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

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

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

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

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

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

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

69 but usually such a condition is terminal, and denotes irreversible pump failure. Many patients can, however, return to useful activity, avoiding sudden unaccustomed exertion, and being maintained on diuretics, potassium and digoxin with suitable surveillance. Curative surgery may be possible in those with heart valve lesions. Heart transplantation. Remarkable technical success has been achieved, and patients have survived for up to two years after opera tion. It is, however, difficult to decide which cases are suitable, for early cases may benefit from less drastic measures, and late cases have involvement of lungs and liver, lessening the changes of success. There are problems too, of transplant rejection, immunosuppression and of the ethics of obtaining donor hearts. There may be a greater place for the use of plastic pumps, which are being developed for use as temporary supports to the circulation, e.g. in myocardial infarction, until the heart function improves. Prevention of cardiac disease; a summary Congenital heart disease should be recognized early, for cure is often possible. Rheumatic heart disease has diminished with the conquest of the streptococcus, but where it has occurred, early recognition and treat ment of valvular complications will prevent heart failure. Hyper tension and its effects can be remedied before the stage of heart failure. We are left with arteriosclerotic heart disease, and while alleviation of its effects is possible, prevention awaits understanding of the arteriosclerotic process. Meantime, we can advise the control of obesity and the cessation of cigarette smoking.

In nearly all parts of the world, the consumption of alcohol is increasing, and the morbidity and mortality of diseases induced by alcohol are rising correspondingly. It has been stated that alcohol is consumed because it pro duces intoxication. This effect is due to its toxicological influence on the central nervous system with the resulting functional disturbances. For many years, the concept that alcoholic liver disease was of nutritional origin and only indirectly related to alcohol consumption and metabolism was accepted. Opinion has changed gradually in recent years and tends now to regard alcohol itself through its combustion, as responsible for many metabolic disorders. Interest in this problem has increased during the past decade, and numerous papers bearing on this subject have appeared. It seems that the oxidation of alcohol in the liver interferes in many ways with the intermediary metabolism of lipids, carbohydrates and proteins, including enzymes and hormones, and exerts damaging influence on the liver, the musculature, the heart, the brain and the kidneys. The "Workshop Symposium" brought together a limited number of the scientists involved in the new development, biochemists, physiologists, pharmacologists, pathologists and clinicians from eight European countries and from the United States and allowed a very lively and informal exchange. The symposium was honored by the presence of Sir Hans Krebs, whose vast experience stimulated the discussion. It is a great pleasure to dedicate this volume to Sir Hans on the occasion of his 70th birthday on August 25th."

Die Herausgeber prasentieren hier ausgewahlte Beitrage des 2. Nationalen Praventionskongresses, der gemeinsam mit dem 6. Deutschen Kongresses fur Versorgungsforschung durchgefuhrt wurde. Der wissenschaftliche Austausch zwischen praktisch tatigen Medizinern und Vertretern aller am Gesundheitssystem interessierten Experten verdeutlicht die Chancen des interdisziplinaren Dialogs fur die Versorgung gesundheitlich gefahrdeter und kranker Menschen.

7 1. THE LIVER IN NORMAL PREGNANCY 9 Liver palpation. . . . . . 9 Spider angiomas and palmar erythema 9 Histological changes in liver biopsies 10 Liver blood flow . . . . . . . . . . 10 Hemoglobin and serum iron . . . . . 11 Total leucocyte and differential count. 11 Prothrombin time 11 Urinary bile components 11 Serum bilirubin . . . 11 Bromsulfalein retention . 12 Galactose tolerance test . 12 Serum alkaline phosphatase 12 Serum transaminases and other enzymes . 13 Serum cholesterol and serum lipids . . . 14 Total serum proteins and serum electrophoresis 14 Serum turbidity and flocculation tests 15 Conclusions . . . . . . . . . . . 15 II. JAUNDICE DURING PREGNANCY . . . . 17 1) Incidence of jaundice durip. g pregnancy 17 2) Classification of jaundice during pregnancy 17 3) Frequency distribution of different diseases causing jaundice during pregnancy . . . . . . . . . . . . . . . . . '. 20 4) Review of literature on jaundice during pregnancy . . 23 Infectious hepatitis during pregnancy . . . . . . . 23 Susceptability of pregnant women to viral hepatitis 23 Incidence of hepatitis in relation to stage of pregnancy 25 Mortality from hepatitis during pregnancy . 26 Clinical course of hepatitis during pregnancy . . . . 27 Sequellae from hepatitis during pregnancy . . . . . 28 Child survival from mothers with hepatitis during pregnancy 29 Transplacentar infection with hepatitis virus and incidence of malformation in babies of mothers with hepatitis during pr- nancy. . . . . . . . . . . . . . . . . . . . . . . . . 30 Jaundice in liver cirrhosis during plegnancy . . . . . . . . . 31 Drug-induced intrahepatic cholestasis during pregnancy . . . . 32 Obstructive jaundice due to choledocholithiasis during pregnancy 33 Effect of pregnancy in chronic idiopathic hyperbilirubinemias (Dubin-Johnson syndrome, Rotor syndrome, Gilbert-Meul- gracht syndrome) . . . . . . . . . . ."

Magnus Hirschfeld war nicht nur, gemeinsam mit drei anderen Berliner Arzten- Ivan Bloch, Albert Moll und Max Marcuse - der Begrunder einer deutschen, seinerzeit auch international unerreichten Sexualwissenschaft. Er war daruber hinaus Jude und homosexuell veranlagt. Dies alles hat ihn zu einem der ersten prominenten Opfer der Nationalsozialisten werden lassen. Bereits 1930 musste er in seinem Berliner Institut fur Sexualwissenschaft, das er 1919 gegrundet hatte, um seine Existenz und sein Leben furchten. Der drohenden Ermordung entging er nur zufallig, weil er sich bei der Zerstorung des Instituts durch den SA-Mob auf einer Vortragsreise befand. Damit ging ein ruhmreiches Kapitel der deutschen Kulturwissenschaften dramatisch zu Ende. Es sollte bis in die jungste Zeit dauern, dass man sich der Bedeutung Hirschfelds in ihrer ganzen Tragweite bewusst wurde. Sein erstes grosses Hauptwerk verfolgt das Thema Homosexualitat in all seinen Facetten. Zugrunde lagen Hirschfelds Ausfuhrungen zahllose Fallstudien und Untersuchungen, die er nach standardisierten Mustern vornahm. In dem umfangreichen Band versuchte er, das Thema in seiner ganze Breite zu erfassen. Auch wenn die biologischen Ausfuhrungen Hirschfelds heutzutage als veraltet gelten, so sind doch seine Analysen immer noch ausgesprochen lesenswert und beruhren in ihrer Detailversessenheit- etwa, wenn Hirschfeld den Tascheninhalt des homosexuellen Mannes beschreibt oder die Eigenarten des Schwulenlebens in den sudlichen Landern, die Wohnungseinrichtung und Berufswahl der typischen lesbischen Frau etc. Mit diesen Beschreibungen ging allerdings auch eine Gefahr einher: Hirschfeld lieferte ungewollt den Nationalsozialisten gewissermassen die Checklisten, mit denen sie dann, verstarkt nach dem Rohm-Putsch von 1934, die Verfolgung der homosexuellen Manner intensivieren konnten."

The papers collected in this volume represent the formal proceedings of the Third European Symposium on Calcified Tissues which was held in Davos, Switzerland from 11th to 16th April 1965 under the sponsorship of the Laboratorium fur experi mentelle Chirurgie, Schweizerisches Forschungsinstitut Davos. This Symposium fol lowed the now established tradition of the previous Symposia held in Oxford in 1963 and in Liege in 1964. Participation was again strictly on a residential hasis. This year the Schatzalp Hotel provided a scenic and secluded meeting place high on a mountain side overlooking Davos yet close to the Forschungsinstitut in which the opening session of the Symposium was held. The papers and communications published in the volume are arranged in order of presentation and are grouped under the five main themes selected for discussion by the Symposium, namely, "Cell function in the formation, maintenance and destruc tion of osseous tissue," "Response of calcified tissues to mechanical factors," "Mecha nisms of mineralization and diseases related to mineral deposition," "Hormones and bone" and "Fundamental structure of dental hard tissues." The programme consisted of a number of review lectures given by invited speakers and of short communications in relation to each of the above themes. No attempt was made to record the dis cussions to the papers as, being a residential meeting, the more valuable and interest ing interchanges took place informally in small discussion groups and not within the time schedule of the prearranged programme."

Hypertension has certainly been one of the topics most fre quently discussed at symposia, meetings, and congresses during recent years. There may be several reasons for this; three of them are obvious: firstly, the fact that a large proportion of the world's population is suffering from various forms of hypertensive disease; secondly, increasing knowledge of the pathogenesis of hypertension and of the disturbances underlying it; and, thirdly, the marked progress which has been made in antihypertensive therapy over the past fifteen years. When plans for the present symposium were being drawn up, it was felt that it should not simply bring forth just another meeting on hypertension, but should place particular emphasis on those aspects which had not been adequately discussed at previous symposia of this kind. Curiously enough, the topic which appeared to have received least attention in the past was therapy, although from the practical point of view this is by far the most important. The choice of therapy as the main theme of the whole symposium also seemed to be warranted in view of the relatively long period that had elapsed since effective antihyper tensive treatment became available; the time had in fact come now to pass judgement on the benefits as well as the shortcomings of drug treatment as available today.

Focusing on communication needs in real-world clinical situations, Dr. Pilar Ortega's updated edition of this practical text helps you address today's growing demand for Spanish-speaking physicians and healthcare workers. This pocket-sized resource provides basic Spanish skills, sample interview questions, relevant cultural information, and more, in addition to online videos of physician-patient interactions, interactive self-assessment tools, and clinical vignettes. You'll find exactly what you need to develop better physician-patient communication skills, increase your cultural competence, and make better clinical decisions in your practice. Understand the nuts and bolts of better communication through Spanish grammar, vocabulary, pronunciation, sample interview questions, and helpful interview techniques. Pocket size allows for quick reference in an easily accessible format. Improve your skills with new and expanded content including more practice exercises for self-assessment, information on cultural issues, grammar tips and practice, complex clinical scenarios, and how to best use interpreters in your practice. Stay up to date with new chapters on pediatric health; common procedures and informed consent; the physician's impression and plan; diabetes medication; travel history and special exposures; adult immunization history; exercise and adult health safety screening; and specialized physical examination. Gauge and hone your doctor-patient communication skills with interactive self-assessment tools and practice exercises. Watch video of real-time physician-patient exchanges (with English and Spanish subtitles), complete interactive practice exercises, and learn from clinical vignettes-all online at Student Consult. eBook version included! Access the entire book online or offline across all devices with the Student Consult eBook.