Authored by an experienced postgraduate examiner, the book presents a series of short and OSCE cases presented in a uniform format, offering guidance on examination techniques, common mistakes made by candidates, and typical presentation of findings. Divided into seven sections, the book begins with advice on how to prepare for and pass clinical examinations. The remaining chapters cover cases relevant to different systems of the body – cardiovascular; respiratory; abdominal; neurological; endocrine, rheumatologic, connective tissue and skin; and eye and fundus. Each case provides a summary of diagnosis, differential diagnosis, management, and further information often required in examinations. The questions and model answers are similar to those most frequently encountered in examinations. The comprehensive text is enhanced by illustrations and figures to assist learning and will be useful not only to candidates preparing for postgraduate clinical examinations, but also to undergraduate students. Key points Practical revision guide for postgraduate students preparing for clinical examinations in internal medicine Questions and model answers similar to those encountered in examinations Authored by experienced postgraduate examiner Previous edition (9789386150035) published in 2016 Table of Contents Foreword Preface to the 2nd edition Preface to the 1st edition Dedication Important note Acknowledgements List of abbreviations Part 1: Advice on how to prepare for and pass clinical examinations Part 2: Cardiovascular cases Part 3: Respiratory cases Part 4: Abdominal cases Part 5: Neurology cases Part 6: Endocrine, rheumatology, connective tissue and skin cases Part 7: Eye and fundus cases Index
£42.75
£20.96
Gillette Childrens Healthcare Press Epilepsy Understanding and Managing the
Book Synopsis
£42.75
Wolters Kluwer Health The Washington Manual of Outpatient Internal
Book SynopsisFocusing on the essential information you need to know for the most commonly encountered problems in outpatient internal medicine, this practical volume in the Washington Manual® series provides concise, high-yield content that reflects today’s advances in patient evaluation and management. In one convenient, portable resource, you’ll find complete coverage of everything from hypertension and diabetes to sleep disorders, nutrition, and care of the cancer patient—all at your fingertips for quick review and reference. Edited by Drs. Maureen D. Lyons, Peter J. McDonnell, and Jennifer M. Schmidt, The Washington Manual® of Outpatient Internal Medicine, 3rd Edition, is an excellent companion to the Washington Manual® of Medical Therapeutics, which thoroughly covers inpatient care. Covers common ambulatory/outpatient problems encountered in each medical subspecialty, all in the famous fast-access Washington Manual® outline format that includes easy-to-follow guidelines, diagrams, and algorithms. Thoroughly revised from cover to cover, including new content on telehealth, the trauma-informed approach, immunization reaction and allergy, functional assessment and safe prescribing for pain, breast masses, sexually transmitted infections, and more. Includes a new, full-color insert of dermatologic images to illustrate skin diagnoses and rashes. Addresses all areas of medicine and core subspecialties, including neurology and toxicology. Provides need-to-know diagnostic and therapeutic guidance from the outstanding house staff and faculty at Washington University School of Medicine in St. Louis. The Washington Manual® is a registered mark belonging to Washington University in St. Louis to which international legal protection applies. The mark is used in this publication by Wolters Kluwer Health under license from Washington University. Enrich Your eBook Reading Experience Read directly on your preferred device(s),such as computer, tablet, or smartphone. Easily convert to audiobook,powering your content with natural language text-to-speech.
£54.62
Wolters Kluwer Health Step-Up to Medicine
Book SynopsisMake the most of your study time and confidently take the next step in your medical career with this bestselling review.!Step-Up to Medicine, 6th Edition, makes it easy to find information fast and take a confident next step toward a successful medical career. Ideal for preparing for clerkships or clinical rotations, shelf exams, and the USMLE Step 2, this bestselling volume in the popular Step-Up series provides a high-yield review of medicine in a concise, comprehensive approach. This 6th Edition is thoroughly updated and enhanced throughout. Clinical pearls, full-color illustrations, and “Quick Hits” provide essential information in an efficient, easy-to-remember manner to ensure excellence on exams and confidence in clinical settings, and a 100-question practice exam reinforces exam readiness and boosts test-taking confidence. NEW! More than 50 additional NBME-style review questions with answers and explanations reinforce key content in context with how students will encounter it on their exams. UPDATED! New and enhanced images throughout—including expanded coverage of dermatology—clarify essential concepts in vibrant detail. UPDATED! Concise tables and figures summarize treatment protocols, drug details, and other essential information for fast, efficient review. NEW! Additional online review questions test students’ retention and alert them to areas requiring further study. “Quick Hits” help students save time and stay focused on core content.
£46.08
£56.69
Springer Nature Switzerland AG Endometriosis Pathogenesis, Clinical Impact and
Book SynopsisThis volume focuses on endometriosis from its pathogenesis and the importance of the early diagnosis to treatment, throughout all aspects of femininity that this disease affects, impacting health and quality of life.It also covers treatment strategies for the pain and for the disease management according to the age and needs of the patient, from adolescence to menopause, passing through the fertile age and the consequences that this disease can have on fertility and pregnancy. This book is a useful, clear and up-to-date tool for gynecologists, gynecological surgeons, reproductive medicine and general practitioners and is an important source of information to face this more and more frequent and devastating disease.Table of ContentsChapter 1. Endocrine disruptors and risk of endometriosis.- Chapter 2. Metabolomic characteristics in endometriosis patients.- Chapter 3. Can we diagnose early endometriosis with ultrasound rather than laparoscopy?.- Chapter 4. Neurotrophins and cytokines in endometriosis pain.- Chapter 5. Endometriosis induced pain: the treatment strategy.- Chapter 6. Management of endometriosis in teenagers.- Chapter 7. The etonogestrel contraceptive implant as a therapy for endometriosis.- Chapter 8. Impact of endometrioma surgery on ovarian reserve.- Chapter 9. What is the place of surgery of deep endometriosis in infertile and pelvic pain patients?.- Chapter 10. Endometriosis and Infertility: surgery and IVF: when, why and outcomes.- Chapter 11. ART and Endometriosis : problems and solutions.- Chapter 12. Morphokinetics in embryos from patients with endometriosis.- Chapter 13. Endometriosis and cancer: prevention and diagnosis.- Chapter 14. Medical management of endometriosis, present and future with special reference to MHT in the patient previously diagnosed with endometriosis.- Chapter 15. Endometriosis and Menopause: Realities and Management.
£71.99
Springer Nature Switzerland AG Epilepsy Case Studies: Pearls for Patient Care
Book SynopsisThis book presents a case based approach to epilepsy management in both diagnostic challenges and treatment of complex cases. Cases reflect “real life” patient scenarios that practitioners encounter with up-to-date terminology and treatment approaches.With 51 chapters, the book presents 51 unique, nuanced cases. Beginning with an initial presentation of a case history, the book opens with a basis for drawing in multiple aspects in the treatment of patients with epilepsy. Each chapter is organized into a clinical history, physical examination results, and ancillary testing to concentrate on differential diagnosis and focus on a definitive procedural approach to the final diagnosis. Subsequent information about the condition expands on the knowledge of the clinical features to a solution of common patient clinical scenarios as it affects people with epilepsy.A comprehensive successor edition, Epilepsy Case Studies is an invaluable resource to clinicians ranging from those looking for a quick review of a topic present in the table of contents, to those crossing disciplines into medical areas where seizures are a symptom of disordered or dysfunctional brain.Table of ContentsCasesNeonatal onset-general (ie spasms)Neonatal onset-focal (hyperglycinemia)Febrile seizuresChildhood onset-general (CAE)Lennox-Gastaut syndromeChildhood onset-focal (BCECTS)Adolescent onset-general (JME)Adolescent onset-focal (unknown cause)Stigmatization Effect (social consequences)Physical and mental well-being (sports and education)Physical Comorbidity (CP)Mental Comorbidity (ADD/Austistic spectrum disorder)Etiologies of a foreign tissue lesion Head trauma Precipitating factors (triggers)Single seizure (treatment focus)Drug cessation (treatment focus)Epilepsy-adult (treatment focus)Epilepsy-elderly (treatment focus)Generic AEDs Side effects Drug interactionsBirth controlHormonal replacementPregnancy (treatment focus)Epileptic panic attacks (diagnosis)Anxiety-DepressionViolence (frontal lobe seizures) PNEA-women (diagnosis focus)PNEA-men (treatment focus)Drug-resistant-neurologically normal (“skip” surgery)Drug-resistant-neurologically normal but complex (invasive EEG)Drug-resistant surgical failure (treatment focus)Work and disabilityMemory lossStatus epilepticus-convulsiveStatus epilepticus-non-convulsiveSUDEPExperimental therapies (treatment)Alternative therapies (treatment)
£999.99
Springer Nature Switzerland AG Pediatric Surgery: Diagnosis and Management
Book SynopsisThis comprehensive book provides detailed practical advice on the diagnosis and surgical management of congenital and acquired conditions in infants and children. Following the great success of the first edition, the new edition has been fully updated to reflect the major developments in the field of the past decade. Advances in prenatal diagnosis, imaging, anaesthesia and intensive care as well as the introduction of new surgical techniques, including minimally invasive surgery and robotic technology that have radically altered surgical conditions are now discussed in the book. In addition new chapters have been added on surgical safety in children, surgical problems of children with disabilities and surgical implications of HIV infection in children among others. This is a superbly structured and richly illustrated guide aimed at trainees, young pediatric surgeons and general surgeons with interest in pediatric surgery. The book also serves as a handy, quick and easy reference for those making decisions in daily practice. Pediatric Surgery, Diagnosis and Management features contributions by leading experts in pediatric surgery and pediatric urology who have unique experience in their respective fields.Table of Contents1 The Epidemiology of Birth Defects.- 2 Prenatal Diagnosis and Fetal Counselling for Surgical Congenital Malformations.- 3 Transport of the Surgical Neonate.- 4 Pre-operative Management and Vascular Access.- 5 Anaesthesia and Analgesia.- 6 Fluid, Electrolyte and Respiratory Management.- 7 Sepsis.- 8 Nutrition.- 9 Access for Enteral Nutrition.- 10 Haematological Problems.- 11 Genetics.- 12 Ethical Considerations in Paediatric Surgery.- 13 Minimally Invasive Surgery in Infants and Children.- 14 Surgical Safety in Children.- 15 Surgical Problems of Children with Disabilities.- 16 Surgical Implications of HIV infection in Children.- Part II Trauma.- 17 Birth Trauma.- 18 Pediatric Thoracic Trauma .- 19 Abdominal and Genitourinary Trauma.- 20 Traumatic Head Injuries.- 21 Paediatric Orthopedic Trauma.- 22 Injuries to the Tendons.- 23 Burns.- 24 Foreign Bodies.- 25 Physical and Sexual Child Abuse.- Part III Head and Neck.- 26 Pierre Robin Sequence.- 27 Choanal Atresia.- 28 Thyroglossal and Branchial Cysts, Sinuses and Fistulas .- 29 Tracheostomy.- Part IV Chest.- 30 Chest Wall Deformities .- 31 Breast Disorders in Children and Adolescents.- 32 Congenital Airway Malformations.- 33 Mediastinal Masses in Children.- 34 Pleural Effusion and Empyema.- 35 Congenital Malformations of the Lung.- 36 Congenital Diaphragmatic Hernia.- 37 Extracorporeal Membrane Oxygenation.- Part V Esophagus .- 38 Esophageal Atresia and Tracheoesophageal Fistula.- 39 Gastroesophageal Reflux Disease.- 40 Achalasia.- 41 Esophageal Perforations and Caustic Injuries in Children.- 42 Esophageal Replacement.- Part VI Gastrointestinal.- 43 Infantile Hypertrophic Pyloric Stenosis.- 44 Gastrostomy and Jejunostomy.- 45 Duodenal Obstruction.- 46 Intestinal Malrotation.- 47 Jejuno-Ileal Atresia.- 48 Meconium Ileus.- 49 Duplications of the Alimentary Tract.- 50 Necrotizing Enterocolitis.- 51 Constipation.- 52 Hirschsprung’s Disease .- 53 Variant Hirschsprung’s Disease.- 54 Anorectal Anomalies.- 55 Appendicitis.- 56 Intussusception.- 57 Omphalomesenteric Duct Remnants.- 58 Hernias.- 59 Short Bowel Syndrome.- 60 Inflammatory bowel disease.- 61 Paediatric Small Bowel Transplantation .- Part VII Liver, Biliary Tract and Pancreas.- 62 Biliary Atresia.- 63 Choledochal Cyst.- 64 Hepatic Cysts and Abscesses.- 65 Portal Hypertension.- 66 Gallbladder Disease.- 67 Pancreatic Disorders.- 68 Splenic Disorders.- 69 Pediatric Liver Transplantation.- Part VIII Anterior Abdominal Wall Defects.- 70 Omphalocele and Gastroschisis.- 71 Bladder Exstrophy.- 72 Cloacal Exstrophy.- 73 Prune Belly Syndrome.- 74 Conjoined Twins.- Part IX Tumors.- 75 Vascular Anomalies .- 76 Congenital Nevi.- 77 Lymphatic Malformations.- 78 Sacrococcygeal Teratoma.- 79 Neuroblastoma.- 80 Wilms’ Tumor.- 81 Soft Tissue Sarcoma.- 82 Hepatic Tumors in Childhood.- 83 Lymphomas.- 84 Ovarian Tumors .- 85 Testis Tumors.- Part X Spina Bifida and Hydrocephalus.- 86 Spina Bifida and Encephalocoele.- 87 Hydrocephalus.- 88 Dermal Sinus and Tethered Cord.- Part XI Genitourinary.- 89 Urinary Tract Infection.- 90 Imaging of the Paediatric Urogenital Tract.- 91 Management of Prenatal Hydronephrosis.- 92 Upper Urinary Tract Obstructions.- 93 Ureteric Duplication Anomalies.- 94 Vesicoureteral Reflux.- 95 Posterior Urethral Valves.- 96 Neuropathic Bladder.- 97 End Stage Renal Disease and Renal Transplantation.- 98 Disorders of Sexual Development.- 99 Cryptorchidism.- 100 Acute Scrotum.- 101 Hypospadias.- 102 Circumcision and Buried Penis.- Part XII Paediatric Gynaecology.- 103 Hydrometrocolpos.- 104 Gynecologic Conditions of Childhood.- Part XIII Long-term Outcomes.- 105 Long-term Outcomes in Pediatric Surgery.
£197.99
Springer Nature Switzerland AG Dorothy Hansine Andersen: The Life and Times of the Pioneering Physician-Scientist Who Identified Cystic Fibrosis
Book SynopsisThis book chronicles the life and accomplishments of Dorothy Hansine Andersen, a pioneering American pathologist and pediatrician who was the first person to define, diagnose, and treat cystic fibrosis.Divided into three parts, the book begins by detailing Anderson’s early life, including being orphaned as an adolescent, her college career, and her laborious start in the medical field. Part II then examines Andersen’s role in defining the new disease “cystic fibrosis of the pancreas” and her career of active engagement in various clinical pursuits and research, both in pathology and pediatrics. Chapters in this section also discuss the numerous attempts made by others to minimize Andersen’s work through gender bias and the Matilda Effect. The book concludes by reviewing the foundations laid for CF, Andersen’s legacy, and her terminal illness. Featuring an engaging narrative style, Dorothy Hansine Andersen is a historically relevant, invaluable text for anyone interested in the life of Dorothy Anderson and the nascence of cystic fibrosis diagnoses.Table of ContentsTable of Contents:Introduction Part I: Life before Babies Hospital Chapter 1: A beginning Chapter 2: Orphaned Chapter 3: College and medical school Chapter 4: False start Chapter 5: A reboot Part II: Babies Hospital during the McIntosh Era Chapter 6: Historical perspectives Chapter 7: Synergy Chapter 8: Andy’s abandoned farm Chapter 9: Scoring the first goal Chapter 10: CF firsts Chapter 11: “To Dr. Andersen who has pulled me through many a tough year” Chapter 12: McIntosh, pediatric pathology, and Columbia University Chapter 13: CF sweat and the Matilda Effect Chapter 14: Glycogen storage diseases Chapter 15: Celiac disease Chapter 16: Randomized, controlled trials Chapter 17: Babies Hospital siblings Chapter 18: A last decade of CF research Chapter 19: Pediatric heart diseases Part III: Beyond Babies Hospital and the McIntosh Era Chapter 20: Time to enjoy the view Chapter 21: A foundation and a club for CF Chapter 22: The end of an era Chapter 23: Cancer Afterword
£33.24
Springer Nature Switzerland AG Migraine in Medicine: A Machine-Generated Overview of Current Research
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£999.99
Springer International Publishing AG Colorectal Liver Metastasis
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£113.99
Springer International Publishing AG Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy
Book SynopsisThis book presents up-to-date information on the general principles of diagnostic and therapeutic nuclear medicine in the context of endocrinology. The content is divided into six parts. Section I examines general aspects of radiopharmaceuticals, scintigraphy, single-photon emission computed tomography (SPECT), positron emission tomography (PET), radionuclide therapies and radioguided surgery. Section II discusses diagnostic applications in benign thyroid diseases and evaluation of thyroid nodules. Section III gives an overview of the management of parathyroid diseases. Section IV presents diagnostic techniques in well-differentiated thyroid cancer. Section V addresses procedures and therapy in adrenal benign and malignant disorders (phaechromocytomas and paragangliomas). Lastly, the diagnosis and treatment of neuroendocrine tumors are featured in Section VI. Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy is intended for non-specialists in nuclear medicine working in the field of endocrinology, and is also a valuable resource for researchers and students.Table of Contents1. Radiopharmaceuticals Definitions 2. Principles of Scintigraphies 3. Principles of Single Photon Emission Tomography 4. Principles of Positron Emission Tomography 5. Principles of Nuclear Medicine Therapies 6. Diagnostic Nuclear Medicine in Hyperparathyroidism 7. Diagnostic Nuclear Medicine in Hyperthyroidism 8. Diagnostic Nuclear Medicine in Well Differentiated Thyroid Cancer 9. Diagnostic Nuclear Medicine in Medullary Thyroid Carcinoma 10. Diagnostic Nuclear Medicine in Pheochromocytomas and Paragangliomas 11. Diagnostic Nuclear Medicine in Pulmonary, Intestinal and Pancreatic Neuroendocrine Tumors 12. Diagnostic Nuclear Medicine in Parathyroid Carcinomas 13. Diagnostic Nuclear Medicine in Multiple Endocrine Neoplasia Syndromes 14. Therapeutic Nuclear Medicine in Hyperthyroidism 15. Therapeutic Nuclear Medicine in Well Differentiated Thyroid Cancer 16. Therapeutic Nuclear Medicine in Pheochromocytomas and Paragangliomas 17. Therapeutic Nuclear Medicine in Pulmonary, Intestinal and Pancreatic Neuroendocrine Tumors 18. Intraoperative Radioguided Localization of Parathyroids 19. Intraoperative Radioguided Localization of Sentinel Node in Thyroid Cancer
£61.74
Springer The Diabetes Textbook
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£113.99
Springer Duodenal Switch and Its Derivatives in Bariatric and Metabolic Surgery
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£999.99
Springer International Publishing AG Von HippelLindau Disease
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£33.24
Springer An Internists Path
Book SynopsisPart I. Deciding on Fellowship.- Introduction: Fellowship after an Internal Medicine Residency.- Do I want to pursue further training?- Fellowship Applications, Interviews, and the Match Process.- The Unmatched Resident: Options and Guidance for Internal Medicine Residents Who Did Not Match into Fellowship.- Part II. Choosing your Scope of Practice outside Academia.- Choosing Your Scope of Practice Outside of Academia: Hospitalist.- Private Practice.- Home-Based Primary Care.- Part III. Finding your Niche in General Internal Medicine without a Fellowship.- Geriatric Medicine.- Obesity Medicine.- HIV Primary Care.- Gender Affirming Care for the Internist.- PrEP for the Internist.- Comprehensive Cancer Care and Survivorship Medicine.- Addiction Medicine for the General Practitioner.- What to Expect after Internal Medicine Residency: Informatics.- Advancing Quality Improvement and Patient Safety in Your Professional Practice.- Mastering Business Administration and Internal Medicine: Shaping the Future of Healthcare Leadership.- Hospital and Outpatient Ethics Committees.- Advocacy as a Clinician.- The Digital Era of Medicine.- Narrative Medicine.- My Journey as a PCP.- Part IV. The Many Roles of the Internist in Academic Medical Education.- Chief Residency: The Pros and Cons.- The Many Roles of the Internist in Academic Medical Education: Inpatient Education as a Hospitalist.- Medical Student Education.- Precepting and Managing a Medical Student Clinic.- The Many Roles of the Internist in Academic Medical Education.- Creating a Learning Environment Committed to Diversity, Equity, Inclusion, and Belonging.- Part V. Becoming a Successful Clinician.- Cultural Humility in Patient Care.- Listening Skills as a Foundation of Patient Care.- Delivering Serious News.- Admission Code Status Conversations: From the Lens of a Hospitalist and Palliative Care Provider.- Workflow and Efficiency Tips for the Hospitalist.- Becoming a Fellow of the American College of Physicians.- The Job Interview.- Part VI. The Hidden Curriculum.- “Why Won’t My Patients Do What I Tell Them?”: Managing Patient Challenges.- Dealing with the Death of a Patient.- Caring For Patients with Dementia.- Sometimes, We Do Harm: How to Deal with Physician Error.- Navigating Imposter Syndrome in Internal Medicine Residency.- Pharmaceutical Company Marketing in the Primary Care Setting.- Getting Sued.- Practicing as a Minority in Medicine.- Identifying as LBGTQ+ in Medicine.- LGBTQ+ Inclusive Care.- Part VII. Life Outside of Medicine.- Through the Lens of Your Mental Health.- Work-Life Balance.- Wellness in Residency.- When Should I Start a Family.- Managing Finances as a Physician.- Cancer Survivorship: When the Physician Becomes the Patient.- When the Physician Becomes a Patient.- A Case for Wasting Your Twenties: A Journey to Fertility Preservation.
£71.99
Springer International Publishing AG The MassGeneral Hospital for Children Adolescent Medicine Handbook
Book SynopsisThe second edition of this definitive guide for clinical care of adolescents builds upon the practical knowledge and guidance of the first edition, and expands into new subjects of adolescent care. The handbook is divided into three sections: general adolescent medicine, sexuality, and mental health, and contains relevant, practical knowledge, covering those areas most often seen in the practice of adolescent medicine.The MassGeneral Hospital for Children Adolescent Medicine Handbook, 2nd edition details best practices in regards to diagnostic evaluations and clinical care, but also instructs practitioners on the best methods to connect, communicate, and continue that care with adolescents, in order to provide optimal treatment, and instill healthy lifetime behaviors. Each chapter is written by clinicians who have been trained at, or are members of the staff of Massachusetts General Hospital, and this edition has nearly doubled the amount of skilled physician authors. While this title has been revised and updated, entirely new chapters devoted to hypertension, immunizations, breast disorders, HIV, and resilience have also been added, reflecting new and changing contributions to the field of adolescent medicine. This second edition brings together the practical, hands-on knowledge of the first edition, along with new information and additional subject areas to create a balanced, multi-specialty method to treating and engaging adolescent patients.Trade Review“In 29 chapters and 3 parts the authors, members of the staff of Mass General Hospital (MGH) or its trainees, review the physical and mental health issues in adolescence including sexuality. … There are many tables and illustrations, some in color. Clearly written. To pediatric interns, residents and practitioners. Highly recommended.” (Pediatric Endocrinology Reviews (PER), Vol. 14 (4), June, 2017)“The purpose is to provide primary care providers in all medical and surgical specialties who may care for adolescents with an overview of the basic, most frequent topics encountered in adolescent medicine. … The author has done a great job in meeting these objectives and this is a needed handbook for primary care providers. … This is an excellent resource for busy primary care providers who need a broad overview of the most commonly encountered adolescent medicine topics.” (Rachel Dawson, Doody’s Book Reviews, June, 2017)Table of ContentsPreface AcknowledgementsPART 1. GENERAL ADOLESCENT MEDICINE1. Adolescent Preventive Services 2. The Adolescent Patient Interview: Adolescent Confidentiality and Consent3. Pubertal Development4. Normal Adolescent Development 5. Male Genitourinary Exam6. The Pelvic Examination and Pap Smear in Adolescents and Young Adults7. Adolescent Dermatology 8. Obesity 9. Nutrition: Healthy Eating in Adolescence; Nutritional Supplements: Performance-Enhancing Drugs, and Dietary Supplements; Irritable Bowel Syndrome; and Inflammatory Bowel Syndrome10. Sports Injuries in the Adolescent11. Cardiac Issues in Adolescence 12. Hypertension in Adolescents13. ImmunizationsPART 2. SEXUALITY, GYNECOLOGY, AND ABNORMAL GROWTH AND DEVELOPMENT14. Amenorrhea15. Abnormal Vaginal Bleeding16. Basics of Hormonal Contraception17. Adolescent Pregnancy18. Polycystic Ovary Syndrome 19. Breast Disorders in Adolescence20. Sexually Transmitted Infections (STI) in Adolescents 21. HIV in Adolescents22. Delayed Puberty, Short Stature, and Tall StaturePART 3. MENTAL HEALTH AND TRANSITION OF CARE23. Adolescent Substance Use and Prevention 24. Adolescent Mental Health Disorders25. Eating Disorders26. Adolescent Relationship Abuse in Clinical Settings: Opportunities for Prevention and Intervention27. Bullying and Cyber Bullying 28. Nature, Nurture, Adolescents and Resilience29. Transition of Care APPENDIX
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Springer International Publishing AG Whole Person Care: Transforming Healthcare
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£62.99
Springer International Publishing AG Incidental Radiological Findings
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£107.99
Wiley-VCH Verlag GmbH Medical Product Regulatory Affairs:
Book SynopsisMedical Product Regulatory Affairs Hands-on guide through the jungle of medical regulatory affairs for every professional involved in bringing new products to market Based on a module prepared by the authors for an MSc course offered by the University of Limerick, Ireland, Medical Product Regulatory Affairs is a comprehensive and practical guide on how pharmaceutical and medical devices are regulated within the major global markets. The Second Edition builds on the success of the first with an even wider scope and full coverage of new EU regulations on the safe use of medical devices. Following a look at drug development, complete sections are devoted to national and EU regulatory issues, manufacturing license application and retention, and regulation in the USA. Other topics dealt with include CDER, CBER and marketing and manufacturing licenses, the ICH process and Good Laboratory/Clinical/ Manufacturing Practices. Medical Product Regulatory Affairs includes information on: Aims and structure of regulation, covering purpose and principles of regulation, national and EU legislative processes, and pharmacopeia Regulatory strategy, covering product development and manufacturing, market vigilance, quality assurance systems, personnel, and documentation Drug discovery and development, covering prescription status, physical properties, therapeutic use, and drug discovery, development, and delivery Non-clinical studies, covering non-clinical study objectives and timing, pharmacological and pharmacodynamic studies, and bioavailability and bioequivalence Clinical trials, covering trial protocol, monitoring of trials, trial master files, and FDA communications The wide coverage of different product types and the main global markets makes Medical Product Regulatory Affairs ideal for training courses on regulatory affairs in academia and industry. It is also a valuable reference for pharmacologists, bioengineers, pharma engineers, and students in pharmacy to familiarize themselves with the topic.Table of Contents1 The Aims and Structure of Regulations 1 1.1 Introduction 1 1.2 Purpose and Principles of Regulation 1 1.3 The Legal Framework for Regulation 3 1.3.1 National Legislative Process 3 1.3.2 EU Legislative Process 4 1.3.3 Working with Legal Texts 6 1.3.4 Guidance Documents 7 1.3.5 Pharmacopoeia 7 1.4 Basic Legislation 7 1.4.1 EU Legislation 7 1.4.2 US Legislation 12 1.5 Scope of the Legislation 15 1.6 Chapter Review 20 1.7 Further Reading 21 2 Regulatory Strategy 23 2.1 Chapter Introduction 23 2.2 Basic Regulatory Strategy 23 2.2.1 Product Development 23 2.2.2 Product Manufacture 23 2.2.3 Market Vigilance 24 2.3 Quality Assurance Systems 25 2.3.1 Personnel 25 2.3.2 Documentation 25 2.3.3 Facilities and Equipment 26 2.3.4 Corrective and Preventative Action 27 2.4 Validation 27 2.5 Regulatory Bodies 29 2.5.1 European Commission 29 2.5.2 The EMA 30 2.5.3 National Competent Authorities 32 2.5.4 Notified Bodies 34 2.5.5 The FDA 35 2.5.6 US Department of Agriculture (USDA) 39 2.5.7 Pharmacopoeia Authorities 39 2.6 International Harmonisation Bodies 40 2.7 International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use 41 2.7.1 VICH 43 2.7.2 The International Medical Device Regulators Forum (IMDRF) 43 2.8 Pharmaceutical Inspection Cooperation Scheme (PICS) 44 2.9 The World Health Organisation (WHO) 45 2.10 Chapter Review 45 2.11 Further Reading 46 3 Drug Discovery, Classification and Early Stage Development 47 3.1 Chapter Introduction 47 3.2 Drug Categorisation 47 3.2.1 Prescription Status 47 3.2.2 Physical Properties 48 3.2.3 Mode of Action 48 3.2.4 Therapeutic Use 49 3.3 Drug Discovery 51 3.3.1 Target Discovery and Validation 52 3.3.2 Lead Discovery, Validation and Optimisation 57 3.4 Drug Development 58 3.4.1 Manufacture and Control 59 3.5 Drug Delivery 59 3.5.1 Location 60 3.5.2 Drug Characteristics 60 3.5.3 Speed and Duration of Therapeutic Effect 62 3.5.4 Stability 63 3.6 Chapter Review 63 3.7 Further Reading 63 4 Non-clinical Studies 65 4.1 Chapter Introduction 65 4.2 Non-clinical Study Objectives and Timing 65 4.3 Pharmacological Studies 69 4.3.1 Pharmacodynamic Studies 70 4.3.2 Pharmacokinetic/Toxicokinetic Studies 72 4.4 Bioavailability and Bioequivalence 73 4.5 Toxicology Studies 74 4.5.1 Toxicity Studies 74 4.5.2 Genotoxicity Studies 75 4.5.3 Carcinogenicity Studies 76 4.5.4 Reproductive Toxicology Studies 76 4.6 Chemistry, Manufacturing and Control Development (CMC) 77 4.7 Quality by Design (QbD) 77 4.8 Quality of Biotech Products 78 4.8.1 Stability Studies 78 4.9 Good Laboratory Practice (GLP) 78 4.10 Chapter Review 80 4.11 Further Reading 83 5 Clinical Trials 85 5.1 Chapter Introduction 85 5.2 Clinical Trials 85 5.2.1 Phase I Trials 86 5.2.2 Phase II Trials 86 5.2.3 Phase III Trials 87 5.3 Clinical Trial Design 88 5.4 Good Clinical Practice 90 5.5 Clinical Trials in the EU 90 5.5.1 Sponsor 93 5.5.2 Investigator’s Brochure (IB) 93 5.5.3 Investigator 94 5.5.4 Trial Protocol 94 5.5.5 Investigational Medicinal Product Dossier (IMPD) 94 5.5.6 Informed Consent 94 5.5.7 Manufacture of Investigational Medicinal Product 95 5.5.8 Clinical Trial Authorisation 95 5.5.9 Independent Ethics Committee Opinion 96 5.5.10 Amendments to Clinical Trials 97 5.5.11 Case Report Forms (CRFs) 97 5.5.12 Adverse Event Reporting 97 5.5.13 Annual Safety Report 98 5.5.14 Monitoring of Trials 98 5.5.15 End of Trial 98 5.5.16 Trial Master File 98 5.6 Clinical Trials in the US 100 5.6.1 Investigational New Drug Application (IND) 100 5.6.2 Institutional Review Board (IRB) 103 5.6.3 Communication with the FDA 104 5.6.4 Labelling of Investigational Drugs 105 5.6.5 Registry of Clinical Trial Information 105 5.7 Chapter Review 105 5.8 Further Reading 106 6 Marketing Authorisation 109 6.1 Chapter Introduction 109 6.2 The Application Dossier 109 6.3 CTD 110 6.3.1 Module Structure 112 6.3.2 Module 3 – Quality 113 6.3.3 Drug Master Files 116 6.3.4 Module 4 – Non-clinical Study Reports 116 6.3.5 Module 5 – Clinical Study Reports 116 6.3.6 Module 2 – Summaries 118 6.3.7 Module I – Region Specific 120 6.3.8 Module 1 – EU 121 6.3.9 Module 1 – US 123 6.4 Submission and Review Process in the EU 127 6.4.1 Union Authorisation 128 6.4.2 Scientific Evaluation Process 129 6.4.3 Decision Making Process 130 6.4.4 National Authorisations 132 6.4.5 Decentralised Procedure 132 6.4.6 Mutual Recognition Procedure 134 6.4.7 Plasma Master Files and Vaccine Antigen Master Files 134 6.5 Submission and Review Process in the US 134 6.6 Chapter Review 138 6.7 Further Reading 138 7 Authorisation of Veterinary Medicines 139 7.1 Chapter Introduction 139 7.2 Overview of Development Process for Veterinary Medicines 139 7.2.1 Pre-clinical Studies 140 7.2.2 Clinical Trials 141 7.2.3 Good Clinical Practices 141 7.3 Authorisation of Clinical Trials in the EU 145 7.4 Authorisation of Clinical Trials in the US 146 7.5 Maximum Residue Limits (MRLs) 147 7.6 Authorisation of Veterinary Medicines in the EU 149 7.6.1 Applications to Establish MRLs 149 7.6.2 Review of Applications and Establishment of MRLs 152 7.6.3 Marketing Authorisations 156 7.6.4 Presentation of the Dossier 156 7.7 Approval of Veterinary Medicines in the US 158 7.7.1 New Animal Drug Application (NADA) 158 7.7.2 Approval of Veterinary Biological Products 163 7.8 Chapter Review 164 7.9 Further Reading 164 8 Variations to the Drug Authorisation Process 165 8.1 Chapter Introduction 165 8.2 Provisions in Support of Special Drug Applications 165 8.2.1 Orphan Drugs 165 8.2.2 Paediatric Applications 167 8.3 Accelerated Access to New Drug Therapies 170 8.3.1 EMA Accelerated Review and Conditional Marketing Routes 170 8.3.2 EU Compassionate Use 171 8.3.3 Expedited Pathways in the US 171 8.3.4 Expanded Access and Emergency Use Authorization (EUA) 174 8.4 Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible 175 8.5 Animal Drugs for Minor Use and Minor Species 176 8.5.1 Conditional Approval 176 8.5.2 Indexing 176 8.5.3 Designation 176 8.6 Special Provisions to Facilitate Access to Drugs for Animal Treatment in the EU 177 8.7 Changes to an Authorised Drug 177 8.8 EU System for Processing Changes 177 8.8.1 Extension Applications 178 8.8.2 Major Variation (Type II) 178 8.8.3 Minor Variation (Type IA or IB) 179 8.9 Processing Changes in the US 179 8.9.1 Manufacturing Change Supplements 180 8.9.2 Major Changes 180 8.9.3 Moderate Changes 180 8.9.4 Minor Changes 181 8.10 Authorisation of Generic Drugs 181 8.10.1 EU Regulations 181 8.10.2 US Regulations 182 8.11 Biosimilars 183 8.11.1 EU Regulations 184 8.11.2 US Regulations 185 8.12 Reference Drug Exclusivity 189 8.13 Other Authorisation Procedures 191 8.13.1 Well-Established Medical Use Products 191 8.13.2 Combination Products 191 8.13.3 Homeopathic Medicines 192 8.13.4 Traditional Herbal Medicines 192 8.13.5 US Regulation of OTC Drugs 193 8.14 Chapter Review 193 8.15 Further Reading 194 9 Medical Devices 195 9.1 Chapter Introduction 195 9.2 Regulatory Strategy for Medical Devices in the EU 195 9.2.1 Use of Standards to Establish Conformity 200 9.2.2 Classification of Devices 201 9.3 Regulatory Strategy for Medical Devices in the US 210 9.3.1 Classification of Devices 210 9.3.1.1 Class I 211 9.3.1.2 Class II 211 9.3.1.3 Class III 211 9.3.2 Classification of New Devices 212 9.4 Development of Devices 212 9.4.1 Design Controls 213 9.4.2 Design and Development Planning 214 9.4.3 Design Input 214 9.4.4 Design Output 216 9.4.5 Design Verification and Design Validation 216 9.4.6 Design Review 217 9.4.7 Risk Analysis 218 9.4.8 Design Changes 218 9.5 Chapter Review 218 9.6 Further Reading 219 10 Authorisation of Medical Devices 221 10.1 Chapter Introduction 221 10.2 Evaluation of Medical Devices in Europe 221 10.2.1 Clinical Evaluation 221 10.2.2 Clinical Investigations 222 10.2.3 Performance Evaluation of IVDs 225 10.2.4 Performance Studies of IVDs 225 10.3 Evaluation of Medical Devices in the US 226 10.3.1 Exempted Investigations 227 10.3.2 Abbreviated Requirement Investigations 227 10.3.3 IDE Investigations 227 10.3.4 Labelling of Devices for Investigational Use 229 10.4 Placing of Devices on the Market in the EU 230 10.4.1 Designation of Notified Bodies 230 10.4.2 Conformity Assessment Procedures 232 10.4.2.1 Conformity Assessment Based on a Quality Management System and Assessment of Technical Documentation 233 10.4.2.2 EU Type-Examination 235 10.4.2.3 Production Quality Assurance 235 10.4.2.4 EU Verification 235 10.4.2.5 EU (Self) Declaration of Conformity 236 10.4.3 Technical Documentation 236 10.4.4 Labelling Requirements 236 10.4.5 Registration of Economic Operators and Devices 238 10.5 Placing of Devices on the Market in the US 238 10.5.1 510(k) Pre-market Notification 239 10.5.2 Traditional 510(k) 239 10.5.3 Abbreviated 510(k) 239 10.5.4 Special 510(k) 239 10.5.5 De Novo 510(k) 240 10.5.6 Notification and Review Procedures 240 10.5.7 Pre-market Approval (PMA) 240 10.5.8 Changes to a PMA-Approved Device 241 10.5.9 Humanitarian Use Devices (HUDs) 243 10.5.10 Labelling of Devices 243 10.6 Chapter Review 243 10.7 Further Reading 244 11 Good Manufacturing Practice (GMP) 245 11.1 Chapter Introduction 245 11.2 Drug GMP Regulations and Guidance 245 11.3 Essential GMP Requirements 248 11.3.1 Quality Assurance System 248 11.3.2 Personnel 248 11.3.3 Premises and Equipment 249 11.3.4 Documentation 257 11.3.5 Production 257 11.3.6 Quality Control 258 11.3.7 Work Contracted Out 259 11.3.8 Complaints, Product Recall and Emergency Un-blinding 259 11.3.9 Self-inspection 259 11.4 Validation 260 11.4.1 Facilities and Equipment Validation 261 11.4.2 Process Validation 262 11.4.3 Computer Systems Validation 262 11.4.4 Methods Validation 265 11.4.5 Cleaning Validation 266 11.4.6 Validation of Sterilisation Procedures 267 11.4.7 Water Purification System Validation 268 11.5 GMP Requirements for Devices 268 11.6 Chapter Review 273 11.7 Further Reading 273 12 Oversight and Vigilance 275 12.1 Chapter Introduction 275 12.2 Registration of Manufacturers and Other Entities 275 12.3 Manufacturing Authorisation of Medicinal Products in the EU 275 12.3.1 Wholesale Distribution of Medicinal Products 276 12.3.2 Registration of Economic Operators for Medical Devices on the EU market 278 12.4 Registration of Producers of Drugs and Devices in the US 278 12.5 Additional Licensing Requirements 279 12.6 Inspections 279 12.6.1 Inspection Techniques 280 12.6.2 Audit Findings and Consequences 286 12.7 Market Vigilance and Oversight of Drugs 289 12.7.1 Pharmacovigilance in the EU 289 12.7.2 Pharmacovigilance Risk Assessment Committee (PRAC) and the EudraVigilance System 290 12.7.3 Pharmacovigilance and Marketing Authorisation Holders 293 12.7.4 Pharmacovigilance Inspections and Audits 294 12.7.5 Renewal of Marketing Authorisations 295 12.7.6 Pharmacovigilance and Reporting in the US 295 12.7.7 Periodic Reports 296 12.8 Advertising and Promotion 297 12.9 Market Vigilance and Oversight of Devices 298 12.9.1 Market Vigilance in the EU 298 12.9.2 Medical Device Vigilance in the US 299 12.9.3 Medical Device Reporting 299 12.9.4 Reports of Corrections and Removals 300 12.9.5 Post-market Surveillance 302 12.10 Chapter Review 303 12.11 Further Reading 303 Index 305
£78.16
Wiley-VCH Verlag GmbH Trends in Antiviral Drug Development
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Springer-Verlag Berlin and Heidelberg GmbH & Co. KG Geriatrics 2: Digestive System · Endocrine System Kidney and Urogenital System Haematological System · Respiratory System Rehabilitation · Nutrition · Drug Treatment
Table of ContentsDigestive System.- The Upper Gastrointestinal Tract. Esophagus, Stomach, Small Bowel, and Exocrine Pancreas.- A. Manifestations of Gastrointestinal Disease in the Aged.- B. Esophagus.- I. The Aging Esophagus.- II. Symptoms.- 1. Dysphagia.- 2. Pain.- 3. Heartburn.- 4. Bleeding.- 5. Impaction.- III. Diagnostic Modalities.- 1. Radiography.- 2. Esophagoscopy.- 3. Manometry.- 4. Acid Drip Test.- 5. Tests of Reflux, pH Probe, and Radioisotopic Scintigrams.- IV. Diseases of the Esophagus.- 1. Motility Disturbances of the Oropharynx and Upper Esophagus.- 2. Motility Disorders of the Middle and Lower Esophagus.- a) Achalasia.- b) Diffuse Spasm.- c) Collagen Vascular Disease.- d) Diabetes Mellitus.- 3. Reflux Esophagitis, Hiatus Hernia, and Barrett’s Epithelium.- 4. Paraesophageal Hiatus Hernia.- 5. Lower Esophageal Rings.- 6. Infection of the Esophagus.- 7. Tumors of the Esophagus.- C. Stomach and Duodenum.- I. Anatomy and Physiology of the Aging Stomach.- II. Diagnostic Modalities.- 1. Radiography.- 2. Endoscopy.- 3. Gastric Analysis.- 4. Serum Gastrin.- III. Diseases of the Stomach and Duodenum.- 1. Functional Disease.- 2. Peptic Ulcer.- 3. Gastritis and Duodenitis.- 4. Bezoars.- 5. Tumors.- D. Small Intestine.- I. The Aging Small Intestine.- II. Diagnostic Modalities.- 1. X-ray.- 2. Tests of Malassimilation.- III. Diarrhea.- IV. Diseases of the Small Bowel.- 1. Regional Granulomatous Enteritis.- 2. Vascular Diseases.- 3. Maldigestion due to Gastric Surgery.- 4. Disaccharidase Deficiencies.- 5. Gluten-Sensitive Enteropathy.- 6. Bacterial Overgrowth Syndromes.- 7. Systemic Diseases Involving the Small Intestine.- 8. Malabsorption due to Drug Ingestion.- 9. Immunologic Deficiency Associated with Malabsorption.- 10. Whipple’s Disease.- 11. Short Bowel Syndrome.- 12. Tumors.- a) Adenocarcinoma.- b) Lymphoma.- c) Leiomyosarcortia.- d) Premalignant Lesions.- e) Carcinoid Tumors.- f) Benign Tumors.- g) Telangiectasia and Angiodysplasia.- E. Exocrine Pancreas.- I. The Aging Pancreas.- II. Diagnostic Modalities.- 1. Radiography.- 2. Endoscopic Retrograde Pancreatography.- 3. Function Tests.- III. Diseases.- 1. Acute Pancreatitis.- 2. Chronic Pancreatitis.- 3. Tumors.- a) Adenocarcinoma.- b) Islet Cell Tumors.- c) Benign Tumors.- References.- The Large Intestine.- A. The Anatomy and Physiology of the Aging Large Intestine.- B. Diagnostic Modalities.- I. Radiography.- II. Endoscopy.- III. Fecal Examination.- C. Diseases of the Large Intestine.- I. Functional Bowel Disorders.- 1. Irritable Bowel Syndrome.- 2. Constipation.- 3. Incontinence.- II. Diverticular Disease.- III. Appendicitis.- IV. Vascular Insufficiency.- V. Vascular Ectasia.- VI. Infectious Disease.- 1. Bacteria.- 2. Parasites.- VII. Inflammatory Bowel Disease.- 1. Ulcerative Colitis.- 2. Crohn’s Colitis.- VIII. Colorectal Cancer.- IX. Benign Tumors.- References.- The Liver and Biliary System.- A. Liver.- I. Physiological Aging.- 1. Anatomical Changes.- 2. Functional Changes.- a) Biochemical Changes.- b) Enzymatic Changes.- c) Hepatic Drug Metabolism in Old Age.- d) Changes in Liver Function Tests.- e) Bile Formation and Composition.- II. Diseases of the Liver in Old Age.- 1. Clinical Evaluation.- a) Biochemical Investigation.- b) Immunological Tests.- c) Haematology.- d) Radiology of the Hepatobiliary System.- e) Endoscopy.- f) Liver Biopsy.- g) Liver Imaging.- 2. Jaundice in Old Age.- a) Unconjugated (Prehepatic) Hyperbilirubinaemia.- b) Conjugated (Hepatic or Posthepatic) Hyperbilirubinaemia.- 3. Circulatory Disturbances.- a) Acute (Heart Failure, Shock).- b) Chronic Heart Failure.- c) Hepatic Vein Occlusion.- 4. Toxic Liver Injury.- a) Hepatic Necrosis.- b) Fatty Liver.- c) Hepatitis-like Reaction.- d) Intrahepatic Cholestasis.- 5. Inflammatory Diseases.- a) Viral Hepatitis.- b) Cholangitis.- c) Liver Abscess.- d) Chronic Inflammations.- 6. Cirrhosis.- a) Classification.- b) Incidence and Mortality.- c) Aetiology.- 7. Liver Failure.- 8. Infiltrations of the Liver.- a) Malignant Disease.- b) Amyloidosis.- 9. The Liver in Systemic Disorders.- a) Diabetes Mellitus.- b) Chronic Bowel Inflammation.- c) Collagen Diseases.- B. Biliary System.- I. Physiological Aging.- 1. Anatomical Changes.- 2. Functional Changes.- II. Disease of the Biliary System.- 1. Clinical Evaluation.- 2. Gallstones.- a) Clinical Features and Associations.- b) Silent Gallstones.- c) Medical Treatment of Gallstones.- d) Gallstones in the Common Bile Duct.- e) Gallstone Ileus.- 3. Cholecystitis.- a) Acute Cholecystitis.- b) Chronic Cholecystitis.- 4. Malignant Disease.- a) Carcinoma of Gallbladder.- b) Carcinoma of the Bile Ducts.- References.- Endocrine System.- Hypothalamo-Hypophyseal-Adrenal Axis.- A. Introduction.- I. Adaptation to Stress, Such as Surgery.- II. Hypothalamic-Pituitary-Adrenal Interrelationships.- B. Morphology.- I. Hypothalamus.- II. Pituitary.- III. Adrenal.- C. Basal Function.- I. Hypothalamus.- II. Pituitary.- III. Adrenal Cortex.- 1. Glucocorticoids.- 2. Mineralocorticoids.- 3. Androgens.- IV. Adrenal Medulla.- D. Dynamic Function.- I. Insulin Tolerance Test.- II. Metyrapone Test.- III. Dexamethasone Suppression Test.- IV. ACTH Test.- V. Surgery.- E. Clinical.- I. Anterior Pituitary.- II. Posterior Pituitary.- III. Adrenal Cortex.- IV. Adrenal Medulla.- V. Ectopic Humoral Syndromes.- VI. Iatrogenic Disease.- F. Conclusions.- References.- The Aged Thyroid Gland.- A. Morphology of the Elderly Thyroid.- B. Physiology of the Aged Thyroid.- I. Iodine Metabolism.- II. Thyroid Hormones.- III. Binding Proteins.- IV. Regulation by the Hypothalamic Anterior Pituitary System.- C. Nontoxic Goiter.- D. Hypothyroidism in Elderly Subjects.- I. Myxedema Coma.- E. Hyperthyroidism in Elderly Subjects.- F. Endocrine Ophthalmopathy.- G. Thyroiditis.- H. Struma Maligna.- I. Laboratory Diagnosis of Thyroid Diseases in Geriatric Patients.- I. TSH and theTRH-TSH Test.- II. Total Serum Thyroxine Concentration, Free Thyroxine, Binding Proteins, and Parameters for Determination of Free T4.- III. Total Triiodothyronine, Free T3, and Thyroid Antibodies.- IV. In Vivo Diagnostic Techniques.- References.- Diabetes Mellitus in Advanced Age.- A. Definition and Classification.- I. Primary Diabetes Mellitus.- II. Secondary Diabetes Mellitus.- III. Subclinical Diabetes Mellitus.- B. Epidemiology of Maturity Onset Diabetes.- C. Etiology and Pathogenesis.- D. Pathophysiology.- E. Diagnosis.- F. Diabetes Therapy in Advanced Age.- I. Dietary Measures.- II. Muscular Exercise in the Elderly Diabetic Patient.- III. Oral Antidiabetic Agents.- 1. Sulfonyl Ureas.- 2. Biguanides.- IV. Insulinization of the Maturity Onset Diabetic.- G. Acute Complications.- I. Coma Diabeticum.- II. Hypoglycemia.- H. Chronic Complications.- I. Diabetic Macroangiopathy.- II. Pyelonephritis.- III. Diabetic Neuropathy.- I. Prognosis.- References.- Sexual Function During Advancing Age.- A. Anatomic and Physiologic Considerations.- B. Totality of Factors in Human Sexuality.- C. Male Psychogenic Impotency.- D. Organic Basis of Impotency.- I. Systemic Illness.- II. Neurologic Deficit.- III. Vascular Problems.- IV. Chronic Hemodialysis.- V. Malignancy.- VI. Cosmetic Factors.- VII. Postoperative Impact.- VIII. Drugs.- E. Methods of Diagnosis of Sexual Impotency.- I. Clinical Acuity of Interviewer.- II. Testing Techniques: Mechanical Aids.- F. Therapy of Male Impotency.- I. Counseling.- II. Prosthetic Devices.- G. Therapy of Female Sexual Dysfunction.- H. Concluding Remarks.- References.- Kidney and Urogenital System.- The Kidney.- A. Characteristic Features of Geriatric Nephrology.- B. Aging of the Kidney.- I. Structural Changes.- 1. Loss of Nephrons.- 2. Glomerular Changes.- 3. Tubular Changes.- 4. Vascular Changes.- 5. Renal Hypertrophy.- II. Functional Changes.- 1. Renal Plasma Flow.- 2. Glomerular Filtration.- 3. Tubular Function.- 4. Fluid and Electrolyte Balance.- C. Disease of the Kidney - Geriatric Aspects.- I. Renovascular Disease.- II. Pyelonephritis and Urinary Tract Infection.- 1. Bacteriuria and Pyelonephritis.- 2. Predisposing Factors.- 3. Urosepsis.- 4. Treatment of Urinary Tract Infection in the Aged.- 5. Resistance Problems in Geriatric Wards.- 6. Treatment of Patients with Indwelling Catheters.- 7. Prognostic Significance of Bacteriuria.- III. Acute Glomerulonephritis.- IV. Nephrotic Syndrome.- V. Other Renal Diseases.- D. Uraemia.- I. Acute Renal Failure.- II. Chronic Renal Failure.- III. Treatment of the Uraemic Elderly Patient.- References.- Bladder and Prostate.- A. Bladder.- I. Embryological Origins.- II. Anatomy.- III. Nerve Supply.- IV. The Functioning Bladder.- V. Symptoms Associated with Bladder Dysfunction.- B. Special Diagnostic Methods.- I. The Cystometrogram.- II. Peak Flow Rate.- III. Micturating Cystogram.- IV. Urethral Pressure Profile.- V. Cystoscopy.- C. Prostate Gland.- I. Anatomy.- II. Benign Enlargement of the Prostate.- III. The Pathology of Prostatic Obstruction.- IV. Symptoms.- V. Diagnosis.- VI. Treatment.- D. Prostatic Carcinoma.- I. Symptoms.- II. Diagnosis.- III. Treatment.- E. Prostatitis.- I. Acute Prostatitis.- II. Chronic Prostatitis.- F. Carcinoma of the Bladder.- I. Pathological Staging.- II. Diagnosis.- III. Treatment.- G. Retention of Urine.- I. Causes.- II. Treatment.- H. Cystitis.- I. Causes.- II. Treatment.- I. Incontinence of Urine.- I. Causes.- II. Clinical Examination of the Incontinent Patient.- III. Treatment.- J. Drug Therapy in Incontinence.- References.- Haematological System.- Blood in the Aged.- A. Ageing of Bone Marrow.- B. Red Blood Cells.- I. Erythrocytes in the Aged.- II. Ageing of Erythrocytes.- III. Erythropoiesis in the Aged.- IV. Haemoglobin.- C. White Blood Cells.- I. General Aspects.- II. Granulocytes.- III. Monocytes.- IV. The Regulation of Granulocyte-Monocyte Production.- V. Lymphocytes and Lymphatic System.- D. Anaemias in the Aged.- I. Introduction.- II. Carential Anaemias.- 1. Iron Deficiency Anaemias.- 2. Megaloblastic Anaemias.- a) Pernicious Anaemia.- b) Folic Acid Deficiency Anaemia.- 3. Other Macrocytic, Non-Megaloblastic Anaemias.- 4. Therapy of Carential Anaemias in the Aged.- III. Haemolytic Anaemias.- IV. Aplastic Anaemias and Pancytopenias.- V. Anaemias Due to Chronic Diseases.- VI. Sideroblastic Anaemias.- E. Disorders of Leucocytes in the Aged.- I. Idiopathic Granulocytic Dysfunction.- II. Neutropenia (Agranulocytosis).- III. Leukaemias and Allied Disorders.- 1. Acute Leukaemias.- 2. Chronic Myelocytic Leukaemia.- 3. Chronic Lymphocytic Leukaemia.- 4. Malignant Lymphomas.- a) Non-Hodgkin’s Malignant Lymphomas.- b) Hodgkin’s Disease.- 5. Monoclonal Gammapathies.- a) Myeloma.- b) Waldenstrom Macroglobulinaemia.- 6. Miscellaneous Conditions.- a) Polycythaemia Rubra Vera.- b) Myelofibrosis.- c) Idiopathic Thrombocythaemia.- F. Disorders of Haemostasis in the Aged.- I. Blood Coagulation and Haemostasis in the Aged.- II. Haemorrhagic Diseases in the Aged.- 1. Congenital Hereditary Haemorrhagic Diseases.- 2. Acquired Haemorrhagic Diseases.- a) Acquired Coagulation Disorders.- b) Thrombocytopenias.- c) Haemorrhagic Syndromes Due to Intervascular Coagulation.- d) Haemorrhagic Syndromes Due to Vascular Factors.- e) Bateman’s Purpura.- III. Thrombosis and Thrombo-Embolic Diseases in the Aged.- 1. Pathogenesis of Thrombophilia.- 2. Diagnostic Problems in Thrombophilia.- 3. Prophylaxis of Thrombophilic States.- 4. Thrombolytic Therapy.- References.- Respiratory System.- Physiological and Pathological Aspects of the Respiratory System.- A. Changes in Structure of the Lungs with Age.- I. Changes in the Alveoli.- II. Changes in Pulmonary Blood Vessels.- B. Changes in Lung Function with Age.- I. Elasticity and Distensibility of the Lungs.- II. Lung Volume.- III. Airway Closure and Distribution of Ventilation.- IV. Ventilation Perfusion Matching: Blood Gases.- V. Gas Transfer.- VI. Exercise.- C. The Appearance of the Chest Radiograph in Old Age.- D. Infection of the Respiratory Tract in Old Age.- I. Upper Respiratory Tract Infection.- II. Influenza.- III. Pneumonia.- IV. Unresolved Pneumonia.- V. Tuberculosis.- E. Conditions Associated with Airways Obstruction.- I. Chronic Bronchitis and Emphysema.- II. Asthma.- III. Obstruction of Large Airways.- F. Cancer of the Lung.- G. Pulmonary Fibrosis and Alveolitis.- I. Cryptogenic Fibrosing Alveolitis.- II. Extrinsic Allergic Alveolitis.- References.- Rehabilitation.- Rehabilitation - Physical and Clinical Aspects.- A. Definition.- B. The Importance of Geriatric Rehabilitation.- C. Legislative Background and Costs.- D. Biological Factors Governing Rehabilitation in Old Age.- I. Physiological Characteristics of Senescence: Diminished Adaptive Capacity and Exaggerated Interindividual Variation.- 1. Methods and Indices for Assessing Physical Capacity in Old Age.- II. Pathophysiological Characteristics: Variation of Clinical Symptoms Typical of Ageing and Multimorbidity; Extent and Consequences.- III. Exercise Tolerance and the Demands of Training.- IV. The Response to Training in Old Age.- V. Methods of Training for Elderly Handicapped Patients.- E. Indications for Rehabilitation in Old Age.- I. General Principles.- II. Assessment of the Need for Rehabilitation.- III. Assessment of the Potential Response to Rehabilitation.- IV. Criteria Which Exclude Rehabilitation.- F. Resources and Methods of Geriatric Rehabilitation.- I. Human Resources: The Rehabilitation Team.- 1. The Geriatrician.- 2. Physiotherapy.- 3. Occupational Therapy.- a) Mobile Occupational Therapy.- 4. Logopedia.- 5. Physical Medicine.- 6. Social Work.- 7. Psychology.- 8. Activating Care.- II. Institutional Resources: Rehabilitation Centers.- 1. Part-time Inpatient Care: The Geriatric Day Clinic.- 2. Inpatient Facilities.- a) The Geriatric Rehabilitation Clinic and the Department of Geriatric Rehabilitation.- b) The Long-Stay Hospital and the Old People’s Home with Rehabilitation Facilities.- III. Ambulant Rehabilitation Measures.- 1. Measures Governed by Local Facilities.- a) The Human Resources.- b) The Material Resources.- 2. Measures Governed by the Patient’s Circumstances.- IV. Other Therapeutic Ancillary Facilities at the Service of Geriatric Rehabilitation.- 1. The Depot of Medical and Self-help Aids.- 2. Social Services and District Nurses.- V. Other Aids and Supporting Services: Meals on Wheels, Shopping Services, and Sheltered Workshops.- G. The Practical Implementation of Geriatric Rehabilitation as Exemplified by Rehabilitation Hospital Procedures.- I. Initial Measures (Early Phase, Bedside Therapy).- II. Indoor Walking Phase.- III. Concluding Phase with Outdoor Therapy.- IV. Transition, Aftercare, and Reintegration.- H. Results of Geriatric Rehabilitation Measures.- References.- Nutrition.- Nutritional Characteristics of the Elderly.- A. Introduction.- B. Physiological Changes Influencing Nutrition.- I. Changes in Body Size and Composition.- II. Energy Expenditure.- III. Metabolism.- IV. Digestion.- C. Requirements of Essential Nutrients.- I. Protein and Essential Amino Acids.- 1. Protein.- 2. Essential Amino Acids.- II. Vitamins.- 1. Vitamin B6.- 2. Vitamin C.- 3. Vitamin D.- III. Minerals.- 1. Iron.- 2. Calcium.- D. Food Consumption and Nutritional Status of the Elderly.- E. Conclusions.- References.- The Role of Nutrition in Human Aging.- A. Introduction.- B. Multifactorial Nature of the Aging Process.- I. Physical Performance.- II. Changes in Energy Metabolism.- III. Lipid Metabolism and the Cardiovascular System.- IV. Nervous System and Sensory Changes.- V. Hormonal Changes.- VI. Kidney Changes.- VII. Skeletal Changes.- VIII. Skin Changes.- IX. Gastrointestinal Tract Changes.- X. Generalization.- C. Degenerative Diseases and Diet.- I. Common Dietary Restrictions.- II. Health Foods.- III. Generalizations.- D. Significance of Diet.- I. Nutrition Survey Evidence.- II. Population Differences.- III. Economic Effects.- IV. Transplanted Populations.- V. Diet and Cancer.- VI. Generalization.- E. Importance of Diet Components.- I. Crude Fiber.- II. Minerals.- III. Lipids.- IV. Trace Components.- V. Generalization.- F. Experience from Surveys and Feeding Programs.- I. Survey Data.- II. Feeding Programs.- III. Economic Considerations.- IV. Generalizations.- G. Conclusions.- References.- Protein and Amino Acid Metabolism and Nutrition During Human Aging.- A. Introduction.- B. Some Aspects of Body Composition in Relation to Aging.- C. Whole Body and Muscle Protein Metabolism.- D. Metabolism of Specific Proteins.- E. Status of Amino Acid Metabolism.- F. Protein and Amino Acid Requirements.- I. Requirements for Essential Amino Acids.- II. Requirement for Total Nitrogen (Protein).- G. Effects of Infection and Other Stressful Stimuli on Protein Metabolism and Requirements.- H. Summary.- References.- Vitamins and the Aging Process.- A. Introduction.- B. Definition.- C. Functions of Vitamins.- D. Some Aspects of Utilization of the Vitamins.- E. Vitamin Status of the Elderly.- F. Methods for Estimating the Vitamin Requirements in Adults.- G. Factors Affecting Vitamin Requirements in Elderly People.- H. Summary and Conclusions.- References.- Human Aging and Obesity.- A. Introduction.- B. The Relationship of Age and Obesity.- C. Effects upon Blood Pressure of Change in Weight Status from Childhood to Adult Life.- D. The Relationship Between Obesity, Mortality, and Coronary Heart Disease.- E. The Treatment of Obesity.- References.- Drug Treatment.- Drug Treatment in the Aged.- A. Introduction.- B. Pharmacokinetics.- I. Absorption.- II. Distribution.- 1. Plasma Proteins.- 2. Erythrocytes.- 3. Tissue Composition.- III. Metabolism.- IV. Excretion.- 1. Kidneys.- 2. Liver.- V. Side Effects.- 1. Glycosides.- 2. Diuretics.- 3. Antihypertensives.- 4. Analgesics.- 5. Anticoagulants.- 6. Sedatives.- 7. Antiparkinsonism Drugs.- 8. Antidepressive Drugs.- C. General Principles of Drug Therapy.- D. Drugs to Combat Ageing.- References.
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Table of ContentsVesicoureteral Reflux.- A. Definition of Reflux.- B. Anatomy of the Ureterovesical Junction.- I. Contribution of the Ureter and Trigone to the Formation of the Ureterovesical Junction.- II. The Vesical Component of the Ureterovesical Valve.- 1. The Mucosal Layer.- 2. The Inner Longitudinal Muscle Layer.- 3. The Middle Circular Muscle Layer.- 4. The Outer Longitudinal Muscle Layer.- C. Innervation.- D. Physiology of the Ureterovesical Valve.- I. The Effect of Interrupting the Anatomical Continuity between the Ureter and the Trigone.- II. The Effect of Cutting the Nerves that Supply the Trigonal Muscle.- III. The Effect of Active Contraction of the Trigone on the Resistance of the Intravesical Ureter.- IV. The Effect of Active Contraction of the Trigone in Tightening and Occluding the Intravesical Ureter during Voiding.- E. Pathology of the Ureterovesical Junction.- I. Structural Changes at the Ureterovesical Junction.- 1. Conditions in which the Ureteral Hiatus Moves Downward in Relationship to the Ureteral Orifice.- 2. Conditions in which the Ureteral Orifice Moves Upward in Relation to the Ureteral Hiatus.- II. The Effect of Vesical Edema on the Ureterovesical Junction.- III. Congenital Anomalies of the Ureter.- IV. Maturation of the Intravesical Ureter.- V. Concept of the Marginally Competent Ureterovesical Junction.- F. Classification of Reflux by Etiology.- I. Reflux Due to Trigonal Weakness.- II. Reflux Due to Obstruction at or below the Bladder Neck.- III. Reflux Due to Neurogenic Vesical Disease.- IV. Reflux Due to Edema of the Bladder Wall.- V. Reflux Due to Congenital Anomalies.- VI. Reflux Due to Iatrogenic Causes.- G. Etiology of Nonocclusive Ureteral Dilatation (Megaloureter).- I. Factors that Increase the Volume of Urine in the Ureter.- 1. Dilation of the Renal Pelvis and Ureter by Forced Intake of Fluids.- 2. Dilation of the Upper Urinary Tract Due to Diabetes Insipidus.- 3. Dilation of the Pelvis of a Kidney Forced to Increase its Output after Unilateral Nephrectomy.- 4. Reflux as a Cause of Ureteral Overfilling.- II. Emptying Capacity of Various Areas of the Ureter.- III. Reflux and the Ureteropelvic Junction.- IV. Reflux and the Ureterovesical Junction.- H. Incidence of Reflux.- I. High Incidence of Reflux in Children with Urinary Tract Infection.- II. Demonstration of Reflux in Adults with Nonobstructive Pyelonephritis.- I. Effects of Reflux.- I. The Role of Reflux in Obstruction at the Ureteropelvic Junction.- II. The Kidney with Chronic Pyelonephritis.- III. The Atrophic Kidney with Chronic Pyelonephritis.- IV. The Normal Kidney.- V. Reflux as the Cause of Pyelonephritis of Pregnancy.- VI. Role of Reflux in the Perpetuation of Urinary Tract Infection.- VII. Miscellaneous.- J. The Role of the Ureterovesical Junction in the Pathogenesis of Pyelonephritis.- I. Childhood.- II. The Teenage Period.- III. The Adult Period.- IV. Prostatic Period.- K. The Treatment of Reflux and its Complications.- I. Medical Treatment.- II. The Surgical Correction of Reflux.- 1. Types of Operation.- 2. Results of Operation.- 3. Indications for Operation.- a) The Severity of the Reflux.- b) The Presence of Saccules.- c) The Severity of the Clinical Course.- d) The Conditions of the Kidneys.- e) The Age of the Patient.- References.- Anomalies of the Kidney.- I. Agenesis.- a) Bilateral Renal Agenesis.- b) Solitary Pelvic Kidney.- II. Hypoplasia.- a) Unilateral.- b) Bilateral.- III. Cystic Disease.- a) Simple (Solitary) Cysts.- b) Multiple Cysts of the Kidney.- c) Multilocular Cysts.- d) Polycystic Kidney Disease.- e) Peripelvic Cysts.- IV. Fusion Anomalies of the Kidney.- a) Horseshoe Kidney.- b) Unilateral Fused Kidney.- c) Fused Pelvic Kidney.- V. Ectopia of the Kidney.- 1. Introduction.- 2. Classification.- a) Simple Ectopy.- b) Bilateral Ectopia.- c) Crossed Renal Ectopia.- d) Ectopic Pelvic Kidney.- e) Thoracic Kidney (Congenital Superior Ectopia).- VI. Anomalies of Rotation.- 1. Introduction.- 2. Embryology.- 3. Incidence.- 4. Etiology.- 5. Symptoms and Diagnosis.- 6. Treatment.- VII. Anomalies of the Vessels.- 1. Introduction.- 2. Production of Hydronephrosis by Aberrant Vessels.- 3. Incidence.- 4. Symptoms.- 5. Diagnosis.- 6. Treatment.- VIII. Supernumerary Kidney.- 1. Introduction and Incidence.- 2. Pathogenesis.- 3. Symptoms.- 4. Diagnosis.- 5. Treatment.- IX. Cystic Disease of the Renal Pyramids.- 1. Definition and Historical.- 2. Incidence.- 3. Etiology.- 4. Pathology.- 5. Clinical Considerations.- 6. Diagnosis.- 7. Treatment.- 8. Prognosis.- X. Anomalies of the Renal Pelvis.- 1. Incidence.- 2. Embryological Development.- 3. Clinical Considerations.- 4. Differential Diagnosis.- 5. Treatment.- Acknowledgments.- References.- Anomalies of the Ureter.- A. Multiplication, Ectopia and Ureterocele.- I. Ureteral Duplication (and Triplication).- 1. Definitions.- 2. Incidence (Table 1).- 3. Embryology and Physiology.- a) Embryology.- b) Physiology.- 4. Surgical Anatomy.- 5. Associated Anomalies.- 6. Associated Reflux.- 7. Associated Disease.- 8. Clinical Aspects.- a) Symptoms.- b) Diagnosis.- ?) Personal History.- ?) Family History.- ?) Physical Examination.- ?) Laboratory Study of the Urine.- ?) Excretory Urography.- ?) Cystoscopy.- ?) Vaginoscopy and Urethroscopy.- ?) Other Radiographic Techniques.- c) Principles of Management.- ?) Incomplete Ureteral Duplication.- ?) Complete Ureteral Duplication.- ?) Triplication or Quadruplication.- II. Ureteral Ectopia.- 1. Definition and Description.- 2. Sites of Ectopic Orifices.- 3. Incidence.- 4. Associated Anomalies.- 5. Clinical Features.- a) Incontinence.- b) Obstruction and Dilatation.- c) Infection.- 6. Diagnosis.- a) History.- b) Family History.- c) Physical Examination.- d) Urinalysis.- e) Urographie Procedures.- ?) Excretory Urography.- ?) Micturition Urethrocystography.- ?) Vasography.- f) Endoscopy.- 7. Treatment.- III. Ureterocele.- 1. Definition, Description, Types.- 2. Incidence.- 3. Pathogenesis.- 4. Associated Anomalies and Disease.- 5. Clinical Manifestations.- 6. Reflux.- 7. Diagnosis.- a) Urography.- ?) Excretory Urography.- ?) Retrograde Urethrocystography.- b) Endoscopy.- 8. Treatment.- a) Simple Ureterocele.- b) Ectopic Ureterocele.- B. Ureteropelvic Junction Obstruction.- 1. Definition and Description.- 2. Incidence.- 3. Causes.- a) Aberrant Renal Blood Vessels.- b) Adhesions and Kinks.- c) High Insertion of Ureter.- d) Stenosis.- e) Functional Disorders.- f) Vesicoureteral Reflux.- 4. Clinical Aspects.- a) Superimposed Intermittent Acute Obstruction.- b) Recurrent Pyelonephritis with Loin Pain.- c) Renal Calculi.- d) Hematuria.- e) Trauma.- f) Associated Hypertension.- 5. Diagnosis.- 6. Treatment.- C. Unusual Positions of the Ureter.- I. Retrocaval (Post-caval; Circumcaval) Ureter.- 1. Definition.- 2. Incidence.- 3. Embryology.- 4. Clinical Aspects.- a) Symptoms and Signs.- b) Diagnosis.- c) Treatment.- II. Retroiliac Ureter.- III. Herniation of the Ureter.- D. Agenesis, Aplasia, Blind Ending.- I. Agenesis.- II. Aplasia.- III. Blind Ending Ureters.- E. Congenital Dilatation of the Ureter.- I. With Obstruction.- 1. Congenital Ureteral Stricture.- 2. Distal Ureteral Atresia.- 3. Congenital Ureteral Valves (or Folds).- II. Without Obstruction.- F. Twists, Kinks, Congenital Diverticula, Blockage by Vessels.- I. Spiral Twist or Torsion of Ureter.- II. Ureteral Kinks.- III. Diverticulum of the Ureter.- IV. Blockage of the Ureter by Blood Vessels.- References.- Congenital Abnormalities of the Bladder.- A. Development of the Bladder.- I. The Cloaca.- II. The Genital Tubercle.- III. Separation of the Bladder from the Intestinal Tract.- IV. Formation of the Trigone.- V. Regression of the Allantoic Duct.- VI. Development of the Bladder Musculature.- VII. Fetal Descent of the Urinary Tract.- VIII. Summary of Important Early Developmental Events.- B. Congenital Abnormalities of the Bladder.- I. Agenesis of the Bladder.- 1. Incidence.- 2. Pathology.- 3. Treatment.- II. Urachal Abnormalities.- 1. Incidence.- 2. Pathology.- 3. Classification.- 4. Clinical features.- a) Congenital Patent Urachus.- b) Vesico-urachal Diverticulum.- c) Umbilical Cyst and Sinus.- d) Alternating Urachal Sinus.- 5. Treatment.- III. Duplication of the Bladder.- 1. Classification.- a) Complete Duplication.- b) Incomplete Duplication.- c) Sagittal Septum.- d) Frontal Septum.- e) Multiseptate Bladder.- f) Hourglass Bladder.- 2. Pathology.- 3. Clinical Features.- 4. Diagnosis.- 5. Treatment.- IV. Bladder Mucosal Redundancy (Trigonal Curtains).- 1. Clinical Features.- 2. Treatment.- V. Congenital Cyst of the Bladder.- 1. Clinical Features.- 2. Pathology.- 3. Diagnosis and Treatment.- VI. Congenital Bladder Diverticulum.- 1. Incidence.- 2. Etiology.- 3. Pathology.- 4. Diagnosis.- 5. Treatment.- VII. The Exstrophy-epispadias Complex.- 1. Pathology.- 2. Pseudo-exstrophy of the Bladder.- 3. Classical Exstrophy of the Bladder.- a) Pathology.- b) Anatomy.- c) Clinical Features.- d) Treatment.- ?) Urinary Diversion.- ?) Functional Closure of Exstrophy.- 4. Cloacal Exstrophy.- a) Pathology.- b) Anatomy and Clinical Features.- c) Treatment.- 5. Variants of Exstrophy.- a) Superior Vesical Fissure.- b) Duplicate Exstrophy.- c) Inferior Vesical Fissure.- d) Incomplete Cloacal Exstrophy.- 6. Epispadias.- a) Pathology.- b) Description.- ?) Balanic Type.- ?) Penile Type.- ?) Penopubic Type.- c) Clinical Features.- d) Treatment.- References.- Anomalies of the Bladder Neck.- Anomalies of the Bladder Neck.- Symptoms.- Diagnosis.- The Normal Bladder Neck.- Technique.- Cinefluorographic Appearance of Normal Bladder Outlets During Micturition.- Dilatation of the Urethra Distal to Wide Bladder Necks.- Bladder Neck Dysfunction.- Errors in Diagnosis and Management.- The Roentgen Appearance of the Normal Male Bladder Neck.- Bladder Neck Dysfunction in the Male.- Bladder Neck Dysfunction Accompanying Posterior Urethral Valves.- Summary.- References.- Anomalies of the Urethra.- I. Introduction.- II. Congenital Absence of the Urethra.- 1. Complete Absence of the Urethra.- 2. Obliteration at the Level of the Bladder Neck.- 3. Obliteration at the Level of the Membranous Urethra.- 4. Obliteration of the Penile Urethra.- III. Meatal Stenosis.- IV. Distal Urethral Stenosis.- V. Congenital Urethral Stricture.- VI. Congenital Valves of the Female Urethra.- VII. Congenital Hypertrophy of the Verumontanum.- VIII. Anterior Urethral Valves.- IX. Diverticula of the Anterior Urethra.- 1. Incidence.- 2. Etiology and Pathology.- 3. Clinical Presentation and Diagnosis.- 4. Treatment and Prognosis.- X. Double Urethra and Accessory Urethra.- 1. Complete Double Urethra.- 2. Incomplete Dorsal Accessory Urethra—blind.- 3. Incomplete Dorsal Accessory Urethra—Communicating with the Urethra.- 4. Incomplete Ventral Accessory Urethra—blind.- 5. Double Urethra in the Female.- XI. Posterior Urethral Valves.- 1. Incidence.- 2. Etiology and Pathology.- 3. Clinical Presentation.- 4. Diagnosis.- 5. Treatment.- 6. Prognosis.- References.- Anomalies of the Male Genitalia.- A. The Undescended Testicle.- I. Causes.- II. Associated Conditions.- III. Differential Diagnosis.- IV. Method of Examination.- V. Medical Treatment.- VI. Surgical Treatment.- 1. Indications.- 2. Surgical Anatomy.- 3. Surgical Principles.- 4. Technique.- 5. Special Situations.- 6. Other Methods.- 7. Results.- B. Other Abnormalities of the Testicle.- Anorchism and Hypoplasia.- C. Appendages of the Testicle, Epididymis and Cord.- D. Anomalies of the Tunics of the Testicle and Scrotum.- E. Epididymis.- F. Vas Deferens.- G. Prostate.- H. Seminal Vesicles.- References.- Hypospadias.- Embryology and Morphology.- Incidence.- Female Hypospadias.- Therapeutic Principles.- Techniques for Correction of Chordec.- Position of New Meatus.- Basic Types of Urethroplasty.- General Results.- Personal Experiences.- Complications.- References.- Anomalies of the Female Genitalia.- I. Anomalies of the Vulva and Vagina.- 1. Reduplication of the Vulva.- 2. Masculinization of the Vulva.- 3. Imperforate Hymen.- 4. Polyps of the Hymen.- 5. Transverse Vaginal Septum.- II. Anomalies of the Mullerian Ducts.- 1. Congenital Absence of the Vagina and Uterus.- 2. Maldevelopment of the Vagina and Uterus.- a) Obstructive Maldevelopment of the Vagina and Uterus.- b) Non-obstructive Maldevelopment of the Vagina and Uterus.- III. Anomalies of the Ovary.- 1. Congenital Absence of the Ovaries.- 2. Supernumerary Ovaries.- 3. Accessory Ovaries.- 4. Displaced Ovaries.- References.- The Intersex States.- I. Criteria of Sex.- 1. The Sex Chromatin and Sex Chromosomes.- 2. Gonadal Structure.- 3. Morphology of External Genitalia.- 4. Morphology of the Internal Genitalia.- 5. Hormonal Status.- 6. Gender Role.- II. The Definition and Classification of Hermaphroditism.- III. Ovarian Agenesis and Dysgenesis.- 1. The Pathology of Gonadal Agenesis.- 2. The Diagnosis in Newborn Infants.- 3. The Diagnosis in Adolescence.- 4. Endocrine Findings.- IV. True Hermaphroditism.- 1. General Considerations.- 2. Criteria for Diagnosis.- 3. Classification of True Hermaphroditism.- 4. Clinical Features.- 5. Sex Chromosome Complements.- 6. Principles of Treatment.- V. Klinefelter’s Syndrome.- 1. Clinical Characteristics.- 2. Laboratory Findings.- 3. Pathological and Cytogenetic Findings.- 4. Treatment.- VI. Double X Males.- VII. Multiple X Syndromes.- VIII. Female Hermaphroditism Due to Congential Adrenal Hyperplasia.- 1. Clinical Considerations.- 2. Adrenal Pathology.- 3. Ovary.- 4. Developmental Anomalies of the Genital Tubercle and Urogenital Sinus Derivatives.- 5. Hormonal Changes.- 6. Pathogenesis of Virilizing Adrenal Hyperplasia.- 7. Diagnosis.- 8. Treatment.- IX. Female Hermaphroditism without Progressive Masculinization.- 1. Classification.- 2. Maternal Ingestion of Androgen.- 3. Maternal Androgen Tumor.- 4. Idiopathic.- 5. Special or Non-Specific Female Hermaphroditism.- X. Male Hermaphroditism.- 1. General Considerations.- 2. Classification.- 3. Masculinizing Male Hermaphrodites.- 4. Asymmetrical Gonadal Differentiation.- 5. Feminizing Male Hermaphrodites (Testicular Feminization Syndrome).- 6. Sex Chromosomes in Male Hermaphroditism.- XI. Differential Diagnosis of Infants with Ambiguous Genitalia.- XII. The Treatment of Hermaphroditism.- 1. General Considerations.- 2. The Construction of Female External Genitalia.- References.- Author Index.
£40.49
Editorial Academica Espanola Lactancia Materna: Iniciativa IHAN
Book Synopsis
£43.81
Springer Verlag, Japan Hepatitis C Virus I: Cellular and Molecular Virology
Book SynopsisThis volume is composed of chapters that review important fundamental aspects of HCV biology and disease pathogenesis including, for example, the discovery and identification of the HCV genome, early virus-cell interactions including identification of various cellular receptors, HCV gene expression studied using the HCV replicon system, identification and characterization of HCV structural- and non-structural HCV proteins, HCV replication in cultured cells, and host factors involved in viral replication. This volume also contains chapters dealing with immunity to HCV infection and pathogenesis. This is particularly important in understanding hepatitis C because HCV infection alone is not cell lytic. Mechanisms underlying the persistent nature of HCV infection are also discussed in these chapters. Many of the authors published articles that were listed among the “top 10 papers” published in the 24 years since HCV was discovered in 1989. Their citations are above 1,000 (Web of Science). The authors describe the background and significance of their contributions to the field in the context of findings from other research groups.Table of ContentsPart I. Hepatitis C Virus.- 1. Towards the Control of Hepatitis C (Michael Houghton).- 2. Hepatitis C Virus Genotypes and Their Evolution (Tadasu Shin-I, Masaya Sugiyama, Masashi Mizokami).- 3. The Structure of HCV (Joseph Marcotrigiano and Maria Teresa Catanese).- Part II. The Viral Life Cycle.- 4. Cell Culture Systems for Propagation of HCV.- 5. HCV Receptors and Virus Entry (Rajiv G. Tawar, Catherine Schuster, and Thomas F. Baumert).- 6. Structural Proteins of HCV and Biological Functions (Kohji Moriishi and Yoshiharu Matsuura).- 7. Role of Nonstructural Proteins in HCV Replication (Tetsuro Suzuki and Ryosuke Suzuki).- 8. The HCV Replicase Complex and Viral RNA Synthesis (Inés Romero Brey and Volker Lohmann).- 9. Host factors and the HCV lifecycle (Glenn Randall).- 10. Lipid Peroxidation and Hepatitis C Virus Replication (Daisuke Yamane and Stanley M. Lemon).- 11. Lipid and Lipoprotein Components Play Important Roles in HCV Egress and Infectivity (Takayuki Hishiki, Yuko Shimizu, Saneyuki Ujino, Hironori Nishitsuji, and Kunitada Shimotohno).- Part III. Immune Recognition and Pathogenesis.- 12. New Animal Models for Hepatitis C (Alex Ploss).- 13. Innate Immune Recognition of Hepatitis C Virus (Kui Li).- 14. B Cell Responses and Control of HCV Infection (Zhen-Yong Keck, Thomas R. Fuerst, Roy A. Mariuzza, and Steven K.H. Foung).
£143.99
Edicoes Nosso Conhecimento Eficácia da terapia de movimento induzido por
Book Synopsis
£21.21
