In this issue of Critical Care Clinics, guest editors Drs. Robert M. Kliegman and Brett J. Bordini bring their considerable expertise to the topic of Undiagnosed and Rare Diseases in Critical Care. Top experts in the field cover key topics such as critical genetic arrhythmia disorders, uncommon causes of rhabdomyolysis, status epilepsy syndromes, autoimmune encephalitis, rapid-onset paralysis and weakness, and more. Contains 17 relevant, practice-oriented topics including understanding cognitive diagnostic errors in the ICU; rapid WES/WGS in the ICU; diagnostic time-outs to improve diagnosis; when "sepsis" is not sepsis: MAS, HLH, malignancies and other sepsis mimics; all that wheezes is not asthma or bronchiolitis; and more. Provides in-depth clinical reviews on undiagnosed and rare diseases in critical care, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Scientists have reached a critical point in the development of new therapies for prostate cancer. The information gleaned from the Human Genome Project, alongside the emergence of new technologies for the use of genetic data has expanded the physician's understanding of disease progression and widened his armamentarium for prostate cancer prevention and control. This expertly-written reference thoroughly analyzes the scientific principles and methodologies behind the most recent translational therapies and provides the necessary context, data, and studies for practitioners to select appropriate candidates for treatment and effectively apply new therapies in clinical practice.

The current interest in prion diseases has been fueled by the panic that originated from the appearance of a new variant of Creutzfeldt-Jakob disease and the evidence linking it to human exposure to the bovine spongiform encephalopathy (BSE) agent. Peer-reviewed to assure accuracy, this book describes the science, concepts, hypothesis, and mechanisms of prion disease transmission. It covers human and animal prion diseases, their incidence, prevalence, origin, and clinical and neuropathologic characteristics. The author provides scientific facts and a clear explanation of the relevance and implications of the findings for science in general.

After half a century of doubt and debate, dyslipidemia has at last been accepted by cardiologists and the medical community at large as a major, treatable cause of atherosclerotic cardiovascular disease. Written by a general practitioner, an epidemiologist, and a lipidologist, this updated second edition provides a broad, cutting-edge perspective of dyslipidemia, presenting the very latest information on lipid disorders from etiology to management. Clear, concise and highly illustrated, this user-friendly work: details normal lipid metabolism; describes the genetic and acquired causes of excessively high cholesterol disorders; reviews the evidence that dyslipidemia is a risk factor for vascular disease; and includes chapters summarising current US, British and European guidelines, the importance of diet and the role of lipid-lowering drugs. A highly practical text providing sound advice on screening, risk assessment and the management of dyslipidaemia, this second edition of Dyslipidemia in Clinical Practice is essential reading for a wide range of specialists who are increasingly dealing with patients with excessively high cholesterol disorders.

What is it about the challenges and stresses of midlife that disrupts equilibrium and promotes a sense of despair, even of crisis? Why does this stage of the life cycle give rise to new mental and physical symptoms that, for some, lead to chronic unhappiness to the point of dysfunction? Of course, there are common midlife events that account for the special narcissistic vulnerabilities of this period of life, and Eda Goldstein ably reviews these events and the theoretical perspectives commonly brought to bear on them. In When the Bubble Bursts, however, Goldstein's special concern is those individuals who come to midlife with heightened narcissistic vulnerabilities that make the navigation of this stage of life more difficult still. In understanding the latter such patients and devising a treatment approach appropriate to their self issues, Goldstein adopts a broadly self-psychological frame of reference. It is a matter, she finds again and again, of understanding how current stressors frustrate healthy self needs and trigger narcissistic vulnerabilities. purview, embraces modalities that are, to varying degrees, supportive, psychodynamic, and psychoanalytic, reworks and strengthens self structures in helping patients find new ways of affirming their sense of self. Her substantive case studies, which accompany the reader through all the chapters in her study, draw on personal and supervisory experiences to illustrate crucial foci of the treatment process with a range of midlife patients in psychotherapy. It is a striking that, amid a voluminous literature on psychodynamic psychotherapy, so little attention has been paid to the narcissistic vulnerabilities of midlife and the manner in which they enter into the psychotherapy of midlife patients. Eda Goldstein remedies this glaring lacuna in the literature with a study that comprises an admirable blend of theoretical astuteness, clinical wisdom, and personal honesty. balanced discussion of theoretical perspectives on adult development and her concluding consideration of the countertransference issues elicited by midlife patient in their midlife therapists, is an edifying and ingratiating contribution to the literatures of psychodynamic psychotherapy, self psychology, and adult development.

This book, besides reviewing basic and clinical aspects of Behcet's disease, covers the latest findings, including genetic studies and treatment with biologics for the disease. Although the cause of Behcet's disease is still unknown, it is well known that genetic factors, such as HLA-B51, are involved in its development. Recently, novel susceptibility loci including IL10, IL23R-IL12RB2, and endoplasmic reticulum aminopeptidase 1 have been identified, providing new insights into the pathogenesis of the disease. In addition to basic research, the beneficial efficacy of anti-TNF-alpha monoclonal antibodies has also been suggested for not only uveitis associated with the disease but also other subtypes of the disease such as entero-, vasculo-, and neuro- Behcet's disease. Behcet's Disease: From Genetics to Therapies provides essential information both for basic researchers working in the fields of immunology, inflammation, and genetics, and for clinical physicians who are interested in Behcet's disease, such as ophthalmologists, rheumatologists, dermatologists, gastroenterologists, neurologists, and vascular surgeons.

This reference analyzes the cellular and molecular biology and mechanisms of the blood-brain barrier (BBB) and presents the most recent studies on the role of the BBB in the development and initiation of a wide range of physiological and pathological conditions affecting the central nervous system.

With a greater emphasis on the basic principles, practical recommendations, and economics of phototherapy, the Third Edition remains the standard source on the UV treatment of skin disease-presenting an expanded number of case studies, clinical solutions, and treatment protocols for a clear understanding of the present and future state of phototherapy, photochemotherapy, and phototesting in the dermatologic arena.

This reference discusses state-of-the-art methods for the management of children with conditions affecting the nervous system-providing over 80 chapters that outline direct, logical approaches to numerous pediatric neurologic disorders using clear tables, algorithms, and figures for quick reference to key material.

The book shows how mathematical and computational models can be used to study cancer biology. It introduces the concept of mathematical modeling and then applies it to a variety of topics in cancer biology. These include aspects of cancer initiation and progression, such as the somatic evolution of cells, genetic instability, and angiogenesis. The book also discusses the use of mathematical models for the analysis of therapeutic approaches such as chemotherapy, immunotherapy, and the use of oncolytic viruses.

Parenteral nutrition is the standard of care for patients who are unable to maintain nutritional status via the gastrointestinal tract. New techniques in this therapy are giving patients with intestinal failure the time they need to achieve maximal intestinal rehabilitation and return to a more normal and productive life. Edited and written by an international group of experts in the field, Intestinal Failure and Rehabilitation: A Clinical Guide presents the most current information regarding the prevention, diagnosis, care, and management of patients with intestinal failure. Organized in a logical manner, the book opens with a review of the basic principles and concepts, and progresses into discussions on diagnostic evaluation using a variety of techniques, and treatment plan formulation. The next section addresses dietary modifications, medical management, the use of trophic substances, enteral and parenteral nutrition, surgery, and transplantation. Following a discussion of special considerations, such as pediatrics and enterostomaltherapy, the text concludes with outcomes and future directions for research. This volume is devoted solely to intestinal failure and all of the information is supported by evidence-based medicine. It greatly enhances understanding of this area and aids in the care and rehabilitation of individuals with intestinal insufficiency.

Learn how a patient's behavior can factor into the prognosis of medically unexplainable illness! The Psychopathology of Functional Somatic Syndromes examines the link between mental illness and physical syndromes that lack organic disease explanations, including chronic fatigue syndrome, fibromyalgia, premenstrual dysphoria, irritable bowel, and Gulf War illness. The author has evaluated the best research work of the past 20 years to determine the association between psychopathology and functional illness, the biological gradient between somatic and psychological symptoms, and the manifestations of dysfunctional coping. The Psychopathology of Functional Somatic Syndromes challenges recent conceptualizations of functional somatic syndromes as brain disorders connected to affective spectrum disorder, serotonin deficiency, cerebral hypoperfusion or abnormal hypothalamic-pituitary-adrenal function and highlights the importance of abnormal illness behavior, sexual victimization, and maladaptive coping for the production and maintenance of these disorders. The Psychopathology of Functional Somatic Syndromes explores observations on the neurobiology and the personality abnormalities of patients made from structured data collected over a period of several years. It describes modern perceptions of functional somatic syndromes and how they have evolved into a tightly knit family of self-standing syndromes with a common core. The book examines the correlation between the burden of psychopathology and the physical features of these illnesses; reviews advances made in the appraisal of the neuroanatomy, neuropsychology, and neurochemistry of functional syndromes; and focuses on the connection between measurable dimensions of personality, coping, and illness behavior and the prognosis of medically unexplainable illnesses. The Psychopathology of Functional Somatic Syndromes examines: psychiatric morbidity brain perfusion post-traumatic stress in Gulf War illness the spectrum of mood disorders the hypothalamatic-pituitary-adrenal axis the sexual victimization of patients and much more! The Psychopathology of Functional Somatic Syndromes is an essential resource for psychiatrists and psychologists working in outpatient practice.

The Understanding IBS chart presents an overall view of the symptoms and causes of Irritable Bowel Syndrome. The main image features the large intestine, with cut-away views showing a spasm and inflammation. Heavy cover stock with protective varnish for durability.

This book is the result of a "State-of-the-Art-Conference" held at the University of Georgia dedicated to the evidence-based treatment of stuttering. An international group of prominent fluency researchers and clinicians were invited to present and discuss current data and issues related to the treatment of stuttering. The topic was defined to include evidence about stuttering, evidence about stuttering treatment, and discussions of how that evidence should guide the continuing research and practice. The explicit link between empirical evidence and suggestions for clinical practice is the goal of the book. The book begins by addressing the notion of "evidence-based practice" and considers its implications for stuttering treatment. Part II presents the intersection of the nature of stuttering; the theories of stuttering; and the implications of nature, theory, and other knowledge for stuttering treatment decisions. Part III provides two of the many measurement issues facing stuttering treatment followed by Part IV, which is devoted to the quality of treatment research evidence, for specific treatments and in terms of some more general methodological and professional issues. The final part summarizes the clinical recommendations made throughout the book and discusses evidence-based, outcomes-focused clinical decisions for stuttering. These chapters are intended to provide "state-of-the-art" information to researchers, clinicians, and students who are interested in developing, identifying, or using the best possible evidence-based treatments for stuttering.

The information in Healthy Solutions can help readers maintain and enhance their own health. Readers will come to understand how natural medicine views health, disease, and healing. Also, how to interpret the body's reaction to illness, and become familiar with self-care remedies for more than 50 health conditions. Explains how to use homopathic tissue salts for treating symptoms, and how to master the therapeutic uses of herbs, spices, and foods.

Approximately 500,000 people in North America and Western Europe die from obesity-related diseases every year. This figure can only increase as efforts to stem this tide lag behind the rise of the overweight population. In the West especially, though by no means exclusively, the associated cost in human lives and suffering is accompanied by an increased strain on healthcare budgets. Partly for this reason, the biomedical community is looking beyond lifestyle changes to search for a drug or drugs that can tackle the problem. A number of potential candidates have come and gone, and still the current level of research into the pharmacotherapy of obesity is unprecedented. Pharmacotherapy of Obesity looks at the drugs currently available and those in development, exploring their mechanisms of action and their best use in the patient. However, this volume also looks at non-drug therapies, exercise regimes, surgery, behavioral treatment and alternative techniques such as acupuncture. The book closes with a look at the contribution that genomics is making to the search for new drugs, and looks ahead to what such drugs might be like. Produced by leading experts in the field, Pharmacotherapy of Obesity provides an essential, multi-disciplinary view of the treatment of obesity. It is ideal for anyone involved in obesity management, whether clinical or research-based, and for researchers in pharmacology, physiology, or the pharmaceutical industry.

In "Chronic Physical Disorders," the most prominent figures in the field of behavioral medicine argue why a biopsychosocial perspective is crucial to reducing the tremendous personal and societal burden of chronic disease. In Part I of this state of the art text, a broad set of theoretical and applied issues are discussed with respect to the role that research can play in the management of chronic physical disorders. Part II focuses on specific chronic disorders, including chapters on coronary heart disease, cancer, diabetes, chronic pain, HIV and AIDS, end-stage renal disease, asthma, and arthritis. Included in each of these chapters is a basic review of biomedical aspects of each disorder followed by a review of the primary behavioral, psychological, and socioenvironmental issues that are most relevant to a given disorder.

Insulin resistance, defined as a reduced biological action of insulin, has emerged as a major factor in the development and progression of a number of common non-communicable diseases in man. The role of insulin resistance in the aetiology of type 2 diabetes is particularly well-established. However, insulin resistance has also come to be regarded as a key component of a broader syndrome of common metabolic defects that conspire to increase the risk of atherosclerotic coronary heart disease. The ramifications of insulin resistance now embrace many different medical specialties.

The objective of this book is to summarize the current state of knowledge about insulin resistance. Section 1 (Pathophysiology of Insulin Resistance) considers the development of current concepts of insulin resistance. This is followed by a critical review of techniques for the assessment of insulin action in humans. The section concludes with an outline of current hypotheses concerning the molecular defects responsible for insulin resistance. Section 2 (Insulin Resistance in Clinical Medicine) broadens the discussion to include physiological and pathological conditions with which insulin resistance is associated; the effects of drug treatment on insulin sensitivity are also considered. Section 3 (Management of Insulin Resistance and Associated Conditions) focuses on the avoidance and treatment of insulin resistance in its clinical manifestations. A discussion of the potential benefits of non-pharmacological measures prefaces a review of the range of drugs used in the treatment of type 2 diabetes and related disorders. References are confined to key articles at the end of each section.

Improved nutrition allied to increased levels of physical exercise are of crucial importance in the battle to stem the increasing incidence and prevalence of insulin resistance; however, translation of such advice into action has proved difficult in practice. Thus, other approaches have been explored. Recent years have witnessed considerable progress in the pharmacological management of insulin resistance. In particular, the thiazolidinediones (and other insulin-sensitizing drugs) appear to provide a more specific assault on insulin-resistance. Clinical experience with these agents remains relatively limited and serious hepatotoxicity has clouded the first agent in this class - troglitazone. With its introduction into the USA in 1995 and driven by the publication of the United Kingdom Prospective Diabetes Study, metformin has enjoyed a renaissance. This well-established agent is finding application for new clinical indications. In parallel, the development of anti-obesity drugs continues apace.

The molecular and genetic mechanisms underlying some forms of insulin resistance are being revealed.
Original intellectual concepts such as the fetal origins hypothesis are challenging traditional views about the aetiology of insulin resistance and its clinical sequelae. These exciting scientific advances notwithstanding, the evolving global epidemic of obesity and type 2 diabetes represents an enormous public health challenge. Now more than ever, research must focus on identifying solutions that are applicable on the level of entire populations. By definition, these must also be practical and cost-effective.

In the Age of Sail scurvy was responsible for more deaths at sea than piracy, shipwreck and all other illnesses, and its cure ranks among the greatest of military successes - yet its impact on history has mostly been ignored. Stephen Bown searches back to the earliest recorded appearance of scurvy in the sixteenth century, to the eighteenth century when the disease was at its gum-shredding, bone-snapping worst, and to the early nineteenth century, when the preventative was finally put into service. Bown introduces us to James Lind, the navy surgeon and medical detective, whose research on the disease spawned the implementation of the cure; Captain James Cook, who successfully avoided scurvy on his epic voyages; and Gilbert Blane, whose social status and charisma won over the British Navy. Scurvy is a lively recounting of how three determined individuals overcame the constraints of eighteenth-century thinking to solve the greatest medical mystery of their era.

When does a young girl's behaviour become a disease? In sixteenth-century Europe, the disease of virgins, or green sickness, was seen as a common disorder affecting young unmarried girls. Its symptoms included weakness, dietary disturbance, lack of menstruation and most significantly, a change in skin colour. Understanding of the condition turned puberty and virginity into medical problems, and proposed to cure them by bloodletting, diet, exercise, and marriage. Helen King examines the origins and history of the disease, from its roots in the classical tradition to its extraordinary survival into the 1920s, despite changes in how the mechanisms of puberty and menstruation were understood, and enormous shifts in medical theories and technologies. From menstrual disturbance to eating disorders, from liver disease to blood disorder, the disease of virgins has been adjusted throughout its history to fit medical fashions. However, little changed in the underlying ideas about the female body, and the need to regulate the sexuality of young women. This compelling study poses a number of questions about the nature of disease itself and the relationship between illness, body image and what

Seizures are frightening events. They frighten the patients who experience them; they frighten those who witness them; they also frighten many physicians who have to deal with them. Most individuals with seizures present to family physicians or to emergency room physicians. However, despite the fact that seizures are among the most common neurological conditions, most general practitioners, family practice specialists, and intemists do not see large numbers of patients with seizures. Given the apoplectic appearance of generalized tonic clonic convulsions, it is not difficult to understand why they arouse such emotional responses in those that experience them, those that witness them, and those whose care is sought for them. Seizures are symptoms of something wrong with the brain. Many different kinds of perturbations in brain anatomy, chemistry, or physiology can produce seizures. For many individuals, seizures occur in the context of an acute illness and will not recur once that illness is treated. These individuals do not have epilepsy. They have transient disturbances in brain function attributable to systemic medical conditions. It is important to recognize these issues, because, first, the seizure may be the initial, or even only, manifestation of the underlying medical problem and this needs to be recognized.

Restorative justice has developed rapidly from being a barely known term to occupying a central role in debates on the future of criminal justice. But as it has become part of the mainstream of debate, so new tensions and issues have emerged. One of the most crucial issues is to find an appropriate combination of restorative justice, based essentially on informal deliberation, and the law. The purpose of this book is to analyse the several dimensions to this issue. It explores the social and ethical foundations of restorative justice, seeks to position it in relation to both rehabilitation and punishment, and examines the possibility of developing and incorporating restorative justice as the mainstream response to crime in terms of the principles of constitutional democracy. Amongst the questions it addresses are the following: How are informal processes to be juxtaposed with formal procedures? What is the appropriate relationship between voluntarism and coercion? How can the procedures and practices of restorative justice be combined with legal standards, safeguards and precepts? How can one balance restorative responses with legally sanctioned punishment? In this book a distinguished team of contributors consider this crucial set of relationships between restorative justice and the law, building upon papers and discussions at the fifth international restorative justice conference in Leuven, Belgium, in September 2001. restorative justice has grown rapidly throughout the worldthis book addresses the central issue of relationship of restorative justice to existing law and legal systemschapters from world leading authorities

Contents:
Part 1. Specific Lesions 1. Alcoholic Fatty Liver Andrew J. Bathgate and Kenneth J. Simpson 2. Alcoholic Hepatitus H. Denk, K. Zatloukal and C. StumptnerIN 3. Fibrosis in Alcoholic Cirrhosis Samuel W. French Part 2. Direct and Indirect Consequences of Alcohol Metabolism 4. Genetics of Ethanol Metabolism and Alcoholic Liver Disease Paul Y. Kwo and David W. Crabb 5. Acetaldehyde Adducts: Role in Ethanol-Induced Liver Disease John Koskinas Part 3. Mechanisms of Damage 6. Free Radicals and Alcohol-Induced Liver Injury Emanuele Albano 7. Ethanol and the Hepatic Microcirculation Robert S. McCuskey 8. Cytokines and Alcohol Liver Disease F. Javier Laso, J. Ignacio Madruga Alberto Orfao 9. Adhesion Molecules and Chemokines in Alcoholic Liver Disease Neil C. Fisher and David H. Adams 10. Role of Endotoxin and Kupffer Cells as Triggers of Hypoxia-Reoxygenation in Alcoholic Liver Injury R.G. Thurman, B.U. Bradford, K.T. Knecht, Y. Iimuro, G.E. Arteel, M. Yin, H.D. Connor, C. Rivera, J.A. Raleigh, M.V. Frankenberg, Y. Adachi, D.T. Forman, D. Brenner, M. Kadiiska and R.P. Mason 11. Ethanol and Protein Turnover Elena Volpi 12. Insulin-Like Growth Factors: Clinical and Experimental Anthony J. Donaghy 13. Cellular Mechanisms of Liver Regeneration and the Effect of Alcohol Martin Phillips, Elika Kashef and Robin Hughes 14. Alcohol and Hepatocellular Carcinoma Stephen D. Ryder 15. Animal Models of Ethanol-Induced Liver Disease Harri A. Järveläinen and Kai O. Lindros Part 4. Epidemiology and Diagnosis 16. Epidemiology and Comparative Incidence of Alcohol-Induced Liver Disease John B. Saunders and Benedict M. Devereaux 17. Serum Diagnosis of Alcoholic Liver Disease and Markers of Ethanol Intake Onni Niemelä Part 5. Extrahepatic Effects 18. Extrahepatic Effects of Alcohol: An Overview Helen L. Reeves and Christopher P. Day 19. Endocrine System Christian Gluud 20. Cardiomyopathy and Skeletal Muscle Myopathy Alvaro Urbano-Márquez, Joaquim Fernández-Solà and Ramon Estruch 21. Cerebral Consequences of Alcoholic Liver Disease Roger F. Butterworth Part 6. Management 22. General Management of Alcoholic Liver Disease Martin Phillips and John O'Grady 23. The Role of the Psychiatrist in the Treatment of Alcoholic Liver Disease José Martínez-Raga and E. Jane Marshall 24. Pharmacological Treatment for Alcoholic Hepatitis and Cirrhosis: Present Practice and Future Strategies Philippe Mathurin and Thierry Poynard 25. Nutritional Support in Alcoholic Liver Disease: Practical Management and Future Strategies Angela Madden 26. Alcohol and Viral Hepatitis: Interactions and Management Albert Parés and Joan Caballería 27. Liver Transplantation in Alcoholic Liver Disease Stephen P. Pereira and Roger Williams

If the word "cure" intrigues you, this book will also. High doses of vitamins have been known to cure serious illnesses for nearly 80 years.

Claus Jungeblut, M.D., prevented and treated polio in the mid-1930s, using a vitamin. Chest specialist Frederick Klenner, M.D., was curing multiple sclerosis and polio back in the 1940s, also using vitamins. William Kaufman, M.D., cured arthritis, also in the 1940s. In the 1950s, Drs. Wilfrid and Evan Shute were curing various forms of cardiovascular disease with a vitamin. At the same time, psychiatrist Abram Hoffer was using niacin to cure schizophrenia, psychosis, and depression. In the 1960s, Robert Cathcart, M.D., cured influenza, pneumonia, and hepatitis. In the 1970s, Hugh D. Riordan, M.D., was obtaining cures of cancer with intravenous vitamin C. Dr. Harold Foster and colleagues arrested and reversed full-blown AIDS with nutrient therapy, and in just the last few years, Atsuo Yanagasawa, M.D., Ph.D., has shown that vitamin therapy can prevent and reverse sickness caused by exposure to nuclear radiation. Since 1968, much of this research has been published in the Journal of Orthomolecular Medicine. This book brings forward important material selected from over forty-five years of JOM directly to the reader.

The Orthomolecular Treatment of Chronic Disease is a very large book, but it is also a very practical book. If you want to know which illnesses best respond to nutrition therapy, and how and why that therapy works, this is the book for you. Part One presents the principles of orthomolecular medicine and the science behind them. Part Two is devoted to orthomolecular pioneers, presenting an introduction to maverick doctors and nutrition scientists in a reader-friendly way that brings the subject to life. Part Three brings together extraordinary clinical and experimental evidence from expert researchers and clinicians.

The Orthomolecular Treatment of Chronic Disease shows exactly how innovative physicians have gotten outstanding results with high-dose nutrient therapy. Their work is here for you to see and decide for yourself.