I opened my series editor manuscript of The Handbook of Contraception: A Guide for Practical Management, edited by Drs. Donna Shoupe and Siri Kjos, on a tiny plane on the way to giving a lecture in Albany, NY. I expected to peruse the ma- script, and found that I could not put it down. The Handbook of Contraception: A Guide for Practical Management is an incredibly informative and enjoyable read. In keeping with the objective of this series for primary care clinicians, there is a quality in this title that is uncommon among medical textbooks. The chapters of this book are written with extraordinary intelligence and und- standing, and with attention to practical considerations in the selection and mana- ment of contraceptive options. The authors have reviewed the science behind contraception, including the chemical structure and effects of hormonal contraception, physiology of contraception, efficacy rates, and side effects, as well as the practical considerations that are relevant in helping patients choose between different cont- ceptive options. They do this with a clarity of language and intent that lets the book cover with sufficient detail the full range of questions that any primary care clinician will have regarding any of the traditional or new contraceptive options. Also included in each chapter is a section on "counseling tips," which explicitly answers many of the questions that clinicians and their patients often have when discussing contraceptive options. For a book so useful and well done, the editors and authors deserve our thanks.

The Indian subcontinent is a vast land mass inhabited by over one billion people. Its rich and varied history is reflected by its numerous racial and ethnic groups and its distinct religious, cultural and social characteristics. Like many developing countries in Asia, it is passing through both demographic and epidemiological transitions whereby, at least in some parts, the diseases of severe poverty are being replaced by those of Westemisation; obesity, diabetes, and heart disease, for example. Indeed, as we move into the new millennium India has become a land of opposites; on the one hand there is still extensive poverty yet, on the other hand, some of the most remarkable developments in commerce and technology in Asia are taking place, notably in the fields of information technology and biotechnology. India has always fascinated human geneticists and a considerable amount of work has been done towards tracing the origins of its different ethnic groups. In the current excitement generated by the human genome project and the molecular and genetic approach to the study of human disease, there is little doubt that this field will develop and flourish in India in the future. Although so far there are limited data about genetic diseases in India, enough is known already to suggest that this will be an extremely fruitful area of research.

In the late eighties of the twentieth century I encountered a paper referring to mathematics dealing with imprecision applied to medical diagnosis. I was working in the area of medical statistics at that time, and obviously I was interested in the contents of the paper. After I had read it I became fascinated by new possibilities of medical data interpretation and processing proposed by the author. The new world of fuzziness, originated by Professor Lotfi Zadeh, seemed to open up to me and I started reading all accessible material about fuzzy set theory. Many years have passed since then. We are now living in the information so- ety and we do not experience troubles in reaching scientific material. Lately I have read many papers and books about treating medical tasks solved by using fuzzy ideas. I am still keen on tracing applications in medicine, and by myself I have been contributing to some concepts in this subject that has motivated me to p- pare my own book. The objective of writing such a book has been a little parti- lar, namely, I have intended to present the subject of fuzzy tools and techniques in medicine for eventual users. These, maybe representatives of medical or phar- cological staffs, are not expected to possess a large amount of mathematical knowledge.

The diagnosis and treatment of common dermatologic problems is a critical area of skill and knowledge for primary care physicians. According to the US Department of 1 Health and Human Services, patients present to their physicians a skin rash as their chief concern for nearly 12 million office visits each year. In 73% of these office visits, patients see their internist, family physician, or pediatrician. In this respect, astonishingly, primary care clinicians see far more skin disease in their offices than dermatologists. Dermatology Skills for Primary Care: An Illustrated Guide advances the targeted skill and knowledge base of primary care physicians, as well as the collaboration between dermatologists and primary care physicians, by its wise choice of organization, scope, and approach. Dermatology Skills for Primary Care: An Illustrated Guide by Drs. Trozak, Tennenhouse, and Russell is an important addition to the dermatology literature because it has been written collaboratively by a skilled dermatologist and two excellent academic family physicians. As such, the book superbly targets the depth and scope of needs of primary care practitioners in the field of dermatology.

It has never been easy to introduce new concepts and therapeutic in-terventions into surgical practice. When attempting to do so, one is faced with the interagency of traditional dogma, which still in this era of evidence-based medicine tends to dominate the surgical thought pr- ess. This is particularly so in the area of coloproctology, where prejudice and personal opinion often influence objective analysis whenever tradition is challenged. A large body of literature on anorectal prolapse has accumulated over the years; although much is based on personal viewpoint rather than scientific evidence, it has nevertheless been passed down through the generations as ac-cepted wisdom and practice. As a consequence, it is a challenge to change the mindset of a generation of surgeons and to introduce new concepts and novel techniques which at first might appear to be a radical departure from conventional teaching. It is obviously not possible to present the basis for the develop-ment of transanal stapling techniques for anorectal prolapse in this Foreword; this is dealt with in detail elsewhere in this book. The in-terested reader will have the opportunity to share in the new and emerging concepts surrounding anorectal prolapse and to deepen their understanding of the pat- physiology and basis for surgical correction. Although hemorrhoidal disease and external rectal prolapse have been known about for centuries, the understanding of internal rectal prolapse (intussusception) and rectocele has only really advanced with the emergence of radiological imaging tech-niques, such as defecography.

The proliferation of information on rotaviruses in the twenty years since their description as human pathogens has made it difficult to keep up with the latest developments in the field. Numerous aspects of rotavirus biology have been addressed in reviews, but these have been infrequent and quite selective in the material covered. The time appeared right to attempt to gather, into a single source, an overview of what we have learned. This volume is the result of that attempt. I hope that the reader will find in this single source, the core of information covering our current state of knowledge. I acknowledge my debt to the authors of the various chapters, for it is they who performed the tedious process of reviewing the literature and synthesizing and organizing it into concise works. R.F. RAMIG Contents Introduction and Overview R.F. RAMIG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Structure of Rotavirus B.V.V. PRASAD and W. CHIU .................... 9 The Rotavirus Genome U. DESSELBERGER and M.A. MCCRAE . . . . . . . . . . . 31 . . Rotavirus Protein Structure and Function G.W. BOTH, AR. BELLAMY, and D.B. MITCHELL 67 Rotavirus Replication J.T. PATTON . . . . . . . . . . . . . . . . . . . . . . .. . . . 107 . . . . . . .

This volume is intended to cover research in the field of muscle morphology since publication of the previous edition by Haggquist in 1956. The development of new techniques, coupled with an intensified interest in muscle, has resulted in a vast literature which no single person could review, especially within the limitations of one volume. When I accepted the flattering offer to write a new edition, I quickly abandoned any hope of a comprehensive review. Instead, I tried to consider, within my limits, those lines of research which I believe to be important for the understanding of mammalian and ultimately human muscles under normal, experimental, and pathological conditions. It would be naive to suggest that muscle can be adequately described in purely morphologi cal aspects; I would characterize the results of my effort as "muscle as seen with the eyes of a morphologist." It gives me pleasure to acknowledge the help of several colleagues who read and commented on drafts of individual chapters: Dr. Brenda Eisenberg, Chicago; Dr. Else Nygaard, Copenhagen; Dr. Stefano Schiaffino, Padova; Dr. Michael Sjostrom, Umea; Dr. Lars Erik Thornell, Umea. None of these individ uals can be held responsible for any error or obscurity that persists. Indeed, without their assistance there would have been more. I also thank those col leagues who allowed me to include their published and unpublished material; their names, and also those of the publishers who kindly granted copyright permission, are given in the individual figure captions."

Completely revised and including new additional material, this second edition of the bestselling Get Through MRCGP: Clinical Skills Assessment provides candidates with a definitive, one-stop revision resource for the CSA part of the MRCGP examination.

• Fully revised in accordance with the current MRCGP and MRCGP(INT) curriculum
• Mock examinations cover a spread of topics and skills outlined in the RCGP curriculum
• Comprehensive discussion of areas that stations test and detailing points needing to be covered to achieve the best results
• Brand new material including six new cases and task boxes to refocus the reader's attention on the different challenges of each station
• Completely rewritten introductory chapter
• Offers valuable advice on how to approach the exam, focus time in day-to-day GP surgeries and how to develop skills required to pass the CSA

Written by an experienced author team that has extensive knowledge of both national and international primary care clinical skills assessment, Get Through MRCGP: Clinical Skills Assessment, Second Edition is essential reading for postgraduate candidates preparing for this challenging examination.

The Tenth International Conference on Intracellular Protein Catabolism was held in Tokyo Japan, October 30-November 3, 1994. under the auspices of the International Committee on Proteolysis (lCOP). ICOP meetings have been held biennially in the USA, Europe, and Japan in turn. The previous three ICOP meetings (7th to 9th) were held in Shimoda, Japan, in 1988. in WildbadKreuth, Germany, in 1990, and in Williamsburg. Virginia, in 1992. Previous meetings were held in resort areas, this was the first meeting held in a large city. Attendance has grown every year so that nearly 400 participants from 19 different countries attended the Tokyo meeting. At the meeting, novel and updated results on the structure-function. physiology, biology, and pathology of proteases and inhibitors were discussed, together with cellular aspects of proteolysis and protein turnover. Thirty-nine invited papers and eight selected posters were presented orally and 171 poster presentations were discussed. This book documents almost all of the lectures and some selected posters. Since the world of proteolysis and protein turnover is expanding very rapidly. far beyond our expectations, it is impossible to cover all the new aspects of this field. However, this book will give an idea of the current status, trends. and directions of the field, and information necessary to understand what is and will be important in this field. Further. the editors hope that the novel ideas, approaches. methodologies, and important findings described in this book will stimulate further study on proteolysis and protein turnover.

An insight into new advances of current interest in metal toxicology, such as mechanisms important in risk-assessment for human health. The book also has chapters on emerging conceptual problems including resistance to metal toxicity effects on gene expression, alongside principles regarding drug-chelation of metals, the potential use of prophyrins as indicators of metal exposure and toxicity. The toxicology of specific metals of major public health concern are discussed in depth, such as mercury, aluminum, arsenic, chromium, and cadmium. Of interest to basic scientists as well as public health administrators.

After a long period of neglect, the gastrointestinal tract is increasingly being recog nized as an important target of anesthetics and anesthesia-related processes, as well as of conditions and treatments related to peri- and postoperative period and inten sive care. Drugs used in anesthesia and intensive care and physiological or pathologi cal changes in the perioperative period affect the digestive system in its function from the pharynx to the colon. Prolonged postoperative ileus or stasis of propulsive peri stalsis in the critically ill or multiply injured patient may impair enteral nutrition and give rise to complications such as sepsis or multiple organ failure. In view of this new understanding of the clinical relevance of gut function, we felt that a book on problems of the gastrointestinal tract in anesthesia, the perioperative period, and intensive care was badly needed. The present volume is the product of an international symposium which brought together physiologists, pharmacologists, experimental and clinical anesthetists, gastroenterologists, surgeons, and intensive care physicians to discuss all major contemporary aspects of bowel function in health and under the influence of anesthesia, surgery, and intensive care."

Now, in one volume, the latest research from the areas of molcular biology, neurochemistry and behavior analysis of drug abuse and dependence, with, wherever possible, an integration of the data from these various levels of analysis. The ensuing reports point to the complexity of the phenomenon of abuse and dependence and clearly demonstrate that it is determined by a variety of variables from molecular biology and genetics through behavioral history. This complexity is shown, however, to be responsive to rigorous scientific analysis and our success to date gives rise to hope that this distressing public health problem can ultimately be brought under control. Each of the chapters is written by a leading researcher in the field.

for the design of control programs; in extreme cases (as dis cussed below, by Fine et al., this volume, and elsewhere) it can happen that immunization programs, although they protect vaccinated individuals, actually increase the overall incidence of a particular disease. The possibility that many nonhuman animal populations may be regulated by parasitic infections is another topic where it may be argued that conventional disciplinary boundaries have retarded investigation. While much ecological research has been devoted to exploring the extent to which competition or predator-prey interactions may regulate natural populations or set their patterns of geographical distribution, few substan tial studies have considered the possibility that infectious diseases may serve as regulatory agents (1,8). On the other hand, the many careful epidemiological studies of the trans mission and maintenance of parasitic infections in human and other animal populations usually assume the host population density to be set by other considerations, and not dynamically engaged with the disease (see, for example, (1,2)). With all these considerations in mind, the Dahlem Workshop from which this book derives aimed to weave strands together -- testing theoretical analysis against empirical facts and patterns, and identifying outstanding problems -- in pursuit of a better un derstanding of the overall population biology of parasitic in fections. For the purpose of the workshop, the term "parasite" was de fined widely to include viruses, bacteria, protozoans, fungi, and helminths."

In this exploration of the significance of illness in the Victorian literary imagination Miriam Bailin maps the cultural implications and narrative effects of the sickroom as an important symbolic space in nineteenth-century life and literature. Dr Bailin draws on non-fictional accounts of illness by Julia Stephen, Harriet Martineau and others to illuminate the presentation of illness and ministration, patient and nurse, in the fiction of Charlotte Bronte, Charles Dickens and George Eliot. She argues that the sickroom functions as an imagined retreat from conflicts in Victorian society, and that fictional representations of illness serve to resolve both social conflict and aesthetic tension. Her concentration on the sickroom scene as a compositional response to insistent formal as well as social problems yields fresh readings of canonical works and approaches to the constituent elements of Victorian realist narrative.

This book provides a state-of-the-art, comprehensive overview of the diagnosis and treatment of sleep disorders. It details evidence-based practice recommendations using parameters primarily developed by the American Academy of Sleep Medicine. The book offers a thorough and extensive board review for specialization in sleep medicine and supports primary care clinicians in appropriately using sleep diagnostic testing results in clinical practice.

Translational Research and Clinical Practice offers a clear and comprehensive introduction to evidence-based medicine. The use of medical literature has always been an integral tool for patient care, yet recently the modern processes of question formulation, literature search, and study evaluation have changed with the advent of the internet and technology. The physician must be able to find empirical evidence from the appropriate study using a searchable question and then determine its impact on patient care. The book provides the general framework for such medical decision making; it covers all kinds of cases and strategies, including questions of diagnosis, therapy, prognosis, differential diagnosis, clinical presentation, and causality.
The tested material and approaches in this book are based on a course developed and taught by the author at Temple University School of Medicine. Organized for ease of use, accessibly written, and replete with clinically germane examples, Translational Research and Clinical Practice is a concise guide for medical students and clinicians seeking to effectively interpret and apply medical evidence in daily practice.

USMLE Step 2 Clinical Skills Triage is the indispensable preparation book for the Step 2 Clinical Skills exam, presenting 40 high-yield patient-encounter cases that simulate the examination experience. Cases are organized for straightforward learning: a sample dialogue that mimics actual doctor-patient communication is followed by guidelines on performing the physical exam, ending the case, writing the patient note, and outlining the differential diagnosis. Comprehensive yet succinct, the cases address almost all possible exam scenarios, including telephone cases and "difficult patient" encounters. Each case contains detailed and relevant information on presenting complaints and conditions, with pertinent points highlighted and boxed for easy review. Written by the author of the popular USMLE Step 3 Triage, this book is optimal for either individual or group study and for any student interested in reviewing how to practice applying medical knowledge and patient-centered skills.

Step 2 Clinical Knowledge is one of the hardest exams you'll take in your medical training, and it's very important to do well Preparation is the key that separates successful candidates from the rest.
USMLE Step 2 Triage provides a thorough yet high-yield review for the exam, covering a gamut of frequently tested specialties and subspecialties with emphasis on pertinent principles of clinical science and patient-centered skills. Consistently organized, each topic is structured to provide the material in a manageable format, divided into several sections: "Symptoms," "Diagnosis," "Treatment," and "Take Home Points." USMLE Step 2 Triage is geared to facilitate the most comprehensive and efficient preparation for the exam; it is packed with tables and figures, and features 100 full color images. Written by the author of the popular USMLE Step 3 Triage and the USMLE Step 2 Clinical Skills Triage, this book will help deliver the best results for any student studying for the Step 2 Clinical Knowledge exam.

The book aims to review knowledge on the disorders of eating behaviour and body composition in some of the non-primate higher animals and to relate these to similar conditions in humans. With advances in understanding the nature of these disorders and their biological basis, it seems timely to assess what cross-species comparisons can tell us about the general underlying factors at work. This may also help to delineate what may be a general biological basis that humans share with their higher animal comrade species and what may distinguish human from non-human, particularly in a cultural context. This could help in combating better the problems of these conditions in the animal species as well as in man and in suggesting well-based preventive measures. As far as people are concerned the last two decades of the 20th century have shown a significant increase in obesity in the richer countries, particularly the USA (Table 1). Possibly associated with the obesity boom, there is an increasing awareness of other disorders of eating behaviour and body composition. These range from anorexia nervosa, at the other end of body composition to obesity, to others, such as bulimia, with more variable effects on body composition.

Few clinical disciplines have been transformed so dramatically by advancements in science and technology as gastrointestinal surgery. To begin with, modern ph- macology has virtually eliminated some kinds of surgery altogether. If one were to take a peek at a typical operating room schedule in a busy hospital of the 1960s, gastrectomies of one kind or another would have constituted a large block of the major surgeries. The advent of effective H2-histamine receptor antagonists and, more ] + recently, the H, K -ATPase (proton pump) inhibitors led to a precipitous decline in those procedures such that they are rarely performed today. Exciting new approaches to treating inflammatory bowel diseases and their complications-such as fistulas- with anticytokine therapy may one day have a similarly profound effect on surgery for this condition as well. Beyond pharmaceutics, advances in imaging techniques have greatly facilitated the identification and characterization of pathology in the gastrointestinal tract in a way that would have been unimaginable only a few years ago. Just to visualize the pancreas in some way was a horrendous task until abdominal ultrasound, magnetic resonance imaging, or computer tomography made it simple. The fact that the gut is a hollow organ that can be accessed through the mouth, anus, or even through the wall of the abdomen has been fully exploited with fiberoptic endoscopes that can bend around corners with ease and permit surgery to be conducted through them.

This practical, engaging book provides concise, real life-tested guidance to healthcare teams concerned with widely reported and incentivized hospital quality and safety metrics, offering both a conceptual approach and specific advice and frameworks for reviewing quality and safety numerator events, from the perspective and experience of clinicians and administrators working within the Ochsner Health System. The text opens with the rationale for closely managing widely (including publicly) reported hospital patient quality and safety measures. Attention is given to the financial implications of quality performance, with respect to both penalties and payment incentives used by payer organizations. It then reviews the major public ratings and their relevant methodologies, including CMS, AHRQ and NSHN. In addition, it addresses ratings by proprietary organizations that have a large member clientele, such as Vizient, USNews, Leapfrog, Healthgrades, CareChex and others. Each metric - for example, the AHRQ Patient Safety Indicators (PSIs), and other metrics such as readmission rate, risk adjusted complications, hospital-acquired conditions and mortality - is addressed in a stand-alone chapter. For each, the importance, approach to review, opportunity for optimization, and engagement of healthcare staff are reviewed and discussed. Overall, this book forefronts the benefits of a collaborative approach within a health system. The concurrent review process, multidisciplinary collaboration among quality improvement, clinical documentation, coding and medical staff personnel are all emphasized. Also described in detail is the approach to and specific opportunities for medical staff education and engagement. Additional key topics include Engagement of the Medical Staff and House Staff (i.e., residents and other trainees), Futile Care, Surgical Quality Improvement (NSQIP), Nursing Provider Partnership, and Translation of Data Review to Successful Performance Improvement. Specialty chapters on pediatric, neurologic and transplant quality metrics are also included.

Authored by leading international researchers, this monograph introduces and reviews developed tomograhic methods for discovering 2D and 3D structures of the ionosphere, and discusses the experimental implementation of these methods. The detailed derivations and explanations make this book an excellent starting point for non-specialists.

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.