Legal action involving doctors, either as defendants or expert witnesses, has greatly increased over the past decade and few can now remain aloof from this aspect of their profession. Written by doctors (including five Council Members of the Medical Defence Union of Great Britain) and lawyers, this practical guide offers clear and comprehensive advice to all concerned. Part I discusses how to write medical reports, especially when consent is required or confidential information is involved. Part II covers contentious issues in various clinical specialties which repeatedly arise in litigation; well-known examples are cases involving whiplash injuries or perinatal brain damage. In Part III lawyers discuss the medico-legal problems of the solicitor's role, court testimony and medical negligence. This book is a valuable reference to all members of the medical profession. Lawyers, officials and others outside the medical profession who come into contact with medical litigation but have limited medical knowledge will find much helpful information.

Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies."

SOLVING FOR WHY chronicles one man's journey to find the answer to the biggest of all life's questions: "Why?" Following a traumatic car accident, Dr. Shrime-the child of Lebanese immigrants fleeing a civil war, who later became a successful practicing surgeon in Boston-found himself compelled to change the course of his life, determined to find meaning and satisfaction even if it meant diverting from America's idea of "success." Featuring stories, insights, and research from his own exceptional life and work, SOLVING FOR WHY is the story of Dr. Shrime's search for-and discovery of-lifelong fulfillment. Now a global surgeon operating on a hospital ship docked off the coast of West Africa and one of the few global experts on surgery in low- and middle-income countries, Dr. Shrime seeks to impart the wisdom of the lessons he's learned over the course of his search for a life of true contentment. In the tradition of Dr. Paul Farmer's To Repair the World, Dr. Atul Gawande's Better, and Dr. Michele Harper's The Beauty in Breaking, SOLVING FOR WHY combines personal stories with deep, thoughtful research into the challenges of working in modern medicine in the 21st century and the commodification of work in America. A story of discovery and transformation, SOLVING FOR WHY seeks to help readers answer the "why" of their own lives and ultimately find joy outside the status quo.

Historically, disorders of salivary glands tend to be 'underdiagnosed and overtreated'. In the vast body of literature on this subject, emphasis has usually been put on therapeutic modalities of various diseases of the salivary glands. Whereas therapy and pathology have been treated in numerous thorough studies, the (patho )physiology of the salivary glands has remained rather poorly understood. Even less attention has been given to the diagnostic methods. Until a few decades ago, diagnosis consisted mainly of a clinical examin ation which included the patient's history, inspection, and palpation. These methods remain crucial, but a variety of new diagnostic tools have appeared since then. Their clinical value is still subject to controversy; each method has its advocates and opponents. The indications for enrolling a patient at a given point in a series of diagnostic procedures are interpreted differently. One of the most striking examples is the use of sialography. This has become a classic diagnostic procedure. Although sialography is still a useful method, it has considerable disadvantages, limitations, and even contraindications. In the major teaching hospitals, residents still tend to consider sialography as a panacea for the majority of their diagnostic problems, whereas the infor mation provided is actually rather restricted. Other modern methods such as CT and MRI have taken over the role of sialography to a certain extent. This also applies to ultrasonography and scintigraphy. Moreover, microbiol ogy, sialometry, sialochemistry, cytology, and histopathology may give super ior information in certain cases."

Die Konstellation scheint rar, die Loesung simpel: Wenn eine Schwangere stirbt, ihr Herz-Kreislauf-System und mithin die Schwangerschaft aber kunstlich auch nach dem Hirntod noch aufrechtzuerhalten sind, muss das Kind gerettet werden. Ist die Frau zudem Organspenderin, koennen freilich auch ihre Organe transplantiert werden. In dieser Absolutheit indes birgt dies einige medizinische wie rechtliche Fehler. In dieser Arbeit werden die medizinischen Umstande der Konstellation erlautert, um zu einer dogmatisch konsistenten wie praktikablen juristischen Loesung zu gelangen. Zu hinterfragen gilt, ob und wann die AErzte die Schwangerschaft abbrechen durfen, wann sie dem Ungeborenen Sterbehilfe leisten koennen und sollen. Zudem geht die Arbeit der Frage nach, wer entsprechende Entscheidungen trifft.

The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE) emphasizes good communication and promotes best practice for the use of electromechanical, ultrasonic, and microwave energy sources in the operating theatre. This manual describes the basic technology of energy sources in the operating room and demonstrates the correct use and indications of energy sources in clinical practice. It also addresses the potential complications, hazards, and errors in the use of surgical energy sources and evaluates the potential interactions of energy sources with other medical devices. Any healthcare professional who has ever picked up an energy device in the OR such as a "Bovie," Ultrasonic or bipolar instrument will better understand how it works, when to apply it, and what are the possible hazards and errors in its use. The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE) is the first volume of its kind to provide such guidance and will be of great value to surgeons, anesthesiologists, nurses, endoscopists, and allied health care professionals who use these devices.

MRCS Applied Basic Science and Clinical Topics offers a complete and up-to-date guide to specialty training in surgery, covering all the core topics examined in the MRCS Part A and B exams. Presented in a clear layout, chapters are mapped to the syllabus to deliver structured revision in all the systems. Featuring concise and easy-to-digest notes, this book provides clinical knowledge, practical skills and the essential revision tool to maximise chances of exam success. Key Points Presents topics in an accessible double-page format for rapid access to information Covers the full knowledge-base examined by the Royal College of Surgeons Highly illustrated with clinical photographs, imaging and diagrams to aid visual memory of topics Equips candidates with the necessary basic science and clinical knowledge to succeed in the MRCS exams Complements MRCS Part A: 500 SBAs and EMQs and MRCS Part B OSCE: Anatomy Highly Commended at the BMA Medical Book Awards 2013

Die neueste Ausgabe des Atlas of Gastroenterology enthalt umfassendes Bildmaterial, das einen besonders aussagekraftigen UEberblick uber die wichtigsten gastrointestinalen, pankreatischen und hepatobiliaren Erkrankungen vermittelt. Alle Erkrankungen des Magen-Darm-Trakts, von Leberabszessen uber endokrine Neoplasmen der Bauchspeicheldruse bis hin zu Motilitatsstoerungen der Speiseroehre, werden anhand von endoskopischen und transabdominalen Ultraschallbildern, Computertomographien, Magnetresonanzbildern, Radionuklidbildern, Angiogrammen und hochaufloesender Manometrie dargestellt, erganzt um Hinweise zur Histopathologie und Zytologie. Der Atlas enthalt uber 2000 aussergewoehnliche Bilder, geordnet nach Krankheitsbild und Therapieansatz, die auch histopathologische Praparate, MRT- und CT-Scans, Endoskopie, EUS und Bilder von offenchirurgischen Eingriffen umfassen. Mit einem hervorragenden Redaktionsteam und 200 Autoren fur die einzelnen Kapitel, bei denen es sich jeweils um international anerkannte Experten in ihren Fachgebieten handelt, richtet sich Yamada`s Atlas of Gastroenterology an eine breite Leserschaft, von Studierenden uber Assistenzarzte, Stipendiaten und AErzte in Ausbildung bis zu Klinikarzten, Professoren und anderen Medizinexperten. Vielbeschaftigte AErzte in Ausbildung oder Klinikarzte, die sich eine schnelle Einfuhrung in das Spektrum der gastroenterologischen Erkrankungen wunschen, finden in Yamada`s Atlas of Gastroenterology eine praktische und hilfreiche Darstellung der haufigsten Erkrankungen mit einer prazisen, umfassenden Erlauterung der wichtigsten Punkte.

Urinary incontinence is becoming an increasingly dominant condition in daily urological and gynaecological practice, although the total number of patients suffering from the different forms ofincontinence remains unclear. An estimated figure for The Netherlands, with a population of 14 500000, has been given as between 500000 and 600000 patients, showing that approximately 4 % of the total population suffer from this condition, the majority being female. The impact ofthis number is tremendous, not only regarding health care costs, but even more with regard to the psycho-social consequences. It is obvious that continuing efforts must be made to under stand more fully the different forms of urinary incontinence. An exact diagnosis is the first step necessary for adequate therapy. We all know how disastrous it can be to institute inappropriate treatment as a consequence of misunderstanding the proper aetiology in each individual case. What has happened in the past 15 years? During that time we have developed sophisticated machinery to diagnose in more detail the exact ori gin of each type of urinary incontinence, and on entering a urodynamic laboratory, one is struck by the complexity of measuring equipment. But how reliable are all these measurements and how can they be translated into an effective therapy? This still remains one ofthe major problems, although continuing progress has been made and will be made by the research work of many experts in the field of urinary incontinence."

The title of this book is a challenge. Anyone with the least knowledge of present day urology will know that there are many very controversial aspects of this subject. Urology is not alone in this unsettled environment for there are similar debates in almost all other aspects of surgery. In addition to the rapid changes in technology, an important part of the explanation for these controversies is simply that more surgeons are prepared to admit that no area of their work is so established that it does not bear further scrutiny and assessment. Argument can be tedious but debate is healthy. This book aims to present material that is debatable: experienced practitioners of each topic explain why an opinion or preference can be sustained. The purist might wish to have these opinions resolved by a well-planned clinical trial, but experience of clinical trials shows that they do not always produce results that are easily translated into a positive change in clinical practice. Would the reader be persuaded more by a statistically significant difference or by an experienced clinician who has reached certain conclusions? Both are risky, but since surgical techniques are often not easily converted into appropriate studies or trials the Editors have obtained the best opinion on each controversy and innovation. The media adore controversy for its own sake. The medical profession accepts controversy but knows that few events in medicine are absolute and few procedures can be done only by one method.

With this book we* want to address young graduate students, clini cians involved in transplantation, and technicians in transplantation immunology laboratories. The volume should give a comprehensive but basic, up to date introduction to the structure, function, and clinical importance of the HLA system. We believe that there is a need for such a survey, and think that the present level of our knowledge is an optimal occasion for publication. A significant number of ques tions have now been resolved, and our knowledge has reached a level of sophistication that provides the basis for additional questions and answers. Although the emphasis of this book is on the role of HLA anti gens in clinical transplantation, their involvement in other clinical contexts is also discussed. The main focus is on the human MHC an tigenic system, but MHC systems in other species are described as they contribute to our understanding of the structural and functional characteristics of HLA antigens. Some important issues related to laboratory techniques are also covered. The contributors have a close affiliation to the field of transplan tation immunology. A majority have even been playing important roles in unraveling the HLA system and its functions. We believe this has contributed significantly to the quality and clinical and practical relevance of the book. As editors, we drew up the principal guidelines and took care that the chapters can be read as separate entities, although this invariably results in some overlapping.

J.F. Crul The topic Legal Aspects of Anaesthesia is still rarely treated in book publications, but deserves increasing attention as more cases of litigation occur each year and anaesthetists also become more aware of the legal structure within which they practice their profession. I am happy to have been able to obtain the cooperation of experts in this field from various European countries. The contributing authors in this book come from both the anaesthesia and surgery side as well as from the jurisprudential background. As these two fields have their own professional jargon we have been very careful in using definitions, avoiding that a specific term might lead to misunderstanding and confusion. The international authorship did not facilitate this task. The subject of this book was also the topic of a meeting of the European Academy of Anaesthesiology held at the French Study Center, La Suquette, Saint Vincent Ie Palue~ held three years before publication of this book. The organizers G. Barrier, J.F. Crul, and J. Lassner felt the need for a book publication presenting the state of the art of anaesthesia and the law in European countries. With the present book this plan has been realized. During the meeting many subjects were thoroughly discussed and the editor considered a number of them as very informative and therefore these were included in this book.

Dr. G. M. Woerlee is well known in my department both as a clinician and teacher. Years ofexperience have taught him that the problems discussed here have as yet not been treated in this way in any single work. In my opinion there is a real need for such abook, not only for resident and specialist anaesthetists, but also among surgeons and internists, specialist and trainee. Management of a patient in the operating room is a matter of teamwork, and knowledge of the problems encountered is the basis of any mutual understanding The information which has been assembled and clearly presented in this book should prove to be of great assistance in guiding our patients though an important phase of their lives. Professor Dr. Joh. Spierdijk, Department of Anaesthesia, University Hospital of Leyden, The Netherlands. vii PREFACE Much of the literature being published in the field of anesthesiology today concerns a narrow, in-depth scrutiny of a specific area or anesthetic technique that does not provide the novice with an overview ofthe perioperativeperiod and the commoneveryday problems faced by the anesthetist. Dr G. M. Woerlee of the University of Leiden with his book, "Com mon Perioperative Problems and the Anaesthetist," has filled a void in the current anes thetic literature. Dr Woerlee reviews in a straightforward, no-frills manner problems routinely encountered during the perioperative period. Other anesthesia textbooks do not cover the material in quite the same logical, step-by-step fashion."

It is fashionable in professional circles to deplore the difficulty of intellectual discourse between "academicians" - men of letters, researchers, rationalist- and "practitioners" - surgeons, radiologists, physical therapists. How benefi cial it would be if educated non-academicians could speak intelligently about t-tests and chi-square tests and men of academia could appreciate the travail, spirit, and needs of a busy office and practice Even this suspected gap between "two cultures" came very near together in the wonderful town of Groningen (The Netherlands) as wise men from both practice and scholarship gathered to talk about the unfathomables of the temporomandibular joint. There were keen discussions about the intense bio logical changes which occur about the complex temporomandibular joint after excessive use or injury. These papers were followed by talks outlining the experiences of those involved in the imaging and non-surgical and surgical management of patients who were enduring such changes. The pitch and interchange of opinions and evidence as to why a disc or its position could effect little or profound disturbance of the temporomandibular apparatus were en lightening to each who listened - and thought. And even more sobering was to hear the report of a well-documented, multiple decades long study of a large number of patients with osteoarthrosis and internal derangement which defined a natural course and eventual end of the disease. With this understanding, one is now faced with the obvious question of how much treatment patients with osteoarthrosis really require."

Management of salivary disorders encompasses a broad array of diseases, both benign and malignant. To better demonstrate the evolution of this field and its diagnostic and therapeutic management, the contents of this book have been organized to reflect the diverse nature of salivary gland anatomy, physiology, and dysfunction in various states of disease. This text first addresses practical office-based diagnostic approaches. It continues with congenital and acquired salivary dysfunction, including the goals for restoration of gland function. The third portion of this book provides detailed information on assessment and therapy for benign and malignant tumors of the major and minor salivary glands. Each chapter is authored by internationally known authorities in this field. Illustrative photographs and sketches are included in each chapter, to demonstrate the disorders and surgical techniques described. In summary, this comprehensive book serves as a useful reference and practical manual for clinicians dealing with salivary gland disorders. Whether as an introductory or advanced reference text, the reader will find that this book fulfills an important role in the management of salivary gland diseases.

This book is intended as a comprehensive reference on the anatomy, pathophysiology, and management of complications in neck dissection. The informative text is complemented by detailed clinical photos, high-quality illustrations, and clinical material from experienced and respected leaders in the field of neck surgery. An understanding of potential complications and early recognition of their signs and symptoms will prepare the surgeon to mitigate risk, minimize morbidity, and improve outcomes for each of their patients. Early recognition of the signs and symptoms of post-operative complications can prevent exacerbating the problem. Complications in Neck Dissection aims to shed light on these complications in greater detail and elaborate on their management. Written by experts in the field, the book reflects upon common and rare complications that are encountered and elaborates on how neck surgeons can prevent them.

A new, comprehensive review of the radiographic examination of the post-operative GI tract. Organized on an organ-by-organ basis, emphasis is placed on conventional studies, supplemented by cross-sectional imaging. Operative techniques and normal post-operative anatomy are depicted with many schematic line drawings. Normal changes, as well as early and late complications are discussed and abundantly illustrated. A must-have reference for general radiologists, specialists in gastrointestinal surgery and radiology medical libraries.

James C. Fang, MD, and Gregory S. Couper, MD, have assembled a panel of prominent surgeons and cardiologists to review the latest clinical, scientific, and investigational surgical and mechanical approaches to heart failure in hopes of improving the lives of this challenging group of patients. Topics range from such traditional strategies as high-risk surgical revascularization in advanced coronary artery disease, to more novel approaches such as ventricular reconstruction and mechanical assist devices. Many chapters are contributed by the original pioneers of specific surgical techniques, which provide s invaluable perspective from personal experience.

Leading physicians from a variety of medical specialties summarize their clinical experiences in treating pituitary adenomas in United States and the United Kingdom. Using simple language to describe their approaches, the authors describe the latest treatments for prolactinoma, acromegaly, Cushing's disease, and nonfunctioning pituitary tumors, and the latest surgical techniques. To round out the clinician's understanding of the illness, a patient describes the experience of diagnosis, treatment, and follow-up. Comprehensive and accessible, Management of Pituitary Tumors: The Clinician's Practical Guide brings together all the medical fields involved in treating pituitary tumors, both for novices in the specialties that manage these cases, and for pituitary specialists seeking to understand better the contribution of other medical disciplines to the treatment of these tumors.

Liver Transplantation: Challenging Controversies and Topics grew out of a need I perceived within the fields of transplant hepatology and liver transplantation. Liver transplantation has rightly gained recognition as an established therapy for end-stage liver disease. Few would argue that liver transplantation is one of the few truly lifesaving and life-altering treatments within medicine and surgery. Not many realize that 20 years passed from the time of the first human liver transplantation in 1963 to its acceptance as therapy by the 1983 NIH Consensus Conference on Liver Transplantation. In 2008, 25 years will have passed since the 1983 NIH conference-a mere 25 years for a field that has provided patients hope, doctors options, and to some the "gift of life. " Many issues in liver transplantation involve indications, patient selection, and outcomes after transplantation-these are standard topics, covered by textbooks of hepatology and transplantation. In contrast, the field of liver tra- plantation is young, evolving, dynamic, and issues and decisions are often controversial. Thus, Dr. Trotter and I, as well as our colleagues at the University of Colorado, felt that a text with a different focus was required, one that highlighted controversy and challenged dogma. Out of this perceived need emerged Liver Transplantation: Challenging Controversies and Topics. To meet the transplant community's need for emerging information about liver transplantation, Dr. Larry Chan, Dr. Igal Kam, and I initiated the Controversies in Transplantation Conference.

This gold standard text has kept its readers abreast of rapid advancements in reproductive medicine and surgery since 1983. Continuing this tradition, this fifth edition has been fully updated and revised to provide clear, didactic advice on best practice for a variety of clinical situations faced by practitioners across many specialties - including urologists, gynecologists, reproductive endocrinologists, medical endocrinologists and many in internal medicine and family practice who see men with suboptimal fertility and reproductive problems. Completely restructured to include pedagogical features such as easily accessible key concepts that cement understanding and real-world use. Covering everything from foundations of anatomy and embryology, through clinical evaluation, diagnostic approaches, treatment and fertility care in context within the healthcare system and society, thrilling advances and future directions are also included. This new edition is an essential reference for all who are working in this young and rapidly evolving field.