The aim of this text is to provide the framework for building a clinical trial as it pertains to operative and non operative invasive procedures, how to get it funded and how to conduct such a trial up to publication of results The text provides all details of building a scientifically and ethically valid proposal, including how to build the infrastructure for a clinical trial and how to move it forward through various funding agencies. The text also presents various types of clinical trials, the use of implantable devices and FDA requirements, and adjuncts to clinical trials and interaction with industry Clinical Trials Design in Invasive Operative and Non Operative Procedures will be of interest to all specialists of surgery, anesthesiologists, interventional radiologists, gastroenterologists, cardiologists, and pulmonologists

Within the last decade music therapists have developed their work with people who have life-threatening illnesses and with those who are dying. This book presents some of that work from music therapists working in different approaches, in different countries, showing how valuable the inclusion of music therapy in palliative care has already proved to be. It is important for the dying, or those with terminal illness, that approaches are used which integrate the physical, psychological, social and spiritual dimensions of their being. The contributors to this book emphasize the importance of working not only with the patient but with the ward situation, friends and family members. By offering patients the chance to be creative they become something other than patients - they become expressive beings, and there is an intimacy in music therapy that is important for those who are suffering. Many of the contributors write in their own personal voice, providing a particular insight which will be valuable not only to other music therapists seeking to enrich their own ways of working, but to all those involved in caring for the sick and the dying. Contributors describe their work with both children and adults living with HIV/AIDS, cancer and other chronic degenerative diseases.

Authored by an acknowledged expert on muscle and movement imbalances, this well illustrated book presents a classification system of mechanical pain syndromes that is designed to direct the exercise prescription and the correction of faulty movement patterns. The diagnostic categories, associated muscle and movement imbalances, recommendations for treatment, examination, exercise principles, specific corrective exercises, and modification of functionalactivities for case management are described in detail. This book is designed to give practitioners an organized and structured method of analyzing the mechanical cause of movement impairment syndrome, the contributing factors and a strategy for management. * Provides the tools for the physical therapist to identify movement imbalances, establish the relevant diagnosis, develop the corrective exercise prescription and carefully instruct the patient about how to carry out the exercise program. * Authored by the acknowledged expert on movement system imbalances. * Covers both the evaluation process and therapeutic treatment. * Detailed descriptions of exercises for the student or practitioner. * Includes handouts to be photocopied and given to the patient for future reference.

It has never been easy to introduce new concepts and therapeutic in-terventions into surgical practice. When attempting to do so, one is faced with the interagency of traditional dogma, which still in this era of evidence-based medicine tends to dominate the surgical thought pr- ess. This is particularly so in the area of coloproctology, where prejudice and personal opinion often influence objective analysis whenever tradition is challenged. A large body of literature on anorectal prolapse has accumulated over the years; although much is based on personal viewpoint rather than scientific evidence, it has nevertheless been passed down through the generations as ac-cepted wisdom and practice. As a consequence, it is a challenge to change the mindset of a generation of surgeons and to introduce new concepts and novel techniques which at first might appear to be a radical departure from conventional teaching. It is obviously not possible to present the basis for the develop-ment of transanal stapling techniques for anorectal prolapse in this Foreword; this is dealt with in detail elsewhere in this book. The in-terested reader will have the opportunity to share in the new and emerging concepts surrounding anorectal prolapse and to deepen their understanding of the pat- physiology and basis for surgical correction. Although hemorrhoidal disease and external rectal prolapse have been known about for centuries, the understanding of internal rectal prolapse (intussusception) and rectocele has only really advanced with the emergence of radiological imaging tech-niques, such as defecography.

Andreas Meiser summarizes the current literature on inhalation sedation of critically ill patients. To meet clinical demands, he describes the development of new devices to administer volatile anesthetics together with common ICU ventilators. Their basic principle is called anesthetic reflection. The author discusses advantages and drawbacks of these devices in line with clinical studies demonstrating advantages of inhaled versus intravenous ICU sedation.About the Author:Dr. med. Andreas Meiser is working as a consultant anesthesiologist on the interdisciplinary operative ICU of the Saarland University Medical Center. He has been a pioneer in the field of inhalation ICU sedation. He has been treating patients using the AnaConDa administration devices since 2004, and has published many original articles in scientific journals on the subject.

Intensivmedizin zum Nachschlagen und Lernen fur die Zusatzbezeichnung "Intensivmedizin". Das Repetitorium Intensivmedizin stellt das Fach der Intensivmedizin kompakt und fundiert dar und gehoert in die Reihe der Repetitorien, die sich hervorragend zur Prufungsvorbereitung oder Beantwortung von Fragen im Klinikalltag eignen. Alle Inhalte sind systematisch und ubersichtlich dargestellt und klar und pragnant in den Aussagen. Zahlreiche Schemazeichnungen und Tabellen erleichtern das Verstandnis und bundeln Informationen. Das Werk erscheint bereits in der 5. Auflage. Dieses ist komplett aktualisiert und erscheint in neuem Layout. Das Werk richtet sich an alle auf einer Intensivstation tatigen AErzte.

In der Intensivmedizin ist es oft notwendig, rasch erste therapeutische Massnahmen ohne Fehler und Unsicherheiten vorzunehmen. Dieses Buch bietet den Arzten wahrend ihrer intensivmedizinischen Ausbildung eine schnelle und ubersichtliche Hilfe in der kompetenten Betreuung eines breiten Patientenspektrums an einer chirurgischen Intensivstation. Haufige Krankheitsbilder aus Abdominalchirurgie, Thoraxchirurgie, Herzchirurgie, Traumatologie, Geburtshilfe und Innerer Medizin werden behandelt und die pathophysiologischen Vorstellungen erlautert. Daruber hinaus werden grundlegende Kenntnisse in Bezug auf kunstliche Beatmung sowie alternative Techniken vermittelt und die Thematik der parenteralen und enteralen Ernahrung ubersichtlich und praxisnah dargelegt. Krankheitsbildern wie Sepsis mit ihrer Pathophysiologie und damit verbundener Verzahnung von Gerinnung und Inflammation wurde besonderes Augenmerk gewidmet, so dass neue und teils noch in Entwicklung befindliche Therapieansatze beurteilt werden konnen."

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of Essential Clinical Anesthesia is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery, and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr. S. R. Mallampati. Essential Clinical Anesthesia is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

Answering questions such as 'how can I change my pain experience?', 'what is pain?', and 'how do nerves work?', this short research-based graphic book reveals just how strange pain is and explains how understanding it is often the key to relieving its effects. Studies show that understanding how pain is created and maintained by the nervous system can significantly lessen the pain you experience. The narrator in this original, gently humorous book explains pain in an easy-to-understand, engaging graphic format and reveals how to change the mind's habits to transform pain.

Rainer Thiele deals with chiropractic and examines two questions: Is chiropractic treatment of lower back pain a successful therapeutic approach? Is chiropractic treatment a standard treatment for headaches? On the topic of chiropractic in lower back pain, a congress abstract was published by the author using the latest randomized clinical studies and discussed as a poster contribution to the 16th Congress for Health Services Research in Berlin. A systematic review answers the question about chiropractic treatment of headaches. About the author: Dr. scient. med. Rainer Thiele wrote this work as part of his doctoral studies in medical science at the UFL (Private University of Liechtenstein) as a cumulative dissertation. He is managing director of the specialist practice for Chiropractic / Osteopathy and Sports Medicine in Munich.

Written in a succinct format, this book presents a variety of pain conditions seen in acute or sub-acute rehabilitation hospitals and in outpatient clinical settings. Bio-medical and bio-psychosocial perspectives, as well as theory, clinical practice, and practical aspects of managing pain are offered throughout this volume. Chapters are organized by sections, beginning with an introduction to pain as well use of the multi-disciplinary treatment approach. Additional sections cover headache management, pain diagnostics, medication management, rehabilitation, injections and procedures, behavioral management, complementary and alternative medicine, neuromoduation, neuroablation, surgical management of pain, and novel techniques. Business and legal perspectives of pain medicine are also addressed. Comprehensive Pain Management in the Rehabilitation Patient is a handy resource for any medical, interventional, surgical, rehabilitative, behavioral, or allied health provider who treats pain across the rehabilitation continuum.

CRQs for the Final FRCA is the first book of its kind and an invaluable resource for any candidate preparing to pass the written aspect of the Final FRCA. It has been specifically designed to reflect the new written examination format, providing ten complete CRQ examination papers and answer templates, with additional tips and references to aid further learning. Each paper has been carefully formulated to include the different topics contained within the examination and cover a vast area of the syllabus. Unlike other revision texts, this book will enable candidates to practise the CRQ format and refine their exam technique to ensure they are best equipped to succeed. It is written by a team of two consultant anaesthetists and two senior trainees who run the North West Final FRCA Exam Practice Course and have extensive experience of preparing trainees to pass the examination.

This concise, easy to follow review of obstetric anesthesia follows the outline set forth by the American Board of Anesthesiology (ABA), making it an invaluable resource for in-service exam and board exams. The book is divided into four sections, beginning with maternal physiology, followed by maternal-fetal considerations, then pathophysiology of complicated pregnancy, and finally problems of term and delivery. Written at the fellow-level, it provides anesthesiology residents, obstetric anesthesiology fellows, and any anesthesiologist providing care to obstetric patients testable information for the boards, as well as practical tips for clinical practice.

In April of 1991, 425 partICIpants from 18 countries met in Hamamatsu in Japan for the 6th International Symposium on Computing in Anesthesia and Intensive Care (lSCAIC). The meeting was one of the most spectacular academic and fruitful in the history of ISCAIC. We had four days of fascinating presentations and discussions covering many areas of technology in Anesthesia and intensive care. New technologies were presented and old technology reexamined. The measures of success of the meeting were the excellent research material in oral and poster presentations, and state of the art reviews of the latest issues by distinguished worldwide key speakers. It must be sure that the meeting was most effective to promote and disseminate up-to-date information in these fields across the participating countries. The aim of this book is to record the exciting achievements of the meeting and extend them further among our colleagues. We hope the readers of this book will share the same excitation as well as the latest information in this speciality. Finally we would like to extend our deepest gratitude to all participants and others for the contribution to the compilation of this book. Kazuyuki Ikeda, M.D.

This comprehensive guide covers prescribing controlled substances for patients with acute or chronic pain and provides a balanced discussion on appropriate treatment, addiction, safety and complications. Chapters feature evidence-based strategies and clinical modalities that address diagnostic challenges, treatment guidance, alternatives to opioid management and the significant legal risks within the current regulatory environment. Authored by leaders in pain medicine, physicians and appropriate health care professionals will find Controlled Substance Management in Chronic Pain to be an indispensable resource.

Breakthrough pain is a common occurrence in patients with cancer pain, and is often associated with a deleterious effect on daily life, impairing quality of life substantially. It is a heterogeneous condition, and management needs to be individualized. This valuable pocketbook discusses the clinical features of breakthrough cancer pain and the different strategies for management. It covers assessment, treatment, and reassessment. It also reviews the evidence for pharmacological interventions, like rapid onset opioids, as well as non-pharmacological interventions and disease modifying treatments. This new edition has been thoroughly updated to account for recent developments within the field. These updates ensure that Cancer-Related Breakthrough Pain (Oxford Pain Management Library) continues to be an invaluable resource for specialists and trainees in palliative care and pain management, as well as being a quick reference guide for GPs, specialist nurses, and other healthcare professionals.

Another title in GMM's highly successful QBase series, this time focusing on the Primary FRCA (Fellowship of the Royal College of Anaesthetists) with sets of examination papers the candidate can use to revise and practice their MCQ technique. As always, the self-learning experience is greatly enhanced by the free CD-ROM containing the QBase examination software. This powerful program allows the user to sit the pre-set exams as printed in the book, or to create their own exams using questions drawn from the total pool available on the CD-ROM. The program can either generate these exams randomly (maintaining the same proportions of each subject as the 'pre-set' exams), or the user can select any number of questions in any subject area, to create their very own exam. However the user chooses to set an exam, they can then mark, analyse and store each attempt, and review and re-sit the same exam at a later date, comparing their scores with previous attempts. When re-sitting an exam, the user can also choose to 'shuffle' the question stems A-E, so that they cannot simply remember patterns of true and false answers. A final unique aspect of the program is that it allows the user to select how confident they are of their answer, and the program can then provide feedback on a user's 'guessing strategy'.

Why write a book on the tourniquet? The tourniquet is used routinely in op- ating theatres throughout the world, but as far as I know there is no single book that surveys the considerable literature that has accumulated. If used sensibly, the tourniquet is a safe instrument. Most of the few complications seen with its use are preventable. However, when something untoward happens, the tour- quet suddenly becomes an interesting subject, particularly if there is the likelihood of medicolegal consequences. This book summarises the scientific background of the tourniquet and describes a safe physiological approach to preventing complications. Examples of medicolegal problems are included. Considerable progress had been made since Lister first excised a tuberculous wrist joint in a bloodless field. Many researchers have studied the effects of ischaemia and pressure on nerves and muscles. Tourniquets have entered the age of computers and are now much more sophisticated. Despite this, there is still much dogma surrounding the tourniquet in operating theatres and in textbooks. This book is aimed at orthopaedic surgeons, anaesthetists and op- ating-theatre staff. I hope that this short text will stimulate a more widespread interest in the tour- quet and improve safe practice.

As Sir William Osler said "The practice of medicine is an art, based on science". The authors believe that the art of precision medicine is knowing when the science of medicine should not be applied to your patient. This practical guide to managing patient expectations while maintaining a good medical practice presents as one of the only books of its kind. Written for anesthesiology residents in training, as well as practicing physicians, Practical Anesthetic Management focuses on giving clinicians the tools to create safer, more effective and efficient practices while catering to patient satisfaction. Featuring pearls for teaching purposes, Practical Anesthetic Management also covers topics like preoperative evaluation, tips on blood-gas analysis, and essentials of airway management, all complete with accompanying videos.

Written for anaesthesia trainees, this comprehensive text covers all the MCQ preparation required for both the Primary and Final FRCA exams. Broken down into five sections, there are 150 questions for each of the physics, pharmacology, anatomy, and physiology sections, and a fifth section of 400 questions covering clinical anaesthesia. The first four sections of 150 questions match the Primary exam and are laid out to follow its format. The fifth clinical section covers the entire clinical syllabus. The authors are educators in anaesthesia and surgery and their wealth of experience has been brought together in this text to benefit the next generation of anaesthetists. Covering the entire syllabus, with 1,000 expertly distributed questions, this is the most comprehensive text available for MCQ preparation for both parts of the FRCA.

This book, which describes in detail the most common procedures employed in inguinal hernia surgery, is exceptional in reflecting fully the most recent advances, as well as the most established techniques, in knowledge and practice. The role of recently developed and emerging technologies, including robotics, minimally invasive surgery, and biological meshes, is clearly explained, highlighting useful tips and tricks. The descriptions of traditional procedures, such as the Lichtenstein repair, are brought fully up to date and take into account the novel perceptions that professionals have of them, for example regarding the important role of nurses. The reader will also find guidance on established and new treatments for specific pain conditions, including postoperative chronic pain, the pubic inguinal pain syndrome, and obscure groin pain in women. The need for such an update on inguinal hernia surgery became clear at the 1st World Conference on Abdominal Wall Hernia Surgery, which highlighted the huge differences in the approaches adopted by scientists around the world and was chaired by the editor of this book. Inguinal Hernia Surgery will be a useful tool for all health care practitioners involved in hernia surgery.

Emergency and critical care providers are often challenged by patients with acute cardiorespiratory symptoms and abnormal electrocardiograms. Critical Cases in Electrocardiography emphasizes clinically-relevant topics, focusing squarely on situations where interpretation of the ECG contributes to clinical decision-making. This atlas is unique, in that it includes numerous examples of ECG 'misses' - cases where the computer algorithm or the clinicians (or both) got the diagnosis wrong. While many textbooks include only smaller, black and white ECG tracings, which do not resemble actual clinical practice, this volume is designed to encourage self-study of the ECG by including full-page tracings in their natural color. The book focuses on 'don't miss' ECG tracings in order to help readers advance beyond the stage of 'competent' electrocardiographer. Anatomic and electrophysiologic correlations are emphasized throughout the work, helping readers appreciate the anatomic and electrical origins of the ECG abnormalities, rather than relying solely on pattern memorization.

This comprehensive textbook, covering all aspects of the perioperative management of patients undergoing organ transplantation, serves as the standard reference for clinicians who care for transplant patients on a day-to-day basis as well as those who encounter organ transplantation only occasionally in their clinical practice. Anesthesia and Perioperative Care for Organ Transplantation covers transplantation of the heart, lung, liver, pancreas, and kidney, as well as multivisceral and composite tissue graft transplantations. For each kind of transplantation, the full spectrum of perioperative considerations is addressed: preoperative preparation, intraoperative anesthesia management, surgical techniques, and postoperative care. Each chapter contains evidence-based recommendations, relevant society guidelines, management algorithms, and institutional protocols as tables, flow diagrams, and figures. Photographs demonstrating surgical techniques, anesthesia procedures, and perfusion management are included. Anesthesia and Perioperative Care for Organ Transplantation is for anesthesiologists and critical care physicians; transplantation surgeons; nurse anesthetists; ICU nurses; and trainees.

This text is aimed at defining the current concepts that define trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It will serve as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader will have full understanding of the tests that are used to study trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications are reviewed in detail. Trauma Induced Coagulopathy will also be a valuable source for quick reference to the clinician that is faced with specific clinical challenges when managing coagulopathy.