Cataract Surgery: Maximizing Outcomes Through Research provides cataract surgeons with helpful information about cataract operations based on the latest fundamental and clinical research. This book comprehensively covers a wide range of topics from the basic principles of each treatment to today's hot topics such as femtosecond laser application, cataract surgery, and new intraocular lenses (IOLs) with accommodating or light-adjustable function. Detailed cutting-edge discussion is provided in each chapter with the addition of diagrams, photographs, and tables to help readers better understand the subject. Authored by leading international experts, the book covers topics from preoperative evaluations to postoperative care including evaluation of accommodation and pseudo-accommodation, glistening and visual function, the eye's image quality with a premium IOL, IOL power calculations, pupil size and postoperative visual function, posterior capsular opacity, corneal astigmatism, femtosecond laser techniques, and more. Cataract Surgery: Maximizing Outcomes Through Research is the perfect book for cataract surgeons and general ophthalmologists who wish to update their knowledge and make use of it in their everyday medical practice.

MRCS Part A: 550 SBAs and EMQs, Second Edition continues the tradition of the best-selling first edition by offering a wealth of practice questions covering applied basic sciences and principles of surgery for candidates preparing for the MRCS Part A written exam. With 40% new content, including the addition of trauma and orthopaedic questions to provide complete coverage of surgical specialties, this book remains an essential revision tool designed to maximise chances of exam success. Key points 550 SBAs and theme-based EMQs test knowledge of applied basic sciences and general surgical principles, respectively, reflecting the formats encountered in the exam Chapters organised by anatomy, physiology, pathology, principles of surgery and general surgery, to help you focus on areas of weakness Provides in-depth answers, with illustrations, to help consolidate knowledge and understand key concepts Gives practical advice on how to approach revision and useful tips to improve exam technique

According to the International Association for Ambulatory Surgery (IAAS), ambulatory surgery should be defined as 'an operation/procedure, excluding an office or outpatient operation/procedure, where the patient is discharged on the same working day'. The rise of ambulatory surgery has been driven by technological advances that reduce the need for overnight hospital stays, enhanced recovery programmes that advocate early mobilisation, and the need for economic efficiency. Recent experience has shown that redistributing surgical procedures from the inpatient setting to ambulatory centres can be done without impacting quality. The majority of people requiring urologic surgery are now treated as day/outpatients thus requiring a different level of care from inpatients. Ambulatory Urology and Urogynaecology is the only book that combines urology and urogynaecology focuses on outpatient management. Packed with learning points, practical hints and tips, and boasting an international group of contributing authors, this book is co-edited by world-leading pioneers in urologic and urogynaecological surgery. Ambulatory Urology and Urogynaecology is ideal for urologists, urogynaecologists and gynaecologists, as well as specialist urology nurses and surgeons. With more and outpatient procedures being performed, this book is the perfect step-by-step guide to consult time and time again.

This book, Recent Advances in Geriatrics, is based on the proceedings of the 8th Course of the School of Gerontology and Geriatrics held in Erice (Trapani, Italy) at the In ternational Centre for Scientific Culture "Ettore Majorana" on March 20-25, 1997. This international effort was organized jointly by professors from the University of Palermo (It aly) and from Wayne State University (Michigan, USA) as a result of a cross-cultural col laboration of several years. _ The increasing average age of the populations in industrialized countries has re sulted in increased interest in the different biological, medical, psychological, and eco nomic aspects related to the health and social care of the elderly. Physicians and health care practitioners are realizing the need for a revised approach to geriatric care. Comprising contributions of clinicians and scientists from Italy and North America, the present volume provides a multidisciplinary approach to many gerontological and geriatric problems, examined from a scientific and a practical point of view. Several of the most important aspects of the aging process - the genetics of aging, body composition modification, immunological, endocrinological, and renal physiology changes - have been addressed. Data from a multi-center Italian study on centenarians is reported, to gether with an update on clinical and pharmacological approaches to dementia syndromes and economic and social aspects related to the care of the elderly."

Among the readily available -emitting radionuclides, the nuclides of iodine have the greatest versatility in labeling both the hydrophilic and the lipophilic compounds that are used in biology and medicine. Biologically important micrmolecules, semimacromolecules, and macromolecules have been identified which, after iodination, almost maintain the same molecular configuration and similar biologic specificity as those of the parent molecules. The multiple techniques for iodination and the clinical use of iodinated products have made possible the present status of the development of diagnostic nuclear medicine. 125r, with a half-life of 60 days, has a crucial role in competitive protein-binding studies. 131r is useful for measuring thyroid uptake, for the diagnosis of thyroid carcinoma and metastasis, and for therapy. 1nr , with a reasonably shorter half-life, is almost ideal for thyroid workup and for a few useful labeled radiopharmaceutical. Although ~c is used more widely in diagnostic procedures, the radionuclides of iodine will always have a major role in biology and medicine. A considerable amount of information is scattered in the literature regarding the chemistry of radioiodination and the mechanism of tracer localization in cells and tissues. Labeled peptides, proteins, and antibodies are extensively used for protein turnover studies, receptor binding and tumor imaging studies, and radioimmunoassay. The general trend in the use of tracers in clinical nuclear medicine has been an evolution from 3H, 14C, 11C, and 13 to 125 , 131 and 123r to ~c and 111rn.

Infectious Complications in Transplant Patients has been uniquely designed and formatted to address issues and trends pertaining to pathogens deemed important in critically ill transplant patients. The chapters have been carefully selected so as to direct the focus of the book towards current approaches to controversial, emerging or topical problems in these patients. Each chapter has been authored by a North American and a European specialist. This format serves to impart an added dimension reflective of the diversity of opinions and practices pertaining to unresolved or controversial issues. The authors are recognized experts in their respective fields.

Written for residents and practitioners of otolaryngology, medical oncology, radiation oncology, and maxiollofacial surgery, this book provides the reader with a comprehensive, concise discussion of the best evidence available on which to base clinical decisions needed when managing patients with squamous cell carcinomas of the oral cavity, pharynx and larynx. Because of its accessible and practical format, this book is considerably different than other related titles on the market. Formatted with questions at the beginning of each chapter that are then answered with evidence and best practices available for each case, each chapter addresses situations the clinician is likely to face in the diagnostic evaluation and treatment of a patient with cancer of the head and neck. Most clinical decisions in the management of cancers of the head and neck region are based on the results of a few controlled, randomized clinical trial trials (Evidence Level I). However, most decision-making is based on the results of case-control studies (Evidence Level II), descriptive studies, reports of expert committees, or opinions of respected authorities (Evidence Level III). This information is scattered throughout the literature and often comingled with information about other topics. Therefore, there is a need for a publication in which the evidence pertinent to making decisions regarding a particular clinical problem is distilled from the literature and presented in a single concise, clinical, situation-driven source. Cancer of the Oral Cavity, Pharynx and Larynx: Evidence-Based Decision Making is just such a resource.

The symposium from which this book originates represents a sig nificant watershed in the field of intraoperative neural monitoring, since the participants concluded that electrophysiologic monitoring techniques should be considered a "standard of care" for surgical pro cedures that place the central nervous system (CNS) at risk for injury. Specifically, it was agreed that the somatosensory-evoked potential (SEP) is a remarkably reliable and sensitive indicator of several aspects of CNS function, and should be routinely employed as an intraopera tive monitor during many neurosurgical and orthopedic procedures. The significance of this conclusion cannot be overstated, for at the time of this writing, intraoperative monitoring methods based on evoked-potential analyses are still considered experimental and are not in routine use. The reasons for this are not clear, given the accu mulation of literature and expertise on this subject over the past five years. Granted, the cost of electrophysiological monitoring equip ment is high, but only initially. The benefits of injury prevention far outweigh these costs, from both medical and economic viewpoints. It is our sincere hope and goal that the medical community be made aware of the value of intraoperative neural monitoring."

Anesthesia and the Central Nervous System is a textbook for a postgraduate course as well as a reference for all anesthesiologists which presents many of the latest concepts in anesthesiology within a brief formal presentation. An outstanding faculty presents topics relating to the biochemistry, physiology, and pharmacology of the nervous system, the anesthetic management of intracranial and spinal cord surgery, and the intensive care management of central nervous system disease. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia. This textbook is the eleventh in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City.

William P. Cooney III, R. A. Berger, and K. N. An Orthopedic Biomechanics Laboratory Department of Orthopedic Surgery Mayo Clinic and Mayo Foundation Rochester, MN 55905, U. S. A. As surgeons struggle to find new insights into the complex diseases and deformities that involve the wrist and hand, new insights are being provided by applied anatomy, physiology and biomechanics to these important areas. Indeed, a fresh new interaction of disciplines has immersed in which anatomists, bioengineers and surgeons examine together basic functions and principles that can provide a strong foundation for future growth. Clinical interest in the hand and wrist are now at a peak on an international level. Economic implications of disability affecting the hand and wrist are recognized that have international scope crossing oceans, cultures, languages and political philosophies. As with any struggle, a common ground for understanding is essential. NATO conferences such as this symposium on Biomechanics of the Hand and Wrist provides such a basis upon which to build discernment of fundamental postulates. As a start, basic research directed at studies of anatomy, pathology and pathophysiology and mechanical modeling is essential. To take these important steps further forward, funding from government and industry are needed to consider fundamental principles within the material sciences, biomechanical disciplines, applied anatomy and physiology and concepts of engineering modeling that have been applied to other areas of the musculoskeletal system.

Infection Prevention in Surgical Settings is a handbook that provides easy access to guidelines for infection control in various surgical settings. It specifically addresses the needs of nurses practicing in perioperative, PACU, ambulatory surgery, endoscopy, or other surgical settings who need access to current guidelines to meet OSHA and JCAHO requirements. Infection Prevention contains procedure guidelines for preparation of the patient, surgical equipment, personnel, and surgical practices. Each procedure contains a brief description, followed by rationales for the principles outlines in the procedure. Each rationale is referenced to AORN standards, CDC guidelines, and other resources.Provides an easy-to-use reference to common, significant infection control practices & issues found in various surgical and other related settings Brings together the work of recognized experts and professional associations that provide factual, relevant, and succinct rational and correct interpretation of infection control practicesFirst handbook devoted to infection control issues that directly relate to surgical environments Follows a consistent format presentation for each procedure that includes the steps, rationale, references, and suggested additional readings Spanish version also available, ISBN: 84-8174-615-0

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."

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno,M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore,progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis,itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied,thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for "evidence-based medicine" is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe"Decadeof limitsoffeasibility,especiallywherecontrolledthe- theBrain". Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide,accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control,paincontrol,aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology,forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree%ocientpreventionin many of these processes involve the major tra- thefuture,themeasuresthatstandrightatthefore- mitters. Furthermore,biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells,bone-marrowcells,macrophages,andother withthemoretask-speci?c,intensive,andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade,andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients.

Quantitative coronary angiography has become an invaluable tool for the interventional cardiologist, providing objective and reproducible measurements of coronary artery dimensions, which can be used to study progression or regression of coronary atherosclerosis, as well as the immediate and long term effects of percutaneous interventions. Until recently, this powerful imaging technology was confined to a small number of so-called high level institutions. Fortunately, with the development of digital cardiac imaging equipment and adaptation of cine-angiographically based computer software for on-line use in the catheterization room, quantitative coronary angiography is now available to all interventionalists. This book is a timely guide for the impending QCA user, providing practical as well as theoretical and scientific information. A comprehensive evaluation of the clinical usefulness of QCA is covered, from the fundamental principles through experimental validation studies, application to clinical trials of a wide range of pharmacological and interventional therapies in the full spectrum of clinical presentation of coronary disease syndromes, evaluation of the therapeutic efficacy of various new devices for coronary intervention, together with extensive presentation of its physiological, functional and anatomical correlations, by comparison with other intracoronary measurement and imaging techniques. In addition, evolving theories and concepts in the ever topical restenosis phenomenon' after percutaneous intervention, based on serial QCA studies, are presented and discussed and a potentially unifying methodological approach to further study of this ubiquitous problem is offered. Thisbook, thanks to the collaboration of many experts in the field of intracoronary imaging and measurement, provides stimulating, interesting and practical information, both for the academic scientist and practising clinician.

This manual reviews the definitions and typical approach to quality assurance in healthcare and includes a review of the most prominent quality studies. A program for quality management in surgery is presented with chapters reviewing patient safety and external reporting requirements. An introduction to medical malpractice and risk management is also provided and followed by a chapter on how to implement the necessary behavioral changes to improve quality practices. The appendix includes useful protocols, forms and order sets.

This manual reviews the important critical functions of a department of surgery which are synthesized into specific departmental roles. A departmental organizational structure and the required personnel is presented along with the appropriate job descriptions and the role of hospital committees for a department of surgery. To help with process management, a listing of policies, protocols and communications are provided. To ease the access to external oversight, the conditions of participation from CMS related to surgery are reproduced and this is followed by a chapter on change management and program development. The appendix includes useful forms and templates.

Reoperation is one of surgery's greatest challenges. This book provides a practical reference on how to prevent, identify and treat all abdominal complications. Organised primarily by body system Reoperative Abdominal Surgery covers the spectrum of conditions and complications faced by the general surgeon. Separate chapters also cover safety issues, and specific issues related to diagnosis, surgical technique and patient presentation. Combining the expertise and advice of leading international surgeons the book offers a clinical instructive manual for trainee and practising surgeons. Focus on abdominal surgery the key province of the general surgeon Expert guidance on the prevention, identification and management of post-operative complications Key reference on difficult surgical area for residents and young surgeons Experience and advice from best surgeons around the world Covers entire spectrum of reoperative abdominal surgery