This work, Essential Endocrinology: A Primer for Nonspecialists, is written with dual purposes in mind: first, to provide a framework of basic endocrinology and diabetology to the medical student, and second, to provide a quick, con cise, and handy "guide" to the junior residents in their early years of training who wish to obtain a working knowledge about endocrine disorders that affect their patients. One of the outstanding advantages of being a teacher of en docrinology to students and junior residents is that it bestows a perspective from a unique vantage point. Books written for the junior members of our profession have suffered from extremes of caliber, ranging from excellence beyond their comprehension to insufferable mediocrity. Textbooks in en docrinology that are simple enough to cover the principles of that speciality and yet comprehensive enough without treading into controversial quicksand are few and far between. This book is aimed at filling that gap and is written with no other criterion than simplifying a complex subject matter. From this touchstone, the work has never really departed. A decade of experience as a teacher and physician in the field of endo crinologyhas impressed on me that the process of "simplification" rests on four basic principles: an understanding of endocrine concepts, the application of these concepts to the understanding of diseases, the transference of knowl edge to clinical situations, and the integration of the patient with the labo ratory, the ultimate testing ground where clinical diagnoses stand or fall."

Why another series on infectious disease? The question is a fair one in view of the proliferation of monographs, texts, and periodicals on the vast subject of infectious disease. The goal of this series is to provide an additional service to the clinician in the form of clinical information not usually assembled in one convenient volume. One type of monograph presented in this series will cover a specific infection, detailing microbiologic, research and clinical aspects. It is hoped that such a compilation will be helpful in both its thoroughness and breadth to the clinician interested in this particular problem. The other type of monograph that this series will provide will discuss a clinical presentation that comprises many possible specific etiologies. Volumes in the series will be multiauthored, giving us the opportunity to invite authorities in each specific area to contribute their expertise and experience. Regular revisions are planned so that each volume will remain as current as it is thorough. We hope that our goals are met and that the present series of mono graphs establishes its own identifiable and valuable niche in the growing compendium of resource material available to the clinician. Preface to the Second Edition Since the first edition of Infectious Mononucleosis was published, we have seen exciting advances in our understanding of this disease."

This book describes key knowledge concepts, skills and up-to-date algorithms pertaining to common emergencies that can take place in a pediatric office, including: seizures, anaphylaxis and shock, and diabetic ketoacidosis. The authors supported by peer review from top specialists in Pediatric Emergency Medicine at the Baylor College of Medicine offer the first comprehensive educational resource on pediatric office emergency preparedness devoted exclusively to the practicing primary care health care provider and his/her team. During emergencies, providers and their staff are called on to work efficiently as a "code-team" which is a source of considerable apprehension for many primary care pediatricians. This unique reference guide contains a wealth of information and resources in a compact and practical form. It presents the most important knowledge, skills, office resources and team interactions required by practitioners to successfully treat pediatric emergencies in the office.

In their second year in medical school, students begin to learn about the differences between "disease" and "illness." In their studies of pathology they learn to understand disease as pertubations of molecular biological events. And we clinicians can show disease to them by our scans, lay it out even on our genetic scrolls, and sometimes even point out the errant nucleotide. Disease satisfies them and us; at Yale, lectures on the gastrointestinal tract run from achalasia to proctitis. There is, alas, little mention of functional bowel disease or of the irritable or spastic colon, for that is not easy to show on hard copy. Functional bowel disease represents "illness," the response of the person to distress, to food, to the environment, and to the existential problems of living. In real life such matters are most important. Richard Cabot first found out at the Massachusetts General Hospital almost a century ago that 50% of the patients attending the outpatient clinic had "functional" complaints. The figure had grown to over 80% when the very same question was reexamined 60 years later.

DDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analysis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was concerned more with diagnosis in the widest sense and this series deals more definitively with general care and specific treatment of symptoms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and assess ment and investigations, but the emphasis is on what to do best for the patient. Family medical practitioners have particular difficulties and advantages in their work. Because they often work in professional isolation in the com munity and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and rela tively untried methods compared with those that are 'old' and well proven. Their advantages are that because of long-term continuous care for their patients they have come to know them and their families well and are able to become familiar with the more common and less serious diseases of their communities."

In the last two years, a wealth of new information has accumulated regarding both clinical and research aspects of health care for the elderly. Although many controversial issues have been resolved, many still remain. Volume 2 of Contemporary Geriatric Medicine is once again dedicated to the clinician who cares for the elderly on a continuing basis. Although, for the most part, general topics first introduced in Volume 1 have been retained, all infor mation in this volume is new and represents the current state of the art. In addi tion, several new topics-including falls, interpretation of laboratory data, and oral health care-have been introduced to enhance this volume's usefulness to the busy clinician. Through these easy-to-read essays, we attempt once again to keep the non geriatrician abreast of the current state of the art regarding the special needs and problems of the elderly. Each chapter is not meant to be an exhaustive review of all topics in the field, but rather to focus on issues receiving a great deal of atten tion. Our goal is to create an exciting approach to contemporary issues in gerIatric medicine."

The contributions to this volume were presented at a Symposium entitled "Current Topics in Muscle and Nonmuscle Motility" held in Dallas 19-21 November 1980 under the auspices of the A. Webb Roberts Center for Con tinuing Education, Baylor University Medical Center Dallas, and the Univer sity of Texas Health Science Center at Dallas. This very useful opportunity for a group of active investigators in motility to meet and discuss their latest findings was made possible in part by the income from an endowment fund established by a generous gift from Dr. Albert P. D'Errico in the Baylor University Medical Center. Dr. D'Errico was the first formally-trained neurosurgeon to practice in the Dallas area, the first Chief of Neurological Surgery, and a member of the Medical Board of the Baylor University Medi cal Center Dallas (1947 -1964). The income from this fund is used to promote the dissemination of up-to-date information in the Neurosciences, to provide intellectual stimulation, to add to the fund of knowledge, and improve the skills of neurosurgeons, neurologists, internists, and others in specialized fields of medicine. We are all indebted for this generous gift that made this enriching educational experience possible. We are also grateful for support the Symposium received from Electron Microscopy Sciences, Forma Scien tific, J. E. O. L. USA, Inc. , Ladd Research Industries, M. J. O. Diatome Co. , Or ganon Co. , Upjohn Co. , G. D. Searle & Co. , and Smith, Kline and French. Robert M.

During the past five years there has been a reawakening of interest in the psychotherapy of patients with medical disorders characterized as psychosomatic. For three decades, psychoanalysis and psychoanalytic psychotherapy were used extensively to treat and study psychosomatic disorders. Early in the 1960s, interest in this approach to these conditions faded, and the .Psychosomatic Service. in most hospitals became the .Consultation Liaison Service. (Lipowski, 1967). The recent focus of biofeedback on psychosomatic conditions provides a new technique with which the physician or psychiatrist may treat these patients (Rickles, 1981). In addition, the successful application of biofeedback training to a variety of complaints such as those presented in this volume has heralded the addition of biofeedback to the treatment modalities used for medical complaints. Frequently, psychological factors can still be seen; for example, when biofeedback treatment may require lifestyle changes on the part of the patient, the exploration of secondary gains or resistances before the disorder can be success fully treated, and the establishment of rapport and empathy which is so important for truly effective biofeedback training. Aside from certain psychological dimensions that are always present in biofeed back training, in this case biofeedback is being used in a primarily medical setting for primarily medical complaints."

Few diagnostic methods in Cardiology have heralded such revolutionary developments as the introduction of coronary arteriography. When, in the early 1960's, Dr. F. Mason Sones demonstrated that visualization of the coronary anatomy in living humans was not only feasible but sufficiently safe and reliable to be used as a clinical tool in the evaluation of patients with known or suspected ischemic heart disease, the thus far somewhat neglected area of coronary circulation became the focus of interest. Naturally, for a considerable period of time a great deal of emphasis was placed upon coronary anatomy. Simple relations between narrowing lesions, impediment to flow, and prognosis were assumed to exist. Spectacular results of surgical coronary revascularization seemed to confirm this concept. Gradually it has become evident that the pathophysiology of coronary artery disease is considerably more complex. Diagnostic methods were introduced to assess and quantify exercise-induced myocardial ischemia. At first, these tests were used mainly to achieve a more discriminative selection of candidates for coronary arteriography and the coronary arteriogram remained the gold standard. Currently, these techniques have evolved to the point where they provide valuable functional and metabolic information. They have become powerful independent tools in clinical investigations and evaluation of individual patients.

The recent interest in the pharmacology of the skin and the treatment of its diseases has come about for two reasons. The first is a realisation that many aspects of pharmacology can be studied as easily in human skin as in animal models, where they may be more relevant to human physiology and disease. Examples of this are the action of various vasoactive agents and the isolation of mediators of inflammation after UV irradiation and antigen-induced dermatitis. The second reason is the fortuitous realisation that a pharmacological approach to the treatment of skin disease need not always await the full elucidation of aetiology and mechanism. For example, whilst the argument continued un resolved as to whether the pilo-sebaceous infection which constitutes acne was due to a blocked duct or to a simple increase in sebum production, 13-cis retinoic acid, was found quite by chance totally to ablate the disease; again, whilst cyclosporin, fresh from its triumphs in organ transplantation, has been found able to suppress the rash of psoriasis, it has resuscitated the debate on aetiology. We are therefore entering a new era in which the pharmacology and clinical pharmacology of skin are being studied as a fascinating new way of exploring questions of human physiology and pharmacology as well as for the development and study of new drugs, use of which will improve disease control and at the same time help to define pathological mechanisms.

Starting in 1986, the European School of Oncology has expanded its activities in postgraduate teaching, which consisted mainly of traditional disease-orientated courses, by promoting new educational initiatives. One of these is the cloister seminars, short meetings intended for highly qualified oncologists and dealing with specific, controversial aspects of clinical practice and research. Another is the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on developments and treatment in specific fields of oncology. This series of ESO Monographs was designed with the specific purpose of disseminating the results of the most interesting of the seminars and study groups, and providing concise and updated reviews of the subjects discussed. It wa& decided to keep the layout very simple in order to keep costs to a minimum and make the monographs available in the shortest possible time, thus overcoming a common problem in medical literature: that of the material being outdated even before publication.

The Sclera is the definitive text on the diagnosis and treatment of scleral diseases, with in-depth chapters on non-infectious scleritis, infectious sclertitis, non-inflammatory diseases of the sclera, and systemic implications of scleral disease. Basic physiology, anatomy, and biochemistry are addressed as well. Written for the ophthalmologist, the revised and updated new edition of The Sclera contains the most current information available on newer characterizations of the composition of the sclera, immune derangements of it, and success in medical and surgical treatment of the inflammatory diseases of the sclera.

As 'seasoned campaigners' we offer our readers more than 60 joint practice years of commonsense experience on children and their prob lems. Child care is a large and fascinating part of general family practice. More than any other discipline it is a mix of understanding the wide range of normal and abnormal development, of skilful diagnosis and treatment of treatable conditions, of long-term care for handicapped children, and of organizing and carrying out prevention. F or all this and more the physician has to rely on sound knowledge and understanding of the child, parents, family, social and community conditions, available services and the likely natural history of the condition - and to dispense all this with humanity, sense and sensi bility. We have divided the book logically into 6 sections: (I) Factual background. (2) Universal problems of behaviour and development. (3) Common clinical disorders, so frequent and yet often so dif ficult to manage. (4) Social, family and community factors that create and influ ence many problems of childhood. (5) How to use available services and resources with discrimina tion and sensitivity. (6) The importance of understanding and managing the whole child. We have no single group of readers in mind. We hope that our views will be appreciated, for example, by parents, nurses, health visitors, general practitioners, community physicians and paedia tricians - in fact all who care for children."

The understanding of pain has undergone extraordinary development over the last 25 years. Half of all medical visits are initiated because of pain. The need for all clinicians and trainees to have a foundational knowledge of pain has become more critically important than ever. Not surprisingly, most books on pain medicine are almost all written by "pain management doctors," physicians who've trained in "pain medicine" and devote their lives to treating pain. However, the burden of pain extends to all doctors, not just those who treat it every day. Managing Pain: Essentials of Diagnosis and Treatment offers a fundamental guide on the diagnosis and therapy of frequently encountered pain conditions for non-pain physicians and clinicians. Written using easily-accessible language, this book first reviews the basics of opioids and other therapies, including psychotherapy and complementary modalities. The second part of the book presents clinically-relevant cases chosen to reflect those conditions most frequently encountered by primary care providers. Edited by world-renowned experts in pain medicine, with many chapters written by non-pain physicians who are experts in their respective specialties, Managing Pain: Essentials of Diagnosis and Treatment is a useful guide for the non-pain-trained healthcare provider who is on the frontlines treating chronic pain.

Having the privilege of editing the English language version of this book I have found the detailed thought, explanation and step-by-step instruction that this book provides most refreshing and stimulating. There are few publications indeed that provide a completely reliable companion to bedside and out-patient instruction for the medical student - and even fewer that enhance the established physician's techniques. Medical skills in the art and science of patient examination are normally learnt experimentally - time, personal instruction and constant repetition are necessary for them to be acquired. Even then it must be admitted by many that there are some techniques that are never fully understood, properly learnt or correctly concluded - and these errors are liable to a lifetime's repetition. This volume with its excellent photographs and illustrations takes the reader clearly and incontrovertibly step-by-step through every detail of all the procedures necessary for the standard forms of examination of a patient. It is a companion for every student and doctor who wishes to learn fully and completely these necessary skills and to improve the ones they already have. Dr Alexander D. G. Gunn, Director, University Health Service, Reading, Berks, UK 1982 Preface to the Dutch edition The idea of writing this book coincided almost them a superficial acquaintance with five or six exactly with the establishment of a 'skills 'fashions' and proficiency in none of them.

This book is addressed to all professionals concerned with the health care of children. It is, first and foremost, a teaching tool. It can be used for class discussion or case conferences with medical students or residents, nurses, and other staff in pediatrics or family medicine. It can also be used for self-teaching or continuing education by those already in practice. No one who reads this book is a beginner at moral reasoning. However, many may well be beginners at discussions that focus sharply on the ethical issues in medicine and introduce philosophical analysis. The goal is to clarify, conceptualize, and guide reasoning in order to come to conclusions that can be defended with good reasons. Case studies provide the most successful method of teaching medical ethics, posing the issues as they arise in real-life situations. The cases in this book are brief and rather skeletal in nature. This is partly to deflect the natural curiosity of those who are driven to seek more and more medical details, hoping thus to resolve the ethical issues or avoid them entirely. It also allows the reader to concentrate on one ethical issue at a time. In real life, of course, the hard questions arise often several at a time, embedded in a rich and complex medical and psychosocial background. As one must learn to walk before one can run, so it is wise to practice on cases where the key issue is highlighted.

This volume provides in a conveniently accessible package a comprehensive collection of accurate and timely information on the management of patients with diarrhea, both in pediatric age and in the adult. As medical knowledge has recently expanded in this area, this volume is full of new practical, clinically useful material for the busy clinician. Illustrations are emphasized to permit rapid acquisition of practical information that is not readily available in the major texts. Each chapter is concise, concentrating on "clinical pearls," and new advances in diagnostic and therapeutic technology. Each chapter discusses the relative costs of diagnostic and therapeutic options to permit financial considerations to be taken into account in the decision making process. Additional unique features include, summaries of key points, recommendations, and indications for requesting GI subspecialty consultation. Providing a comprehensive but practical overview of the issues surrounding the diarrheal diseases, this volume will prove of great value and utility to gastroenterologists, surgeons, internists, primary care physicians.

Traditions are dangerous; doubly so in science. Traditions are unchanging; science is about change. This was the 4th International Colloquium on Carbohydrate Metabolism in Pregnancy and the Newborn to be held in Aberdeen, and by now the form is set. How much its content has changed is a matter of nice judgement and not under the control of the organizers. It is not within their power to bring news of revolution, if there has been no revolution. Certainly many of the speakers had kent faces from previous Aberdeen meetings, but so they would be at any meeting on diabetes anywhere in the world. The written proceedings of scientific conferences have purposes other than to record changes: sometimes they need to state a consensus. The 3rd Colloquium came to an agreement about the importance of prepregnancy recognition and control of abnormalities of carbohydrate metabolism. The 4th set out to examine what results it had achieved. Much of this book is taken up with follow-up studies of the applications of similar regimes in different parts of the world. Since the first Aberdeen meeting in 1973, progress in the manage ment of diabetic pregnancy has been slow and steady, but the change in the city and the society where the meetings took place has been fast.

The literature of medicine continues to expand at a remarkable pace. The number of papers and monographs published has increased dramatically in the past five years. Nowhere has this increase been as dramatic as in the field of acute and chronic hepatitis. Why then should there be still another book? Despite the sheer volume of words published, it is still difficult to find in anyone volume a compilation of all of the most significant work. Most mono graphs have considered either chronic or acute hepatitis, not both. Few works have addressed both the clinician and the basic scientist. This book addresses both of these audiences and considers both of these diseases. It was designed to provide an authoritative but concise assessment of our changing concepts of acute and chronic hepatitis. It covers what is currently known and, based on the most convincing research, believed about these diseases. To fulfill this ambitious goal, only authors with international reputations in their fields of expertise were invited to contribute. In the evolution of our current thoughts on the pathogenesis and manage ment of acute and chronic hepatitis, our ideas have changed several times. This book presents the facts as they are known today and, in areas where all the facts are not established, presents the well-founded opinions of those considered to be authorities. The authors present established and usually confirmed data and do not deal extensively with areas of speculation or unconfirmed material."

The question facing anyone contemplating a book on low back pain is: Why write another book? It is certainly true that there are many books on this topic addressing a wide variety of audiences. Some books are all inclusive and scholarly in nature, others are personal descriptions of diagnostic and treat ment philosophies. This book is a combination of these two extremes. It represents our views on the low back problem, supported by scientific data. Most aspects on back pain presented in this book can be found in other texts. The organization of the material is unique, however. Our approach is to start by listening to and looking at the patient. It becomes apparent, then, that patients can be classified into one of the syn dromes described in chapters 4 through 13. We believe that this syndrome classification, which is quite simple to make clinically, will allow you to diagnose and treat your patients more effectively. To set the stage for the syndrome chapters the first three chapters of the book are generic to the remaining chapters. They reviewe the epidemiology, pathology, biomechan ics, etiologic theory, diagnostic methods, and treatment modalities applicable to the low back syndromes. They should be read before the syndrome chap ters. At the end of the book you will find four chapters that are specific to disease entities."

This volume contains papers presented at the First International Symposium on Mechanism and Treatment in Essential Hyperten sion, which was held on October 23 and 24, 1985 in Nagoya, Japan. The meeting was an official satellite symposium to the meeting of the Fifth International Symposium on Rats with Spon taneous Hypertension and Related Studies in Kyoto, October 20-22, 1985. The Nagoya symposium was made possible by offi cial grants from the city of Nagoya and Aichi Prefecture and the generous financial support of many companies. The aim of the symposium was to provide a forum for presen tation and discussion of recent advances in the area of essential hypertension, particularly with regard to calcium mechanisms in vasoconstriction and vasodilation in arterial vessels and the func tion of arterial smooth muscle. The role of calcium ions in the function of arterial smooth muscle has attracted a great deal of attention in the last two decades. The mode of action of calcium ions was revealed at the molecular level. The hypertension model of the spontaneously hypertensive rat has been widely utilized for research into the fundamental mechanisms of genetic hyperten sion, stroke, and cardiovascular disease as well as into therapeutic measures. New tools of calcium agonists and antagonists have become available to research into the mechanism, prevention, and treatment of essential hypertension at the molecular, subcellular, and cellular levels of arterial smooth muscle, at the organ level of arterial vessels, as well as at the total systemic level."

Designed to assist the physician in the application of computers in private medical practice, this comprehensive guide outlines where, why, and how this valuable tool can best be used. Integrating the mechanisms of computerization with the implications for health care, the authors draw on personal research and experience to describe models used effectively in the medical setting. Chapters cover administrative procedures, applications for marketing and quality assurance, and the link to an office-hospital application. Aslo included is information on software, hardware, database management, expert systems, artificial intelligence, and indications of future trends. This work will serve as an essential reference in meeting the ever-increasing medical information needs of the private practitioner.

The gratifYing response to the first edition of Tuberculosis has prompted this revision. There are many important changes incorporated into this edition, including the dramatic effect of AIDS on the incidence and clinical mani festations of mycobacterial infection, new developments in epidemiology and bacteriology, and thoroughly updated therapeutic recommendations and principles of prophylaxis. The chapters that deal with clinical manifestations of tuberculosis have also been updated and include important and clinically applicable information on manifestations of tuberculosis in both the normal and immunocomprom ised host. As with the first edition, it is hoped that this text will continue to represent a definitive resource for both the basic scientist and the clinician who deal with the prevention and treatment of mycobacterial infection. II Preface to the First Edition We have just witnessed the lOOth anniversary of Koch's discovery of the tubercle bacillus. This event did not end the centuries-long saga of tuber culosis, however; it was but one major step in the ongoing struggle to un derstand and combat this disease. Tuberculosis is very much with us today, and its clinical manifestations and principles of treatment must be understood by both the primary care physician and the specialist. This monograph covers all aspects of tuberculosis in a single volume. It is divided into three parts, covering, respectively, general considerations, clin ical manifestations, and atypical mycobacterial infection."

The "First International Conference on Traditional Chinese Medicine: Science, Regulation and Globalization" was held from August 30 to September 2, 2000 at the University of Maryland at College Park, Maryland. There were approximately 250 participants from the Peoples Republic of China, Taiwan, Hong Kong and the United States. This objective of this conference was to promote international collaboration for the modernization of Traditional Chinese herbal medicines (TCM) and their introduction into the global health care system. It was mainly sponsored by the Ministry of Science and Technology of the People's Republic of China and the NllI National Center for Complementary and Alternative Medicine (NCCAM). It was organized by Dr. William Tai, then director of the Institute of Global Chinese Affairs at the University of Maryland and Dr. Yuan Lin, president of Marco Polo Technologies, Bethesda, MD. This conference was conceived by Dr. Tai two years earlier recognizing that this was an appropriate time and also the unique location of the University of Maryland. Today, there is a growing recognition of the of alternative medicine in modem societies and the rapid loss of importance knowledge about traditional methods for the treatment of the multitude of human illnesses found throughout the world. TCM has been in common use in China for thousands of years; and many of its formulations are well defined.

The need for greater international collaboration is becoming increas. ingly clear. Practically every nation or people has, in addition to its own characteristics and history, its own medical tradition. Methods and ways of thinking that are successfully established in one place may not be accepted in another for some time. The medical tradition and training in different countries can take quite different forms. What would our present knowledge be - Without the creative, spontaneous ideas and contributions from the romance countries? - Without the opportunity of research, as it is practised on a large scale in the USA, where so many young Europeans took their first steps in experimental science? - Without the conscientious clinical work done in Central Europe and the valuable experience gained there? - Without, finally, the sober and critical scientific approach, as fostered in the cool heads of Northern Europe for generations? None of these qualities is sufficient without the others, but together they are a source of strength. Ultimately, we hope, through sensible con centration of efforts (while maintaining variety), to overcome the lack of an integrated approach in experimental science and to prevent repetition of painful mistakes. In this regard, the first two ESKA congresses have brought us great advances."