In Molecular Diagnostics for Melanoma: Methods and Protocols, expert researchers and clinicians in the field of melanoma provide updated information on biomarkers and assays for diagnosis, prognosis, and assays predicting response to treatment for routine testing. The focus of the volume is on biomarkers with established clinical validity rather than those on early discovery stage. With additional in-depth discussion of the molecular biology and pathology of melanoma, treatment options in adjuvant and metastatic setting, and implications of biomarker testing for clinical management of melanoma patients. Written in the highly successful Methods in Molecular Biology series format, chapters include extensive introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Comprehensive and practical, Molecular Diagnostics for Melanoma: Methods and Protocols seeks to provide both clinicians and scientists with technical information and extensive background information on the wide ranging approaches available in the field of diagnostics of melanoma.

Diagnosis and Treatment of Fungal Infections, 2nd Edition is a thorough update to Diagnosis and Treatment of Human Mycoses. Globally recognized experts are brought together again to provide the latest research and clinical evidence on fungal infections and basic mycology. This concise text is divided into sections dedicated to the patient approach, laboratory and radiological diagnosis, antifungal agents, mycoses and instructive cases. Ideal for patient care or as a teaching guide, the busy infectious disease, hematology, oncology, pulmonology, or critical care specialist will find this resource to be a practical tool for diagnosing, treating, and managing patients with fungal infections.

Endometriosis is one of the most common gynecological diseases, causing pelvic pain, infertility, and cancer. The condition reduces the quality of life for the estimated 10% of menstruating women who are affected by it. This book provides a clear insight into the pathogenesis and pathophysiology of endometriosis—essential information for clinicians intending to successfully treat the condition. The first part covers a range of topics including stem cells, NK cells, macrophages, inflammation, cytokines, epigenetics, prostaglandin, sex steroids, aromatase, apoptosis, nerve fibers, and malignant transformation to aid in understanding the pathogenesis and pathophysiology of the disease. The second part provides useful tools for therapy, specifically, notable recent techniques in prevention, imaging, biomarkers, medical treatments, surgical treatments, prevention of recurrence, and infertility treatments. Each chapter was written by an expert in the field, with nearly 40 researchers and clinicians contributing to the work. This book will be highly useful to clinicians as well as to research scientists who are interested in this enigmatic disease.  

Milton Taylor, Indiana University, offers an easy-to-read and fascinating text describing the impact of viruses on human society. The book starts with an analysis of the profound effect that viral epidemics had on world history resulting in demographic upheavals by destroying total populations. It also provides a brief history of virology and immunology. Furthermore, the use of viruses for the treatment of cancer (viral oncolysis or virotherapy) and bacterial diseases (phage therapy) and as vectors in gene therapy is discussed in detail. Several chapters focus on viral diseases such as smallpox, influenza, polio, hepatitis and their control, as well as on HIV and AIDS and on some emerging viruses with an interesting story attached to their discovery or vaccine development. The book closes with a chapter on biological weapons. It will serve as an invaluable source of information for beginners in the field of virology as well as for experienced virologists, other academics, students, and readers without prior knowledge of virology or molecular biology.

Providing authoritative and up-to-date medical and scientific information about Tourette syndrome, "A Family's Guide to Tourette Syndrome" speaks to patients, families, care providers, academic institutions, and medical centers in easy-to-understand language about this neurodevelopmental disorder that affects children, adolescents, and adults worldwide. Each chapter is authored by leading neurologists, psychiatrists, psychologists, scientists, and others with expertise and research interests in Tourette syndrome.
"Praise for A Family's Guide to Tourette Syndrome"

"I am delighted to see the breadth and wealth of valuable clinical and scientific findings that have been gathered together in this comprehensive resource for families. The information provided in this book is testimony to the talent, abiding intellectual curiosity, and dedication to compassionate care and sheer persistence of each of the professionals who have contributed chapters. Their common goal was clear and selfless-to uncover sound medical and scientific data that could provide much needed answers to the baffling complexities of Tourette syndrome. A mere two decades ago, it was clear to all in the field that the prospect of obtaining sufficient funding to explore more deeply the intriguing preliminary findings uncovered about the disorder was all but non-existent. Simply put-other research funding priorities prevailed at the time. And so we can appreciate that the decision by each of them to dedicate their professional efforts to the study of Tourette syndrome is especially laudable. And for this we all owe the contributing authors a profound debt of gratitude." -Sue Levi-Pearl, Emeritus TSA Vice President, Medical and Scientific Programs

The Pocket Guide to Mycological Diagnosis provides useful and concise information for microbiologists and professionals diagnosing the most medically relevant fungal species. Cellular and molecular techniques, immunological methods, and more accurate microscopy equipment available in most mycology laboratories now make diagnosis more routine. Furthermore, information regarding medical mycology, including identification of specific fungal pathogens, is widely available. This book helps mycologists address the emerging challenges of diagnosis. Key Features Succinct summary of fungal disease diagnosis Includes opportunistic fungal infections that can afflict immunocompromised patients Permits the identification of common fungal pathogens Reviews antifungal drugs Related Titles Ghannoum, M. A. & John R. Perfect, eds. Antifungal Therapy, 2nd ed. (ISBN 978-1-4987-6814-6) Miyaji, M., ed. Animal Models in Medical Mycology (ISBN 978-1-3158-9059-3) Razzaghi-Abyaneh, M., M. Shams-Ghahfarokhi and M. Rai, eds. Medical Mycology: Current Trends and Future Prospects (ISBN 978-1-4987-1421-1)

The Pocket Guide to Mycological Diagnosis provides useful and concise information for microbiologists and professionals diagnosing the most medically relevant fungal species. Cellular and molecular techniques, immunological methods, and more accurate microscopy equipment available in most mycology laboratories now make diagnosis more routine. Furthermore, information regarding medical mycology, including identification of specific fungal pathogens, is widely available. This book helps mycologists address the emerging challenges of diagnosis. Key Features Succinct summary of fungal disease diagnosis Includes opportunistic fungal infections that can afflict immunocompromised patients Permits the identification of common fungal pathogens Reviews antifungal drugs Related Titles Ghannoum, M. A. & John R. Perfect, eds. Antifungal Therapy, 2nd ed. (ISBN 978-1-4987-6814-6) Miyaji, M., ed. Animal Models in Medical Mycology (ISBN 978-1-3158-9059-3) Razzaghi-Abyaneh, M., M. Shams-Ghahfarokhi and M. Rai, eds. Medical Mycology: Current Trends and Future Prospects (ISBN 978-1-4987-1421-1)

Stroke is the leading cause of permanent disability, including post-stroke dementia, pain, depression, and personality changes. While large clinical trials reflect information about large stroke populations, the presentation of each and every stroke patient is individual and special. More Case Studies in Stroke presents a new selection of stroke cases from seven countries prepared by practising stroke physicians. The book includes both common and unusual cases, as well as misleading cases of diseases mimicking stroke. The aim is to reinforce diagnostic skills through careful analysis of individual presenting patterns, and to guide treatment decisions. Each case consists of a clinical history, examination findings and special investigations, followed by diagnosis and discussion. The outline of the actual diagnostic process, including the use of modern diagnostic tools, decision making and course, challenge the reader at all stages of their career from medical students to neurologists and stroke physicians.

Molecular Diagnostics: 12 Tests That Changed Everything focuses on specific laboratory tests and emphasizes how the availability of these tests has altered how clinicians treat their patients. Presented as a standard outline, each chapter focuses on a specific molecular test and provides background on the test and its clinical applications. Continuing with some discussion on how the test is done, interpreted, and used clinically, each chapter then concludes with a discussion of how that test has changed the way medicine is practiced with respect to the disease or condition in question. Authored by renowned experts in the field, Molecular Diagnostics: 12 Tests That Changed Everything is a valuable resource for pathologists, pathology residents, laboratory directors, development personnel, lab medicine fellows and those working in the broad area of oncology, infectious disease and genetics.

This book explores how PPPM, clinical practice, and basic research could be best served by information technology (IT). A use-case was developed for hepatocellular carcinoma (HCC). The subject was approached with four interrelated tasks: (1) review of clinical practices relating to HCC; (2) propose an IT system relating to HCC, including clinical decision support and research needs; (3) determine how a clinical liver cancer center can contribute; and, (4) examine the enhancements and impact that the first three tasks will have on the management of HCC. An IT System for Personalized Medicine (ITS-PM) for HCC will provide the means to identify and determine the relative value of the wide number of variables, including clinical assessment of the patient -- functional status, liver function, degree of cirrhosis, and comorbidities; tumor biology, at a molecular, genetic and anatomic level; tumor burden and individual patient response; medical and operative treatments and their outcomes.

A rapid development in diverse areas of molecular biology and genetic engineering resulted in emergence of variety of tools. These tools are not only applicable to basic researches being carried out world over, but also exploited for precise detection of abnormal conditions in plants, animals and human body. Although a basic researcher is well versed with few techniques used by him/her in the laboratory, they may not be well acquainted with methodologies, which can be used to work out some of their own research problems. The picture is more blurred when the molecular diagnostic tools are to be used by physicians, scientists and technicians working in diagnostic laboratories in hospitals, industry and academic institutions. Since many of them are not trained in basics of these methods, they come across several gray areas in understanding of these tools. The accurate application of molecular diagnostic tools demands in depth understanding of the methodology for precise detection of the abnormal condition of living body. To meet the requirements of a good book on molecular diagnostics of students, physicians, scientists working in agricultural, veterinary, medical and pharmaceutical sciences, it needs to expose the reader lucidly to: Give basic science behind commonly used tools in diagnostics Expose the readers to detailed applications of these tools and Make them aware the availability of such diagnostic tools The book will attract additional audience of pathologists, medical microbiologists, pharmaceutical sciences, agricultural scientists and veterinary doctors if the following topics are incorporated at appropriate places in Unit II or separately as a part of Unit-III in the book. Molecular diagnosis of diseases in agricultural crops Molecular diagnosis of veterinary diseases. Molecular epidemiology, which helps to differentiate various epidemic strains and sources of disease outbreaks. Even in different units of the same hospital, the infections could be by different strains of the same species and the information becomes valuable for infection control strategies. Drug resistance is a growing problem for bacterial, fungal and parasitic microbes and the molecular biology tools can help to detect the drug resistance genes without the cultivation and in vitro sensitivity testing. Molecular diagnostics offers faster help in the selection of the proper antibiotic for the treatment of tuberculosis, which is a major problem of the in the developing world. The conventional culture and drug sensitivity testing of tuberculosis bacilli is laborious and time consuming, whereas molecular diagnosis offers rapid drug resistant gene detection even from direct clinical samples. The same approach for HIV, malaria and many more diseases needs to be considered. Molecular diagnostics in the detection of diseases during foetal life is an upcoming area in the foetal medicine in case of genetic abnormalities and infectious like TORCH complex etc. The book will be equally useful to students, scientists and professionals working in the field of molecular diagnostics.

Early detection of breast cancer is critical. Yet efforts to cut back on mammography or even stop screening altogether have been gaining ground in the medical community's decades-long debate over testing and treatment. It is not a purely scientific debate-back-room politics and hidden agendas have played as much a role as clinical data, leading to some surprising conclusions. Written by one of the first physicians in the country to specialize in breast cancer risk assessment, genetic testing and high-risk interventions, this book focuses on the screening controversy and explains the arguments used on both sides. The author covers the history of screening, from the first mobile unit on the streets of Manhattan to the cutting edge imaging technology of today.

Helps clinicians to systematically look beyond the obvious to arrive at a correct diagnosis Written specifically for both the notice and experienced cardiovascular clinician in acute care settings, this is the only resource to focus on the art of conducting an indepth patient history. Quite often, a patient will tell their first provider one thing, and their second provider something else, even when asked the exact same question. If recorded and interpreted correctly, a clinician can use a comprehensive history alone to obtain a correct diagnosis without exhaustive and expensiveevaluations. Using the steps and strategies outlined in this text, the cardiovascular clinician will learn to adopt specific and detailed a line of questioning to dissect patient symptoms down to their core. This book includes two clinical scenarios for chief complaints that cardiovascular clinicians may see in their practice. Unpacking these scenarios challenge clinicians to look beyond the obvious and recognize atypical presentations. Each scenario dissects and then discusses the history and other pertinent patient information to illuminate subtle differences in the process of information gathering. With this breakdown, the clinician can then identify if the patient has an acute cardiovascular issue. Each chapter ends with a sample of "how to present the patient" to an MD or peer and describes common pitfalls and assumptions to avoid. Key Features: Focuses specifically on acute cardiovascular issues in acute care settings Referenced by chief complaint or consult questions Targets patient history portion of the work up Examines subtle differences between cardiac diagnosis vs. non-cardiac diagnosis based on how patient history is taken Highlights common errors in review of information using EMR vs. standard questioning

Technological developments in the life sciences confront us with new facets of a Faustian seduction. Are we "playing God" more and more, as claimed by critical authors of modernity? Achievements in genetic research produce ethical dilemmas which need to be the subject of reflection and debate in modern societies. Denial of ambivalences that ethical dilemmas arouse constitutes a threat to societies as well as to individuals. The book presents a compilation of some of the results of the interdisciplinary European study "Ethical Dilemmas Due to Prenatal and Genetic Diagnostics" (EDIG), which investigated some of these dilemmas in detail in a field which is particularly challenging: prenatal diagnosis. When results from prenatal diagnosis show fetal abnormalities, women and their partners are confronted with ethical dilemmas regarding: the right to know and the right not to know; decision-making about the remainder of the pregnancy and the desire for a healthy child; responsibility for the unborn child, for its well-being and possible suffering; life and death. This book provides answers from an ethical, psychoanalytical and medical viewpoint.

Not all scientific discoveries are genius. Continual Raving tells the combined stories of how scientists across the 19th and 20th centuries defeated meningitis - not through flawless scientific research, but often through a series of serendipitous events, misplaced assumptions, and flawed conclusions. The result is a story of not just a vanquished disease, but how scientific accomplishment sometimes occurs where it's least expected. Although symptoms of meningitis were recorded as early as Hippocrates and the ancient Greeks, our understanding of the disease's origins and mechanisms remained obscure for most of human history. That changed in 1892, when German physician Richard Pfeiffer observed and isolated bacteria ultimately shown to cause meningitis in children - and concluded that those bacteria cause influenza. Haemophilus influenzae, as thee meningitis-causing bacteria have been erroneously named ever since, continued their strange journey to discovery in the decades that followed. Continual Raving traces the disease's strange encounters with science, including: * Heinrich Quincke, the German internist who first used a needle to draw spinal fluid from between a patient's back bones * Simon Flexner's management of American meningitis epidemics using immune serum from a horse * American bacteriologist Margaret Pittman's discovery (during the Great Depression, no less) of a sugar overcoat that protects the bacteria from white blood cells * Pediatrician Ashley Weech, who gave the first antibiotic used in America (based on instructions written in German) to a young patient sick with meningitis * Microbiologist Hattie Alexander, who learned why these antibiotics sometimes fail in such patients * Four scientists, in two teams, as they vied to be the first to create the right vaccine to prevent meningitis in infants In each of these deeply human stories, variables of chance, circumstance, and incorrect assumptions intervene to shape not just the arc of the scientists' lives, but the trajectory of how humans have come to understand one of our most pernicious diseases. Continual Raving is a mosaic tale of how science conquered meningitis - and a larger story of the sometimes winding road to discovery.

Many young, inexperienced doctors, have difficultly pinpointing a diagnosis: Is it a condition to which certain diseases could belong, or a disease definable in line with certain criteria? How can I apply my basic knowledge of diseases to a real patient? How can I find the correct diagnosis for a disease that I am seeing for the very first time? The traditional diagnostic pathways conveyed by current methods of teaching, from visual identification of the disease, knowledge of diseases, understanding of symptoms or patterns to diagnosis, leave certain diagnostic questions unanswered, especially on first experience of such a clinical pattern. Syndrome-based Approach to Diagnosis: A Practical Guide offers lecturers an alternative training concept in their teaching, which provides students with a model for self-study as well as the educational tools for learning how to think in clinical terms.

In a world where human disconnection is so prevalent, Prognosis HOPE restores humanity to healthcare and brings hope back to both caregivers and care-seekers. Patients don't always get the care they deserve and it's time for both caregivers and care-seekers to stand up and demand that change. Before becoming a registered nurse, Angie Felts was hit by a drunk driver. She sustained a traumatic brain injury that put her life on hold for nearly twenty years and provides a unique perspective on the dehumanization present in healthcare today. In a candid, yet entertaining way, Angie shares her personal story, along with the stories of her mentors, colleagues, and patients, to demonstrate her method for human connection: Prognosis HOPE. A four-step method that is simple and easy to implement, Prognosis HOPE puts patients back in the driver's seat and enables medical professionals to return to their true callings as healers by celebrating human connection instead of getting bogged down by a diagnosis or complicated care plan. Angie empowers readers to see that they can change their own lives and leads both caregivers and care-seekers back to humanity through joining forces and sharing in the human experience.

According to the Autoimmune Diseases Coordinating Committee (ADCC), between 14.7 and 23.5 million people in the USA - up to eight percent of the population are affected by autoimmune disease. Autoimmune diseases are a family of more than 100 chronic, and often disabling, illnesses that develop when underlying defects in the immune system lead the body to attack its own organs, tissues, and cells. In Handbook of Autoimmune Disease, the editors have gathered in a comprehensive handbook a critical review, by renowned experts, of more than 100 autoimmune diseases, divided into two main groups, namely systemic and organ-specific autoimmune diseases. A contemporary overview of these conditions with special emphasis on diagnosis is presented. Each chapter contains the essential information required by attending physicians as well as bench scientists to understand the definition of a specific autoimmune disease, the diagnostic criteria, and the treatment.

Urgent Care Dermatology: Symptom-Based Diagnosis, by Drs. James E. Fitzpatrick, Whitney A. High, and Lamar Kyle, helps you quickly identify skin conditions and provide necessary treatment at the point of care. Concise, to-the-point text is highlighted by more than 1,000 high-quality photographs - all conveniently organized by lesion appearance - making this resource ideal for first-line clinicians to quickly identify and treat dermatologic conditions. Appearance-based format designed for non-specialists who diagnose and treat skin conditions, such as family practice physicians, urgent care providers, nurse practitioners, and physician assistants Organized by presentation (scaly lesions, blisters, etc.), with a full chapter on treatment pearls that offers expert advice pertaining to diagnosis and treatment Richly illustrated with more than 1,000 full-color clinical examples of lesions you're likely to see Each topic is covered in a two-page spread for quick reference - text on the left and images on the right Up-to-date coverage of morbilliform eruptions, scaly papular lesions, dermatitis (eczematoid reactions), and abscesses, as well as a timely chapter on cutaneous diseases of travelers organized by global region Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, videos (including video updates), glossary, and references from the book on a variety of devices Appearance-based format designed for non-specialists who diagnose and treat skin conditions, such as family practice physicians, urgent care providers, nurse practitioners, and physician assistants. Organized by presentation (scaly lesions, blisters, etc.), with a full chapter on treatment pearls that offers expert advice pertaining to diagnosis and treatment. Richly illustrated with more than 1,000 full-color clinical examples of lesions you're likely to see. Each topic is covered in a two-page spread for quick reference - text on the left and images on the right. Up-to-date coverage of morbilliform eruptions, scaly papular lesions, dermatitis (eczematoid reactions), and abscesses, as well as a timely chapter on cutaneous diseases of travelers organized by global region. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, videos (including video updates), glossary, and references from the book on a variety of devices.

Prognostication of acute neurologic disease is a major task for neurohospitalists and neurointensivists. The family conference raises the delicate matter of how to decide that outcome is indefinitely poor and how to define disability. This monograph is the first book on how to communicate prognosis in acute neurologic conditions. Communicating Prognosis includes useful data on prognosis in all major neurologic conditions and provides practical advice on how to effectively lead such a conference and how to resolve potential conflicts. This book provides straightforward common sense on-the-spot advice and touches on all aspects of support of devastated families.

This book fills the need for a resource presenting important diagnostic facts that clinicians should have learned during their classroom lectures and subsequent clinical training, but often didn't. The content will be literature-based information that can help the clinician avoid diagnostic errors. Most other diagnosis books on the market are either "physical diagnosis" texts targeting student readers or "differential diagnosis" books intended for use by practicing physicians, though both types of books aim to be comprehensive. What sets this book apart from other diagnosis books is that it is a curated collection of facts, tailored specifically to address common gaps in clinical knowledge and describe less-traveled pathways to important diagnostic destinations. This book focuses on high-impact techniques. Essential Diagnostic Facts Every Clinician Should Know contains: -Classical diagnostic pearls clinicians should have learned in physical diagnosis courses. For example, a patient with acute pericarditis may find that leaning forward relieves the pain. -Red flag symptoms of serious disease. For example, an infant that tastes salty when kissed might be the first clue to a diagnosis of cystic fibrosis. -Pathognomonic signs allowing an occasional early diagnosis: For example, Koplik spots in a febrile child are found only with measles. -Plastic pearls exposed: For example, contrary to clinical lore, back pain at night has not been found to be a useful indicator for serious spinal pathology. -Counterintuitive clinical manifestations: For example, the patient with gout may have a normal or even low serum uric acid level during an acute attack. -Clinical manifestations that may point to uncommon diagnoses: For example, nocturnal bone pain, sometimes dramatically relieved by aspirin, characterizes osteoid osteoma.

The articles collected in this volume are based on lectures given at the IMA Workshop, "Computational Radiology and Imaging: Therapy and Diagnostics", March 17-21, 1997. Introductory articles by the editors have been added. The focus is on inverse problems involving electromagnetic radiation and particle beams, with applications to X-ray tomography, nuclear medicine, near-infrared imaging, microwave imaging, electron microscopy, and radiation therapy planning. Mathematical and computational tools and models which play important roles in this volume include the X-ray transform and other integral transforms, the linear Boltzmann equation and, for near-infrared imaging, its diffusion approximation, iterative methods for large linear and non-linear least-squares problems, iterative methods for linear feasibility problems, and optimization methods. The volume is intended not only for mathematical scientists and engineers working on these and related problems, but also for non-specialists. It contains much introductory expository material, and a large number of references. Many unsolved computational and mathematical problems of substantial practical importance are pointed out.

DSM-5 Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is a user-friendly, supplementary guide for psychiatrists, psychologists, and other mental health practitioners who need to know how DSM-5 differs from its predecessor in terms of organizational structure, diagnostic categories, and the criteria themselves. While it does not replace the comprehensive and authoritative DSM-5, it illuminates its content by teaching mental health professionals how to use the revised diagnostic criteria and by providing a practical context for its clinical use. The book offers many valuable features, including: * An historical overview of the development of the DSM in general, and DSM-5 in particular, a progression that might be said to mirror the evolution of psychiatry as a whole. The material on the creation of DSM-5 includes coverage of dimensional assessment, reliability and field trials, and the controversies that arose during development of DSM-5.* An indispensable chapter on how to use DSM-5 that addresses coding, diagnostic certainty, the demise of the multiaxial system, and the key changes to each diagnostic category.* Full coverage of the significant reorganization from DSM-IV-TR to DSM-5, which is designed to incorporate advances in neuroscience, brain imaging and genetics. Chapters were reordered to reflect scientific advances in the understanding of psychiatric disorders, and the presumed etiological and the pathophysiological relationships among them.* Extensive coverage of the decision to integrate dimensional measures into DSM-5, which may enhance the clinician's ability to assess symptom variation and severity and aid in patient evaluation, treatment decisions, and outcome monitoring. The various measures are presented and their use discussed.* Finally, as the authors were not part of the revision process, they offer a fresh, down-to-earth perspective that will resonate with clinicians by focusing on the changes that will most significantly impact clinicians' professional lives. DSM-5 Guidebook provides a roadmap to the many changes in this living document, DSM-5, and will prove invaluable to psychiatrists, psychologists, psychiatric nurses, neurologists, social workers, and all who strive to understand mental illness as it is conceived today.

In 1973, the American Psychiatric Association decided to publish a revised edition of their Diagnostic and Statistical Manual (DSM). There was great hope that a new manual would display psychiatry as a scientific field and aid in combating the attacks of an aggressive anti-psychiatry movement that had persisted for more than a decade. The Making of DSM-III is a book about the manual that resulted in 1980-DSM-III-a far-reaching revisionist work that created a revolution in American psychiatry. Its development precipitated a historic clash between the DSM-III Task Force - a group of descriptive, empirically oriented psychiatrists and psychologists - and the psychoanalysts the Task Force was determined to dethrone from their dominance in American psychiatry. DSM-III also inaugurated an era in which it and the diagnostic manuals that followed played enormous roles in the daily lives of persons and organizations all over the world, for the DSMs have been translated into many languages. The radical revision process was led by the psychiatrist Robert L. Spitzer, a many-talented man of great determination, energy, and tactical skills, arguably the most influential psychiatrist of the second half of the 20th Century. Spitzer created as major a change in descriptive psychiatry and classification as had the renowned German psychiatrist Emil Kraepelin, almost a century earlier. Kraepelin had been the epochal delineator of dementia praecox from manic-depressive illness, the forerunners of modern schizophrenia and bipolar disorder. In her book, Hannah Decker portrays the many internal and external battles that roiled the creation of DSM-III and analyzes both its positive achievements and significant drawbacks. She also astutely explores the deleterious effects of the violent swings in scientific orientation that have dominated psychiatry over the past 200 years and are still alive today. Decker has written a revealing and exciting book that is based on archival sources never before used as well as extensive interviews with the psychiatrists and psychologists who have brought into being the psychiatry we know today.

Thyroid function tests are utilized by essentially all medical practitioners, across every clinical setting, in patients from newborns to the elderly. They are the most frequently measured endocrine tests. The sensitive thyrotropin (TSH) assay reflects thyroid hormone feedback to the pituitary, and is diagnostic of both thyroid h- mone excess as well as deficiency. The log-linear relationship between serum TSH and thyroxine concentrations means that small changes in serum thyroxine are amplified by changes in serum TSH. The availability of the sensitive TSH assay in essentially all clinical laboratories has improved and simplified the assessment of thyroid function for the diagnosis of thyroid disease and to monitor treatment. Serum free thyroxine and thyrotropin concentrations, as well as other thyroid tests, can be measured utilizing an automated immunoassay platform that provides rapid and accurate results. This simplified approach to thyroid assessment, often requ- ing only a serum TSH measurement, and rapid availability of the thyroid function tests results, has expanded the scope of thyroid testing and clinicians ordering and interpretingth yroid tests. There remain, however, many challenges in selecting the appropriate thyroid function test to order, the correct interpretation of results, and applying these results to the diagnosis and management of thyroid diseases. It is especially important to be aware of limitations of thyroid function tests, as well as special clinical c- cumstances that can influence thyroid function measurements. The serum TSH concentration, for example, may not accurately reflect thyroid status in many si- ations including after prolonged hyperthyroidism when serum TSH remains s- pressed for months, in the presence of hypothalamic or pituitary disease, or due to a number of interfering medications. The serum free thyroxine, measured by the analog method, is not accurate with high or low serum binding proteins and d- ing pregnancy. Hospitalized patients often have thyroid function test abnormalities that are transient and return to normal after recovery from the acute illness. Iodine excessand deficiency candramatically influence thyroid function tests. Significant insights have been gained into the regulation of thyroid hormone synthesis and especially the role of thyroid hormone metabolism in supplying t- sues locally with an adequate supply of thyroid hormone. In a number of instances, these factors influence the selection and interpretation of thyroid function tests. Polymorphisms, common sequence variations, in genes of components that regulate thyroid function and thyroid hormone action may also contribute to variability in thyroid function tests in a population. v vi Preface This volume draws on an outstanding international panel of experts in thyroid function tests and thyroid function assessment. They represent clinicians, clinical researchers, and basic science researchers, all with a focus on some aspect of the assessment of thyroid function. The chapters all provide a clinical perspective, but are informed by themost recent scientific advancements. The first section of the book (Chaps. 1-3) presents the most recent advances in thyroid physiology, a review of genetic influences on thyroid function tests, and a discussion on the influence of iodine on thyroid function. In Chap. 1, Drs. Huang and de Castro Neves describe thyroid hormone metabolism, emphasizing the key role of thyroid hormone activation and inactivation in thyroid hormone action. Dr. Visser is a world leader in studies of thyroid metabolism and genetic influences on thyroid function. In Chap. 2, Dr. Visser and his colleagues, Drs. van der Deure, Medici, and Peeters, provide a clear view of this important and r- idly expanding field. The population variation in the TSH "set point" (relationship between serum TSH and thyroxine in an individual), for example, is thought to be genetically determined, and influences the evaluation of thyroid function and thyroid function targets for treatment of thyroid disease. Dr. Zimmerman, an int- nationally recognized expert in iodine, and his colleague, Dr. Andersson, provide in Chap. 3 an in-depth treatment of the most significant influence on thyroid function throughout the world-iodine intake. The influence of iodine deficiency and excess on individual thyroid function is discussed, as well as the population effects on t- roid diseases and especially fetal and neonatalde velopment. The basics of thyroid function measurements, approaches, limitations, and cl- ical applications are described for the major categories of thyroid function tests (Chaps. 4-7). The authors of these chapters are innovators in the field, strongly id- tified with the origination or significant refinement of the core tests utilized in t- roid assessment. In Chap. 4, Dr. Hershman describes the measurement of TSH, the clinical application and utilization. This remains the cornerstone of thyroid testing, but must be interpreted with an understanding of the dynamics of thyroid regulation. An active controversy in thyroid measurement involves the appropriate use of serum thyroxine measurements and especially the value of the analog free thyroxine me- urement, the most commonly used thyroxine assay. In Chap. 5, Dr. Stockigt p- vides a detailed assessment of thyroxine and triiodothyronine measurements and a clear message for their use and limitations. The most common etiology of thyroid disease is autoimmune, and the appropriate use of thyroid autoantibody measu- ments remains confusing to many clinicians. In Chap. 6, Dr. Weetman and his c- league, Dr. Ajjan, clearly describe the range of thyroid autoantibody tests and how they should be utilized clinically. Thyroglobulin measurement is the key tumor marker to follow thyroid cancer patients and Dr. Spencer and her colleague, Ivana Petrovic, describe the essential features of this measurement in Chap. 7. It is ess- tial that clinicians using thyroglobulin measurements to monitor thyroid cancer are aware of the performance of the assay being used and the factors that can interfere with the measurement. Application of thyroid function testing to the key clinical settings is discussed by expert clinicians and clinical researchers in Chaps.8-13. The appropriate selec- Preface vii tion of thyroid function tests in the diagnosis and monitoring of thyroid disease in the ambulatory setting is discussed by Drs. Farwell and Leung in Chap. 8. This is the most common setting for thyroid function test measurement and a rational approach is described. Specific issues of thyroid function in infants and children are discussed in Chap. 9 by Drs. LaFranchi and Balogh. Screening for thyroid disease among newborns has been a highly effective approach to prevent mental retar- tion. The assessment of thyroid function in newborns, especially premature infants, is challenging as are the interpretation of thyroid function tests in infancy through childhood. Illness has a significant impact on thyroid function tests and assessment in this group is described by Drs. LoPresti and Patil in Chap. 10. A logical approach to these patients is provided as are ways to identify those patients with thyroid disease that need to be treated. Assessment of thyroid function in pregnancy is ch- lenging and is being increasing recognized as a crucial time to normalize maternal thyroid status. Adverse outcome for mother and her child can result from thyroid hormone deficiency or excess. In Chap.11, Drs. Lazarus, Soldin, and Evans ca- fully describe the use and limitations of thyroid tests in pregnancy and provide an approach to testing and monitoring thyroid function. The incidence of autoimmune thyroid disease increases significantly with age and in Chap. 12 Dr. Samuels p- vides a clear approach to the assessment of thyroid status in the elderly and interp- tation of thyroid studies. The influence of drugs on thyroid function testing remains a major clinical issue with recognition of an ever increasing list of medications that influence thyroid function and thyroid testing. In Chap. 13, Drs. Pearce and An- thakrishnan comprehensively describe these medications with a special emphasis on their mechanism of action and on iodine-containing medications. I am most grateful to my colleagues for their enthusiasm and willingness to p- vide such outstanding contributions to this book. The editorial team at Springer is excellent and has been highly supportive and effective. My special thanks to E- tor Laura Walsh, Associate Editor Dianne Wuori, Editorial Assistant Stacy Lazar, Senior Production Editor Jenny Wolkowicki and Crest Premedia Solutions for final production.