A growing number of people suffer from so-called resistant hypertension, that is to say, high blood pressure that does not respond to treatment. This disorder is of great current interest and importance for public health, being a common clinical problem faced by both primary care clinicians and specialists. Furthermore, as older age and obesity are among the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. While the prognosis of resistant hypertension is unknown, cardiovascular risk is undoubtedly increased since patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors. This volume, compiled by a panel of world-renowned experts, offers a comprehensive exploration of resistant hypertension, covering epidemiology, complex diagnostic aspects, and the therapeutic options currently available, with due attention to overall treatment strategies. New therapeutic agents and procedures, such as renal denervation and baroreceptor stimulation, are also described. In addition, the book addresses the economic aspects of resistant hypertension and the role of the different professional figures, from GPs to hypertension specialists, in dealing with it.

The mechanistic basis of chronic inflammation remains unclear. The research sheds new light on the immune cells expressing the activation markers HLA-DR and regulatory T cells (Tregs) and the cells expressing Siglec receptors as being key players in the immune system responsiveness to antigens and thus in lung tissue damage of chronic inflammation. The results help understand the mechanisms of action of common drugs used in COPD, such as formoterol, tiotropium, or corticosteroids, and point to novel drug targets. The chapters also deal with brain damaging effects, by far unrecognized, of inhaled corticosteroid therapy, a time-proven management of chronic inflammatory airway conditions; asthma being a case in point. Novel methods, likely less producing side effects, of macrolide antibiotics administration by inhalation are discussed, emphasizing not only bacteriostatic but also anti-inflammatory action.

In preparing the material for this book, I took the advice of my students who generously shared their views and opinions with me. I was told that it would be preferable to have images of the various diseases with legends describing the disease. Students would be able to learn and retain the inf- mation more successfully if the material was accompanied by pictures and schematic drawings. Recent advances in technology have made it possible to photograph regions that are difcult to view with the naked eye, such as the ear, nose, throat, nasopharynx, and larynx - all the areas of otorhinolaryngology. Such an illustrated text in this feld is important and necessary for teaching purposes. In this book I tried to compile images of the basic conditions that are commonly seen in general practice and to give the reader a visual survey with a brief description of the condition. I added tables and schematic drawings in order to provide practical information. It is not the purpose of this book to be a comprehensive textbook, since many textbooks are already available with more detailed information of the conditions illustrated here. This book is primarily intended for medical students, family and general practitioners, and ENT trainees. It may also serve as basic reading material for those in allied specialties. I hope my colleagues fnd this book useful and it contributes toward their teaching purposes.

A concise review of the epidemiology, pathogenesis, and management of common respiratory conditions seen in a primary care setting. Using an illuminating case-based approach, Dr. Mintz assesses the key clinical questions that a primary care physician would ask and applies the most up-to-date research and guidelines to offer the practitioner evidence-based solutions. The author covers the range of knowledge needed to provide excellent care for patients with respiratory disease, from the basics of pulmonary function testing to understanding and caring for common respiratory illnesses, including chronic obstructive pulmonary disease, asthma, allergic rhinitis, and pneumonia. For each disorder, Dr. Mintz explains the key points regarding the epidemiology of the disease, its pathophysiology, the differential diagnosis and diagnosis, and its recommended treatment. A special PDA version of Disorders of the Respiratory Tract: Common Challenges in Primary Care is also available.

Atlas of Conducted Electrical Weapon Wounds and Forensic Analysis provides a comprehensive publication on the subject of Conducted Electrical Weapon (CEW) wounds and signature markings created by this class of weapon. This volume will serve as a very useful resource for all professions tasked with assisting persons that have allegedly been subjected to a CEW exposure. The volume provides an introduction to basic CEW technology and the types of CEWs currently available. It also serves as a comprehensive pictorial atlas of signature markings that CEW exposures make in the immediate and more remote post-exposure periods. Also, it discusses the ability of forensic specialty examinations of the CEW itself to aid in the determination of whether the alleged CEW exposure is consistent with the objective evidence and the subjective statements. Finally, this text addresses the important and growing area of factitious CEW markings that will be useful for consideration by investigators and litigators. Atlas of Conducted Electrical Weapon Wounds and Forensic Analysis provides an objective atlas of evidence for reference that will benefit those professionals who often must make diagnostic, treatment or legal judgments on these cases including Emergency and Primary-Care Physicians, Medical Examiners, Forensic Pathologists, Coroners, Law Enforcement Investigators, and Attorneys.

This practical, concise guide discusses how to distinguish different types of tremor and make the diagnosis of essential tremor. Written in an easy-to-read format, this book summarises other conditions that may be confused with essential tremor and details all current treatment options for this condition, including medications, surgery and non-invasive alternatives. Examination techniques for patients with a tremor complaint are described, some of which may be novel to the general practitioner, and case studies full of diagnostic and examination pearls are provided. Essential Tremor in Clinical Practice is an updated version of Abdul Qayyum Rana's previous book, An Introduction to Essential Tremor. Busy clinicians, including internists, general and family practitioners, and geriatricians will benefit from this short yet comprehensive, clinically focussed volume.

Understanding the key components of the diagnosis, assessment and management of inflammatory arthritis patients is essential to improving patient care. This book aims to cover these areas. It places inflammatory arthritis into a historical context; deals with the epidemiology, pathology, clinical assessment and investigation of inflammatory arthritis patients and provides a comprehensive overview of currently available treatment options. It provides insight into stratified medicine, an area of emerging importance in the management of heterogeneous diseases like RA. Finally, it provides an overview of what treatments strategies are in development.

This book is a comprehensive guide to the screening, management, and treatment of female patients with addictions. There are a range of clinical issues specific to women with substance use disorders and substance abuse during pregnancy is known to have deleterious effects on neonates. This book focuses on the effective care of the addicted patient and discusses novel outpatient therapy, therapeutic substitution, abstinence therapy, and the importance of counseling in the delivery of care. Topics include the physiology of nicotine, opiates, EtOH, and other substances of abuse; the role of receptors and neurotransmitters in addiction; the effects of tobacco and substance abuse on women' s health; and tobacco cessation methods. Featuring practical approaches to gender-responsive treatment, Tobacco Cessation and Substance Abuse in Women's Healthcare is a valuable resource for obstetricians, gynecologists, family medicine practitioners, and residents hoping to expand their knowledge of tobacco cessation and substance abuse in women's health.

Eating disorders, addictions, and substance use disorders are each challenging in their own right, but they also commonly co-occur, causing major challenges for clinicians. This book presents cutting-edge research on the overlap of these complex disorders and reviews integrative assessment strategies and treatment approaches, including enhanced cognitive behavioral therapy, dialectical behavior therapy, abstinence approaches, motivational enhancement, mindfulness meditation, and pharmacotherapy. The issue of whether eating-disordered behaviors such as dieting, binge eating, and excessive exercise are merely other forms of addictive behavior is examined. The authors argue both for and against the concept of food addiction in research, clinical treatment, and public policy. The book will be of interest to psychiatrists, addiction medicine physicians, mental health/substance abuse clinicians, dieticians, researchers, and those affected by the disorders.

Integrative Weight Management: A Guide for Clinicians intends to educate physicians and nutritionists about the wide ranges of approaches to weight control from non-traditional sources. The options for weight management in conventional practices are limited to a small number of medications, a confusing array of dietary approaches and surgical procedures with their inherent risks and complications. Unfortunately medical practitioners are not exposed to nutrition and weight control principles during training and thus are reluctant to manage their patients weight control issues. This volume is structured into 4 sections: Introduction to Weight Management Disorders; Morbidity and Mortality of Obesity; Therapy of Obesity; and Integrative Medicine and Obesity. Integrative Weight Management: A Guide for Clinicians represents a powerful collaboration of dozens of leading experts in the fields of nutrition, weight management and integrative medicine who have managed countless numbers of patients and summarized the research from thousands of articles to create an up-to- date state of the art guide for healthcare practitioners, allied health professionals and public health authorities who manage those who are overweight/obese along with the associated metabolic consequences.

Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is a comprehensive, timely and up-to-date review of pediatric sleep disordered breathing (SDB) and offers a thorough focus on several key areas: namely, the normal development and maturation of the airway and breathing during sleep, the techniques that are in place for assessment of SDB in children, the clinical manifestations and characteristics of several pediatric populations at risk for SDB, the implications of SDB in various end-organ systems, and, finally, a critical review of the evidence on current therapeutic approaches. This unique and complete text is of welcome interest to all practicing physicians and healthcare professionals who evaluate children with sleep problems -- namely pulmonologists, pediatricians, sleep physicians, pediatric neurologists, pediatric otolaryngologists, and family practitioners, as well as clinical researchers, pediatric nurse practitioners and respiratory therapists. Written by a distinguished and international panel of authors who are renowned experts in their field and who offer an expanded view of the problems associated with SDB, Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is an indispensible resource for all physicians who evaluate children for sleep-disordered breathing.

Gastroesophageal Reflux and the Lung provides a comprehensive review of current knowledge concerning normal deglutition and foregut digestive processes and examines how abnormalities of swallowing or excessive/abnormal GER can lead to respiratory tract dysfunction and lung disease. In-depth Chapters deliver a concise review of the prevalence of GER in patients with lung disease and synthesize the current evidence regarding its diagnosis and management. Each chapter includes key points and a summary. In addition to outlining the current state of knowledge, each chapter provides a summary of ongoing research in the field and identifies the need for future research. Written by an international group of authors who are experts in their respective fields, Gastroesophageal Reflux and the Lung is a valuable resource for practicing clinicians, internists, pulmonologists and primary care personnel.

Infertility is defned as the inability to conceive after having unprotected intercourse for a year. Infertility is increasing worldwide and has various causes both in the male and the female partner. Immune reactions to sperm can contribute up to 2-30% of infertility. The sperm has both autoantigenic as well as isoantigenic potential, and is thus capable of p- ducing antisperm antibodies (ASAs) and sperm-reactive T cells in both infertile men and women. Also, over 75% vasectomized men produce autoantibodies to sperm that can cause a problem in regaining fertility even after successful re-anastomosis in vasovasostomy. Early claims regarding the incidence and involvement of ASAs in involuntary human infertility were probably overemphasized because of unreliable techniques and naivety concerning the complexity of the immune response and antigenic nature of the sperm cell. These factors, the lack of well-designed and controlled experimental studies, and the dearth of effective therapeutic modalities resulted in the confusion of the occurrence and importance of ASAs in human infertility. Consequently, evaluation of infertile couples for ASAs and their possible role in infertility was not considered a signifcant proposition. The development of more accurate assays and the discovery of mucosal immunity capable of responses independent of systemic immunity have caused inclusion of sperm cells and genital tract secretions in the analysis of ASAs.

Patients with chronic pain present a unique set of challenges to the primary care clinician. In Chronic Pain: A Primary Care Guide to Practical Management, Second Edition, leading pain specialist Dawn A. Marcus, MD, again offers practical, clear, and succinct evidence-based approaches to the diagnosis and treatment of the myriad painful conditions clinicians see in their offices every day, such as headache, back pain, arthritis, fibromyalgia, and abdominal pain. Sections addressing pain management in children, pregnant women, and seniors are also included. This new edition is designed to provide a pragmatic approach to assessing and treating the complex issues and characteristics of chronic pain patients. New chapters expand upon the evidence-based recommendations and practical office tools previously provided, with the addition of new chapters addressing risk management; pain syndromes in the shoulder, upper extremity, and lower extremity; and cancer and end-of-life pain. Chronic Pain: A Primary Care Guide to Practical Management, Second Edition provides strategies and techniques that are designed to improve the confidence with which the primary care physician can approach patients with complex pain complaints, reduce staff stress, and improve patient success.

This history of the medical profession in pre-Revolutionary Russia examines an influential segment of the educated elite. The author shows how Russian physicians differed in social origin, careers, and professionalization from their counterparts in other lands. Originally published in 1982. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

Many patients with pulmonary complaints fail to improve despite physicians' best efforts. Sometimes, we ascribe this failure to lack of adherence with therapy, or to the severity of the condition. What we often fail to appreciate, however, is that sometimes the lack of improvement can be explained by the patients' psychological states. The first section of Functional Respiratory Disorders: When Respiratory Symptoms Do Not Respond to Pulmonary Treatment will help clinicians recognize functional respiratory symptoms that can arise as a result of both organic and psychological causes. The second section of this book provides detailed discussions of such disorders, links to video examples of laryngoscopic evaluation of patients with vocal cord issues, case studies and quizzes. Examples and exercises that should strengthen the clinician's confidence in identifying and treating these functional conditions are also provided. Finally, the third section of the book will help the clinician differentiate the patients for whom referral to a mental health provider is mandatory from those for whom other approaches may be useful. For the latter group, the book teaches clinicians to empower themselves by learning how to incorporate various therapies for functional disorders into their practice, including biofeedback, breathing techniques, basic cognitive behavioral therapy techniques, and hypnosis. Links are provided to instructive video examples of biofeedback, hypnosis, and speech therapy. Practical strategies for obtaining training in these modalities are provided in the appendix. Functional Respiratory Disorders: When Respiratory Symptoms Do Not Respond to Pulmonary Treatment is an important new book that will help clinicians consider the possible impact of functional contributions to the clinical presentation of every patient with respiratory symptoms and identified respiratory disease.

The book provides an overview of current trends in biotechnology and medicinal plant sciences. The work includes detailed chapters on various advance biotechnological tools involved in production of phytoactive compounds of medicinal significance. Some recent and novel research studies on therapeutic applications of different medicinal plants from various geographical regions of the world have also been included. These studies report the antimicrobial activity of various natural plant products against various pathogenic microbial strains. Informative chapters on recent emerging applications of plant products such as source for nutraceuticals and vaccines have been integrated to cover latest advances in the field. This book also explores the conservation aspect of medicinal plants. Thus, chapters having comprehensively complied in vitro conservation protocols for various commercially important rare, threatened and endangered medicinal plants were provided in the present book.

A Fateful Meeting A year and a half ago, I was sitting at a conference listening to Ed Noffsinger speak, and suddenly had the most profound ''Aha'' moment of my professional career. Here was someone presenting a practical and tested solution to some of the most challenging problems currently plaguing the US healthcare system, problems such as poor access to primary and specialty care; the uncontainable and rising costs of healthcare; our nation's relatively poor quality outcomes; and finally, the sense of frustration, disempowerment, loneliness, and disenfranchisement that patients and their families too often experience. Dr. Noffsinger's solution seemed deceptively simple-shared medical appointments (SMAs) that afford the highest quality healthcare to be delivered in the highest quality care experience-a group setting. Experience collected over a decade and involving more than 100,000 patient visits throughout the United States, Canada, and parts of Europe has demonstrated that SMAs, when used in primary care as well as in the medical and surgical subspecialties, lead to increased access to care, enhanced quality of care, and improved patient satisfaction. For physicians, the efficiency gains and team support from their participation in SMAs translate into much needed relief and improved career satisfaction.

Stroke Essentials for Primary Care: A Practical Guide is a must-have resource, offering the essential, practical knowledge required to evaluate and treat stroke patients. While an indispensable guide for primary care clinicians, including family practitioners and medical internists who often assume the care of stroke patients without the aid of a neurologist (primarily in underserved areas), the information contained herein is also an invaluable resource to all physicians in training, especially residents and fellows in neurology, cardiology, and surgery, among others. Stroke Essentials for Primary Care: A Practical Guide provides the latest diagnostic and treatment information that allows for greater clinical confidence. Designed to allow easy access to essential information, most chapters include a quick summary of their content and conclusions. Chapters review information on such topics as distinguishing features of presentation, rapid determination of stroke type, prevention strategies, long-term complications, and special topics that may apply to specific populations. Targeted and easy to read, Stroke Essentials for Primary Care: A Practical Guide is an essential resource for all practitioners in primary care medicine and specialty physicians in training.

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

Often, information in review books can raise as many questions as it answers. This interferes with the study process, because the learner must either look up additional information or skip ahead without truly comprehending what he or she has read. As an alternative, Pediatric Infectious Disease: A Practically Painless Review presents bite-size chunks of information that can be read and processed rapidly, helping learners to stay active while studying and to pick up new information the first time they read it. This book's question and answer format allows for self-testing or study with a partner or a group. The format also facilitates dipping into the book during a few minutes of downtime at the hospital or office. Pediatric Infectious Disease: A Practically Painless Review is a quick and easy way to master tricky infectious disease topics and is suitable for those studying for the pediatric board exam, practicing physicians brushing up their skills, and any busy clinician who wants to learn more about this topic while on the go.

With hundreds of question and answer items and bite-sized chunks of information that can be read and processed easily, reviewing for the pediatric board exams - or just brushing up in your spare time - has never been easier. Pediatric Tricky Topics, Volume 1: A Practically Painless Review includes review items in pediatric orthopedics, trauma, environmental medicine, toxicology, rheumatology, and neurology topics, among others. The Q&A format allows for self-testing or study with a partner or a group and is practical and accessible enough to dip into during a few minutes of downtime at the hospital or office, and as such it is suitable for those studying for the pediatric board exam, practicing physicians brushing up their skills, and any busy clinician who wants to learn more about these topics while on the go.

In this updated third edition, expert physicians assemble user-friendly, clinically-oriented guides to aid in the day-to-day management of the allergic patient. With an emphasis on common allergic diseases and the pharmacological tools to control them, this book disseminates the practical knowledge that practitioners have accumulated through practice and teaching. Three new chapters focus on antihistamines, antileukotrienes, and children experiencing recurrent respiratory tract infections. This book is intended for the front-line physician who cares for allergic patients. It will help any physician improve the care offered to those patients.

There is a world-wide epidemic on obesity. This epidemic is driving the immense proportions of Type 2 diabetes across the globe. While there are numerous therapies for treating Type 2 diabetes, the most effective therapy is prevention. Prevention of Type 2 diabetes can be achieved properly by simultaneous prevention of obesity. Prediabetes, or metabolic syndrome, is the period between simple obesity and diabetes, and this critical period needs to be identified in a more consistent and systematic manner by clinicians worldwide. Clinical trials have indicated that diabetes prevention can be achieved by lifestyle changes and also by certain medications, though none are yet approved for use in prevention. On the other hand, there are funding agencies such as the NIH, CDC, and State Institutions that are interested in studying the prevention paradigms in different communities and ethnic minorities who are most prone to this epidemic. For these reasons, this title by renowned physician-scientist Derek LeRoith is both timely and vitally important for academic physicians, practitioners, allied health care providers, analysts, community activists, and all others interested in this increasing epidemic. This book provides a unique and comprehensive synthesis of the prevention and early diagnosis of Type 2 Diabetes, focusing on identifying risk factors and then moving into topics that address how to prevent their progression to full-blown diabetes. The difficult task of changing patients' behavior is given special emphasis. The chapters in this practical volume are written by a wide range of international experts, reflecting the editor's distinguished, internationally renowned career. The volume is organized in eight sections: an introduction to the overall issue of prevention, definitions of values based on ADA guidelines, pathophysiology, discussion of a range of interventional trials regarding prevention, and an overview of state-of-the-art clinical management approaches. Comprehensive and timely, Prevention of Type 2 Diabetes: From Science to Therapy is an essential reference for those treating and researching Type 2 Diabetes.

Designed for quick, easy reference in the office or clinic, Atlas of Vulvar Disease is a robust pictorial and textual guide to the diagnosis, treatment, and management of vulvar diseases. Written by Edward J. Wilkinson, MD, a professor of pathology and expert in gynecologic pathology, and I. Keith Stone, MD, a professor of obstetrics and gynecology, this atlas is a must-have resource for both clinicians and pathologists focused on women's health. Organized by dermatologic findings, Atlas of Vulvar Disease presents a complete overview of diseases within each broader topic area. Each disorder includes a definition, general features, clinical presentation, microscopic features, differential diagnosis, clinical behavior and treatment, and progressive therapeutic options, to guide the diagnosis and treatment of various vulvar diseases. Hundreds of full-color clinical photographs and relevant histopathologic photographs illustrate the clinical appearance and histopathologic characteristics of the full spectrum of vulvar diseases. Tables on sexually transmitted diseases, vesicobullous disease, and the classification of vulvar diseases are included to assist in differential diagnosis. Clinical pathological correlations aid in the diagnosis and interpretation of laboratory findings. Two indexes facilitate quick look up a disease entity or a clinical presentation. A free companion web site features the full-text as well as an extensive image bank of clinical and histopathologic photographs from the book.