Rectal cancer is an exceptional tumour entity within the variety of gastrointestinal tumours. While clinical techniques such as rectal digital examination and endoscopy would enable diagnosis as early as the stage of polypoid preneoplasia, only 10% of rectal cancer patients undergo surgery at an early stage of the disease. The prognosis of rectal cancer without infiltration of the muscu- laris is relatively good. However, with locally more advanced tu- mours, possibly associated with lymphnode metastases, the prob- ability of successful treatment decreases considerably. Further- more, there is a clear prognostic discrepancy between proximal and distal rectal cancers. Rectal carcinomas, especially in the dis- tal location, except those diagnosed at an early stage, usually re- quire surgical treatment with postoperatively disturbed or lost anal sphincter function. A permanent colostomy may not be avoidable. The current trends and developments in diagnosis and therapy of rectal cancers may be described as follows: * The search for new diagnostic procedures and the attempt to define risk groups for which intensive preventive measures would be clearly successful. New insights may come from mod- ern molecular biology or molecular genetics, especially with re- gard to hereditary colorectal carcinoma. * A further increase in the rate of sphincter-preserving surgery without impairment of local tumour control or overall prog- nosis. New surgical techniques such as trans sphincteric resec- tion, but also various multimodal local treatment regimens, especially for low-risk tumours, are promising approaches.

Inflammation in itself is not to be considered as a disease . . . and in disease, where it can alter the diseased mode of action, it likewise leads to a cure; but where it cannot accomplish that solitary purpose . . . it does mischief - John Hunter, A Treatise on the Blood, ITfIlammation, and Gunshot Woundr (London, 1794)1 As we reached the millennium, we recognized the gap between our scientific knowledge of biologic processes and our more limited clinical capabilities in the care of patients. Our science is strong. Molecular biology is powerful, but our therapy to help patients is weaker and more limited. For this reason, this book focuses on the problems of multiple organ failure (MOF), multiple organ dysfunction syndrome (MODS), and systemic inflammatory response syndrome is, patients who have severe injuries; require major, (SIRS) in high-risk patients, that overwhelming operations; or have serious illnesses requiring intensive care; patients who have diseases elsewhere, in other organs or systems, that limit their capabilities to survive a new insult; and patients who are elderly or at high risk for sepsis or other complications. These are the patients who need our help. They need the advances in science, in molecular biology, immunology, pathophysiology, biochemistry, genetics, high technology, and other areas of maximum support at the bedside. These advances could potentially have the greatest impact on improving patient care.

Trigeminal neuralgia and other cranial neuralgias comprise a group of facial pain conditions, characterised by disabling pain attacks that selectively respond to specific treatments. Although not as common migraine, they affect over 1% of the population and must be recognised and adequately treated in clinical practice. The spectrum of cranial neuralgias is wide and as a consequence the conditions are managed by a range of different specialists. Studies show that delayed diagnoses and mismanagement are common and can lead to depression and suicide. 36 recognised experts from nine countries have contributed to OPML Trigeminal Neuralgia and Other Cranial Neuralgias to guide you through the maze of pathophysiology, clinical features, diagnosis-making, and condition-specific treatments. The approach is practical and evidence-based and ready for real-world applications. The value of phenotyping, targeted investigations, and treatment algorithms is emphasised. The editors and contributors subscribe to the view that there needs to be a holistic approach with multidisciplinary teams working together and with patients being at the centre of this process. Psychologists and patent support groups can help to ensure that patients are managed holistically and share the decision-making process. Their involvement in the handbook has helped to emphasis this. There remain considerable challenges, but the field is rapidly evolving and there are increasing number of opportunities opening up to improve our understanding of these conditions and hence their management. The editors and contributors have included case scenarios, algorithms, self-administered tools for training in diagnosis and management, clinical tips and carefully chosen references. Each chapter includes a lay summary and key points and can be read as a stand-alone unit.

Lachen ist die beste Medizin. Dass Medizin aber auch ganz schoen zum Lachen sein kann, beweist Dr. Ronny Tekal jede Woche aufs Neue, wenn er mit arztlichem Insiderwissen in der Kolumne "NebenWirkungen" der AErzteWoche einen satirischen Blick auf die gar nicht so heile Welt der Heilkundigen wirft: Wer schon immer wissen wollte, was die "Halbgoetter in Weiss" mit den "Halbgoettern mit heruntergezogener Hose" verbindet, ob "Irren arztlich ist" und Mediziner voellig hilflos sind, wenn sie "Datenlos durch die Nacht" geistern, wie man seine "Farm im Darm" bewirtschaften kann, statt sich im nikotinhaltigen "Nebel des Grauens" zu verlieren, welche Groesse der eigene "Medizinische Fussabdruck" hat oder wo "Sankt Harvard" liegt, wie man uber die Partnerboerse "Tinder fur AErzte" die idealen Behandler findet, wo sich im Spital die "Becher-Polonaise" tanzen lasst und was die AErzte unterm Kittel tragen, findet hier garantiert die passenden Antworten. Dieses Buch enthalt die besten NebenWirkungen der vergangenen 10 Jahre. Fur AErzte. Und Patienten. Und alle, die das eine oder das andere einmal werden wollen.

Please visit www.cancerstaging.org for information about content updates and staging forms. The AJCC Cancer Staging Manual is used by physicians and health care professionals throughout the world to facilitate the uniform description and reporting of neoplastic diseases. Proper classification and staging of cancer is essential for the physician to assign proper treatment, evaluate results of management and clinical trials, and to serve as the standard for local, regional and international reporting on cancer incidence and outcome. Significantly expanded and developed by international disease site expert panels, the Eighth Edition AJCC Cancer Staging Manual brings together all the currently available knowledge on staging of cancer at various anatomic sites. In this edition, evidence-based TNM staging is supplemented, as appropriate, by selected molecular markers and newly acquired insights into the molecular underpinnings of cancer. This edition features 12 entirely new staging systems, a wide range of changed or new staging definitions, and a refined emphasis on a personalized-medicine approach. To enhance the print and electronic usability of the cancer staging forms, they are now available exclusively for access and downloading at www.cancerstaging.org. The Eighth Edition AJCC Cancer Staging Manual remains the gold standard reference for oncologists, surgeons, pathologists, radiologists, cancer registrars and medical professionals world-wide to ensure that all those caring for cancer patients are fully versed in the language of cancer staging.

Comprehensive in scope and easy to use, Atlas of Gynecologic Surgical Pathology, 4th Edition, provides the current, authoritative information you need to effectively sign out cases in female genital pathology. In this 4th Edition, internationally renowned authors Drs. Philip B. Clement and Robert H. Young are joined by new co-author Dr. Jennifer Stall to continue this bestselling atlas's tradition of excellence. Hundreds of superb pathologic images, diagnostic pearls, and fully updated content make this practical, bench-side resource ideal for minimizing risks in reporting both routine and difficult cases. Comprehensively discusses the differential diagnosis of female genital tract neoplasms and their many mimics from the perspective of their varied microscopic features. Highlights important aspects of the clinical background, including age of patient, history of other tumors, and distribution of disease. Stresses helpful aspects of gross features and the importance of thorough sampling. Emphasizes practically important, immunohistochemical findings relevant to establishing the correct diagnosis. Includes newly described variants and new histologic entities. Considers molecular aspects of the entities discussed. Includes the latest classification and staging systems for gynecologic diseases and disorders, with up-to-date information on staging. Includes hundreds of high-quality pathologic images, including new images contributed by Dr. Jennifer Stall from her review of the late Dr. Robert E. Scully's vast collection of cases. Features tables listing differential diagnoses of each tumor and tumor-like entity to help you identify key points to consider in problem areas. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Dieses Buch enthalt wertvolle praktische Anleitungen und Tipps fur die PJ-Tertiale Innere und Chirurgie und bereitet optimal auf das mundliche Staatsexamen vor. Von A wie Anamnese bis Z wie Zugange legen werden alle Schritte und Handgriffe mit vielen Bildern und kurzen Texten erklart. Auch schon fur die Famulatur ist dieses Buch eine grosse Hilfe. So koennen Sie sich ideal auf die Zeit in Praxis und Klinik vorbereiten und wissen Bescheid, wenn Sie beim Patienten sind oder mit Kollegen zusammen arbeiten. Neben der Beschreibung der praktischen Handgriffe bietet das Buch ausserdem:* Checklisten - Welches Material benoetige ich wofur?* Merksatze - Was sind die Dos and Donts?* Zwischenmenschliches - Dinge, die sonst nicht im Lehrbuch stehen.Der HerausgeberDr. Carl Meissner ist Allgemeinchirurg in der Allgemein- und Viszeralchirurgie am Klinikum Magdeburg. Sein PJ ist noch nicht so lange her und er weiss noch sehr genau, welches Handwerkszeug ein junger PJler braucht.

Paediatric Surgery has been fully updated to reflect current guidelines and practices, and offers a contemporary overview of the subject in general, as well as detailed information about core subjects. Structured to assist problem-solving and diagnosis, the handbook contains detailed clinical features on all aspects of neonatal and general paediatric surgical conditions, it is a key revision tool for the MRCS and FRCS Paediatrics post-graduate exams, as well as the UEMS European exam in paediatric surgery. The chapter on common operations has been expanded, including new topics on orchidopexy, scrotal exploration, thoracotomy, and appendicectomy, as well as information on robotic surgery. There is also a new chapter on global paediatric surgery, outlining the challenges and future direction of the discipline in India, East Africa, West Africa, and South Africa. Neonatal medicine and neonatal surgery both have new topics on resuscitation, ventilation strategies, jaundice, and congenital lung abnormalities. With the knowledge level based around what is needed in clinical practice, supporting background and science is included to strengthen understanding. Pragmatic and practical, this second edition of Paediatric Surgery is a vital tool for all those who work in the field.

The eighth edition of the acclaimed text Operative Pediatric Surgery continues to provide a unique level of comprehensive detail on the full range of surgically treatable conditions presented in neonate and childhood as well as in utero. Written by expert international authors, all chapters cover both minimal access and open surgery, with operative techniques illustrated by both high-quality colour line artwork, operative photographs, and a library of video clips. Encompassing the full range of pediatric surgery operations that both trainee and experienced pediatric surgeons require, this established operative guide is the standard reference for the pediatric surgeon and will ensure that they can access the most up to date and authoritative information to benefit their clinical practice. * ensures authoritative coverage of all aspects of pediatric surgery *includes the latest operative techniques *reviews alternative surgical approaches *aids visualisation by the inclusion of over 1000 illustrations *establishes total confidence

Die in diesem Ratgeber zusammengefassten Informationen uber die Craniomandibulare Dysfunktion (kurz: CMD oder Kiefergelenksyndrom) gehoeren keineswegs zum Allgemeinwissen, auch in vielen medizinischen Fachrichtungen setzt sich die Erkenntnis dieser Zusammenhange nur langsam durch. Viele unklare Beschwerden koennen auf den Kauapparat zuruckgefuhrt werden. Das Buch informiert den Patienten umfassend uber Funktionszusammenhange des eigenen Koerpers und ihre moeglichen Stoerungen. Neben den zahlreichen Informationen, die in diesem Buch enthalten sind, kann man sich anhand eines einfachen Selbsttests ein erstes Bild machen - wenn sich die Funktion Ihres Kauapparats ausserhalb des Normbereichs bewegt, erhalten Sie einen wichtigen Hinweis, wo weiterzusuchen ist. Die als CMD bezeichneten Funktionsstoerungen koennen sich weitgehend korrigieren, zumindest aber soweit entscharfen lassen, dass die von ihnen ausgehenden Beschwerden unter Kontrolle gebracht werden koennen. Die Basis dafur bilden moderne und umfassende Diagnosemethoden, bei denen auch moegliche begleitende Belastungsfaktoren des Alltags erhoben werden. Die CMD-Untersuchung wird damit, sofern gewunscht, zu einer Bestandsaufnahme von Fehlfunktionen, bei welcher tatsachlich der ganze Mensch in den Blick genommen wird!

The 6th International Symposium on Artificial Heart and Assist Devices met in Tokyo in July 1996, bringing together researchers and specialists from around the world. The symposiums proceedings in this volume comprise papers from nine sessions, each opening with contributions by leading scientists: TAH, heart transplantation, biomaterials, VAS, clinical application, pathophysiology, engineering, new approaches, and special sessions. Of special note is the inclusion, for the first time, of pathophysiology related to clinical use of assist devices. The clinical application section includes a paper by Dr. Michael DeBakey on the progress made in recent years. With descriptions of the scientific exhibition, accompanied by photographs of all artificial heart devices and systems displayed by major laboratories and manufacturers, Artificial Heart 6 presents the latest information on developments in the field of artificial heart, biomaterials, and heart transplantation.

This color atlas is a detailed guide on how to perform open, endoscopic, and robotic thyroidectomy techniques safely and effectively. Each chapter offers step-by-step descriptions of essential surgical procedures and techniques. Relevant information is included on surgical anatomy, and clear guidance is provided on preoperative set-up, draping, instrumentation, and complications and their treatment. The description of endoscopic thyroidectomy techniques focuses on the bilateral axillo-breast approach (BABA), while in the case of robotic thyroidectomy both BABA and the bilateral axillo-postauricular approach are described. In each case, the evidence supporting the technique is carefully examined. In the closing chapter, the role of new energy sources in thyroid surgery is discussed. The lucid text is supported by more than 200 full-color illustrations clarifying surgical anatomy, instrumentation, and procedures, and surgical video clips are also available to readers via a website. This atlas will be invaluable in enabling surgeons to achieve optimal outcomes when performing thyroid surgery.

This evidence-based guide is the first of its kind to outline the surgical and perioperative management of patients with anatomical anomalies and support clinical decision-making under these difficult circumstances. Presented in a simple, accessible format and organized by anatomical area, this book contains all the essential topics required by trainees and practitioners to assess the patient quickly, diagnose anatomic anomalies, determine the feasibility and safety of the planned surgical and anesthetic procedures, and arrange for advanced consults and care, if needed. Newer techniques for surgical and anesthetic management of patients with anatomic anomalies are presented to facilitate practitioners' development of their skills. Chapters include the latest ultrasound techniques and images, as well as case studies. Physicians, nurses, and trainees involved in the surgical, anesthetic, perioperative, or critical care of patients will find this guide to be their go-to resource in the OR, lab, or pain clinic.

Now in its second edition, the Oxford Handbook of Oral and Maxillofacial Surgery has been fully updated to reflect current guidelines, with new images and annotated x-rays to support the text. Split into sections based on clinical areas, vital knowledge is distilled into bullets and summary boxes for quick and easy reference. Covering all common complaints likely to arise in everyday duties alongside a dedicated emergencies section, this handbook ensures all trainees from both medical and dental backgrounds, specialist nurses, and medical students gain a solid understanding of oral and maxillofacial surgical presentations, practices, and procedures.

The third edition of the Color Atlas of Emergency Trauma brings the reader to the bedside of patients with traumatic injuries, at one of the largest and busiest trauma centers in North America. It includes over 1200 images, designed as a comprehensive visual and reference guide to emergency trauma care. Organized by major body regions, this atlas explores the full spectrum of common and uncommon traumatic injuries, including those caused by firearms, stab wounds, blunt trauma, crush injury, and burns. It also covers special patient groups, such as pregnant, pediatric and geriatric populations. Each chapter is augmented with patient images at presentation, radiographic, intraoperative and autopsy images, and color illustrations and photographs showing key anatomy from the cadaver laboratory. With common pitfalls discussed and invaluable tips from a multidisciplinary group of experienced trauma care providers, this book is a useful and practical resource for all those involved in trauma care.

Stay on top of the latest advances, treatments, and best practices with the new third edition of Oral and Maxillofacial Surgery. This trusted, three-volume resource covers the full scope of the field with up-to-date, evidence-based coverage of surgical procedures performed today - including cleft and craniofacial surgeries, oral surgery, oncologic surgery, orthognathic surgery, trauma surgery, surgical pathology, surgery of TMJ disorders, dental implants, dentoalveolar surgery, cosmetic surgery, and reconstructive surgery. More than 4,800 full-color images and illustrations serve as valuable visual references. You'll also find complete guidelines for a wide range of practice issues such as anesthesia, diagnostic imaging, treatment planning, , psychological considerations, office design and ergonomics, plus new information on implants and orthognathic surgery. It's all the information you need to perfect your oral and maxillofacial surgical techniques and provide state-of-the-art care for your patients. NEW! Full color design provides a more vivid depiction of pathologies, concepts, and procedures. NEW! Expert Consult website includes all of the chapters from the print text plus "classic" online-only chapters and an expanded image collection, references linked to PubMed, and periodic content updates. NEW! Thoroughly revised and reorganized content reflects current information and advances in OMS. NEW! New chapters on implants and orthognathic surgery cover the two areas where oral and maxillofacial surgeons have been expanding their practice. NEW! Digital formats are offered in addition to the traditional print text and provide on-the-go access via mobile tablets and smart phones.

Pierre Pfutsch zeigt, dass mit dem Notfallsanitatergesetz aus dem Jahr 2014 die berufliche Tatigkeit im Rettungsdienst stark aufgewertet wurde. Den Berufsangehoerigen wurde eine dreijahrige Ausbildung, die Moeglichkeit zur akademischen Bildung und sogar die Ausubung bestimmter heilkundlicher Massnahmen zugestanden. Nach Ansicht des Autors wird seitdem die Frage nach Delegation bzw. Substitution arztlicher Leistungen verhandelt. Zu Beginn waren Rettungssanitater zum uberwiegenden Teil ehrenamtliche Mitarbeiter, die kaum mehr als eine Erste-Hilfe-Ausbildung besassen und lediglich fur den Transport zustandig waren. Aufgrund des medizinischen Fortschritts und der steigenden Unfallzahlen im Strassenverkehr setzte Ende der 1960er-Jahre eine Professionalisierung dieses Berufsfeldes ein. Treffen Notfallsanitater vor dem Notarzt am Unfallort ein und mussen bei lebensbedrohlichen Zustanden tatig werden, begeben sie sich in eine juristische Grauzone, die einige Unsicherheiten mit sich bringt. Der Autor: Dr. Pierre Pfutsch ist Historiker und wissenschaftlicher Mitarbeiter am Institut fur Geschichte der Medizin der Robert Bosch Stiftung in Stuttgart und forscht dort zur deutsch-deutschen Zeitgeschichte von Gesundheitsberufen.