Over the last decades the incidence of skin cancers is dramatically increasing world-wide. This is not only confined to the incidence of melanoma but includes also other skin cancers such as basal cell carcinomas. Based on the recent WHO classification of skin cancers, this lavishly illustrated reference book covers comprehensively the epidemiology, histology and pathology, as well as diagnostic signs and treatment options of skin cancers. Homogenously and reader-friendly structured, it links the diagnostic and genetic features of each disease in order to guide the reader to the most appropriate therapeutic strategies for the best possible treatment outcome. In order to demonstrate the world wide activities in the field, all chapters cover the variations of the individual experiences and expertise in different nations.

A description of our current understanding of antiepileptic drug use during pregnancy, this book includes chapters on the impact of seizures on the mother and developing child, changes in maternal physiology during pregnancy and its impact on drug disposition, and the pharmacokinetic differences between the various anti-seizure medications. It also deals with the possible harmful effects of antiepileptic drug exposure during pregnancy on the physical and intellectual development of the fetus. Clinicians have to balance the potential adverse effects of the medicine for the fetus and mother-to-be against the risks that uncontrolled seizures hold for both when treating pregnant women with antiepileptic drugs. Only recently have enough scientific data emerged to provide a rational basis for treatment decisions that take in both aspects. This work provides a single, accessible and up-to-date resource for busy clinicians.

This book covers all relevant techniques of diagnosis as well as interpretations of clinical signs in Clinical Neuro-Ophthalmology. All information is highly structured, highlighting 'definition', 'note' and 'pearl', so that it can also be used by the physician during the patient encounter. The included flow chart posters remind the physician of the most important information. This unique and practical guide offers invaluable and practical advice for physicians treating patients with neuro-ophthalmic problems.

For every physician that interprets ECGs, there is great need to understand a vast amount of information regarding the technique. That the basics of the technique have changed little over the last 100 years means that there is a huge amount of subtle detail that must be learnt to enable its effective use as a diagnostic test. The ECG technique is critical for deciding upon further diagnostic procedures and therapeutic interventions (notably coronary angiography, PTCA, stenting, coronary artery bypass grafting, pacemaker insertion, ablation, electroconversion etc). Without attaining the skills to practice the ECG procedure and knowledge of its diagnostic value - skills often overlooked during medical training - physicians will be unlikely to use it to the benefit of their patients.

Despite wide recognition as a serious public health problem, anaphylaxis and hypersensitivity reactions remain under-recognized and under-diagnosed. This book fills the gaps in our understanding of the identification of triggers, recognition of clinical presentations, understanding of the natural history of these reactions, and selection of treatment strategies including those focused on cellular and molecular targets. The book provides a detailed examination of disease etiology, pathogenesis, and pathophysiology and their correlation to clinical practice. Forefront knowledge of the mediators and mechanisms of anaphylaxis is covered with an emphasis on how new discoveries shape our current and emerging therapies.

This book comprehensively summarizes the adverse effects of tobacco smoking on human health. The current second edition has integrated a large set of new data that have been published in numerous scientifc studies and meta-analyses over the past few years. Unfortunately, the harmful sequelae of tobacco smoking are played down by the ind- try and politicians in many industrialized countries. However, about 800,000 people/year in the EU die from the immediate consequences of smoking. The particularly insidious feature of tobacco consumption is that smoking-attributable harmful effects on health do not generally become apparent until three or four decades after smoking initiation. Although some positive changes in the legislative handling of tobacco have appeared in the past fve years, we still need to form a pact, sealed by politicians, the medical prof- sionals, teachers and the media, to target the problem across nations. In this respect, a minority of countries, including the US and the UK, have given positive examples. There are four areas that need to be improved in future: (1) strict bans on tobacco adv- tisement on a global level, (2) better measures to protect against side-stream (passive) smoke exposure, (3) establishment of prevention programs, especially for children and (4) tre- ment of tobacco addiction.

Diagnostic imaging is an essential component in the evaluation of the patient with known or suspected respiratory tract disease. While chest radiography continues to serve as the primary tool for imaging the chest, advances in computed tomography (CT) have led to a variety of applications such as high-resolution CT (HRCT), advanced 3-D airway imaging, and image-guided procedures. The aim of this book is to deliver a clinically-oriented approach to pulmonary imaging. Each chapter of the book will provide an organized approach to the different facets of imaging of specific clinical scenarios, focusing on strengths and weaknesses of available imaging tests. High quality examples of typical imaging findings of specific conditions will supplement the text. The target readers include practicing internists, pulmonologists, thoracic surgeons, and primary care practitioners. Other readers will include respiratory care therapists and medical students. The proposed cohort of authors represents experts in the field of thoracic radiology. These authors have experience in thoracic radiology and medical writing, each will deliver a high-quality chapter meeting the aims and scope of this book while addressing the target audience. Aside from the first three chapters, which are introductory materials, each author will be invited to select a clinician with whom they work closely to serve as a co-author in order to provide a chapter that maintains the clinical orientation of this book.

This handbook is an invaluable resource for improving the management of diabetes. Chapters cover the fundamentals, including epidemiology, history and physical examination, and functional evaluations. Diabetes in children, adolescents, adults, and geriatrics are addressed. Differential diagnosis is emphasized, and evidence-based guidelines and patient-specific considerations aid the reader with injury evaluation and care. Notably, the book highlights the importance of understanding diabetic symptoms when determining the source of illnesses. In addition, the text presents the spectrum of treatment options for diabetes. The book is complete with appendices that explain the evidence-based approach used throughout and the science behind therapeutic modalities.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the "silver tsunami." Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.

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.

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 fully revised and updated second edition of Sexual Health and Genital Medicine in Clinical Practice covers the range of conditions seen in genitourinary medicine, sexual health and sexually transmitted infection clinics, making it a useful and practical guide to all health practitioners in this area. This book is aimed at medical practitioners who require a quick reference guide to help with diagnosis and management of genital problems. In addition, it provides essential guidance on what to do next when faced with a patient presenting with a genital complaint, whether the patient can be successfully treated with a drug regimen or needs to be referred up to the Sexual Health and Genital Medicine specialist. Sexual Health and Genital Medicine in Clinical Practice will be of particular interest to residents on their rotations through this field of medicine, doctors in training, specialist nurses, and primary care practitioners.

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.

Compact, hand-carried ultrasound devices are revolutionizing how healthcare providers practice medicine in nearly every specialty. The 2nd Edition of this award-winning text features all-new chapters, a greatly expanded video library, and new review questions to keep you fully up to date with the latest technology and its applications. Access to this product, which may be at the discretion of your institution, is up to 3 years of online and perpetual offline access. Elsevier reserves the right to restrict or remove access due to changes in product portfolio or other market conditions. Provides comprehensive guidance for any specialty on the latest point-of-care ultrasound applications for physicians and other health care providers. Helps you interpret findings with a peer-reviewed, online video library with more than 1,000 ultrasound videos of normal and pathologic findings. These videos are complemented by anatomical illustrations and text descriptions to maximize learning. Offers new online resources, including over 120 clinical cases and 350 review questions in every chapter. Features fully updated content throughout, plus all-new chapters on hemodynamics, transesophageal echocardiography, transcranial Doppler ultrasound, pediatrics, neonatology, and 2nd/3rd trimester pregnancy. Shares the knowledge and expertise of expert contributors who are internationally recognized faculty from more than 60 institutions. Recipient of British Medical Association's President's Choice Award and Highly Commended in Internal Medicine at the BMA Medical Book Awards 2015 (first edition). Enhanced eBook version included with purchase gives you access to all the text, figures, videos, cases, review questions, and references while on the go.

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.

Now going into its third much-expanded edition, the highly praised Nutritional Health: Strategies for Disease Prevention has been brought fully up to date to include all the new thinking and discoveries that have the greatest capacity to improve human health and nutritional advancement. About half the new edition will be revised and updated from the second edition while the other half will consist of major revisions of previous chapters or new subjects. Like the two previous editions the book will consist of general reviews on various topics in nutrition, especially those of much current interest. The authors provide extensive, in-depth chapters covering the most important aspects of the complex interactions between diet, its nutrient components, and their impacts on disease states, and on those health conditions that increase the risk of chronic dieases. Up to date and comprehensive, Nutritional Health: Strategies for Disease Prevention, Third Edition offers physicians, dietitians, and nutritionists a practical, data-driven, integrated resource to help evaluate the critical role of nutrition.

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.

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.

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

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.