The scope for improving health care using stem cell therapies is thrilling, but has considerable technical challenges and methodological constraints that need to be addressed. Keeping with the tradition of Humana Press to bring these developments to the forefront in a timely manner, this book presents scientific advances in stem cell methods for a wider use by novice and expert scientists, through the series of Methods in Molecular Biology.

Although breast-feeding has long been associated with lowered infant morbid- ity and mortality from infectious disease, until relatively recently little was known regarding the individual components of human milk aside from their nutritive func- tions and the presence of secretory antibodies. Over the last 40 years, and especially over the last decade, evidence has been growing that human milk contains a large number of materials that are bioactive and that are not found in artificially formu- latedinfantdiets. Disparatelinesofresearcharecurrentlyproducingsurprisinglylong listsofnewlyrecognizedhumanmilkcomponents-antimicrobialsand immunomod- ulators, includinganti-inflammatoryagents, antioxidants, cytokines, andhormones- with biological activities that relate to pathogenesis, inflammation, development, metabolic regulation, and other functions. The sum of all of these biologically active milk components may account for the strong protection that human milk affords nursing infants. Strictly speaking, most components of human milk could be considered bioac- tive, since nutrients are bioactive by definition. A major emphasis of this book, how- ever, is on defining what is known about components of human milk that inhibit common pathogens of the infant, those that have hormonal and/or cytokine activity, those that have immunomodulatory and/or anti-inflammatory activity, xenobiotics, and nutrients that are uniquely essential to early development. The topic of bioactive substances in human milk was explored in depth at the th 8 International Conference of the International Society for Research on Human Milk and Lactation (ISRHML) held at Plymouth, Massachusetts, October 25-29, 1997. This book contains the proceedings of that conference.

This is a basic book on evidence-based medicine (EBM). It starts with an introduction to the topic. It outlines the relationship between EBM and research and quality of care. Then it goes on to cover the most commonly used modules of EBM, i.e. therapy, diagnosis, prognosis and meta-analysis. Each module starts with an introduction to fundamental concepts, and description of the related research process, and then follows the critical appraisal of related type of research article. At the end, it covers the different systems of grading of level of evidence and strength of recommendations. The book also has three examples of critical appraisal on diagnosis, therapy, and meta-analysis.

The complement system, first described more than a century ago, was for many years the ugly duckling of the immunology world, but no more. Complement in recent years has blossomed into a fascinating and fast moving field of immediate relevance to clinical scientists in fields as diverse as transplantation biology, virology, and inflammation. Despite its emergence from the shadows, complement retains an unwarranted reputation for being "difficult." This impression derives in large part from the superficially complicated nomenclature, a relic of the long and tortuous process of unraveling the system, of naming components in order of discovery rather than in a syst- atic manner. Once the barrier of nomenclature has been surmounted, then the true simplicity of the system becomes apparent. Complement comprises an activation system and a cytolytic system. The former has diverged to focus on complement to distinct targets-bacteria, - mune complexes, and others-so that texts now describe three activation pa- ways, closely related to one another, but each with some unique features. The cytolytic pathway is the same regardless of the activation process and kills cells by creating pores in the membrane. Complement plays an important role in killing bacteria and is essential for the proper handling of immune complexes. Problems occur when complement is activated in an inappropriate manner-the potent inflammation-inducing products of the cascade then cause unwanted tissue damage and destruction.

Arachidonic acid (AA) and other 20 or 22-carbon polyunsaturated fatty acids (PUFAs) are precursors of lipid mediators of inflammation known as eicosanoids. These mediators are critical in disease processes and in regulating normal cell function. Remodeling is important in maintaining homeostasis and in regulating cell function by dictating how PUFAs are converted to lipid mediators of inflammation. Thus, PUFA remodeling is a critical process in the biosynthesis of a multitude of mediators, and understanding this process will unravel better therapeutic targets for controlling inflammatory diseases such as asthma and Alzheimer s disease.
AA metabolism is described in an integrated context linking the remodeling processes with the biosynthesis of mediators and diseases. By following the movement of the substrate (AA), the volume describes how upstream biosynthetic pathways influence the formation of lipid mediators of inflammation, showing the metabolic interrelationship between all AA-derived mediators."

The metabolic syndrome is a common syndrome affecting about 20 % of the adult population in Europe, and probably the prevalence is of the same magnitude in other industrialised countries worldwide. It is mainly caused by western lifestyle resulting in abdominal obesity, but also a genetic predisposition plays a role. This syndrome, which is linked to leisure lifestyle and overeating/obesity, can develop into type 2 diabetes, cardiovascular disease and cancer. Therefore, proper treatment and prevention are heavily needed. This book discusses lifestyle intervention and treatment, specifically with pharmacological compounds, in order to formulate a strategy for treating the metabolic syndrome in the daily clinic.

From explanations of the roles of hormones to detailed descriptions of testing options and treatment choices, this book is a guide to male hormones: What they do, what goes wrong, and what can be done about it. Testosterone levels begin to decline in men at the age of 30. But, as this book shows, men can take steps to normalize hormone levels. With the twin goals of education and empowerment, two naturopaths explain the roles of male hormones and why decreasing testosterone levels affect body and mind. His Change of Life: Male Menopause and Healthy Aging with Testosterone offers detailed descriptions of testing options and, most importantly, specific treatment choices offered by both allopathic and alternative models that will enable men of all ages to live life to the fullest. Symptoms the authors address include night sweats, reduced flexibility, loss of muscle mass, low sex drive, and high blood pressure. Solutions they explain include stress management, exercise, nutrition, dietary supplements, and androgen replacement therapy. Conventional treatments are also covered, as are potential side effects of actions men may take. The authors detail which actions are safe to take on your own, and which need the supervision of a medical expert. 14 tables and graphs explain the main points of each chapter A list of endnote references appears at the end of every chapter

An Exciting New Approach to Regaining Health Without Surgery!

Fact: By the time they reach menopause 40 percent of American women have at least one uterine fibroid; 600,000 women are diagnosed each year.

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Fibroid tumors, while usually benign, can swell a woman's uterus to the size of a basketball, frequently causing heavy menstrual bleeding, cramping, bladder infections, and even infertility. Most doctors recommend surgery as the only answer. Now this innovative holistic program brings new hope for a surgery-free life to millions of American women.

Dr. Allan Warshowsky combines traditional Western medicine and holistic science to cure not just the fibroid condition but also the underlying imbalances and systemic dysfunctions that can cause fibroids. With an exciting program of diet, exercise, supplements, herbs, and mind/spirit work, Dr. Warshowsky shows fibroid sufferers how to become the strong, healthy women they deserve to be.

The correspondence between Sir Ronald Ross (1857-1932) and Sir Patrick Manson (1844-1922) is rich in both scientific and human terms. It records, in great detail, Ross's research in India between 1895 and 1899, which elucidated the role of mosquitoes in the transmission of malaria, work for which Ross was awarded the 1902 Nobel Prize for Medicine or Physiology.

Evidence for the efficacy of behavioral approaches to the treatment and management of physical illness is mounting, as is the evidence for behavioral interventions for psychological disorders. A pressing question that remains is how to effectively treat co-morbid physical and psychological illnesses. Diseases co-occur more often than not, and the co-occurrence of physical and psychological illnesses is associated with greater impairment and healthcare costs. Unfortunately, the treatment literature has traditionally been disease-specific, with fewer insights and discoveries regarding the underlying processes of co-morbid physical and psychological illnesses, and even fewer of approaches to treatment.Research on co-morbidities between physical and psychological illnesses has focused primarily on depression. Quite extensive literatures describe the negative impact of depression on type 2 diabetes, cardiovascular disease, cancer, obesity, pain, and other physical illnesses. More recently, higher rates of physical illness have been documented in individuals with bipolar disorder, anxiety disorders, schizophrenia, and impulse control disorders. Studies emanating from the National Comorbidity Survey-Replication (NCS-R), the only U.S. population-based database that includes diagnostic information on all DSM-IV psychological disorders, have revealed strong links between a number of physical and psychological illnesses. These data draw attention to the prevalence of physical and psychological co-morbidities at the population level, which has stimulated research on the biobehavioral mechanisms of those co-morbidities, with the goal of developing and improving treatment approaches. As this area of research grows, practical resources are needed for clinicians and researchers who encounter individuals with co-morbid physical and psychological illnesses in their work. This book is the first to provide a comprehensive overview of psychological co-morbidities of physical illness, biological and behavioral mechanisms of those co-morbidities, and implications for treatment. Each chapter focuses on a physical condition, such as obesity, type 2 diabetes, HIV infection, tobacco dependence, cardiovascular disease, cancer, asthma, pain, irritable bowel syndrome, autoimmune disorders, and obstetric/gynecological conditions. Chapters are structured to cover 1) the epidemiology of the most prevalent co-morbid psychological disorders within that physical condition (e.g., depression and other mood disorders, anxiety disorders, psychotic disorders, impulse control disorders, and eating disorders; 2) biobehavioral mechanisms of the co-morbidity; 3) a review of the behavioral treatment literature including evidence-based practice guidelines (where available); and 4) treatment considerations including issues of stepped care, evidence-based treatment decisions, treatment sequencing, treatment blending, treatment interactions, and contraindications. Content is guided by available research evidence and relevant theoretical models, and it is presented in such a way as to inform clinical practice, identify important gaps in the research literature, and provide directions for future research. The book serves as a tool for clinicians and researchers who work in the area of behavioral medicine in medical, academic, and/or training settings. Patients with psychological and medical co-morbidities may be encountered by clinicians working in either mental health or medical settings, where the presenting problem could be either the psychological disorder or the medical disorder. As such, assessment and treatment issues are discussed from both perspectives. For the clinician, the book reviews brief assessment tools, provides practical summaries of the treatment outcome literature and treatment considerations (e.g., treatment sequencing, contraindications), and includes treatment decision hierarchies that help the clinician incorporate each facet of evidence-based decisions (the evidence, patient characteristics, and their own expertise). For the researcher, the book brings together the literature for the medical and psychological disorder, highlighting still unanswered research questions relevant to the co-morbidity. Literature relevant to the underlying biobehavioral mechanisms of the co-morbidity as well as treatment are summarized. While a vast literature exists for the treatment of these disorders in isolation, one important purpose of this book is to bring together this literature to uncover specific areas in need of future study that will further our understanding of why different disorders co-occur and the best ways to treat them when they do.

Medically unexplained somatic symptoms are problematic in psychiatry, primary care settings, and other clinical areas. The burden they impose on health-care systems constitutes a significant public health problem. At the international symposium "Rethinking Somatoform Disorders," this problem was addressed by specialists working in somatoform disorders, psychiatric nosology, epidemiology, and biological and cross-cultural psychiatry. The meeting was the third of the Keio University International Symposia for Life Sciences and Medicine, in collaboration with the World Health Organization and the World Psychiatric Association.

One of the fascinations of psychiatry is that it is amenable to many different approaches. In seeking to account for mental disorder, for example, it is pos sible to explore the meaning and significance of symptoms in the psychody namic sense, to examine the social determinants of illness, or to adopt an es sentially biological viewpoint in investigating links between physiological and psychological dysfunction .. As a clinical discipline it may be practiced in the community, in the specialized clinic or hospital, or shoulder-to-shoulder with other medical practitioners in the general hospital. This richness and diversity are at once a strength and a weakness, attracting practitioners with a wide range of talents and interests, yet sometimes leading to polarizations and false an titheses. The so-called "medical model" of psychiatry has come under a good deal of attack, and deservedly so when claiming an exclusive provenance over all types and aspects of mental disorder. What cannot be gainsaid, however, is the central role of medicine in relation to many parts of the field, and the success in terms of understanding and therapy that has resulted from medicine's in volvement. Nor can it be doubted, after the most cursory acquaintance with the physically or mentally ill, that the relationship between these two forms of suffering is often so close and so mutually reinforcing that distinctions are drawn somewhat arbitrarily. This last is perhaps the cardinal reason for the alliance between medicine and psychiatry."

Clinicians at all levels must consider a myriad of tests in the diagnostic process, requiring an up-to-date understanding of changing technology and the demands of time- and cost-efficiency. Ferri's Best Test, 5th Edition, is a unique, easy-to-use guide that simplifies complex information and helps you choose the best test to supplement your clinical diagnostic skills. It includes both lab and imaging tests for concise, convenient access to all diagnostic test options for more than 200 common diseases and disorders. . Practical, concise, spiral-bound, and pocket-sized-designed from cover to cover for quick, on-the-go reference. . Three convenient sections provide quick access to key information on clinical laboratory testing, diagnostic imaging, and diagnostic algorithms. . New and updated content on cardiac computed tomography angiography, computed tomography perfusion imaging, COVID-19, and much more. . Coverage of 23 new laboratory tests and 14 new diseases and disorders. . Essential information on indications, advantages, disadvantages, approximate costs, normal ranges, typical abnormalities, likeliest causes, and more. . Experienced author Dr. Fred Ferri uses a unique, easy-to-follow format to simplify complex information and help you choose the best test for every patient. . New appendices on electrocardiography and respiratory testing and function. . Comparison tables and illustrations help improve your test selection. . Enhanced eBook version included with purchase. Your enhanced eBook includes an image collection with access on a variety of devices.

At the Sixth Wiggers Bernard Conference, a group of scientists from various disciplines discussed new findings relating to nitric oxide synthase inhibitor in shock, sepsis, and organ failure. Dedicated to the presentation and discussion of both positive and negative findings related to the use of NOS inhibitors, the meeting served as a forum for issues relating to specific and non-specific inhibitors, as well as the role of nitric oxide-oxygen radical interactions. Both experimental and clinical data were presented in the trauma and sepsis field.

The immune system has evolved mechanisms enabli ng it to discriminate between self and non-self constituents. A normally functioning organism is naturally unresponsive to self antigens originating from clonal deletion, aner- gy, or an active suppression of self-reactive T cells. The wide spectrum of autoimmune responses may be divided into systemic and organ-specific dis- eases and encompasses the actions of autoantibodies, autoantigeu-autoanti- body complexes, and sensitized T lymphocytes. The aim of this book is to review the current understandin g, concepts and hypotheses regarding the pathogenesis and therapeutic approaches in autoim- mune disorders. The first six articles are generally concerned with the mech- anisms operating in autoimmune phenomena, whereas the subsequent reviews discuss particular phenomena in representative autoimmune dis- eases. The introductory article underlines the significance of the interactions between antigen-specific T cells and other elements ot the immune system and proposes that not suppression, but rather activation of the immune sys- tem, leading to a redirection of the immune response, would be therapeuti- cally beneficial. The next articles present the importance of costim ulatory signals in determining various types of immune responses, including autoim- munity, and the role of regulatory T cells. Further, an interesting phenome- non of epitope spreading as a mechanism for the progression of autoimmune diseases is presented.

In 2009 the University Medicine Greifswald launched the "Greifswald Approach to Individualized Medicine" (GANI_MED) to implement biomarker-based individualized diagnostic and therapeutic strategies in clinical settings. Individualized Medicine (IM) has led not only to controversies about its potentials, but also about its societal, ethical and health economic implications. This anthology focusses on these areas and includes - next to clinical examples illustrating how the integrated analysis of biomarkers leads to significant improvement of therapeutic outcomes for a subgroup of patients - chapters about the definition, history and epistemology of IM. Additionally there is a focus on conceptual philosophical questions as well as challenges for applied research ethics (informed consent process, the IT-based consent management and the handling of incidental findings). Finally it pays attention to health economic aspects. The possibilities of IM to initiate a paradigm shift in the German health care provision are investigated. Furthermore, it is asked whether the G-DRG system is ready for the implementation of such approaches into clinical routine.

Clinical Decision Support and Beyond: Progress and Opportunities in Knowledge-Enhanced Health and Healthcare, now in its third edition, discusses the underpinnings of effective, reliable, and easy-to-use clinical decision support systems at the point of care as a productive way of managing the flood of data, knowledge, and misinformation when providing patient care. Incorporating CDS into electronic health record systems has been underway for decades; however its complexities, costs, and user resistance have lagged its potential. Thus it is of utmost importance to understand the process in detail, to take full advantage of its capabilities. The book expands and updates the content of the previous edition, and discusses topics such as integration of CDS into workflow, context-driven anticipation of needs for CDS, new forms of CDS derived from data analytics, precision medicine, population health, integration of personal monitoring, and patient-facing CDS. In addition, it discusses population health management, public health CDS and CDS to help reduce health disparities. It is a valuable resource for clinicians, practitioners, students and members of medical and biomedical fields who are interested to learn more about the potential of clinical decision support to improve health and wellness and the quality of health care.

As we move into the 21st century it is becoming increasingly difficult to offer appropriate introductory clinical experiences for medical students. Many schools offer clinical experiences in the first year of medical school, when the learner has little background in the traditions and origins of the doctor-patient interaction. Others begin this process in the second year, after a professional language base has been established, but concise educational materials are scarce that integrate the meaning of the privileged clinical encounter with the process and content of interviewing and examining patients. In the tertiary hospitals, where most medical schools are based, the educators must provide an orienta tion to the clinical encounter, an intensely personal experience, in the midst of glittering technological marvels that easily distract both the novice physician and the wizened teacher. Understanding the context and historical basis for the privilege of interviewing and examining another person about intimate matters relating to health and disease is essential to this process. Considering these factors, this textbook is written to assist medical educators and medical students involved in early clinical training. As the demand for "high-tech" medicine has accelerated, so has the public concern over the loss of "high-touch" or compassionate, humane interactions with physicians. Physicians are perceived as more concerned with readouts from machines and fiberoptic views of the patient than with understanding and car ing about the people we have labeled as patients."

Heat shock proteins (HSP) have received ample interest by immunologists over recent years. Initially they were found to be dominantly immunogenic microbial antigens. The connection with inflammation was established when it was uncovered that T cells specific for these antigens have a crucial role in the induction and regulation of experimental arthritis. Since then, the raised presence of immunity to HSPs in virtually all conditions of inflammation, including autoimmune diseases, transplant rejection and atherosclerosis, has emphasised the critical significance of immunity to HSPs in inflammatory diseases.

In this issue of Anesthesiology Clinics, guest editors Drs. Alison J. Brainard and Lyndsay M. Hoy oversee the topic of Total Well-being. Articles in this issue highlight perspectives from across multiple subsets of anesthesiology, including nutrition, arts and humanities, coaching, and the inequalities of medicine. The editors' goal is that readers will come away inspired, informed, and excited to create an approach for total well-being that can be tailored to their workplace and lives. Contains 19 practice-oriented topics including women in anesthesiology; parenting/lactation in anesthesia; intensivists and wellness, post-pandemic; early-career physician burnout; integrating antiracism into MedEd with health humanities program; and more. Provides in-depth clinical reviews on total well-being, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

From Simon & Schuster, The Male Body is Abraham Morgentaler's physician's guide to what every man should know about his own sexual health. The Male Body: A Physician's Guide to What Every Man Should Know About His Sexual Health covers genital injuries, vasectomies, prostate cancer, AIDS prevention, infertility, and sexual problems.