Due to the fact that Restless Legs Syndrome/Willis-Ekbom Disease is usually a chronic condition, this book aims to provide physicians with the necessary tools for the long-term management of patients with RLS. The first part of the book addresses the various comorbidities and long-term consequences of RLS on life quality, sleep, cognitive, psychiatric and cardiovascular systems, while the second part focuses on the management of long-term treatment and the drug-induced complications in primary RLS and in special populations. Written by experts in the field, this practical resource offers a high-quality, long-term management of RLS for neurologists, sleep clinicians, pulmonologists and other healthcare professionals.

This book presents an authoritative overview of the emerging field of person-centered psychiatry. This perspective, articulating science and humanism, arose within the World Psychiatric Association and aims to shift the focus of psychiatry from organ and disease to the whole person within their individual context. It is part of a broader person-centered perspective in medicine that is being advanced by the International College of Person-Centered Medicine through the annual Geneva Conferences held since 2008 in collaboration with the World Medical Association, the World Health Organization, the International Council of Nurses, the International Federation of Social Workers, and the International Alliance of Patients' Organizations, among 30 other international health institutions. In this book, experts in the field cover all aspects of person-centered psychiatry, the conceptual keystones of which include ethical commitment; a holistic approach; a relationship focus; cultural sensitivity; individualized care; establishment of common ground among clinicians, patients, and families for joint diagnostic understanding and shared clinical decision-making; people-centered organization of services; and person-centered health education and research.

This book is designed to present a comprehensive, state-of the-art approach to assessing and managing bariatric surgery and psychosocial care. Unlike any other text, this book focuses on developing a biopsychosocial understanding of patients' obesity journey and psychosocial factors contributing to their obesity and its management from an integrated perspective. Psychiatric Care in Severe Obesity takes a 360 approach by covering the disease's prevalence and relationship to psychiatric illness and social factors, including genetics, neurohormonal pathways and development factors for obesity. This book presents evidence and strategies for assessing psychiatric issues in severe obesity and uses common psychiatric presentations to feature the impact on bariatric surgery and key assessment features for weight loss. Concluding chapters focus on evidence-based psychosocial treatments for supporting patients with weight loss and bariatric surgery and includes educational tools and checklists for assessment, treatment, and care. Experts on non-pharmacological interventions such as mindfulness, cognitive-behavioral therapy and nutrition education describe treatment approaches in each modality, concluding with pharmacological approaches for psychiatric conditions and eating pathology. Additional tools in the appendices support clinicians, making this the ultimate guide for managing psychiatric illness in patients suffering from severe obesity. As obesity continues to grow in prevalence as a medically recognized epidemic, Psychiatric Care in Severe Obesity serves a vital resource to medical students, psychiatrists, psychologists, bariatric surgeons, primary care physicians, dietitians, mental health nurses, social workers, and all medical professionals working with severely obese patients.

DDDDDDDDDDDDD 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 is on what to do best for the ment and investigations, but the emphasis 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."

This handbook gives profound insight into the main ideas and concepts of integrated care. It offers a managed care perspective with a focus on patient orientation, efficiency, and quality by applying widely recognized management approaches to the field of health care. The handbook also provides international best practices and shows how integrated care does work throughout various health systems. The delivery of health and social care is characterised by fragmentation and complexity in most health systems throughout the world. Therefore, much of the recent international discussion in the field of health policy and health management has focused on the topic of integrated care. "Integrated" acknowledges the complexity of patients needs and aims to meet it by taking into account both health and social care aspects. Changing and improving processes in a coordinated way is at the heart of this approach.

Part one of the book presents the gastrointestinal problems that commonly face the general practitioner. Emphasis is placed on analysis of clinical data and how this may provoke the most profitable lines of investigation. Many of the investigation and treatment protocols are within the scope of general practice, but hospital management is also included. It was possible to deal with common oesophageal diseases under the heading of oeso phageal problems in Part 1. In contrast, it proved impossible to discuss adequately all of the common diseases affecting other organs of the digestive system under the problem headings. For this reason, a fuller ac count of many common alimentary diseases is provided in Part two. M. L.-5. K. G. D. W. 9 Series Foreword This series of books is designed to help general practitioners. So are other books. What is unusual in this instance is their collec tive authorship; they are written by specialists working at district general hospitals. The writers derive their own experi ence from a range of cases less highly selected than those on which textbooks are traditionally based. They are also in a good position to pick out topics which they see creating difficulties for the practitioners of their district, whose personal capacities are familiar to them; and to concentrate on contexts where mistakes are most likely to occur. They are all well-accustomed to working in consultation."

Over several years working in a district general hospital as a physician with a cardiological interest, the common problems in this field are clearer. This knowledge has come through normal out-patient clinic referrals, care of in-patients, and by working in a domiciliary consultative capacity. The problems that concern family physicians nowadays are somewhat different from the problems of two or three decades ago. The accent now is very much on the implications of hypertensive and ischaemic heart disease. Rheumatic fever is rarely seen, though its sequelae may still be discovered. Hence the approach of this book is to the common problems of today in family practice, and the book is not intended to be a reference text book of cardiology. It does not include references because it has been written from personal experience gained from the treatment and management of patients with common cardiac problems. It is hoped that it will be of value primarily to family physicians because it has been written in an attempt to fill a need as measured by the problems that are referred to specialists in the cardiological field. It may prove of value to those medical students and nurses who wish to consider medical problems in a practical way, that is from the ways that cardiac problems present in practice.

The fact that there are special problems in the care of the elderly in the community is ample justification for writing a separate volume on the subject. The knowledge that there are increasing numbers of older people in virtually every country in the world makes it all the more important that the family physician should have sympathy with and understanding of the problems of them, since they are lilcely to make up a significant part of his worlcload and, increasingly, will take up more of his time and energy. There is a progressive amount of disability with advancing years, and this is particularly true of those aged 75 years and over. Increasing age is associated with serious impairment of hearing and vision, senses which younger people take for granted. Old age sees the arrival of major diseases of middle age with much greater frequency, such as ischaemic heart and cerebrovascular disease, diabetes mellitus and osteoarthritis. There are other disorders that are virtually confined to the elderly, such as fractures of the femoral neck, Paget's disease and myeloma. We now know that the disintegration of the con ducting tissue of the heart is largely an age-related phenomenon. Ageing processes affect every major organ system in the body and the impairment of physiological perfor mance resulting from these affects the elderly individual's response to infections, disease and environmental changes in complex ways that are not seen in younger people."

This series of books is designed to help general practitioners. So are other books. What is unusual in this instance is their collec tive authorship; they are written by specialists working at district general hospitals. The writers derive their own experi ence from a range of cases less highly selected than those on which textbooks are traditionally based. They are also in a good position to pick out topics which they see creating difficulties for the practitioners of their district, whose personal capacities are familiar to them; and to concentrate on contexts where mistakes are most likely to occur. They are all well-accustomed to working in consultation. All the authors write from hospital experience and from the viewpoint of their specialty. There are, therefore, matters important to family practice which should be sought not within this series, but elsewhere. Within the series much practical and useful advice is to be found with which the general practitioner can compare his existing performance and build in new ideas and improved techniques. These books are attractively produced and I recommend them."

This text outlines the importance of biopsychosocial factors in improving medical care, and illustrates evidence-based, state-of-the-art interventions for patients with a variety of medical conditions. Each chapter is focused on a particular health concern or illness, which is described both in terms of prevalence and frequent psychological and psychiatric comorbidities that may present to clinicians working with these populations. Consistent with evidence-based care, information on the efficacy of the treatments being described is presented to support their continued use. To accommodate the needs of clinicians, we describe population specific approaches to treatment, including goal settings, modules and skills as well as strategies to assess and monitor progress. To facilitate learning, each chapter contains one or more case examples that explicate the skills described to convey change within a behavioral medicine protocol. Each chapter also includes resources in the form of books and websites to gain additional knowledge and detail as needed. Authors are experts in the field of each chapter, ensuring that information presented is recent and of high quality.

This new edition of the popular 2007 original text is completely updated with full color, high quality photographs and illustrations for easy reference by dermatologists, dermatology residents, primary care and emergency medicine physicians. Presented in an easily accessible manner, this second edition discusses more than 40 diseases that could lead to serious medical consequences, including death. Organized alphabetically and focusing more heavily on dermatopathology than its predecessor, Deadly Dermatologic Diseases, Second Edition contains a single clinical photograph accompanied by three photomicrographs that detail the diagnostic features of each case. Additionally, each subsection discusses a disease prognosis with a current bibliography in a succinct, bulleted manner, making this a must-have reference for clinicians and pathologists alike.

This book focuses on the circumstances that lead to the marked increased vulnerability of seniors and are most challenging to clinicians including the presence of multiple chronic medical conditions, variable losses of physiological function, and heterogeneity among individuals. Written by the experts who lead the initiative to deliver high quality surgical and medical care to the elderly, Geriatrics for Specialists is the first book of its kind to provide the comprehensive knowledge specialists and associated generalists need to deliver quality health care to seniors. With topics on important cross cutting issues like frailty, delirium and polypharmacy and specialty chapters on emergency medicine, anesthesia, many surgical and medical disciplines and rehabilitation, this book provides clinicians the knowledge and tools needed to evaluate, treat and manage the unique needs of seniors. Geriatrics for Specialists was created as a resource for specialist, generalists and allied health professionals and their students and trainees who care for elderly patients.

In writing this short monograph on 'Problems in Peripheral Vascular Disease', I have tried to steer a course between a simplistic dogmatic approach more appropriate to an under graduate text, and a detailed specialist treatise of interest only to vascular surgeons. Although arterial surgery has been performed for centuries, the main indications in the past were to deal with the effects of trauma and aneurysm formation. The development of arterio graphy and the ability to see arterial blocks and stenoses allowed surgeons to carry out increasingly sophistidated operations for an enlarging range of pathological conditions. Even today, arterial surgery continues to develop, and although we are often dealing with the 'surgery of ruins', a successful outcome is just as rewarding for surgeon and patient alike. In this book I have also included a discussion on venous problems including a note about recent developments in direct surgery of the deep veins of the lower limb which could be a re warding field of endeavour for the vascular surgeon. The original descriptions by Buerger and Raynaud are taken from 'Classic Descriptions of Disease' by Ralph H. Major. While reviewing my own surgical practice, I have had the pleasure of reading once again the publications of H.H.G. Eastcott (arterial surgery), J.T. Hobbs (varicose veins), G.L. Hill (Buerger's disease), Adrian Marston (intestinal ischaemia), Martin Bimstingl (vasospastic disorders) and C.H. Hawkes (lumbar canal stenosis)."

This third edition of the Beecham Manual has its origins in a manual produced by Selwyn Carson for his general practice in Christchurch, New Zealand. He produced loose-leaf sets of instructions for his practice team and colleagues. Beecham Research Laboratories of New Zealand did a great service for the medical profession by publishing and distributing Dr Carson's manual there. The British version of the Beecham Manual had different objectives. The vocational training programme needed basic resources and the British Manual was created as an easy to read reference book on common prob lems and methods in general practice. The first and second editions met with enthusiastic approval from princi pals, trainers and trainees. This third edition follows the same general format but has been completely revised and updated and includes many new additions. The five sections are: o planned care of definable population and other groups o principles of teaching and learning o emergencies and their management o psychiatry o clinical care of common conditions We have kept to simple, clear and brief presentations of our conjoint views based on our experiences in our own practices. We dedicate this third edition to our colleagues involved in caring, learning and teaching. They may not agree with us completely but we hope that we will make them consider our suggestions and use them for thought, debate and discussion. We hope also that it will be used as a work book for the whole practice team."

The topics chosen for discussion represent the most common problems referred by family doctors to chest clinics. It was taken for granted that the reader will be familiar with the symptoms, signs, and natural history of respiratory diseases, so that the stress is on differential diagnosis and treatment. Tuberculosis once occupied nearly all the time of chest physicians. At present weeks go by without a single case presenting itself. There has been no comparable improvement in cancer of the lung, which remains one of the most intract able problems. Asthma was seldom referred to out-patient clinics when the disease was regarded as more unpleasant than dangerous. The hazards of severe attacks and the advan tages of liaison with a hospital department are now widely recognized. A similar change of attitude to the management of chronic bronchitis brought many new patients to the chest clinics in place of the vanishing tuberculous population. Some uncommon pulmonary diseases are included: allergic alveolitis, because of the importance of early diagnosis, and sarcoidosis in order to discourage unnecessary treatment. The book is intended to be a practical guide and is not a critical review. This might serve as an excuse for its didactic style and the exclusion of controversial subjects. Some statements are repeated at more than one place in order to help readers who wish to consult individual chapters bearing on some current problem. Source references are omitted and are replaced by a short list of books recommended for further reading."

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 analyis 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 defini tively 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 as sessment 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 islation 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."

One of the eXCltmg challenges of medicine has been the reaching of decisions based on less than complete evidence. As undergraduates in teaching hospitals future physicians are taught to think in clear and absolute black and white terms. Diagnoses in teaching hospitals all are based on supportive positive findings of in vestigations. Treatment follows logically on precise diagnosis. When patients die the causes of death are confirmed at autopsy. How very different is real life in clinical practice, and particularly in family medicine. By the very nature of the common conditions that present diagnoses tend to be imprecise and based on clinical assessment and interpretation. Much of the management and treatment of patients is based on opinions of individual physicians based on their personal expenences. Because of the relative professional isolation offamily physicians within their own practices, not unexpectedly divergent views and opinions are formed. There is nothing wrong in such divergencies because there are no clear absolute black and white decisions. General family practice functions in grey areas of medicine where it is possible and quite correct to hold polarized distinct opinions. The essence of good care must be eternal flexibility and readiness to change long-held cherished opinions. To demonstrate that with many issues in family medicine it is possible to have more than one view I selected 10 clinical and II non -clinical topics and invited colleagues and fellow-practitioners to enter into a debate-in-print."

JOHN JOHN FRY FRY All All examinations examinations create create problems problems and and stresses stresses in in examinees. examinees. The The examination examination for for the the Membership Membership of of the the Royal Royal College College of of General General Practitioners Practitioners is is no no exception. exception. Although Although the the examiners examiners state state that that their their objectives objectives are are to to pass pass candidates candidates wherever wherever and and whenever whenever possible, possible, nevertheless nevertheless the the failure failure rate rate remains remains con sistently sistently at at 30% 30% plus plus of of those those taking taking the the examination. examination. The The reasons reasons for for failure failure fall fall into into a a number number of of groups. groups. The The candidate candidate may, may, through through over-confidence, over-confidence, not not have have prepared prepared for for the the examination. examination. He He may may have have assumed assumed that that it it is is not not necessary necessary to to read, read, learn learn and and digest digest data, data, facts facts and and experience experience on on general general practice. practice. How How wrong wrong that that is, is, he he will will discover discover when when he he sits sits the the exam. exam."

Providing comprehensive discussion of this newly developing branch of sports medicine, this unique and up-to-date book focuses specifically on the treatment of athletes who train for and participate in endurance sporting events, including not only traditional endurance athletes such as runners, swimmers, bikers and triathletes, but also rowers, adventure racers, military personnel, and cross-fit athletes. Detailing strategies for not only treating and preventing injuries and conditions but also for optimizing an athlete's performance, it is divided into three thematic sections. The first section covers common medical conditions faced by the endurance athlete, including cardiovascular conditions, asthma, and heat- and altitude-related illnesses, while also discussing gender differences, pregnancy and the pediatric endurance athlete. Section two focuses on the management of common musculoskeletal conditions, such as stress fractures, overuse injuries of the soft tissue, compartment syndrome, shoulder and hip injuries, and exercise and osteoarthritis. The last section presents special considerations for the endurance athlete, including gait and swim-stroke analysis, bike fitting, mental preparation, optimizing nutrition, and how to organize medical coverage for events, as well as decision-making for return to play. A timely topic and one which has not been written about extensively in one concise collection of chapters, Endurance Sports Medicine is a valuable guide for sports medicine physicians, orthopedists, athletic trainers, physical therapists, coaches, officials, and athletes in understanding the needs of the determined individuals who participate in endurance sports.

WHY WE MUST PRACTISE TRANSCULTURAL MEDICINE Health professionals and GPs should concern themselves with ethnicity, religion and culture as much as with the age, sex and social class of their patients. Transcultural medicine is the knowledge of medical and communication encounters between a doctor or health worker of one ethnic group and a patient of another. It embraces the physical, psychological and social aspects of care as well as the scientific aspects of culture, religion and ethnicity without getting involved in the politics of segregation or integration. English general practitioners and health professionals tend to regard everyone as English, and to assume that all patients have similar needs. Would that it were as simple as that! For economic reasons - based on supply and demand - the mass migration of working populations from the new Commonwealth countries, along with their dependent relatives (including their parents) to Britain took place during one decade - the 1960s. Broadly speaking, the workers were in their thirties and forties, and their dependent parents were in their fifties and sixties. All these will, of course, be 30 years older in the 1990s.

One of the few real and lasting benefits of international medical meetings is the opportunity to meet, talk, gossip and get to know colleagues from other countries. So it was that we met, talked and planned at WONCA (World Organization of National Colleges and Academies and Academic Associa tions of General Practitioners/Family Physicians) meetings at Montreux and New Orleans. We realized that although we worked in different places and in different practices 'primary health care' was essentially the same the world over. Our roles, our problems, our clinical content, our challenges and objectives were similar whether we work in Europe, North America, Australasia, South Africa or developing countries. With such similarities we asked ourselves - 'why not share our common experiences for mutual benefits?' The question developed into an idea and the idea into this book. We started by selecting what we considered were important topics and then we invited friends and colleagues to join us in putting our experiences and beliefs from years of practice to readers from all over the world to demonstrate our common concerns and to learn from one another."

This unique textbook is designed to provide a summary of state of the art developments in both male and female fertility and its association with cancer for both new and experienced practitioners. Clear, concise and readable, the text allows the reader to obtain rapid answers to this challenging medical issue. Special emphasis is placed on diagnostic and treatment algorithms. Topics covered include demographics of cancer in the reproductive age male, fertility conditions which predispose to cancer development, the role of assisted reproduction for fertility management, as well as fertility preservation strategies for the male and female cancer patients. Cancer and Fertility will be of great value to general urologists, uro-oncologists, gynecologists, medical oncologists, obstetricians, primary care providers, allied health providers.

This text presents difficult management issues surrounding women with epilepsy in a unique format. The Editors provide several controversial cases in adolescence, pre-conception, pregnancy and menopause with invited experts offering their differing opinions. The Editors compare the clinical approaches and build a consensus based on the best available evidence. Professionals charged with managing this challenging patient group will be given insights on providing the best possible care based on current available data and expert opinion.

This book brings together a cutting-edge selection of the most current applications of mindfulness-based cognitive therapy (MBCT), giving clinicians as well as researchers a concise guide to current and future directions. Each chapter begins with in illustrative case study to give readers an example of how MBCT would be used in the clinical setting, followed by an overview of the condition, the theoretical rationale for using MBCT, modifications of MBCT for that disorder, evidence for MBCT use. Chapters also discuss practical considerations of MBCT, including patient selection, home practice, group size, format, and facilitator training. Written by some of the world's leading physicians using MBCT, Mindfulness-Based Cognitive Therapy: Innovative Applications is of great value to psychiatrists, psychologists, social workers, and therapists.