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.

This work by two accomplished Polish researchers provides medical technicians and researchers alike with detailed descriptions of up-to-date methods used for computer processing and interpretation of medical images. The broad scope of the book takes in images acquisition, storing with compression, processing, analysis, recognition and also its automatic understanding. The introduction provides a general overview of the computer vision methods designed for medical images.

Intensive care is a rapidly changing area of medicine, and after four years from the 2nd edition the volume editors and authors have deemed necessary to update it. In the recent years, in fact, five new randomised controlled trials and five new meta-analyses demonstrate that selective decontamination of the digestive tract [SDD] is an antimicrobial prophylaxis to prevent severe infections of not only lower airways but also of blood. Additionally, SDD has been shown to reduce inflammation including multiple organ failure and mortality. An intriguing observation is the evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Moreover, a new chapter on microcirculation had been added. The volume will be an invaluable tool for all those requiring in depth knowledge in the ever expanding field of infection control.

Perioperative Addiction addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations. Features: * Guidance for spotting and managing addicted patients * All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol * Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals * Fascinating overview of the long history of addiction * Genetic basis of addiction, and the range of pharmacological treatments for addiction

General Medical Semiology Guide, Part Two is the second volume in a two volume set that provides a comprehensive understanding of medical semiology. Highly illustrated with many original images from the author's daily medical practice, the book highlights all signs of diseases and important semiological maneuvers. Each chapter contains a specific questionnaire of important questions that should be asked of patients in different situations to obtain valuable information that will assist in both medical thinking and in the formulation of diagnoses. Part Two covers topics on how to examine primary and secondary skin lesions, hair changes, nails, lymph nodes, breasts, and more.

This book helps to recognize the rights of refugees and provides a framework to identify and approach health needs, from basic elements like service mapping and initial interventions to more complex elements of ongoing healthcare and support and broader topics such as migration public health, migration policy and health systems. Beyond biomedical frameworks, it draws on socio-ecological models to inform assessments and integrated models of care to improve health and health equity. Set out in three comprehensive sections: public health theory (Part 1), applied public health (Part 2), and clinical approaches (Part 3), this book draws on multiple disciplines and insights from humanitarians, academics, policy experts, and clinicians from diverse contexts, with expertise in forced migration, to create an accessible reference tool to inform healthcare professionals' interactions with forcibly displaced individuals and populations in all contexts for both high and low resource countries. Apart from providing information across the spectrum of health issues, clinical specialties and global contexts, it discusses associated areas, including human rights and law, public health, medical anthropology and cultural awareness. Key Features: Bridges the gap between existing academic literature on refugee health and guidelines for health management in humanitarian emergencies Helps to develop an integrated approach to healthcare provision, allowing healthcare professionals and humanitarians to adapt their specialist knowledge for use in forced migration contexts and with refugees. Recognizes the complex and interconnected needs in displacement scenarios and identifies holistic and systems-based approaches. Covers public health theory, applied public health and clinical aspects of forced migration.

New technologies in 3D printing offer innovative capabilities in surgery, from planning complex operations through to educational purposes and providing alternatives to traditional training with more cost-effective outcomes. This hot topic title synthesizes the most up-to-date information on 3D printing and its application into surgical specialties including, hebatobilliary and pancreatic surgery, vascular surgery, orthopedic surgery, obstetrics and gynecology, cardiovascular and thoracic surgery, and more. Discusses challenges and opportunities of 3D printing across surgical sub-specialties. Covers 3D printing and its application in major surgical specialties, as well as dentistry, transplantation, global surgery, and diagnostic and interventional radiology. Consolidates today's available information on this burgeoning topic into a single convenient resource.

Nuclear Imaging of the Chest provides up-to-the minute information on the diagnostic nuclear imaging of chest disorders. The authors habe endeavored to integrate and consonsolidate the many different subspecialities in order to enable a holistic understanding of chest diseases from the nuclear medicine standpoint. Highlights of the book include the description of aerosol lung imaging in COPD and the updates on breast and lung cancer imaging. It is required reading not only for nuclear medicine practitioners and researchers but also for all interested radiologists, traumatologists, pulmonologists and cardiologists.

rope it was mainly the states of the northern and centrat European areas which succeeded in achieving the extermi nation or at least the regression of brucellosis. (The origi nal plan to present the conditions in Asia and Oceania, in cluding Australia, in maps as weil, and thereby to achieve a comprehensive worldwide review of the known and as certainable distribution of brucellosis, was not, however, practicable. ) Information available from these parts of the world, especially from Asia, is so fragmentary that the great expense required for the compilation of the map did not seem justified. On the other hand it seemed desirable to collate and document these data which had been ac quired as a basis for future research. It is tobe hoped that, at a later date, when more comprehensive data become available, the Heidelberg Academy will be able to decide to support a cartographic presentation of the occurrence of brucellosis in these parts of the world as weil. Last, but not least, the intensive research carried out by bacteriologists had led to the discovery of new species of Brucella, such as B. ovis, B. canis and B. neotomae. Further types - such as Type 4 of B. suis which occurs in reindeer and caribou - were identified. Though these new species and types, which are undoubtedly to be classed with the brucellae, have achieved regional significance in places, the three dassie species B. melitensis, B. abortus and B."

Throughout the world, scientists and the general with environmental illness. Part II presents an over public are concerned about the adverse effects of view of chemical and physical agents commonly toxic agents found in contaminated air, water, food, found in contaminated air, water, food, and soil. and soil. In the past, attention has focused on haz The problem of hazardous wastes is also discussed. ards originating in the workplace. As a consequence, Part III characterizes the body's defense against occupational medicine has become a well-recognized such exposure. Defenses at the portals of entry are and established clinical discipline. Much less atten discussed, with emphasis placed on the role of tion has been paid to nonoccupational hazards. There nutrition. Detoxication and immunologic defense is a growing awareness, however, of the dangers of mechanisms are described. Part IV indicates the exposure to toxic chemical and physical agents in importance of and provides instruction on the the homes, community, and general environment, method of including occupational and environmen especially for the fetus, the infant, the very young, tal factors in the routine medical history. The role of the elderly, and the chronically ill, those most sus enhanced susceptibility as a factor in an individual's ceptible. Environmental medicine, fOCUSing on the response to toxic exposure is discussed."

1 Einfuhrung.- 2 Diagnostische Verfahren in der Gerontopsychiatrie.- 2.1 Screening.- 2.2 Klinische Untersuchung.- 2.3 Neuropsychologische Tests.- 2.4 Elektrophysiologische Verfahren.- 2.5 Bildgebende Verfahren.- 2.6 Sonstige apparative Verfahren.- 2.7 Laborchemische Verfahren.- 3 Grundlagen der Therapie.- 3.1 Therapieziele.- 3.2 Therapeutische Grundhaltung.- 3.3 Hilfe fur Angehoerige.- 4 Typische gerontopsychiatrische Krankheitsbilder.- 4.1 Normales Altern.- 4.2 Amnesie (Gedachtnisstoerungen).- 4.3 Delir.- 4.4 Demenz.- 4.5 Depressive Stoerungen im Alter.- 4.6 Schizophrenie und andere Wahnerkrankungen.- 4.7 Neurotische Stoerungen, insbesondere Angststoerungen im Alter.- 4.8 Suchterkrankungen im Alter.- 5 Verhaltensauffalligkeiten.- 5.1 Aggression.- 5.2 Antriebssteigerung/motorische Unruhe/Erregungszustand.- 5.3 Antriebsminderung (Apathie).- 5.4 Emotionale Instabilitat (Affektlabilitat), Reizbarkeit.- 5.5 Gangstoerungen und andere Bewegungsstoerungen.- 5.6 Veranderte Nahrungsaufnahme.- 5.7 Schlafstoerungen.- 6 Rechtliche Aspekte.- 6.1 Betreuungsgesetz.- 6.2 Strafrecht.- 6.3 Zivilrecht.- 6.4 Sozialrecht (Pflegeversicherung).- 7 Medikamente.- Literatur.

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.

This is the first comprehensive volume to be published on the subject of electrical trauma in humans. Many of the world's leading experts describe the basic mechanisms of tissue injury in victims of electrical trauma, the complex and varied manifestations of electrical trauma, and state-of-the-art clinical treatment protocols. Promising new therapies still in the research stage are also discussed and assessed. The volume describes the basic physiochemical mechanisms responsible for tissue damage and explains the complex and variable ways in which electrical trauma manifests itself. An understanding of these underlying processes provides the basis for a rational and consistent approach to treatment which is highlighted in this volume. Electrical Trauma serves as a new and important source of information from a variety of perspectives that contributes to the understanding of the electrical injury problem. It is suitable for clinicians in plastic surgery, intensive care and burn units and for those with an academic and research interest in the mechanisms and causes of electrical trauma.

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.

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."

To integrate current knowledge in terms of basic and clinical science and to highlight problems, thirty world-renowned experts in the field of acute lung injury describe the state of up to date knowledge regarding the epidemiology, pathophysiology, and clinical management of acute lung injury. Novel techniques for the clinical support of these difficult patients are discussed in full. Prospects for successful pharmacological intervention are also outlined. This book is aimed at those practising within the field of critical care and is likely to become an indispensable aid to all concerned with the investigation and management of patients with severe respiratory failure.

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.

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics (1989) offering healthcare workers and students a new perspective on ethical practice. Textbook of Healthcare Ethics focuses on the social conditions in which medical practice occurs and how ethical healthcare decisions involves nurses, social workers, psychologists, technicians, and patients as well as physicians. This thoroughly revised and expanded edition addresses historical and theoretical underpinnings and practical concerns. A series of case studies serve as a guideline for further discussion. The text examines provocative issues such as organ donation, care of the terminally ill, abortion, HIV-positive healthcare professionals, physician-assisted suicide, and experimentation with fetal tissue. This is an ideal book for all members of the healthcare team as well as students and residents in any discipline of medicine.

2 Vol. 3: Hormones, Psychology and Behavior (1952). A range of interests was covered in respect to the influence of glucocorticoids on behavioral responses, as well as to the glucocorticoid status in various behavioral states and disorders. Vol. 4: Anterior Pituitary Secretion and Hormonal Influence in Water Metab olism (1952). Book II of this volume contains considerable detail about the various relationships of the glucocorticoids to other hormones with respect to their influence on water and electrolyte excretion. Vol. 5: Bioassay of Anterior Pituitary and Adrenal Cortical Hormones (1953). An entire section was devoted to chemical measurement and bioassay of gluco corticoids in blood and urine, with a comparison of these methods. Vol. 7: Synthesis and Metabolism of Adrenal Cortical Steroids (1954). Additional data on the intermediary metabolism and biosynthesis of the glucocorticoids are available in this volume and supplement the review by HECHTER and PINCUS listed below (cf. DoRFMAN, Chapter 3, Part 1 of this Handbuch volume). Vol. 8: The Human Adrenal Cortex (1955). A very wide range of articles was presented which extended from studies of the adrenal cortex itself to studies of adrenal function in a variety of human somatic and psychological stressful situa tions, and clinical conditions. DEBono, R. C., and N. ALTSZULER: Insulin Hypersensitivity and Physiological Insulin Antagonists. Physiol. Rev. 38: 389-445 (1958). The subject of this review went beyond glucocorticoids, but the influence and role of these steroids in relation to insulin, other hormones and carbohydrate metabolism was thoroughly handled."

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."

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%."

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.

"Infection in the Compromised Host" has become a classic chapter in textbooks devoted to infectious diseases and internal medicine. The numbers of compromised hosts are increasing in the era of modem medicine because of our expanded capabilities to deal with difficult diseases, especially neoplasms. As a consequence, microbiologic complications related to the intensive care administered to these patients are increasing as well. Under these circum stances, not only does the underlying illness create conditions favorable for the development of unusual infections, but often the therapy contributes to the acquisition of potential pathogens that turn into agents responsible for severe and frequently fatal disease. Granulocytopenia and immunosuppression have been the two key fac tors in predisposing patients with cancer and other serious diseases to severe bacterial infections. Colonization by hospital-acquired pathogens and breaks in the anatomic barriers-as a result of disease or medical intervention-have contributed to the high incidence of infectious diseases in these patients. Although there is some overlap between the types of infection in granulocytopenic and immunosuppressed hosts, each ofthese clinical entities has distinctive features thatjustify considering them separately, reserving the term immunocompromised hosts only when refer ring to patients who are predisposed to opportunistic infections. For about two decades, infections in granulocytopenic patients have attracted the atten tion of clinicians because they represent a model for the study of antimicrobial drugs in hosts deprived of an essential element of defense against bacterial infection, that is, an adequate number of normally functioning granulocytes.

Teach us to live that we may dread Unnecessary time in bed Get people up and we may save Our patients from an early grave. A most revealing paraphrase by Asher* of a verse by Bishop Thomas Ken more than adequately summarizes the plight of the immobilized patient, who often lies dormant and de pressed for years on end. In this volume, Dr. Steinberg has offered the reader a unique opportunity to share his many years of experience in caring for the immobilized patient. His careful attempt to explore the pathophysiologic effects of immobilization on a number of organ systems, combined with a host of practical aspects with regard to patient care, is unique and refreshing. This text should command the re spect of any physician faced with the vicissitudes and frus trations of caring for the immobilized. The final chapter de tailing "The Psychological Aspects of Immobilization," by Hammer and Kenan, offers the reader considerable insight into the essentials and value of occupational and physical therapy. It should prove most valuable to physicians as well "Asher, R. A. ]. Dangers of going to bed. Br. Med. J. 2:907, 1947. v vi FOREWORD as social workers, paramedical personnel, and the many physical therapists who come into daily contact with the nonambulatory patient. L. V. Avioli St. Louis Preface It may be a paradox that the importance of disability and immobilization has been enhanced by the very progress of medical science."