Acute Care for Elders (ACE) is a model of care designed to improve functional outcomes and to improve the processes for the care of older patients. This model includes: an environment of care designed to promote improved function for older patients; an interdisciplinary team that works together to identify/address the vulnerabilities of the older patients; nursing care plans for prevention of disability; early planning to help prepare the patient to return home; and a review of medical care to prevent iatrogenic illness. Acute Care for Elders: A Model for Interdisciplinary Care is an essential new resource aimed at assisting providers in developing and sustaining an ACE program. The interdisciplinary approach provides an introduction to the key vulnerabilities of older adults and defines the lessons learned from the Acute Care for Elders model. Expertly written chapters describe critical aspects of ACE: the interdisciplinary approach and the focus on function. The fundamental principles of ACE described in this book will further assist hospital leaders to develop, implement, sustain and disseminate the Acute Care for Elders model of care. Acute Care for Elders: A Model for Interdisciplinary Care is of great value to geriatricians, hospitalists, advance practice nurses, social workers and all others who provide high quality care to older patients.

Primary Liver Cancer: Surveillance, Diagnosis and Treatment focuses on the many therapies rapidly evolving to assist with controlling hepatocellular carcinoma as well as emerging technologies to assist in early diagnosis as well as prevention. All chapters are written by experts in their fields and include the most up to date information for diagnosis, treatment, surveillance, epidemiology, staging, recurrence and prevention. This volume will serve as a useful resource for clinical gastroenterologists, hepatologists, oncologists, pathologists, and physicians who treat patients with chronic liver disease and hepatocellular carcinoma.

There is ample opportunity and scope for gynaecology in prim ary care in general practice. Many conditions and problems can be managed successfully in this context without referral to hos pital and specialist care. The first aim of this book is to deal with common problems that are referred for consultant opinion and specialist management to the average District General Hospital by analysing problems of presentation and diagnosis on a symptom-orientated basis. Selection for primary care management as opposed to hospital referral is then considered, following which the wide range of available treatment is evaluated with particular emphasis on the maximum use of up-to-date but proven regimes. The full use of the expertise of the practitioner is highlighted throughout. The second aim is to encourage the practice of primary care gynaecology and to help those doctors who have a special in terest in the subject, while hopefully stimulating others to de velop a similar one. With this in mind, the approach to the problems is realistic and often dogmatic while opportunities for individual management and for practical procedures are kept to the forefront.

This is a book about primary care clinicians and the "clinical uncertainty" endemic to their work. Even when seemingly straightforward, each patient raises unique questions regarding how best to listen to their complaints, empathize with their suffering, or respond to their silences.

This book is also about "addressing" uncertainty in primary care practice and "engaging" it. Engagement requires knowledge, explicit and tacit, placed in the service of a single patient s problem. It also requires carefully managed communication, facilitating dialogue with the patient and encouraging shared problem-solving.

Most importantly, this book is about "collaborative engagement with case-based uncertainty in the setting of small groups of clinicians. "Sommers and Launer contend that the medical profession s tradition of working independently should be augmented with an explicitly shared, collegial one of jointly creating wisdom through practice-based learning.

An international panel of expert clinicians and educators provides: Perspectives on clinical uncertainty in the medical literatureA taxonomy of clinical uncertainty with patient examplesAnalysis of the educator role to support clinicians in engaginguncertainty A compendium of small group methods for collaborative engagement with clinical scenariosAnalysis of the special challenges ofcollaborative engagement

A mind-opening manifesto, "Clinical Uncertainty in Primary Care" will equip primary care clinicians, educators, public health and behavioral health professionals with resources for infusing practice with meaning through collegial collaboration.

From the Foreword: Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which, and the extent to which it is intrinsic to medicine and they present a cogent case for itsspecial relationship to primary care practice Clinical Uncertainty in Primary Care not only presents amodel of collegialcollaboration and support, it also implicitly legitimatesit. Renee Fox. "

This volume covers the myriad of functional and motility gastrointestinal disorders in a comprehensive manner. The book is divided into seven major sections, with each section beginning with a brief case presentation highlighting the specific disorder to be reviewed. Appropriate criteria is highlighted, followed by a brief review on the epidemiology, etiology, pathophysiology, diagnosis and treatment of each specific disorder. 2-3 key teaching "pearls", test questions and key references are also provided for each chapter. The book is organized so that each chapter can stand on its own and be used as a quick reference source in the clinic. Alternatively, it can be read cover to cover as an authoritative textbook on gastrointestinal functional and motility disorders. Written by international experts in the field of motility disorders, Functional and Motility Disorders of the Gastrointestinal Tract: A Case Study Approach is an invaluable resource for experienced physicians, students, residents, fellows, nurse practitioners and physician assistants.

Often considered the prototypic autoimmune disease, Lupus is characterized by protean manifestations and affects a wide range of organ systems. Despite widespread availability of anti nuclear antibody testing and other technological diagnostic advances, the diagnosis of lupus can be elusive, difficult, and inexact. Treatment of the disease can also be challenging. Advances in immunology and biotechnology have led to a burgeoning world of new therapies in development that offer patients the real possibility of new therapies and physicians and scientists novel insights into the pathogenesis of this complicated immunological disease. Lupus Erythematosus: Clinical Evaluation and Treatment summarizes the clinical aspects of lupus facing the general clinician in the 21st century. In this invaluable, practical book, the reader will find introductory chapters regarding general diagnostic and treatment principles, followed by chapters addressing the lupus-specific organ manifestations. Special topics regarding pregnancy and comorbidities are also presented. Written by highly experienced physicians with special expertise in lupus, Lupus Erythematosus: Clinical Evaluation and Treatment is an indispensable reference for the common and not so common problems affecting patients with lupus.

This book, designed for professionals, introduces a psychobiological model for understanding the paths that lead people to illness and provides recommendations for alterations of maladaptive pathways so that health is regained. Research findings are incorporated to identify causal variables for illness that can be targets for change. Evidence based recommendations for healthy behaviors and therapies are described. Throughout the book, the authors emphasize recognition of turning points on the path to illness that, through informed decision making and implementation of behavioral change, can be re-directed to pathways to health. This book presents case material to illustrate the directions that lead people to illness or to health. The pathways metaphor provides an organizing force, both in addressing variables contributing to illness onset, and in identifying interventions to restore health. This approach will guide the clinician to understanding how people become ill and the types of interventions that are appropriate for stress related illnesses. The clinician will also become better informed about ways to help clients make better decisions, mobilize clients' survival skills, and implement an interactive model of care. The book includes chapters on stress-related illnesses with high prevalence in today's society. For each illness, the genetic-psychobiological etiology is explored with enough detail so that the clinician understands the best method of patient assessment and treatment. One of the strengths of the book is the step-wise system of interventions that are applied to the stress-related illnesses. Beginning with re-establishment of normal daily psychobiological rhythms and continuing to evidence based state of the art interventions, the professional is presented with detailed intervention plans. For example, the section on "Applications to common illnesses: metabolic disorders of behavior: diabetes, hypertension, and hyperlipidemia" considers the confluence of genetics, behavior, and maladaptive mind body interactions to produce the metabolic syndrome. Then the personal and professional assessments are described to establish the baseline for recommending treatment while fully engaging the patient. Finally, multilevel interventions are formulated for these disorders. The plan begins with clinician guided self care recommendations to re-establish the normal rhythm of appetite and satiety. The next level of interventions consists of skill building techniques, such as relaxation and imagery. Lastly, psychotherapy and advanced applied psychophysiological interventions are detailed. Case examples are used throughout to illustrate the pathways to illness, the turning points, and the pathways to health. From the patients' viewpoints, the pathways metaphor is a motivator. The patient is guided to understand the paths that led to illness. Subsequently, the patient becomes empowered by the pathways framework to begin to make choices that lead to health.

Whereas during the past decade endoscopy has become established as the leading means of diagnosis and management of diseases affecting the esophagus, starnach and large bowel, radiology has retained its pre-eminence for the clinical study and evaluation of the small bowel. This book provides unique coverage of all current radiological techniques used to study the small bowel, including not only barium studies and angiography but also cross-sectional methods such as uhrasound and computer tomography as well as nuclear medicine. Ernerging techniques such as magnetic resonance imaging are given close consideration, and interventional procedures are dealt with fully. Following an introduction on anatomy, physiology, and pathology pertinent to radiol ogy, the book describes in great detail common and less common congenital and development anomalies, trauma, infectious and infl.ammatory conditions, and tumors. The radiological accounts are illustrated by unique color photographs of pathological specimens. It is important for all professionals involved in the management of patients with small-bowel disease tobe critically informed about the specific advantages as well as the limitations of the various modern imaging techniques now employed for the in vivo morphological evaluation of the small bowel. This comprehensive book provides a timely update of our knowledge in this field and is a welcome addition to our series "Medical Radiology;' which aims to provide exhaustive coverage of modern diagnostic radiology. It will be of great interest for general and abdominal radiologists, gastroen terologists, and abdominal surgeons.

This book is about a new surgical procedure, surgical hysteroscopy, for out-patients. It is both a diagnostic approach and a surgical procedure. As a simple and non-aggresive technique, it is a "patient-friendly" procedure with a little surgical trauma as it avoids hysterectomy or laparotomy procedures thus preserving the genital tract. It is the leading procedure in the treatment of uterine bleeding. It has also proved to be an essential investigation technique of in the assessment of infertility. This book is the result of surgical practice and teaching experience in the field of hysteroscopic procedures.

A riveting expose of child abuse in America and how the newest breed of pediatricians determines what happened, why, and at whose hands. Although more than one million children are abused each year in the United States, child abuse often remains a secret to family members, professionals, and politicians who neither see nor understand it. Child abuse pediatricians are the newest breed of pediatricians, specialized in exposing abuse. With detective-like acumen, child abuse pediatricians deduce through careful medical analysis who has abused and who has been abused. Describing the most compelling cases among the thousands that they have evaluated, author Lawrence Ricci reveals the trauma, pain, disability, and sometimes death that abused children experience at the hands of trusted adults. This gripping look at the dark side of American families is about good parents and poor ones, perpetrators and victims, and collateral victims such as innocent family members. It is also about the professionals who have made it their career to expose child abuse and to treat children who have suffered from it. The conclusion calls for systematic changes that could help to stem the tide of child abuse. Explains how signs of abuse can be missed by professionals, community members, and even family members Includes interviews and insights from more than two dozen child abuse pediatricians Addresses physical, sexual, and emotional abuse, including abuse by neglect and abuse due to Munchausen syndrome by proxy Details how cases can go wrong in court rooms when confuscation by defense attorneys overpowers evidence brought to court by child abuse pediatricians Offers ideas for stemming the tide of child abuse

Nocturia: Causes, Consequences and Clinical Approaches is the first volume exclusively on the topic of nocturia and is designed to be a comprehensive treatise on the subject. The volume is organized into 11 chapters first introducing and defining nocturia and its impact to patients and society, followed by chapters dealing with predictors and risk factors; relationship to sleep disorders; overactive bladder; and water homeostasis. Therapeutic areas addressing nocturia are covered in specific chapters and include pharmacotherapy affecting the bladder, prostate and kidneys as well as behavioral therapy and surgical intervention. Separate chapters are devoted to alternative therapies as well as the impact of nocturia in the elderly. The volume closes with a chapter presenting avenues for future investigation into the etiology and management of nocturia. Clinical case scenarios inclusive of figures and tables illuminate the evaluation and management of patients with nocturia. Nocturia: Causes, Consequences and Clinical Approaches will give physicians and related healthcare providers the background to understand the conditions causing nocturia, how nocturia affects society and the basis for its rational treatment. It will be used as a state of the art reference by urologists, urogynecologists, internists, nephrologists, pulmonologists, endocrinologists and sleep medicine specialists.

For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance will be lower than that compared to monotherapy, which initially requires higher doses to be administered to be effective. Consequently, there have been increasing calls of the necessity for a much more combined approach in the treatment of hypertension. Adding to this, Combination Therapy in Hypertension will cover current control rates of blood pressure worldwide, the benefits of monotherapy and combination therapy, examine the effectiveness, risk of adverse effects, compliance, and cost of the available therapies and will also include information on relevant outcome studies.

Healthcare Changes Reach Main Street: A Call to Action for Physicians provides guidance, examples, and information on processes and time lines for physicians based on the implementation of The Affordable Care Act (ACA) that was established in 2010. This volume focuses on how geriatricians and other healthcare professionals can be engaged in responding to the roll-out of the ACA in their communities, and through this engagement assume leadership roles in local hospitals, healthcare organizations, and medical societies to advance quality improvement and new models of care for older adults. In-depth chapters provide an update on quality improvement efforts at the state level, as well as changes in Medicaid financing and the significant impact this will have for older adults, particularly dual-eligibles. Many elements of the ACA are yet to be rolled out and many healthcare decisions are yet to be made. Healthcare Changes Reach Main Street: A Call to Action for Physicians will guide healthcare decision makers and help them to play a leadership role in advancing quality care for older adults in our changing healthcare environment.

Written for virtually every professional and leader in the health care field, as well as students who are preparing for careers in health services delivery, this book presents a framework for developing a patient safety program, shows how best to examine events that do occur, and reveals how to ensure that appropriate corrective and preventative actions are reviewed for effectiveness. The book covers a comprehensive selection of topics including * The link between patient safety and legal and regulatory compliance * The role of accreditation and standard-setting organizations in patient safety * Failure modes and effect analysis * Voluntary and regulatory oversight of medical error * Evidence-based outcomes and standards of care * Creation and preservation of reports, data, and device evidence in medical error situations * Claims management when dealing with patient safety events * Full disclosure * Patient safety in human research * Managing confidentiality in the face of litigation * Managing patient safety compliance through accountability-based credentialing for health care professionals * Planning for the future

Gastroparesis is an increasingly recognized disorder. Treatment can be difficult due to the several mechanisms for symptom production. Gastroparesis: Pathophysiology, Presentation and Treatment serves as a concise reference on this disorder that allows clinicians to quickly access and evaluate the necessary information for treating and managing patients with gastroparesis. Each chapter is written byexperts in their respective area. The volume will enable the reader to better understand all aspects of this disorder. The book presents current concepts in a variety of areas opening with the epidemiology, clinical presentation and pathophysiology of gastroparesis. The natural history of patients is explored as well as evaluation of patients with suspected gastroparesis. This section includes chapters on Wireless Capsule Motility, Electrogastrography and Antroduodenal Manometry. This important resource concludes with a full section on treatment including dietary, prokinetic, antiemetic, sensory, electric stimulation, and surgical methods. New developments include the use of gastric electric stimulation for treatment, the use of SmartPill for diagnosis, and a number of new agents in development for this disorder. Gastroparesis: Pathophysiology, Presentation and Treatment is the ideal reference for gastroenterologists, and also for surgeons, endocrinologists, primary care physicians and nutritionists looking to keep pace with the latest information treatment options for their patients. "

Cardiovascular disease is a leading cause of death throughout the world. Chronic negative emotions such as depression and anxiety place cardiac patients at greater risk for death and recurrence of cardiovascular disease. In 2008 the editor published a book related to this topic, titled Psychotherapy with Cardiac Patients: Behavioral Cardiology in Practice (American Psychological Association). Aside from that book, there are very few resources specifically written for clinicians who treat psychologically distressed cardiac patients. Unlike other medical specialty areas such as oncology, the field of cardiology has been slow to integrate behavioral treatments into the delivery of service. Perhaps because the field has been largely defined and dominated by researchers, mental health clinicians are only starting to recognize behavioral cardiology as a viable arena in which to practice. There is a large void in the practitioner literature on behavioral cardiology. In a review of Psychotherapy with Cardiac Patients, Paul Efthim, Ph.D. wrote, "Her new book goes well beyond previous works by giving specific and detailed guidance about how to tailor psychological interventions with this variegated population." He added, "It would benefit from even more details about treatment approaches." This proposed volume goes beyond the editor's previous volume by providing in-depth descriptions of behavioral treatments for distressed cardiac patients written by eminent leaders in behavioral cardiology. This book describes a wide range of behavioral treatments for the common psychologically based problems encountered by clinicians who treat cardiac patients. The book is organized as follows: Part I focuses on the most psychologically challenging and common presentations of cardiac diagnosis; coronary artery disease, arrhythmia, and heart failure. This section also includes a chapter on heart transplantation, which is a treatment, not a diagnosis, but a treatment that incurs profound psychological impact for the individual. In Part II, behavioral interventions for the general cardiac population are described. Mainstream therapies such as stress management, cognitive-behavioral therapy, and medical family therapy are described, along with approaches that have less empirical support but considerable practical significance such as personality-guided therapy and interventions aimed at altering type D personality traits. The literature in behavioral cardiology has a rich history of investigating maladaptive personality traits and thus it is important to include behavioral approaches that target personality in this volume. Part III focuses on common behavioral problems encountered by clinicians who work with this patient population. Most patients who seek psychological help do so because they perceive themselves to be stressed due to their job or overextended in all areas of their life. Other people with heart disease present with sleep problems and/or an inability to motivate themselves to exercise or quit smoking. There are many practical behavioral approaches that can be helpful for patients with these difficulties and these are detailed in this section of the book. The conclusion of the book focuses on how to integrate the behavioral treatments described in the preceding chapters into a comprehensive treatment model.

Bipolar disorder is one of the most common and disabling conditions affecting humankind. It is a leading cause of disability and mortality worldwide, affecting millions of people. The illness is complex and dynamic, so that many individuals are misdiagnosed for years and clinicians struggle with identifying the most appropriate and successful treatment. Because it is complex and common, people suffering from bipolar disorder seek help from clinicians of all types - from psychiatrists, family doctors, gynecologists, and internists to psychologists, social workers and other therapists. For clinicians without significant experience with bipolar disorder, how to manage the condition can be mystifying. Even experienced psychiatrists will frequently find themselves uncertain of the best approach to a given individual with bipolar illness. This pocket-sized guide was specifically written with this diverse group of clinicians in mind. It provides a concise, practical and current overview of bipolar disorder, including making a correct diagnosis, identifying important medical and psychiatric comorbidities, and describing our current understanding of the epidemiology, genetics and neurobiology of the condition. In addition to these topics to provide context, the majority of the book is focused on a programmatic approach toward managing bipolar disorder, including discussions of specific subpopulations, such as children or women who are pregnant. The book may also be of interest for people with bipolar disorder and their families, to help guide treatment seeking and provide education about this sometimes mystifying condition. The author is an internationally recognized and trusted expert in the study and treatment of bipolar disorder, annually named a Best Doctor (R) and recognized by US News and World Report (R) as a Top 1% Psychiatrist, whose own extensive clinical experience working with people with bipolar disorder guides this book.

In the last decade there has been no major clinical mono- graph on this increasingly common and difficult malignancy which is a killer of young people. The gap in the literature is now filled by this authoritative volumewhich will be essential reading for any body involved in the study or management of melanoma.

Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.

This book is based on the proceedings of the fourth Medical Microcomputer Workshop held at the Middlesex Hospital Medical School on 3-5 September 1986. The workshop was attended by clinicians and computer scientists with an interest in applying computer technology to current medical practice. The problems ranged from audit and patient management through to the more complex applications of data analysis obtained from current diagnos tic techniques. The choice of microcomputers has never been greater with low cost making them readily available. A single microcomputer has limita tions in clinical practice and the use of networks for multi-user tasks has expanded its capability but increased the complexity both in terms of hardware and the software needed to run it. Although comprehensive commercial packages are available, none of these are entirely suitable for medical applications without modification. Many of the chapters presented in this book describe the problems encountered and the solutions achieved by configuring and modifying applications software.

This volume provides a history of Eosinophilic Esophagitis (EoE), a basic understanding of the physiology of the eosinophil, and a current understanding of the pathophysiology and genetics of EoE. The emphasis is on clinical applications including presenting symptoms, diagnosis and treatment options for patients with EoE. Written by both pediatric and adult experts in the fields of gastroenterology, allergy and pathology, this volume includes the most up to date information. Providing practical information useful in the treatment of patients, this book will be of great value to gastroenterologists, allergists, pathologists, medical residents, fellows, internists, and general practitioners who treat patients with eosinophilic esophagitis.

Gastric secretions contain hydrogen ions at a concentration that is more than one million times higher than their intracellular concentration. This phenomenal gradient as well as the demonstrated ability of gastric juice to digest tissues has motivated clinicians and investigators alike to emphasize acid secretion and acid ablation in studying the pathogenesis and therapy of peptic ulcer disease. Conse quently, over the past 150 years, we have made considerable progress in under standing the mechanisms and regulation of acid secretion by the stomach. Not surprisingly, therapy for both peptic disease and mucosal injury has also been predominantly directed at either neutralizing acid or suppressing its production. During the past 10 years, attention has been focused on factors other than acid in the genesis and therapy of ulcer disease. Work done worldwide demon strated that acid hypersecretion is not a common event in peptic ulcer disease. Therefore, we began realizing that factors other than acid secretion may be important in the genesis of ulcer disease or in gastroduodenal mucosal damage. In addition, new physiological information has established that the gas troduodenal mucosa is normally protected by a complex series of events includ ing mucus and bicarbonate secretion, cell renewal, surface mucosal restitution, and preservation of the microvasculature and mucosal proliferative zone.

In the recently updated Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic concept of hypochondriasis was eliminated and replaced by somatic symptom disorder and illness anxiety disorder. Hypochondriasis and Health Anxiety: A Guide for Clinicians, edited by Vladan Starcevic and Russell Noyes and written by prominent clinicians and researchers in the field, addresses current issues in recognizing, understanding, and treating hypochondriasis. Using a pragmatic approach, it offers a wealth of clinically useful information. The book also provides a critical review of the underlying conceptual and treatment issues, addressing varying perspectives and synthesizing the current research. Specific topics the text covers include: clinical manifestations, diagnostic and conceptual issues, classification, relationships with other disorders, assessment, epidemiology, economic aspects, course, outcome and treatment. Additionally, the book discusses patient-physician relationship in the context of hypochondriasis and health anxiety and presents cognitive, behavioral, interpersonal and psychodynamic models and treatments. The authors also address the neurobiological underpinnings of hypochondriasis and health anxiety and pharmacological treatment approaches. Based on the extensive clinical experience of its authors, there are numerous case illustrations and practical examples of how to assess, understand and manage individuals presenting with disease preoccupations, health anxiety and/or beliefs that they are seriously ill. It approaches its subject from various perspectives and is a work of integration and critical thinking about an area often shrouded in controversy.

One of the major advances in the understanding of the mechanism of action of hormones, neurotransmitters and drugs had arisen from the hypothesis that the physiological or pharmacological responses are trig gered by their interaction with specific cell compo nents, termed receptors. However, the presence of receptors has been inferred from indirect data, and only recently has it been possible to study the kinetics of the interaction between drug and receptors directly, through the so called "binding technique. " This NATO-ASI on "Principles and Methods in Receptor Binding" was devoted mainly to the following aspects of the study of receptors: the principles underlying the use of the binding technique; the mathematical models necessary to interpret binding data; the application of binding methods to specific receptors; and, finally, a few selected examples of coupling between receptors and physiological re sponses. In the chapters of this book, special interest is devoted to the analysis of the simplest models for the interaction of receptors with their ligands (either hormones or neurotransmitters or drugs). The graphical techniques used to analyze the data from binding exper iments are extensively discussed, together with the statistics that have to be used in binding analysis. Moreover, the basic concepts to analyze binding data using a personal computer are presented. v vi PREFACE The factors which should be considered when setting up a binding assay (such as choice of ligand and incubation conditions, preparation of tissue, termina tion of incubation) are discussed."

Throughout the world, scientists and the general with environmental illness. Part II presents an over public are concerned about the adverse effects of view of chemical and physical agents commonly toxic agents found in contaminated air, water, food, found in contaminated air, water, food, and soil. and soil. In the past, attention has focused on haz The problem of hazardous wastes is also discussed. ards originating in the workplace. As a consequence, Part III characterizes the body's defense against occupational medicine has become a well-recognized such exposure. Defenses at the portals of entry are and established clinical discipline. Much less atten discussed, with emphasis placed on the role of tion has been paid to nonoccupational hazards. There nutrition. Detoxication and immunologic defense is a growing awareness, however, of the dangers of mechanisms are described. Part IV indicates the exposure to toxic chemical and physical agents in importance of and provides instruction on the the homes, community, and general environment, method of including occupational and environmen especially for the fetus, the infant, the very young, tal factors in the routine medical history. The role of the elderly, and the chronically ill, those most sus enhanced susceptibility as a factor in an individual's ceptible. Environmental medicine, fOCUSing on the response to toxic exposure is discussed."