Knowledge Translation in Health Care is a practical introduction to knowledge translation for everyone working and learning within health policy and funding agencies, and as researchers, clinicians and trainees. Using everyday examples, it explains how to use research findings to improve health care in real life. This new second edition defines the principles and practice of knowledge translation and outlines strategies for successful knowledge translation in practice and policy making. It includes relevant real world examples and cases of knowledge translation in action that are accessible and relevant for all stakeholders including clinicians, health policy makers, administrators, managers, researchers, clinicians and trainees. From an international expert editor and contributor team, and fully revised to reflect current practice and latest developments within the field, Knowledge Translation in Health Care is the practical guide for all health policy makers and researchers, clinicians, trainee clinicians, medical students and other healthcare professionals seeking to improve healthcare practice.

The NATO-Advanced Research Workshop "Esterases, Lipases and Phospholipases: From Structure to Clinical Significance" was held at the University of Bordeaux II, France from 22nd- 24th September 1993 under the Directorship of Professor Michel Clerc of the University of Bordeaux II. The meeting was organised by Hugues Chap (INSERM U 326, Toulouse, France), Georges Ferard (University of Strasbourg, France), Wolfgang Junge (University of Kiel, Germany) and Michael Mackness (University of Manchester, UK). In recent years it has become increasingly apparent that hydrolytic enzymes of the esterase, lipase and phospholipase type play central roles in the pathophysiology of many human diseases. The purpose of this NATO-ARW was to bring together experts (both clinical and scientific) in all three interrelated fields to review the current basic and clinical position and discuss future developments particularly with respect to future research aimed at determining the basic biochemical lesion involving hydrolytic enzymes involved in human disease and the use of these enzymes in diagnosis. As well as formal lectures from established researchers, the meeting also involved a number of lively round-table discussions on future developments and presentations from younger research workers, all of which are recorded in this Proceedings and which contribute to the success of the meeting.

RevMED 300 SBAs in Clinical Specialties is a book of 300 single best answer questions covering a range of topics in paediatrics, obstetrics and gynaecology and psychiatry. These topics are the focus of 4th or 5th Year examinations in most medical school curriculums and have usually been separated from topics in general medicine and surgery.Question books are an exceptionally useful resource for medical students preparing for their clinical exams. RevMED 300 SBAs in Clinical Specialties is written by students who have recently sat clinical examinations at medical school and is designed to be student-friendly with detailed explanations and flow charts summarising the most up-to-date guidelines. The questions have been edited by teaching fellows and registrars to ensure the topics covered provide students with a functional understanding of important concepts with the hope of aiding their future careers.

Current Review of Asthma comprises up-to-date information related to the field of asthma diagnosis and treatment. The book has broad appeal, because it features in-depth, concise discussions on concomitant diseases and treatment choices. Examples of some of these chapters include epidemiology, pathology, airway remodeling, and pathophysiology. The 37 contributors are well-known scientists and clinicians from the US and UK. Each chapter establishes an overview of the topic, followed by a detailed analysis of the information at hand, which is supplemented by charts, tables, and graphs. In addition, editor Dr. Michael A. Kaliner contributes his own chapter, entitled "The Pathogenesis of Bronchial Asthma," written from 30 years of experience treating patients with asthma. This book is an invaluable resource to both the primary care physician and the asthma specialist.

People with intellectual disability often have health needs that go unrecognised and untreated; this may be because of difficulties in communication, diagnostic overshadowing, discrimination or indifference. There is concern that public health measures aimed at reducing the main health killers in the population will not address these issues for people with intellectual disability and may preferentially widen the inequality that already exists. This book is a comprehensive and systematic review of physical and mental health co-morbidities in people with intellectual disability. Such an evidence base is vital in shaping public health policy, healthcare commissioning and the development of more effective healthcare systems, as well as supporting better understanding and practice at an individual clinical level. This is essential reading for policy makers and commissioners of services, as well as individual practitioners across mainstream and specialist health and social care, in considering not only service developments but practice at the coalface.

In the previous two volumes of this series, we presented classic problems in internal medicine as illustrated by actual cases cared for in our institution. It has been gratifying for us to see the interest that these volumes have generated with students and trainees. We remain committed to the case method of instruction, and believe that there is no better method to learn medicine than to have an individual patient problem as the basis for study of pathophysiology, natural history, diagnosis and management. We hope that our readers find this third volume as enjoyable and instructive as the editors found it. Juan M. Bowen, MD Ernest L. Mazzaferri, MD, FACP xiii Acknowledgement The editors are grateful to Jeff Smith and Jenny Riegler for their unflagging professionalism and patience. xiv Contents Case 1 Mitral Regurgitation - Chronic Versus Acute: Implications for Timing of Surgery * . * * * . . * . . . . . * . . . . . . . . . . . 1 Harisios Boudoulas, MD Charles F. Wooley, MD Advances and diagnostic imaging in a surgical technique have changed the approach to mitral valve regurgitation. This chapter provides an expert's perspective. Case 2 Cystic Fibrosis in Adults .. * ************ 36 Andrew Libertin, MD John S. Heintz, MD As children with cystic fibrosis grow into adulthood, the internist assumes a greater role in their care. Case 3 Thrombotic Thrombocytopenic Purpura . . . . . . . . . . 51 . . . Donald E. Thornton, MD Earl N. Metz, MD, FACP Patients with ITP continue to present difficulties in diagnosis and management. Two experts discuss the current approach to ITP.

Volume 15 follows the format of earlier volumes in the series. The contents give the next installment in the varied aspects of acoustical imaging research. On this occasion, some emphasis was placed on the rela tionship of l1nderwater acoustics to acoustical imaging and a volume of papers under the title "Underwater Acoustics Proceedings from the 12th ICA Symposium held in Halifax," will appear at roughly the same time as this volume. There is no duplication in these volumes but they are in terlinked, at least to the extent that papers from common conference sessions appear in one or another volume. An innovation is the review paper presented at the beginning of the volume "A History of Acoustical Imaging," by G Wade. This fairly detailed review comes at a point in time when so much has been achieved and in some cases passed by, that a record of some of the earlier work might help to keep a balance with the large collections of research papers which have appeared in the many volumes."

In September 1991, Victor Zammit and I were in the Department of Biochemistry, the University of Cambridge, discussing ou r collaborative research project when we real ized thepotential value and need fora conference specifically concerned with fatty acid oxidation and ketogenesis. Thei dea, onceseeded, was indulged and flourished into the first "Fatty Acid Oxidation & Ketogenesis (FAOx&K) Conference"t hatwas held in the Department at Eastertime, 1992. Itw as attended byc olleagues mainly from the U. K. , France and Spain. From these modest beginnings atradition for holding a conference every second yearh asgrown and this Book results from the 4th International FAOx&K Conference that was held in London at the Institute of Child Health & Great Ormond Street Hospital forChildren NHSTrust, University College London Medical School in the new Conference Suite and was attended by colleagues from over twenty c ountries and five different c ontinents. I would like to thank allm y colleagues who havec ontributed to the conferences and, mos t importantly, to this Book. The first two c onferences were held in the University of Cambridge and were orga nized entirely by me but Simon Eaton, who came to work in London with me in Febru ary 1997,b ecame Conference Secretary andco organized the last two meetings. His contribution tot he conferences has been invaluable and w ithout hisdedicated help and effort neither the latermeetings n ort his Book would haveb een possible.

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."

There are many unanswered questions regarding the molecular nature of antibodies, components of complement, and other substances which participate in the immune response. The list of substances which need to be analyzed chemically is increasing. Plasma cell products, of course, have long been of great interest because the most prevalent ones are immunoglobulins. Other cell types, however, are the source of the broad spectrum of additional substances which classically fall into the sanctum of the molecular immunologist. It is these substances, and especially those more recently discovered, which are responsible for the broadening investigative interests of immunologists. In this volume we have provided you with descriptions of research being done with immunoglobulins and with complement. Additionally, we have in cluded two reports that deal with molecules which are among the more recent acquisitions of the molecular immunologist. The components of complement are known to react in a cascading manner which results in the lysis of cellular antigens. The first step in the classical pathway requires the activation of CI by the antibody-antigen aggregates. This volume of Contemporary Topics in Molecular Immunology begins with the report of Reid and Porter which describes their investigation of the mechanism of activation of C I. Their descriptions of C I q and of the reaction of C I with immunoglobulins are especially intriguing. It is clearly apparent from their report that activation of the components of complement is a complex phenome non.

Proceedings of the Third International Symposium on Frontiers in Biomedical Polymers including Polymer Therapeutics: From Laboratory to Clinical Practice, held May 23-27, 1999, in Shiga, Japan. This book focuses on the progress and unique discoveries in the interdisciplinary scientific and technological area of biomedical application of polymers. The topics include polymeric materials for biomedical and pharmaceutical applications, as well as polymeric materials in therapeutics.

The chapters of this book report cutting-edge research on molecular events in adiposity and type 2 diabetes, thus opening the way for innovative drug-based therapeutic strategies. It addresses all those who wish to keep in touch with recent developments in the field.

The recent sequencing of mycoplasma genomes has marked a turning point in the molecular genetic analysis of these microorganisms. Transcriptome and proteome analyses promise to provide the first definition of the total protein complement of a cell. The mycoplasma group includes the smallest known self-replicating organisms carrying the smallest number of genes. No wonder, therefore, that mycoplasmas have a special appeal to those interested in deciphering the minimal set of genes essential for life. Mycoplasma genomics facilitated better understanding of mycoplasma pathogenesis. Most impressive are the findings concerning the interaction of mycoplasmas with the immune system, macrophage activation, cytokine induction, mycoplasma cell components acting as superantigens, and autoimmune manifestations. The molecular definition of mycoplasmal adhesins responsible for mycoplasma attachment to host cells and evasion of the host immune system by antigenic variation of mycoplasmal surface components are other 'hot' subjects of research.Demonstration of the ability of mycoplasmas to enter host cells, cause fusogenic, apoptotic and oncogenic effects, as well as the possible association of mycoplasmas with arthritis, had their share in intensifying research on mycoplasma pathogenesis, bringing more researchers into the circle of those interested in this group of organisms. The present book is a comprehensive, up-to-date, multi-authored treatise.

The Update compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to every on involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

In this new volume, Dr. Gregory Fanelli, of the Geisinger Medical Center and a reknowned expert on knee injuries, provides orthopaedic surgeons with an unprecedented review of the most recent and advanced knowledge needed to successfully diagnosis and treat PCL injuries. This comprehensive and practical volume covers everything from biomechanics and anatomy, evaluation and non-operative treatment to the latest surgical treatments of PCL injuries using arthroscopy, grafts and synthetic ligament substitutes. In addition, contributions from such well-known specialists as Drs. M. Malek, Roger Larson and Fred Flandery make this an essential text for every orthopaedic surgeon.

Read with two objectives: first, to acquaint yourself with the current knowledge of a subject and the steps by which it has been reached; and secondly, and more important, read to understand and analyze your cases. William Osler, The Student Life What follows is a collection of cases-or more aptly, the stories of our patients and friends who have been seen at The Ohio State University Hospitals where our faculty have provided their care and about whom this volume is written. Today many fear that our patients are being moved from center stage while we are being distracted by the technology of medicine. This volume was written with patients in mind. The idea is that the most intriguing questions and the most rewarding answers begin and end at the bedside. This is a story of our patients, told by expert clinicians and spiced with commentary along the way. This volume in no way at tempts to be comprehensive. Instead, it is like the practice of medicine, scattered, somewhat disjointed, while at the same time intensely personal and focused upon whatever problem the patient brings to us. The discussions are not so much about disease entities as they are about patients with problem." The two are uniquely dif ferent. For instance, when the physician suspects hepatitis, not every imaginable cause can be actively investigated. Instead, tests and procedures are discriminate ly chosen, a part of medicine that is still more art than science."

This second International Symposium on Mucus in Health and Disease once again brings together basic scientists such as Biochemists, Anatomists, Biologists and Clinicians who are dealing with aspects of mucus in the various tracts of the body where it is of such great functional importance. It is fitting that the meeting should take place at Manchester University where there is so much activity in this field and our grateful thanks are due to Or Eric Chantler for his untiring efforts in organising this meeting. At the first Mucus meeting, Sir Francis Avery Jones stated "this is a subject which will justify further Symposia, both local and international." As he predicted, this meeting succeeds the first and adds further to our progress in understanding the complex and unique structure and function of the mucus secretion in its various sites of the body. Much was learned from the first meeting and it is hoped that the second will be an appropriate successor to it. The emphasis in this meeting has been to encourage discussion and the presentation of research material. In this respect, review articles have been kept to a minimum. The structure of the Conference has been organised around eight keynote addresses: one on the biosyn thesis of the general mucus glycoproteins and another on its physical properties. Other keynote papers are on the biochemical and clinical aspects of mucus in the respiratory, gastrointestinal and urogenital tracts by recognised authorities in these subjects."

The Sapporo International Symposium on "Recent Advances in Nitric Oxide Research" was held in Sapporo, Japan, in 1997, following the Fifth International Meeting on the Biology of Nitric Oxide in Kyoto, Japan, organized by Dr. Salvador Moncada, Dr. Noboru Toda, and Dr. Hiroshi Maeda. The field of nitric oxide research continues to expand rapidly, and our understanding of the physiological and pathophysiological roles of NO has increased greatly. The Kyoto Meeting was stimulating and informative, providing impetus for the Sapporo Symposium, which I had the great honor to organize. To communicate the information from these events, Dr. Ichiro Sakuma and I decided to publish this book. The contents of its chapters were contributed by the participants who were active at the Sapporo symposium and cover the majority of the presentations made during that symposium. Dr. Csaba Szabo of Children's Hospital Medical Center in Cincinnati (U. S. A. ) reviews the roles of peroxynitrite and poly(ADP-ribose)synthetase in shock, inflammation, and reperfusion injury, and Dr. David A. Geller and his colleagues of the University of Pittsburgh (U. S. A. ) review the regulation and function of NO in the liver. As contributions from the Hokkaido University School of Medicine (Sapporo), Dr. Hiroko Togashi and colleagues present their data on transient cerebral ischemia and NO production, Dr.

This book brings together a range of academic, industry and practitioner perspectives on translational medicine (TM). It enhances conceptual and practical understanding of the emergence and progress of the field and its potential impact on basic research, therapeutic development, and institutional infrastructure. In recognition of the various implications TM has for public health policy and commercial innovation, the book addresses the major systemic aspects of the field. The contributors explore the dynamic interactions and key challenges in translating new science into viable therapies for the clinic, which includes recognizing the importance of social, commercial, and regulatory environments in addition to good science.

It is a pleasure to present the book, Evaluation and Treatment of Obesity, for reference and textbook use. The text is an outgrowth of the Obesity Weight Control Track of the 1982 La Crosse Health and Sports Science Symposium, sponsored annually by the La Crosse Exercise Program, Uni versity of Wisconsin-La Crosse. With versatile faculty, topics, and attend ing professionals, the Obesity-Weight Control Track stimulated an effort to produce interdisciplinary resources on obesity. Out of this effort, three books have been compiled and edited. This book, Evaluation and Treatment of Obesity, introduces an interdis ciplinary, practical approach to obesity management. The other two books, Nutrition and Exercise in Obesity Management and Behavioral Management of Obesity, expand on the basic theories introduced in this book, providing in-depth information of value to the practicing profes sional. These three books apply the latest information from the fields of medicine, nutrition, exercise, and psychology to the problem of obesity. The information is intended to guide health professionals in the inter disciplinary management of obesity. In 1983 the Obesity-Weight Control Track focused on controversial issues of theoretical and practical concern. The speakers from this track contributed their expertise to the compilation of two additional books. Thus, Trends and Controversies in Obesity Research and Innovation in Obesity Program Development will complete the series. Consider the five volumes a consolidated, comprehensive reference related to the growing, interdisciplinary field of weight control."

Bone is a sex hormone-dependent organ, which has important implications for current therapeutic strategies in the prevention and possible treatment of bone loss in the elderly. This book contains the proceedings of the Schering Workshop on "Sex Steroids and Bone." The various chapters by leading experts give and overall view of current knowledge on the control of bone hemostasis by sex steroids and new ideas on how this controlcould be exerted. It was also of particular concern to integrate a general survey of in vivo experimentation and histomorphometric evaluation of bone tissue. The organizers of the workshop and editors of this volume hope that it will contribute to a better understanding of the role of sex steroids in bone and thus pave the way for a better experimental approach instudying drug effects on bone with the ultimate goal of improving therapy in bone diseases.

Computing and information management technologies touch our lives in the environments where we live, play and, work. High tech is becoming the standard. Those of use who work in a laboratory environment are faced with an obvious challenge. How do we best apply these technol ogies to make money for our companies? The first level of deliverable benefits is achieved through task automation. The second level is ob tained by integrating the individual islands of automation. The third, or top level, of benefits is related to applying intelligence to computing applications. The use of computing technology, at level one, to automate lab pro cedures, methods, and instruments has been profitable for many years. We can easily find yearly returns in the range of 10-50% for investments at this level. For level two, the integration of some applications has evolved and has led to data management systems and local area net working in the lab environment. Investment paybacks at level two are substantially higher, in the range of 200-400%. Examples of applications at the top level, that of intelligent systems and applications, are few and far between. And what about the payback for investments at this level? With such limited experience at level three, we can only estimate the benefits. But again, they appear to be much higher, in the range of 2000- 4000%."

The present volume is one of a series concerned with topics considered to be of growing interest to those whose ultimate aim is the understanding of the nutrition of man. Volumes on Sweetness, Calcium in Human Biology and Sucrose: Nutritional and Safety Aspects, have already been published, and another, on Dietary Starches and Sugars in Man: A Comparison, is in preparation. Written for workers in the nutritional and allied sciences rather than for the specialist, they aim to fill the gap between the textbook on the one hand and the many publications addressed to the expert on the other. The target readership spans medicine, nutrition and the biological sciences generally and includes those in the food, chemical and allied industries who need to take account of advances in these fields relevant to their products. Funded by industry but with an independent status, the Inter national Life Sciences Institute (ILSI) is a non-profit organization founded to deal objectively with the numerous health and safety issues that today concern industry internationally. ILSI sponsors scientific research, organizes conferences and publishes monographs relative to these problems. London Ian Macdonald March 1988 Series Editor Preface This volume has been prepared at a time when interest in both the biological roles of zinc and its nutritional significance is growing rapidly.

Historical Introduction The Marfan Syndrome: From Clinical Delineation to Mutational Characterization, a Semiautobiographic Account VictorA. McKusick l n 1876, E. Williams, an ophthalmologistin Cincinnati, Ohio, described ectopia lentis in a brother and sister who were exceptionally tall and had been loosejointed from birth. I Although there is a Williams syndrome that has aortic manifestations (supravalvar aortic stenosis), the name Williams was never associated with the disorder we now call Marfan syndrome. The reason is clear: Williamswas geographically removed from the leading medical centers and published in the Transactions of the American Ophthalmological Society; surely his report attracted little attention and the non-ocular features were not emphasized. 2 The case report that brought the disorder to attention was provided by a prominent Pari- sian professor of pediatrics, Antoine Bernard-Jean Marfan (1858-1942), who did much to establish pediatrics as a specialty in France and elsewhere. He was the author of widely read textbooks and monographson pediatrictopics and waseditor of Le Nourrisson for a great many years. In addition to the syndromeunder discussion here, his name is often attached to "Marfan's law" (that immunity to pulmonary phthisis is conferred by the healing of a local tuberculous 3 lesion) and Marfan's subxiphoid approach for aspiratingfluid from the pericardial sac. (Please pardon my use of the possessive form of the eponym in these two instances!) Pictures of Marfan (Fig.