Drugs may cause disease, or they may aggravate the morbidity of the condition for which they are prescribed, and certain patients may for one or other reason be particularly liable to drug injury. The inextricable relationships between the toxic profiles of drugs, the natural history of the diseases for which they are given, and the adverse drug effects that may develop in the course of such diseases are of considerable interest. It is the study of these rather neglected aspects of pharmacology and therapeutics which has formed the basis of this book. An explanation is required of the approach and the style which have been followed. The monograph does not purport to be comprehensive. Only important drug groups which are commonly used in practice are considered. Emphasis has been placed on achieving maximum benefit and safety of the appropriate drugs in the management of common illnesses. When treatment fails, either ab initio or subsequent to an initial response, the risk-benefit relationship of drugs inevitably alters. For this reason the main factors responsible for treatment failure have been considered, with special attention to the possible contribution of or implications for drug therapy in such a situation. Finally, proposals have been put forward for improving the diagnosis and reporting of adverse drug effects. In order to be practical and, as far as possible, constructive it has been necessary for me to "take a position" on numerous issues.

I have been much absorbed in David Cope's poetry as necessary continuation of tradition of lucid grounded sane objectivism in poetry following the visually solid practice of Charles Reznikoff & William Carlos Williams. Though the notions of 'objectivism' were common for many decades among U. S. poets, there is not a great body of direct-sighted "close to the nose" examples of poems that hit a certain ideal objectivist mark-"No ideas but in things" consisting of "minute particulars" in which "the natural object is always the adequate symbol," works of language wherein "the mind is clamped down on objects," and where these "Things are symbols of themselves. " The poets I named above specialized in this refined experiment, and Pound touched on the subject as did Zukofsky and Bunting, and lesser but inter esting figures such as Marsden Hartley in his little known poetry, and more romantic writers such as D. H. Lawrence. In this area of phanopoeiac "focus," the sketching of particulars by which a motif is recognizably significant, David Cope has made, by the beginning of his third decade, the largest body of such work that I know of among poets of his own generation. Allen Ginsberg Table of Contents Foreword, Allen Ginsberg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v THE STARS The Line-up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . . . . . Empty Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The River. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Down on the Farm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 The Storm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 American Dream. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . Baseball. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 . . . . . . . . . . . . Crash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 . Lunch Hour. . . . . . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . . . . . . . . . . . . . Winter Camp. . . . . . . . . . . . . . . . . . . . . . . . . . 10 . . . . . . . . . . . . . . . . . A Circle of Lights . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 . . . . . . . . . . GO Labor Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . . . . . . . . . . . Peace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . . . . . . . . . . . . ."

This third edition of Genetic Counseling has been thoroughly revised to reflect current practice. In particular, the chapter on prenatal diagnosis (Chapter 10) has been largely rewritten and considerably expanded, reflecting the rapid develop ment in this field and its increasing medical importance. This chapter provides a detailed description of the alpha-fetoprotein test and a brief description of ultrasonography for the diagnosis of morphologic defects. Further, we discuss fetoscopy and the sampling of fetal blood with the aid of a fetoscope. In this as in past editions, these descriptions are not meant as working instructions for actual practice, but rather as background for the general practitioner who is dealing with the problems of genetic counseling. We have added a chapter (Chapter 7) on the use of conditional probability (Bayes Principle) for the calculation of more exact specific risk figures. It is true that the daily practice of medicine sees far fewer situations in which these methods can reasonably be applied than some theoreticians like to think. However, the usefulness of these methods has recently increased, especially in cases of X-chromosomal recessive diseases where the termination of a preg nancy, if the fetus has been ascertained to be male and if the mother is "most probably" heterozygous, has become more commonplace. With such a trend, the degree of probability must be determined as exactly as possible."

Das vorliegende Buch umfaBt die Vortrage eines Symposiums, das von der Sektion Klinische Geriatrie der Deutschen Gesellschaft fUr Gerontologie im Oktober 1981 in Frankfurt unter dem Thema" Tagesklinische Behandlung im A Iter" ausgerichtet wurde. Diese Form der klinischen Behandlung alter Menschen stellt eine Herausforderung an das herkommliche Konzept der vollstationaren Versorgung im Krankenhaus und in anderen Institutionen dar. Die negativen Auswirkungen der Hospitalisierung und In- stitutionalisierung auf alte Menschen sind bekannt. Das Krankenbett bedeutet haufig Verlust der Eigenstandigkeit, zunehmende Abhangigkeit sowie Verlust familiarer und sozialer Bindungen. Dazu kommt die vollstandige Obertragung der Verantwortlich- keiten fUr den alten Patienten von Angehorigen auf die Institutionen. Die Tagesklinik kann fUr einen bestimmten Patientenkreis die vollstationare Behand- lung abktirzen oder ganz vermeiden und gleichzeitig medizinische Diagnostik und Therapie nach klinischen Gesichtspunkten anbieten. Wir haben aufgrund unserer Er- fahrungen in Frankfurt gelernt, daB der fUr die tagesklinische Behandlung geeignete Patientenkreis wesentlich groBer ist, als wir zu Beginn unserer Arbeit vermutet haben. In unserem Behandlungskonzept steht die Tagesklinik gleichberechtigt neb en der voll- stationaren Behandlung im Krankenhaus und ist keinesfalls ein untergeordnetes An- hangsel. Daruber hinaus mtissen angesichts der standig steigenden Kosten im Krankenhauswe- sen und der demoskopischen Verschiebungen in der Altersstruktur der Bevolkerung al- ternative Wege beschritten werden, urn den in Zukunft noch steigenden Bedarf an ma- teriellem und personellem Aufwand fUr die medizinische Versorgung alter Menschen bewaltigen zu konnen. Die tagesklinische Behandlung ist eine solche Alternative.

Im seit 1985 jährlich als Buch erscheinenden Arzneiverordnungs-Report werden die Rezepte für die Patienten der gesetzlichen Krankenversicherung (GKV) mit Methoden der evidenzbasierten Medizin analysiert.Seit dieser Zeit bietet der Report eine unabhängige Informationsmöglichkeit über die verschiedenen Komponenten der Arzneimittelverordnung und trägt damit zur Transparenz des Arzneimittelmarkts, zur Bewertung von Arzneimitteln und zu einer sowohl zweckmäßigen und sicheren evidenzbasierten als auch wirtschaftlichen Arzneitherapie bei.

Pravention lasst sich am besten mit vorausschauender Problemvermeidung ubersetzen. Seit der Ottawa-Charta der Weltgesundheitsorganisation gelten Pravention und Gesundheitsforderung als die geeignetsten Instrumente, dem Kostenanstieg im Gesundheitswesen durch Vermeidung des Sozialversicherungsfalls entgegenzuwirken; mit andern Worten: durch Vermeidung von Bedarf an Behandlung, Rehabilitation und Pflege. Die lange politische Missachtung des Praventionsansatzes und seine kaum mehr nennenswerte offentliche Forderung haben zu einer volligen Unterentwicklung hierzulande beigetragen. Der 1. Nationale Praventionskongress will einen Neuanfang in Sachen Pravention und Gesundheitsforderung, und er will in diesem Zusammenhang eine zukunftig starkere Zusammenarbeit zwischen Wissenschaft und Praxis anstossen."

The last thirty years have seen an unprecedented increase in the discovery of new drugs, and moreover, these drugs, unlike many of the nostra of former times, have varied and powerful pharmacological actions. The occurrence of one or two "drug disasters," together with a change in public attitudes, has made it necessary for governments to introduce legislation to control the intro duction and release of new therapeutic agents, and most countries in the Western World have some form of drug licensing agency. Whole series of regulations have appeared which aim at discovering and defining the toxicity of new drugs. Many of these regulations rely heavily on testing drugs in animals before they are used in man, and at present very extensive and prolonged animal studies are required by most licensing authorities. It is most opportune that Professor Folb has decided to review the present position in this monograph. It is not only inhumane but also wasteful of time and money if extensive animal experiments which have little or no relevance to the human situation are carried out; furthermore, such results may even be dangerously misleading. There is little doubt that some preliminary animal investigations are necessary, but it is essential to keep their relevance under continuous review and to adopt a critical and flexible approach rather than heap regulation upon regulation."

Coronary heart disease is the principal cause of death in all Western countries. Abnormalities in the serum lipids are one of the major risk factors widely recognised as leading to this epidemic of heart disease. These abnormalities occur very com monly in the general community and in general practice, and practitioners are pre vailed upon daily to provide specific advice about diet and cholesterol and to interpret chemical estimations. This is a very emotive area of medicine, one where often the patients most active in seeking advice have the least to gain. On the other hand, there may be young people carrying a severe coronary risk, knowingly or not, who prefer to avoid risk factor in tervention. There are strong vested interests in the commercial world who would prefer to overlook any therapeutic value of dietary modification for selected in dividuals, and others who see great merit in a particular diet. The pharmaceutical in dustry has a vested interest in the cholesterol story as well. The individual doctor needs to decide for himself whether the cholesterol issue requires action or not, and for this he needs access to up to date and relevant data. This is one of the purposes of this book. The use of lipid-lowering therapy is usually quite a straightforward exercise for any medical practitioner, once the decision has been taken to initiate it.

Blood is life, its complex composition is finely attuned to our vital needs and functions. Blood can also signify death, while 'bloody' is a curse. Arising from the 2021 Darwin College Lectures, this volume invites leading thinkers on the subject to explore the many meanings of blood across a diverse range of disciplines. Through the eyes of artist Marc Quinn, the paradoxical nature of blood plays with the notion of self. Through those of geneticist Walter Bodmer, it becomes a scientific reality: bloodlines and diaspora capture our notions of community. The transfer of blood between bodies, as Rose George relates, can save lives, or as we learn from Claire Roddie can cure cancer. Tim Pedley and Stuart Egginton explore the extraordinary complexity of blood as a critical biological fluid. Sarah Read examines the intimate connection between blood and womanhood, as Carol Senf does in her consideration of Bram Stoker's novel Dracula.

Wahrend uber die Moglichkeiten und Grenzen bildgebender Verfahren in der Detektion und Diagnostik von Raumforderungen der Oberbauchorgane, insbesondere der Leber, eine Vielzahl von Publikationen existieren, sind Veroffentlichungen uber die Wertigkeit, die klinische Relevanz und den differenzierten Einsatz von bildgebenden diagnostischen Untersuchungsverfahren zur Abklarung von Milzveranderungen rar. Zudem wurden in der Vergangenheit meist nur einzelne Kasuistiken veroffentlicht. Der Grund hierfur liegt in der Seltenheit umschriebener Milzprozesse. In der vorliegenden klinischen Studie wurden retrospektiv die im Zeitraum von Januar 1996 bis Dezember 2003 am Institut fur Pathologie der Universitatsklinik Regensburg erhobenen makroskopischen histologischen Diagnosen von fokalen und diffusen Lasionen der Milz gesammelt, kategorisiert und analysiert. Durch anschliessenden Vergleich der Detektions- und diagnostischen Ergebnisse der bildgebenden Befunde aus den Ultraschalluntersuchungen (konventionell-native B-Mode- und kontrastmittelunterstutzte Sonographie), den Schnittbildverfahren (Computer- und Magnetresonanztomographie) sowie der nuklearmedizinischen bildgebenden Diagnostik (Positronen-Emissions-Tomographie) mit dem durch radikale oder partielle Milzexstirpation oder Probebiopsie gewonnenen histologischen Material und den daraus abgeleiteten Validitatsparametern lassen sich der klinische Stellenwert und die Grenzen dieser bildgebenden Verfahren in der Milzdiagnostik verdeutlichen. Besondere Bedeutung kommt dabei der Beantwortung der Frage nach einem moglichst effizienten und effektiven Einsatz der trennscharfsten bildgebenden Untersuchungsverfahren sowie der Entscheidung fur deren seriellen oder parallelen Einsatz in der Primar- und weiterfuhrenden Diagnostik zu

Gas Bubble Dynamics in the Human Body provides a broad range of professionals, from physicians working in a clinic, hospital or hyperbaric facility, to physical scientists trying to understand and predict the dynamics of gas bubble behavior in the body, with an interdisciplinary perspective on gas-bubble disease. Both iatrogenic and decompression-induced gas bubbles are considered. The basic medical and physiological aspects are described first, in plain language, with numerous illustrations that facilitate an intuitive grasp of the basic underlying medicine and physiology. Current issues in the field, particularly microbubbles and microparticles, and their possible role in gas-bubble disease are included. The physical and mathematical material is given at several levels of sophistication, with the "hard-core" math separated out in sections labelled "For the Math Mavens", so that the basic concepts can be grasped at a descriptive level. The field is large and multi-disciplinary, so that some of the discussion that is at a greater depth is given separately in sections labelled "In Greater Detail". Skipping these sections for whatever reason, shouldn't materially hamper acquiring an overall appreciation of the field.

This work provides new editions with introduction and commentary of five odes from Pindar's Nemeans. Three celebrate victories won by Aeginetans at the Nemean games (Nemeans 4, 6, and 8). The remaining two are drawn from the appendix to the book: Nemean 10, for the Argive wrestler Theaeus and his family, including the famous myth of the Dioscuri, and Nemean 11, for the installation of a prytanis on the island of Tenedos. The commentaries elucidate problems of metre, text, and interpretation, and provide up-to-date treatment of the language and subject-matter of the poems.

Kleinians is a compelling account of the extraordinary revolution in psychology pioneered by the psychoanalyst Melanie Klein and nine of her colleagues and followers, including Susan Isaacs, Joan Riviere, Wilfred Bion, Frances Tustin and Hanna Segal.

Drawing on her experience as a professor, writer and therapist, Janet Sayers tells the story of this revolution through an account of the personal and public lives of its main architects, their families and patients. The result is a lively mixture of biography, psychoanalytic theory and individual case studies. The author begins with Klein's pioneering extension of Freud's theories to the analysis of very young children. This led to her claim that from birth onwards children internalize figures from their outer world, resulting in an interaction of inner and outer factors which then govern our psychology. Sayers shows how, sometimes with bitter controversy, this radical insight was variously developed, and is still being developed by Klein's followers, thereby enormously enhancing our understanding of the creative and destructive factors shaping our everyday lives.

Kleinians continues the engaging biographical approach of Sayers's previous successful collections, Mothering Psychoanalysis and Freudian Tales, and will be appealing and informative to all those interested in psychology -- to students and specialists (in psychiatry, psychotherapy, counselling and social work), and to general readers alike.

This very important work laid the foundation for my subsequent dissertation and for my research work and publications on colorectal cancer. For the first time, several authors systematically summarized one disease exclusively as to its origins, pathology, diagnostics and therapy. This novel concept made a lasting impression on me in my scientific work. Manfred Georg Krukemeyer, MD, Department of Surgical Research, Westphalian Wilhelm University, Munster"

Physiology is the study of the normal working of the body. It is essential that its principles should be understood by nurses and doctors, for only if you know how the body works normally can you understand what is happening during disease. This first chapter covers the whole of physiology in outline, so that as later you read the chapters devoted to giving details of the various systems, you will be able to see where each system fits into the scheme of things. THE CELL You can learn a great deal about physiology by considering the requirements of a simple, single-celled organism such as the amoeba. These requirements may be summarized as follows: 1. Supplies. All living organisms require a supply of energy if they are to survive. Plants can obtain their energy directly from the sun and by using very simple inorganic materials they can manu facture all the substances they need. But animals must obtain their energy from the complex materials which they take in as food. The energy is released by the process known as oxidation (burning), in which food is broken down and combined with oxygen to release all the energy which is required. Animals therefore obviously need a supply of food and a supply of oxygen. Since the animal body is largely made up of water, they need a supply of water as well. The amoeba finds it easy to obtain all these materials from the water which surrounds it."