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.

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.

Combining the fundamental coverage of a traditional nursing assessment text with a modern, student-friendly presentation and an enhanced emphasis on clinical judgment, Nursing Health Assessment: A Clinical Judgment Approach, 4th Edition, helps students easily develop the understanding, critical thinking, and decision-making skills to excel in any clinical setting. A consistent, two-column format presents normal and abnormal findings and guides students progressively through realistic clinical case scenarios, instilling the nursing knowledge to observe and assess situations, prioritize patient concerns, and generate the best possible solutions. Case-based Next Generation NCLEX (R) (NGN) style questions throughout the text (and answers with rationales in an appendix) align with the NCSBN Clinical Judgment Model (NCJMM) to prepare students for success on the Next Generation NCLEX (R) and to help them confidently deliver safe patient care in any clinical setting. New and Updated Features for the 4th Edition NEW! 180 case-based Next Generation NCLEX (R) (NGN) style questions (and answers with rationales) boost students' exam readiness and test-taking confidence. NEW! NCSBN Clinical Judgment Measurement Model (NCJMM) cues, hypotheses, and evaluation components incorporated into case studies throughout the text strengthen students' critical thinking and decision-making capabilities. UPDATED! New and revised content familiarizes students with social determinants of health, incorporates unbiased language, and reflects current infection and source control measures. UPDATED! Diagnoses incorporate International Classification for Nursing Practice [INCP] language to clarify challenging terminology.

This book examining diagnosis was first published in 1985. Diagnosis is at the centre of medical practice and depends on skilled information processing and decision making. Medical students, who will spend their working lives gathering information from patients, making decisions and solving problems need to be taught the necessary techniques. One aim of the book is, therefore, to give teachers an account of some of the basic ideas which have been applied to the diagnostic process and to medical problem solving in general. Another aim is to make teachers more aware of the principles underlying their clinical work, for it has been shown repeatedly that clinicians' actions do not always coincide with their teaching and there is a distinct gap between what they do and what they teach. This introduction to the fundamental concepts of information processing and decision making is written at a level which makes it appropriate reading for those who have not previously read widely in these areas. It will be of interest to clinical teachers in medical and allied health professions.

Useful in many areas of medicine and biology, Bayesian methods are particularly attractive tools for the design of clinical trials and diagnostic tests, which are based on established information, usually from related previous studies. Advanced Bayesian Methods for Medical Test Accuracy begins with a review of the usual measures such as specificity, sensitivity, positive and negative predictive value, and the area under the ROC curve. Then the scope expands to cover the more advanced topics of verification bias, diagnostic tests with imperfect gold standards, and those for which no gold standard is available.

Promoting accuracy and efficiency of clinical trials, tests, and the diagnostic process, this book:

• Enables the user to efficiently apply prior information via a WinBUGS package
• Presents many ideas for the first time and goes far beyond the two standard references
• Integrates reader agreement with different modalities X-ray, CT Scanners, and more to study their effect on medical test accuracy
• Provides practical chapter-end problems

Useful for graduate students and consulting statisticians working in the various areas of diagnostic medicine and study design, this practical resource introduces the fundamentals of programming and executing BUGS, giving readers the tools and experience to successfully analyze studies for medical test accuracy.

Hematology is difficult to teach at the medical school level. The curriculum is necessarily fragmented across different years of study, and often separated considerably in time. Understanding hematology requires insight into several distinct aspects: applied physiology (generally taught early), an understanding of the essential pathological processes involving the blood are taught somewhat later (if at all), and the (necessarily) strong laboratory aspect is generally taught more or less concurrently with other clinical pathology topics, such as clinical chemistry and immunology. By the time the student is faced with blood diseases in the wards, the laboratory/pathological bias is well entrenched. It is thus difficult for the student to get an integrated view of the subject. The unspoken assumption, often reinforced by clinical tutors trained in the traditional perspective, is that blood tests are all that are required for a diagnosis in blood diseases.

The result has been that clinical expertise in blood diseases is generally poor. This is reflected in the importance given to the examination of the hematological system in most student primers. The hematological system, by and large, is almost completely neglected. Such relevant features such as pallor, jaundice, bleeding, splenomegaly and so on are dealt with either in passing or in relation first to another system or the general examination . It is almost as though it is taken for granted that the haematological system cannot be assessed clinically and yet, as demonstrated later in the book, it is in very many cases impossible to reach a complete haematological diagnosis without clinical assessment.

Effective, patient-centred care of hematological patients requires, as with all other patients, a comprehensive clinical insight into these disease processes, i.e. an integrated clinical and pathological approach. Added to these problems is the fact that the number of laboratory tests has increased explosively, and the laboratory simply does not have the time to attempt more than a brief, generalized, and increasingly, an automated interpretation of the results. Thus the onus of clinical interpretation necessarily falls more and more on the attending clinician, whose grounding in clinical haematology is too often inadequate, for the reasons mentioned.

Hematology is emerging as a clinical specialty in its own right. The training of hematology physicians today includes extensive clinical exposure (indeed they are expected to handle the clinical aspects themselves), while training of medical registrars requires considerable knowledge of haematology and its reports. Achieving an integrated approach would be made immeasurably easier by a book presenting the subject in a fully integrated, clinical way. This then has been the motivation for this book.

There is no shortage of hematological texts, some of them very good, and it would be presumptuous and self-indulgent to add to them without clear justification. However, practically all of the student-orientated texts tend still to teach hematology from a formal and largely static laboratory perspective, and the reports emanating from the laboratory tend to reinforce this. Many of the Crash Course types of hematology book on the market have (at least) two major weaknesses: they considerably oversimplify the subject, contributing to the very mechanistic and almost anti-intellectual approach to blood diseases and especially to the FBC and Hemostatic Screen; and they tend to concentrate on primary blood diseases, whereas in practice most abnormalities of the blood and in the FBC are secondary to disease outside the system that is to say, they work primarily from a pathological and not from a clinical viewpoint. The FBC is one of the most common and valuable tests in use; it is a relatively expensive test and generally speaking is poorly interpreted, and the potential wealth of information that can be gleaned is missed.

The approach described in this book is different from that in most student texts, and has been very successful in practice, starting almost from scratch, but omitting many of the basics such as the details of hematopoiesis, laboratory technology, and so on, which are hardly relevant to the practising clinician and student in the wards, and are primarily of interest to the hematologist and sometimes to the clinical specialist. Considerable emphasis is given to the clinical history and examination, and the interpretation of the clinical patterns thus exposed. Hopefully it will overcome many of the traditional problems experienced in practical diagnostic haematology.

All the practical essentials are covered, and effectively this book contains all the information the student will ever need, apart from details of therapy (until and unless they enter certain specialties).

The book is restricted to adult haematology, for practical reasons. While there are considerable areas of similarity between adult and paediatric haematology, there are also very significant differences. Thus, the only congenital diseases discussed in this book are those that can present after childhood and occasionally those that pose a significant problem in adult practice. Generally these are discussed only briefly. Often with these the assistance of a haematologist would have to be sought anyway. Sometimes even the haematologist may have to further consult someone sub-specializing in paediatric haematology."

Practicing physical medicine and rehabilitation physician Grant Cooper, MD, provides a concise step-by-step approach to confidently establishing a working clinical diagnosis and finding appropriate treatment options for the most common musculoskeletal ailments. Organized by body region and written with superb clarity, this guide details the important questions to ask in history taking, the physical examination maneuvers appropriate for each pathology, the possible explanations and additional tests needed to diagnose the condition, and the most up-to-date treatment options available. The author offers clear explanations why each step in the history and physical examination is performed and discusses the basic pathophysiological processes involved. The ailments covered include neck and shooting arm pain; shoulder pain; elbow pain; wrist and hand pain; low back, hip, and shooting leg pain; knee pain, ankle pain, and foot pain. Numerous photographs demonstrate the correct hands-on methods for physical examination of the patient. A value-added CD-ROM version of book is included for downloading and use in the reader's PC or PDA.

The manifestations of dermatologic disease in the geriatric population are often subtly different to those in the younger age groups and there is a need to produce a practical and clinical reference for dermatology fellows and residents, geriatricians and related clinicians to identify dermatoses and their differential diagnosis specific to the aging population. Diagnosis of Aging Skin Diseases will provide the clinician with a visual encyclopedia of geriatric dermatoses that can be used on rounds or in a reference environment. It also provides a structured review of the differential diagnosis of the lesions illustrated within the book, which will make this a priceless reference resource for all physicians dealing with older skin.

Shaped by Quantum Theory, Technology, and the Genomics Revolution The integration of photonics, electronics, biomaterials, and nanotechnology holds great promise for the future of medicine. This topic has recently experienced an explosive growth due to the noninvasive or minimally invasive nature and the cost-effectiveness of photonic modalities in medical diagnostics and therapy. The second edition of the Biomedical Photonics Handbook presents fundamental developments as well as important applications of biomedical photonics of interest to scientists, engineers, manufacturers, teachers, students, and clinical providers. The second volume, Biomedical Diagnostics, focuses on biomedical diagnostic technologies and their applications from the bench to the bedside. Represents the Collective Work of over 150 Scientists, Engineers, and Clinicians Designed to display the most recent advances in instrumentation and methods, as well as clinical applications in important areas of biomedical photonics to a broad audience, this three-volume handbook provides an inclusive forum that serves as an authoritative reference source for a broad audience involved in the research, teaching, learning, and practice of medical technologies. What's New in This Edition: A wide variety of photonic biochemical sensing technologies have already been developed for clinical monitoring of physiological parameters, such as blood pressure, blood chemistry, pH, temperature, and the presence of pathological organisms or biochemical species of clinical importance. Advanced photonic detection technologies integrating the latest knowledge of genomics, proteomics and metabolomics allow sensing of early disease state biomarkers, thus revolutionizing the medicine of the future. Nanobiotechnology has opened new possibilities for detection of biomarkers of disease, imaging single molecules and in situ diagnostics at the single cell level. In addition to these state-of-the art advancements, the second edition contains new topics and chapters including: * Fiber Optic Probe Design * Laser and Optical Radiation Safety * Photothermal Detection * Multidimensional Fluorescence Imaging * Surface Plasmon Resonance Imaging * Molecular Contrast Optical Coherence Tomography * Multiscale Photoacoustics * Polarized Light for Medical Diagnostics * Quantitative Diffuse Reflectance Imaging * Interferometric Light Scattering * Nonlinear Interferometric Vibrational Imaging * Multimodality Theranostics Nanoplatforms * Nanoscintillator-Based Therapy * SERS Molecular Sentinel Nanoprobes * Plasmonic Coupling Interference Nanoprobes Comprised of three books: Volume I: Fundamentals, Devices, and Techniques; Volume II: Biomedical Diagnostics; and Volume III: Therapeutics and Advanced Biophotonics, this second edition contains eight sections, and provides introductory material in each chapter. It also includes an overview of the topic, an extensive collection of spectroscopic data, and lists of references for further reading.

Biomedical imaging is a fascinating research area to applied mathematicians. Challenging imaging problems arise and they often trigger the investigation of fundamental problems in various branches of mathematics.

This is the first book to highlight the most recent mathematical developments in emerging biomedical imaging techniques. The main focus is on emerging multi-physics and multi-scales imaging approaches. For such promising techniques, it provides the basic mathematical concepts and tools for image reconstruction. Further improvements in these exciting imaging techniques require continued research in the mathematical sciences, a field that has contributed greatly to biomedical imaging and will continue to do so.

The volume is suitable for a graduate-level course in applied mathematics and helps prepare the reader for a deeper understanding of research areas in biomedical imaging.

This book constitutes the refereed proceedings of the First International Conference on Medical Biometrics, ICMB 2008, held in Hong Kong, China, in January 2008.

The 17 revised full papers and 23 revised poster papers presented were carefully reviewed and selected from numerous submissions for inclusion in the book. Medical biometrics is emerging as a very promising and reliable method for automated medical diagnosis. It integrates multidisciplinary technologies in biology, medicine, electronics, computing, and statistics. The papers are organized in topical sections on feature extraction and classification, health care, medical diagnosis, as well as medical image processing and registration.

This concise pocket guide to urological investigative procedures reviews the indications and pitfalls of tests before they are requested and suggests which investigations should be performed in individual urological conditions.

Part I describes principles, methodology, advantages and disadvantages of each investigation and covers all urological investigations/tests from simple X-ray of the abdomen (KUB) to PET scanning. Part II offers advice on the choice of investigations for individual urological conditions. For each investigation in Part I and urological condition in Part II, important bullet points are highlighted in a a ~boxa (TM) - useful during a busy ward round, out-patient clinic, or for last-minute consultation prior a viva examination.

This comprehensive yet easy-to-read hadbook is aimed at urological trainees, urology nurse specialists, recently qualified junior urologists as well as practicing urologists as part of review and audit of practices.

Rapid technical advances in medical imaging, including its growing application to drug/gene therapy and invasive/interventional procedures, have attracted significant interest in close integration of research in life sciences, medicine, physical sciences and engineering. This is motivated by the clinical and basic science research requi- ment of obtaining more detailed physiological and pathological information about the body for establishing localized genesis and progression of diseases. Current research is also motivated by the fact that medical imaging is increasingly moving from a primarily diagnostic modality towards a therapeutic and interventional aid, driven by recent advances in minimal-access and robotic-assisted surgery. It was our great pleasure to welcome the attendees to MIAR 2004, the 2nd Int- national Workshop on Medical Imaging and Augmented Reality, held at the Xia- shan (Fragrant Hills) Hotel, Beijing, during August 19 20, 2004. The goal of MIAR 2004 was to bring together researchers in computer vision, graphics, robotics, and medical imaging to present the state-of-the-art developments in this ever-growing research area. The meeting consisted of a single track of oral/poster presentations, with each session led by an invited lecture from our distinguished international f- ulty members. For MIAR 2004, we received 93 full submissions, which were sub- quently reviewed by up to 5 reviewers, resulting in the acceptance of the 41 full - pers included in this volume."

The rise in popularity of dermoscopy has meant that more and more practitioners need a ready reference to consult in a clinical setting where larger atlases are less practical. The Handbook of Dermoscopy features a wealth of photographs, checklists, and algorithms to assist in spot diagnoses. Coverage includes melanocytic lesions, seborrheic keratosis, basal cell carcinoma, dermatofibroma, vascular lesions. Melanoma, pattern analyses, the ABCD/ABC/ABCDE rule, and Menzies's method.

The 7th International Conference on Medical Imaging and Computer Assisted Intervention, MICCAI 2004, was held in Saint-Malo, Brittany, France at the "Palais du Grand Large" conference center, September 26-29, 2004. The p- posaltohostMICCAI2004wasstronglyencouragedandsupportedbyIRISA, Rennes. IRISA is a publicly funded national research laboratory with a sta? of 370,including150full-timeresearchscientistsorteachingresearchscientistsand 115 postgraduate students. INRIA, the CNRS, and the University of Rennes 1 are all partners in this mixed research unit, and all three organizations were helpful in supporting MICCAI. MICCAI has become a premier international conference with in-depth - pers on the multidisciplinary ?elds of medical image computing, comput- assisted intervention and medical robotics. The conference brings together cl- icians, biological scientists, computer scientists, engineers, physicists and other researchers and o?ers them a forum to exchange ideas in these exciting and rapidly growing ?elds. The impact of MICCAI increases each year and the quality and quantity of submitted papers this year was very impressive. We received a record 516 full submissions (8 pages in length) and 101 short communications (2 pages) from 36 di?erent countries and 5 continents (see ?gures below). All submissions were reviewed by up to 4 external reviewers from the Scienti?c Review C- mittee and a primary reviewer from the Program Committee. All reviews were then considered by the MICCAI 2004 Program Committee, resulting in the acceptance of 235 full papers and 33 short communications.

The Hands-on Guide to Clinical Reasoning in Medicine is the perfect companion to your time on clinical placements, providing an easy-to-read, highly visual guide to help develop your clinical decision making skills, and transfer your knowledge into practice. Packed full of useful tips, key boxes, exercises and summaries that are designed to help you apply the knowledge gained in clinical practice. Divided into the common clinical placements that you would find yourself in: Respiratory, Cardiovascular, Neurology, Geriatrics, Gastroenterology, Nephrology, Endocrinology and Rheumatology, each chapter covers the diagnosis of common clinical conditions, as well as decision-making in their investigation and management. Written for medical students in their clinical years, as well as new doctors and advanced nurse practitioners, The Hands-on Guide to Clinical Reasoning in Medicine provides students with an accessible resource for honing their clinical reasoning skills. Take the stress out of clinical decision making with The Hands-on Guide!

This book provides medical students at the first clinical stage with comprehensive knowledge for the examination subject of clinical chemistry, laboratory diagnostics, hematology, also with regard to exam preparation. A unique feature are the diagrams of cardinal symptoms (19 cardinal symptoms in all, such as pain, temperature, high blood pressure, etc.) which provide a guide from symptom to diagnosis using decision trees. Such overviews are also useful for practicing physicians. The most important methods and techniques are defined in the glossary.

Since antibodies tagged with markers have been developed, immunocytochemistry has become the method of choice for identifying tissue substances or for the localisation of nucleic acid in tissue by in situ hybridisation. Resin-embedded tissue is routinely used and new techniques are constantly introduced. Thus, the novice entering these fields has a breathtaking variety of methods open to him. This labmanual covers the embedding of tissue using epoxy resin methods to the more sensitive procedures employing the acrylics. The possibilities and results are discussed so that an understanding of the techniques can be acquired and appropriate choices made. The various resins available and all steps involved in tissue processing, beginning with fixation, as well as the great variety of labelling methods and markers that are commonly used for "on-section" cytochemistry and immunocytochemistry are described, including detailed protocols for the application.

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.

What is the probability that a patient with a sore throat has strep? How about the likelihood of DVT in a patient with leg symptoms? What is the prognosis for patients with melanoma, pneumonia, or breat cancer? Covering a full range of topics from cardiovascular and pulmonary disease to ophthalmology, hematology and pediatrics, EVIDENCE-BASED DIAGNOSIS is the only single volume, quick reference designed for use in daily practice. Containing over 150 clinical prediction rules as well as need-to-know background information on each rule to determine its validity and relevance for your practice, these rules are essential for every physician in a time of limited health care resources. Designed as an aid in diagnosis and treatment, clinical prediction rules will allow you to make more accurate diagnosis and treatment decisions while eliminating superfluous testing. As an added bonus, a CD-ROM with software designed by the author is included with this volume. The software is designed to allow you to calculate clinical prediction rules with the ease and convenience of the computer. Simply check the boxes, click enter and receive the probabilities. Mark H. Ebell, M.D., M.S. is Associate Professor in the Department of Family Practice at Michigan State University. He is editor of the "Journal of Family Practice" and coeditor of the "Evidence-Based Practice" newsletter, and is the author of over 80 peer-reviewed publications.

The Third Edition of the Handbook of Current Diagnosis and Treatment provides expert recommendations on the management of more than 200 major medical disorders. Each disorder is condensed into two pages of information using a consistent layout and format that shows diagnosis and treatment guidelines, accompanied by clinical photographs. All contributions are prepared by specialists and contain the most recent reference citations and latest clinical data.

Despite diagnosis being the key feature of a physician's clinical performance, this is the first book that deals specifically with the topic. In recent years, however, considerable interest has been shown in this area and significant developments have occurred in two main areas: a) an awareness and increasing understanding of the critical role of clinical decision making in the process of diagnosis, and of the multiple factors that impact it, and b) a similar appreciation of the role of the healthcare system in supporting clinicians in their efforts to make accurate diagnoses. Although medicine has seen major gains in knowledge and technology over the last few decades, there is a consensus that the diagnostic failure rate remains in the order of 10-15%. This book provides an overview of the major issues in this area, in particular focusing on where the diagnostic process fails, and where improvements might be made.

Preface This book describes problems and results of research in the gap between two fields: Human genetics, and clinical neurophysiology. Whenever I talked about my research on the genetics of the EEG, the answer of human geneticists was: "Very interesting, but I do not understand anything about the EEG. " On the other hand, EEG specialists usually remark: "Very interesting, but I do not understand anything about human genetics. " This is why I wrote this book. It tries to summarize results my own and from some others - and to point to problems. In the from researc- light of the recent progress especially in human molecular genetics, this field of research promises deep insights into biological mechanisms of brain function, as well as genetic variation involved in mental performance, and personality of humans. However, the logistic problems of such studies are not easy to overcome: It is necessary to study carefully ascertained population samples either of "normal" persons, or of persons selected for phenotypic characteristics that are not easy to diagnose. Moreover, EEG diagnosis and classification must be very specific, and is not trivial at all. All these problems require careful preparations at various levels, long-lasting efforts, and patience. Of this I am sure, however: The results would justify the efforts. I am too old to plan such a program myself; moreover, as an emeritus professor, I do not have the means for such studies.

"Kroll-Smith and Floyd have, with both clarity and sensitivity, provided considerable insight into an important arena of contemporary experience."
--"American Journal of Sociology"

"Elegantly written. . . . the book is built around the narratives of multiple chemical sensitivity (MCS) sufferers themselves. . . . Due to its relevant subject matter, its interdisciplinary approach, its readability, and its interesting theoretical arguments, "Bodies in Protest" should be appealing to a wide audience."
--"Organization and Environment"

"This engagingly written and thought-provoking book provides one of the first sustained sociological analyses of a baffling, controversial, and spectacular medical condition."
--"Social Forces"

Gulf War Syndrome: Is It a Real Disease? asks a recent headline in the "New York Times," This question--are certain diseases real?--lies at the heart of a simmering controversy in the United States, a debate that has raged, in different contexts, for centuries. In the early nineteenth century, the air of European cities, polluted by open sewers and industrial waste, was generally thought to be the source of infection and disease. Thus the term miasma--literally deathlike air--came into popular use, only to be later dismissed as medically unsound by Louis Pasteur.

While controversy has long swirled in the United States around such illnesses as chronic fatigue syndrome and Epstein-Barr virus, no disorder has been more aggressively contested than environmental illness, a disease whose symptoms are distinguished by an extreme, debilitating reaction to a seemingly ordinary environment. The environmentally ill range from those who have adverse reactionsto strong perfumes or colognes to others who are so sensitive to chemicals of any kind that they must retreat entirely from the modern world.

"Bodies in Protest" does not seek to answer the question of whether or not chemical sensitivity is physiological or psychological, rather, it reveals how ordinary people borrow the expert language of medicine to construct lay accounts of their misery. The environmentally ill are not only explaining their bodies to themselves, however, they are also influencing public policies and laws to accommodate the existence of these mysterious illnesses. They have created literally a new body that professional medicine refuses to acknowledge and one that is becoming a popular model for rethinking conventional boundaries between the safe and the dangerous.

Having interviewed dozens of the environmentally ill, the authors here recount how these people come to acknowledge and define their disease, and themselves, in a suddenly unlivable world that often stigmatizes them as psychologically unstable. "Bodies in Protest" is the dramatic story of human bodies that no longer behave in a manner modern medicine can predict and control.