Low back pain is described as a very common condition that tends to affect about 70% of the population at some point in time with varying degrees of symptom severity. Although definitions vary, sciatic pain is generally defined as back-related pain radiating to the leg (normally below the knee and into the foot and toes) and is one of the commonest variations of low back pain. Patients with sciatica typically experience a more persistent and severe type of pain, a less favorable outcome, consume more healthcare resources and have more prolonged disability and absence from work than those with low back pain alone. Managing Sciatica and Radiculopathies in Primary Care Practice provides a comprehensive, up-to-date overview of the subject and key information for primary care practitioners about low back pain in patients, including definitions and causes, current management approaches, diagnostic and treatment algorithms, as well as clinical practice guidelines.

Many drugs used in current anesthetic practice are administered intravenously. An appreciation of their kinetics and dynamics is of great assistance in determining the most appropriate drug to use, and optimal dosage regimens for any given patient. This book is specially oriented to the requirements of anesthesiologists. It will enable the student of those subjects to gain enough knowledge to make these subjects usable in daily anesthetic practice. As such it is intermediate in difficulty between mathematically oriented texts, and those which only offer a very qualitative understanding of these subjects. Practical applications and examples of the uses to which kinetic and dynamic principles can be put in daily practice are emphasized and illustrated. Basic principles and techniques with which the reader can perform kinetic and dynamic calculations are explained simply and demonstrated in detail using examples derived from clinical practice. Two appendices provide kinetic and dynamic data on the most commonly used anesthetic drugs. The last chapters use the principles discussed in the first chapters to show how variations of normal physiology and disease affect drug kinetics and dynamics. This is especially valuable to the clinician as it enables clinically useful, albeit qualitative, predictions to be made of the direction of any change of kinetic and dynamic parameters of drugs due to these factors.

Anesthesiology and Pain Management contains the edited presentations of the 39th Annual Postgraduate Course in Anesthesiology, February 1994. The chapters reflect new data concepts within the general framework of `pain research and basic science', and `clinical topics in pain management'. The purpose of the textbook is to serve as a vehicle to bring many of the latest concepts in anesthesiology to those who did not attend the conference, within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the current interests in anesthesia. This volume, as well as past and future volumes, reflects the rapid and continuing evolution of anesthesiology in the late twentieth century.

Key features: * Provides a clear explanation for many of the pain generators in low back pain and illuminate this perplexing and ubiquitous problem. * Addresses a gap in the existing literature, as "non-specific" or mechanical lumbosacral spine pain accounts for by far most chronic spinal pain sufferers' complaints for clinicians dealing with spinal pain syndromes like general medical practitioners, and spinal specialists in various fields such as sports medicine. * Illustrates anatomical structures that can be injured and thus become responsible for causing mechanical lumbosacral spine pain, frequently, such injuries cannot be detected on sophisticated imaging such as MRI.

Patients with cardiac conditions routinely present for noncardiac surgeries, requiring special protocols for perioperative assessment and management by the anesthesiologist. Essentials of Cardiac Anesthesia for Noncardiac Surgery: A Companion to Kaplan's Cardiac Anesthesia provides current, easily accessible information in this complex area, ideal for general anesthesiologists and non-cardiac subspecialists. From preoperative assessment through postoperative care, this practical reference covers all perioperative approaches to today's patients with cardiac conditions. Provides guidance on the anesthetic diagnosis and management of the full range of cardiac lesions, helping minimize adverse outcomes and reduce complications for patients with common, complex, or uncommon cardiac conditions. Includes complete coverage of echocardiography and current monitoring techniques needed for thorough perioperative assessment - all from the anesthesiologist's perspective. Discusses safe and effective perioperative anesthetic management of patients presenting with advanced levels of cardiac care such as drug-eluting stents, multiple antiplatelet drugs, ventricular assist devices, multiple drugs for end-stage heart failure, and implanted electrical devices that produce cardiac resynchronization therapy, as well as patients with complicated obstetric problems or other significant cardiovascular issues. Features a concise, easy-to-navigate format and Key Points boxes in each chapter that help you find answers quickly. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This is the premier evidence-based textbook in critical care medicine. The Third Edition features updated and revised chapters, numerous new references, streamlined content, and new chapters on key topics such as the new paradigm in critical care medicine, cardiac output monitoring, surgical optimization, vital signs, and arterial blood gas analysis. The book maintains the author's trademark humor and engaging writing style and is suitable for a broad and diverse audience of medical students, residents, fellows, physicians, nurses, and respiratory therapists who seek the latest and best evidence in critical care. From reviews of previous editions: "This is an excellent introduction to the concept of evidence-based medicine...The writing is clear, logical, and highly organized, which makes for fast and enjoyable reading. I believe this book will get daily use in most intensive care units, by a wide range of readers." -Respiratory Care "This is one of the most comprehensive handbooks on critical care medicine with a strong emphasis on evidence base...Overall, this book should be useful for junior doctors or intensive care trainees who are starting their term in an intensive care unit." -Anaesthesia and Intensive Care

Bladder Pain Syndrome: A Guide for Clinicians provides a comprehensive update in the pathophysiology, epidemiology, terminology, evaluation and treatment of patients with pelvic pain perceived to be related to the urinary bladder. The volume covers the tremendous evolution during the last decade in our understanding of pain syndromes and their diagnosis and treatment. It is now clear that Bladder Pain Syndrome belongs to the family of pain syndromes, and therefore treatment has moved from the treatment of the bladder to the treatment of a pain syndrome with the special problems this presents when the pain syndrome involves urinary symptoms. Interstitial Cystitis was poorly defined and the interpretation and patient selection differed enormously around the world in many ways, making exchange of information unreliable and confusing. Bladder Pain Syndrome is clearly defined and the result is a much better patient selection. This volume provides state of the art background for making a correct evaluation and diagnosis of patients with pelvic pain and voiding problems resulting in a more focused treatment to the benefit of the patients. The volume also covers the close relationship between different pain syndromes including those outside the pelvis. Bladder Pain Syndrome: A Guide for Clinicians will be of great utility to urologists, gynecologists and all health professionals dealing with patients with pelvic pain.

Low Back Disorders, Third Edition With Web Resource, guides readers through the assessment and treatment of low back pain, providing evidence-based research on the best methods of rehabilitation and prevention of future injury. In this book, internationally recognized low back specialist Stuart McGill presents the research and applications of back anatomy and biomechanics to build effective prevention and rehabilitation programs for patients or clients. This third edition of Low Back Disorders contains all of the essential tools for those with low back maladies. Strong foundational information on anatomy and injury mechanisms guide readers through the essential functions of the structures of the low back and related tissues, and common misconceptions about pain and discomfort are addressed and corrected. The text provides detailed insights into injury assessment by an extensively expanded set of tests with accompanying instructions. These provide guidance and recommendations for individualized rehabilitation strategies and exercises. Also new to this edition is a web resource featuring 20 fillable Handouts for Patients or Clients that can be edited and printed to suit practitioner and patients’ needs. The web resource also contains an online video suite that showcases various exercises and assessments. In addition to offering strategies for relieving and potentially eliminating pain, the text provides insight into the conditions and environments that may initially cause back pain and makes recommendations on reducing these influences so that clients can be pain free. This book contains more than 500 photos, graphs, and charts on anatomy, biomechanics, and assessments; 50 tests and exercises with step-by-step instructions are available to aid readers in developing successful programs for patients and clients. In addition to the evidence-based foundation of this edition, the following enhancements have been made: • Completely updated information and streamlined chapter organization ensure that practitioners use best clinical practices. • Practical checklists throughout the text provide easy access to testing and assessment clinical techniques and information. • Practical Applications provide clinical information to aid readers in understanding concepts and theory. • To aid instructors, the text includes a newly added image bank to visually support class lectures. Low Back Disorders, Third Edition With Web Resource, contains essential research and corresponding clinical applications in a clear and organized format. Part I introduces the functional anatomy and biomechanics of the lumbar spine. It also presents epidemiological studies on low back disorders and dispels common myths of lumbar spine stability. Part II reviews risk factors for low back disorders and common prevention methods, with specific attention paid to reducing workplace risk factors. Part III explains evaluating and diagnosing clients and developing exercise and rehabilitation programs. Specific exercises that are proven to enhance performance and reduce pain are also explained. Evidence-based research and cutting-edge application strategies from a leading spine specialist in North America make Low Back Disorders, Third Edition With Web Resource, the authoritative text for the examination and rehabilitation of the low back. Its approach to back care will lead readers in developing intervention, rehabilitation, and prevention programs to address the unique needs of each patient or client. Earn continuing education credits/units! A continuing education course and exam that uses this book is also available. It may be purchased separately or as part of a package that includes all the course materials and exam.

Imagine if the mere breeze of an air conditioner were to send you into excruciating pain. For those suffering from Complex Regional Pain Syndrome (CRPS), historically called Reflex Sympathetic Dystrophy (RSD), this crippling neuropathic pain is an unrelenting reality. With symptoms such as swelling, hypersensitivity, stiffness, burning pain, and temperature abnormalities, CRPS can develop at any time and quickly leaves its victims disabled and isolated. This book explains CRPS in an accessible style, featuring modern self-help techniques, complementary therapies, and holistic strategies for maximizing the potential for healing. Readers with CRPS will find a wealth of tips on life modifications to help better manage their condition, along with a list of "dynamite distractions" to refresh the pain-wracked mind and help them rediscover their imagination and humor. Patient testimonies on techniques for transforming the pain and discomfort of CRPS provide hope, and interviews with practitioners, including pain specialist Edward Carden and occupational therapist/neurological acupuncturist Sheri Barnes, offer insights every patient should know. There's even a chapter addressed to loved ones with advice for their difficult roles as encouragers and caregivers. CRPS remains a mysterious, poorly understood condition. This book provides the information and positive options everyone affected by CRPS needs.

This book presents the development and experimental validation of the structural test strategy called Oscillation-Based Test - OBT in short. The results presented here assert, not only from a theoretical point of view, but also based on a wide experimental support, that OBT is an efficient defect-oriented test solution, complementing the existing functional test techniques for mixed-signal circuits.

When I first proposed this book, one of the hopes was that it would be the stage upon which would be conducted a quiet, well reasoned discussion of the various techniques of stereotactic radio surgery. At that time, there was quite a bit of rancorous debate that tended to obscure the scientific and medical merits of each of the separate methods. At the present time, I am happy to report that the field of stereotactic radiosurgery is much less riven by such inappropriate posturing. The field has taken many steps towards maturity, both technically and medically. In the course of this mat uration process, there have been many grandiose plans and speeches made on behalf of stereotactic radiosurgery. Inevitably, the reality will not live up to the hype, but such is the natural course of devel opment in these sorts of matters. However, even though events may not match our hopes, we should keep in mind the words of Herbert Parker. Recognizing that new modalities for the treatment of cancer do not stand much chance of revolutionary success, nevertheless, he quite correctly pointed out that " . . . with any type of radiatiQn, the margin between success and failure is small. If the chance of success is a little greater . . . thi~ might well be classed as a great advance. " Mark H.

The first of its kind, this book describes pediatric palliative care in more than 23 countries. Each region in the world is covered and countries included are both resource poor and rich. Authors are multidisciplinary and regarded nationally and internationally in their field. Clinicians, advocates, policymakers, funders, and researchers will learn how programs were developed and implemented in each country. Authors describe children for whom pediatric palliative care is needed and provided for in their country. When applicable, a brief history of pediatric palliative care is included noting especially policy changes and legislative acts. For example, the chapter on Poland describes how pediatric palliative care grew from the Catholic church into a national movement spearheaded by several health care workers. The Pole national spirit that brought them through a change in political regime has also been a driving force in the pediatric palliative care movement. The chapter on South Africa, for example, illustrates how a resource poor country has been able to leverage philanthropic and government funding tomake its dream of having an infrastructure of pediatric palliative care a reality. These are just a few examples of the inspiring stories that are included in this book. Readers from countries who wish to start a pediatric palliative care program, or advance an existing program, will learn valuable lessons from others who have faced similar barriers. Introduction and concluding chapters highlight the strengths and weaknesses of the modern pediatric palliative care movement."

This book is the first of four books on the core principles of acute neurology. This book is a primer - and a great deal more - on how to clinically recognize acute brain injury and to treat its consequences. Acute brain injury often changes the dynamics of cerebral blood flow, cerebrospinal fluid mechanics and eventually intracranial pressure. And furthermore, acute brain and spine injury impacts on heart function, blood pressure control, breathing regulation and even gastric and bladder function. It is necessary to not only understand these fundamentals but also how certain measures could influence or correct these manifestations. Major concepts are illustrated to facilitate understanding. Each chapter concludes with a section that explains its relevance to clinical practice.The book truly combines basic neuroscience with practical know- how in an easy to read prose useful for both the novice and expert.

Pain is a complex experience, influenced by many variables. There is currently growing interest in the influence of sex and gender on the experience of pain. The fact that there are sex differences in pain and analgesia is now a well-recognized phenomenon within the field of pain medicine. However, the specific mechanisms underlying these differences remain somewhat poorly understood. Traditionally, these sex differences in pain experience have been attributed largely to psychological, behavioral and socio-cultural variables - in particular, a perceived greater willingness on the part of women to report painful symptoms and seek medical attention. Although psychosocial factors do influence pain perception, there is now substantial evidence to support a strong role for hormonal factors mediating sex differences in pain modulation. In Pain in Women: A Clinical Guide, a renowned group of experts in pain medicine breaks new ground in the field by synthesizing and elucidating the range of biological and neurohormonal factors underlying these conditions and clarifying potential treatment options based on these factors. The initial section of this unique title introduces the topic of pain in women and its importance and then goes on to describe hormonal and myofascial considerations in this patient population. The second section addresses specific pain disorders common in women and the various treatment options for these, including rehabilitative and complementary and alternative medicine (CAM) treatments. The third and final section covers the specific populations of the pregnant/postpartum woman, issues related to breast cancer, the female athlete, menopausal considerations and the role of physical therapy in women's health. Timely and state-of-the-art, Pain in Women: A Clinical Guide is an important new reference that fills a significant need in the developing area of pain medicine.

The International Hypoxia Symposium convenes biannually to bring together international experts from many fields to explore the state of the art in normal and pathophysiological responses to hypoxia. Representatives from five continents and 32 countries joined together in February 2003 for four days in the dramatic mountains of Banff, Alberta. As editors of the Proceedings of the International Hypoxia Symposia, we strive to maintain a 26 six year tradition of presenting a stimulating blend of clinical and basic science papers focused on hypoxia. Topics covered in 2003 include hibernation and hypoxia, hypoxia and fetal development and new advances in high altitude pathophysiology, oxidative stress and membrane damage, hypoxic regulation of blood flow, heat shock proteins in hypoxia, and future directions in hypoxia research. In 2003 we also had the privilege ofhonoring John W. Severinghaus as a friend, colleague, mentor and inspiration to many in the field. Tom Hornbein's personal tribute to John Severinghaus is the first chapter in this volume, followed by an entertaining update of the history of the discovery of oxygen written by John Severinghaus.

In susceptible individuals, malignant hyperthermia (MH) can be triggered by various anesthetics during surgery. First described in 1960, research since then has concentrated on reducing the very high mortality rate associated with MH. Although significant progress in treatment has been made with the introduction of dantrolene sodium in 1979, many questions remain unanswered. Following on the results of more than 30 years of investigative efforts, the Third International Symposium on MH was held in Hiroshima, Japan, in 1994, immediately before the Seventh International Workshop on MH. Specialists in the field discussed the most up-to-date findings from the point of view of clinical classification, history, and incidence based on the evidence of epidemiology, diagnostic muscle testing, genetics, and biochemistry. These proceedings of the symposium present important keys to understanding the mechanism of MH and related syndromes at the genetic level and include procedures for the monitoring and care of patients. This volume will be invaluable not only for surgeons and anesthesiologists but also for physiologists and researchers.

Several new developments in the field of neuroimmunology with focus on the brain-to-immune system communication have been the incentive for this PIR volume. It covers topics such as brain-immune interactions, the impact of stress on the immune response, pain and immunosuppression, the modulation of inflammation and pain by the sympathetic nervous system, consequences of nerve injury for the immune system, neuronal mechanisms of immune cell recruitment, and the modulation of the immune response by corticotropin-releasing hormone or adenosine. The authors are a unique group of scientists who are all interested in brain-to-immune interactions; however, each from a different perspective. The volume will serve both neurobiologists and immunologists to understand the influence of the central nervous system on peripheral inflammation. Many aspects of this book will also be stimulating for researchers in the pain field.

This is a practical guide to the evidence-based diagnosis and management of orofacial pain. It covers common clinical presentations of acute and chronic orofacial pain and summarizes clinically relevant neurobiology. Because diagnosing orofacial pain can be a challenge, the book describes the appropriate history-taking methods, detailed examinations, and relevant tests that will help clinicians to work through the differential diagnosis. Effective medical, surgical, and behavioral approaches are presented, and the importance of a multimodal approach is consistently emphasized throughout the book. The target audience includes pain physicians, anesthesiologists, dentists, neurologists, nurse practitioners, and physician's assistants.

Despite numerous reports of cerebral damage in cardiac surgery, the subject has not been given the attention it requires. This book, with a preface by Torkel Aberg, will remedy that situation. The causes and incidence of pre- and post-operative cerebral damage are considered in the first section. Cardiac surgery patients frequently have preoperative cerebral impairment, not suprising when one considers the impaired circulation from a damaged heart and the brain's prodigious need for blood. Moreover, several perioperative aspects of surgical procedures have been considered as possible causes of cerebral dysfunction, for example: microbubbles, toxic by-products, non-pulsatile blood flow. The second section describes how imaging techniques (CT scan, MRI, regional cerebral blood flow imaging), and functional assessment techniques. (PET scan, EEG, BEAM and evoked potentials) can be used to measure cerebral damage. In the third section, psychometric and neuropsychological techniques are used to assess impaired mental abilities (abstract thinking, language, memory, visuo-spatial ability, mental flexibility, attention and concentration). The final section explores the relationship between cerebral dysfunction and psychopathology (several types of depression, anxiety, and aspects of organic brain syndrome, delirium and dementia).

COX-2 inhibitors are important drugs with analgesic and anti-inflammatory effects. The discovery of COX-2, the evolution of drug development in this field and the implications of these developments in patient therapy are topics of this volume. This book presents both pre-clinical and clinical information and is important for clinicians interested in the latest information about this class of drugs, for researchers and for students in the field.

Charles Ernest Overton's 1901 monograph Studien aber die Narkose has become a scientific classic in a number of different fields. This book represents the first English translation, and in fact the first translation into any other language, of the original German work. In addition to. the edited translation, this volume contains introductory chapters by Keith Miller, Peter Winter and Leonard Firestone and myself. As editor, I have attempted above all else to ensure that the translation faithfully represents Overton's ideas and data, while making the material readily understandable to the modem scientific reader. This has frequently required that extremely long sentences, common in turn-of the-century German but considered cumbersome today, be simplified into two or even three sentences. In addition, I have paid particular attention to the correct translation of scientific terms, and I accept complete responsibility for any inaccuracies in this area. Overton's original contents list included headings and subheadings, but only a fraction of these appear in the original text. For the sake of clarity they have all been included in the body of the translated work. Also included is an index containing all chemicals mentioned in the book, along with their Chemical Abstracts System Registry Numbers for un ambiguous identification, a complete list of Overton's publications (Appendix B), and a list of all biographical articles about Overton and articles dealing specifically with analyses of his data (Appendix C)."

This volume contains selected works from the 25th Anniversary of the International Conference on Intracranial Pressure (ICP) held in Williamsburg, Virginia. The theme of the meeting was Intracranial Pressure and Neuromonitoring and focused on all the current state of the art brain monitoring methodologies and their application to brain injury. The brain monitoring techniques covered a wide spectrum from neurochemical monitoring of the injured brain to specialized techniques for assessing shunt function in normal pressure hydrocephalus. It also includes the most recent advances in monitoring of the brain oxygen levels using electrodes or the less invasive Near Infrared Sprectroscopy devices. Controversial issues regarding the management of ICP and CPP or both are also addressed and there are several works dealing with this topic. Of particular interest is the group of papers describing diagnosis and outcome in normal pressure hydrocephalus. It is the first compilation of papers which covers all the latest brain monitoring studies in both ischemia, trauma and hydrocephalus. The manuscripts in this volume have been selected from over 300 abstracts submitted to this international symposium. The abstracts are also published in order to provide the most comprehensive view of the progress made in brain injury research.

Drug dosage in renal insufficiency has become an toxication. In 1975, his Poison Index was pub important facet of nephrology, a subspeciality of lished, first in German, and two years later in internal medicine which is only 30 years young but English, with supplements in 1979 and 1983. This constantly growing in scope and importance. Two volume has become an obligatory reference in more thirds of all drugs are partially, mainly, or exclu than 2500 dialysis units. sively excreted by the kidneys. In the presence of Based on GOnter Seyffart's experience and renal insufficiency, dose adjustments are therefore knowledge in this field, the plans for this book obligatory. In patients on dialysis, drug elimination matured in 1984, a logical step in view of his by this route must also be considered. untiring effort and diligence. In order to deal with As the reader of this book will discover, 20 more than 1200 different drugs and almost 4000 percent of currently used drugs are contraindicated references, 21 contributors were sollicited, while it where there is any degree of renal insufficiency, took six years to complete the work. The major and for at least another 60 percent a dose reduc share of the effort was thus left to the main author tion is required. It is obvious, therefore, that the and editor and he has produced a concise work of detailed knowledge required can never be com impressive clarity.

Chronic pain is one of the most common and debilitating health care conditions, and among the most notoriously challenging to treat. Chronic non-cancer pain presents a significant burden to society in terms of lost workforce productivity and significant healthcare resource utilization and cost. Although controversies persist surrounding the use of opioid analgesics, consensus now exists among medical experts that they can be useful for carefully selected patients. Safe opioid prescribing, however, hinges on effective risk management. All clinicians who treat pain with opioids are obliged to implement therapy according to accepted principles of prescribing and to minimize the risk of misuse, abuse, addiction, and diversion through risk assessment and management strategies. Proper risk assessment allows for a care plan that is structured to optimize therapeutic outcomes while minimizing risks of potential opioid-related morbidities or problematic drug-related behaviors as effectively as possible. Opioid Management Tools and Tips provides health professionals with basic guidance, tools, and resources for identifying patients who may be at risk for opioid misuse and effective managing the risk of abuse, addiction, and diversion. This second edition contains updated guidelines on opioid selection as well as legal and regulatory resources.