Chronic obstructive pulmonary disease (COPD) is an increasingly important health problem world-wide. Whereas most other leading diseases have shown a decline in the past decades, COPD morbidity and mortality is on a steady increase. Exacerbations are usually defined as an increase in cough, a change in the colour or quantity of sputum, and a worsening dyspnea. The role of bacterial infections and the efficacy of antimicrobial therapy in acute exacerbations of chronic bronchitis (AECD) is still controversial. Exacerbations of chronic bronchitis are a common occurrence in clinical practice and are a leading cause of antibiotic prescription among respiratory infections. It is still uncertain whether each new exacerbation may deteriorate the natural history of chronic bronchitis. Undoubtedly, every episode includes a temporary worsening in lung function and may therefore pose the threat of respiratory failure or death in more severely obstructed patients.

Functional somatic syndromes are defined as physical syndromes without an organic disease explanation, demonstrable structural changes, or established biochemical abnormalities. This book reviews the state of scientific and clinical understanding of the nine most common functional somatic syndromes. For each syndrome, expert contributors provide a brief historical perspective, a current definition, a case presentation, confirmatory and contradictory research findings, a discussion of the leading pathogenetic hypotheses, and guidelines for diagnosis and treatment. Chapters offer advice for the determination of disability of patients with these medically unexplained disorders, while describing both medical and psychiatric interventions. Stressing the importance of a sound therapeutic relationship as a basis for treatment, this is an invaluable resource for professionals in primary care and many other disciplines.

A practical primer for physicians wanting to learn about simple and complex urodynamic testing. The clear, concise workbook structure allows for quick reference to multichannel urodynamic tracings and their interpretation. Brief but thorough discussion of the underlying theory and concepts behind urodynamic testing enable readers to gain a firm grasp of the implications of test results in individual patients. It provides an understanding of all the techniques used for the evaluation and treatment of the incontinent or lower urinary tract dysfunctional female patient, and also includes a quick reference guide to outpatient treatment. In contrast to other didactic texts, this book allows readers to initiate testing programs and will thus be of practical benefit to all those interested in improving patient care.

Peroxisomal disorders constitute a major research front in clinical genetics, paediatrics and cell biology. Since 1983, the metabolic defect in some 20 different peroxisomal disorders has been described. The best known conditions include Zellweger syndrome, rhizomelic chondrodysplasia punctata and X-linked adrenoleukodystrophy and, in the most recent edition of The Metabolic and Molecular Basis Inherited Disease, edited by Scriver and colleagues, more than 100 pages are now devoted to the subject. Progress in our understanding of these conditions, and their diagnosis, results from the application of a variety of laboratory investigations. These include microscopic studies, analysis of metabolites (very long-chain fatty acids, bile acids, and plasmalogens), enzyme studies (peroxisomal beta-oxidation pathway and dihydroxyacetone phosphate acyltransferase), immunodetection of peroxisomal (membrane) proteins and molecular analysis of mutant DNA. In order to encourage a greater awareness in this field and the diagnostic protocols required, an international course was organised in Gent, Belgium, in May 1994, on the clinical and biochemical diagnosis of peroxisomal disorders. A number of international experts in the field who provided intensive hands-on experience over 3.5 days, have now collected their course work and reviews together in this Handbook. The volume is introduced by Sidney Goldfischer, who in 1973 was the first to recognise the absence of peroxisomes in Zellweger syndrome, but whose observations were not fully appreciated for a further decade. This handbook provides the most comprehensive and detailed account of laboratory methods for the diagnosis of peroxisomal disorders. The methods are clearly presented and well illustrated, and should allow laboratories to introduce these methods into their repertoire. Audience: Paediatricians, neurologists, clinical biochemists, pathologists, genetic counsellors, obstetricians, and GPs interested in the recognition, diagnosis and prenatal prevention of peroxisomal disorders.

Male infertility is a clinician-orientied book aimed at the clinician dealing with the infertile couple because rational, effective management is only possible if the couple are considered together. The aim of the work is to provide advice to the clinician and to give reference to the underlying science. This will not only enable clinicians to understand the underlying science but will also give scientists an insight to clinical work. This blend of science and clinical work is reflected in the contributors who are experts drawn from both fields.

Rontgenthoraxaufnahmen richtig interpretieren

Thoraxaufnahmen, die auf der Intensivstation aufgenommen werden, unterscheiden sich in der Aufnahmetechnik und in den veranderten physiologischen und anatomischen Verhaltnissen von Standard-Thoraxaufnahmen, die am Rasterwandstativ angefertigt werden. Die Interpretation dieser Bilder bereitet selbst erfahrenen Radiologen und Intensivmedizinern haufig Schwierigkeiten.

Der Weg zur korrekten Interpretation: - Rontgen- und Aufnahmetechnik - Strahlenschutz und -belastung - Klinische Problematik und Interpretation von Thoraxaufnahmen auf der Intensivstation.

Neu in der 2. Auflage:

Bildmaterial moderner Aufnahmeverfahren

Indikationsstellung fur CT-Aufnahmen

Vergleich von Projektionsradiographie und Schnittbildradiographie und mogliche Pitfalls

Ein Praxisbuch von Radiologen, Intensivmedizinern und Medizinphysikern zum Lernen und Nachschlagen. Ein Muss fur jeden auf der Intensivstation tatigen Arzt "

Cryptorchidism remains a common but poorly understood anomaly affecting 2%-5% of children. Major controversies exist over the timing and type of treat ment (i. e. surgical vs hormonal therapy) and whether intervention prevents sub sequent infertility and testicular cancer. Part of the dilemma is caused by lack of understanding of the normal process of descent, despite intensive research and study since the eighteenth century, when Hunter and von Haller first described the gubernaculum (caudal genito-inguinal ligament) and processus vaginalis (Williams and Hutson 1991a). More needs to be known, not only of the normal mechanism, but also of the ways that it can be deranged to produce undescended testes. This review describes the recent results of studies on normal descent, with emphasis on our studies of the different stages of descent. As the reader will appreciate, the ever-more complex models proposed to account for normal tes ticular descent predict that undescended testes will be caused by a multitude of anomalies affecting different stages of the process. A description is given of current hypotheses of the aetiology of cryptorchidism, correlating these with studies of cryptorchid animal models. For a more detailed description of the numerous ideas about the mechanism, the reader is referred to Heyns and Hutson (1995) and other monographs (Fonkalsrud and Mengel 1981; Abney and Keel 1989)."

Adhesions can cause a wide range of problems, complaints and hazards, even after simple abdominal procedures, such as appendectomy, with complications ranging from recurrent discomfort and pain to intestinal obstruction. Postsurgical adhesions increase the risk of following operations of the abdominal and thoracic cavity. They impair peritoneal dialysis and chemotherapy and play a crucial part in laparoscopic procedures. Adhesion-related problems account for a large amount of clinical work and have a significant socioeconomic impact. This book presents the current knowledge on the aetiopathogenesis of adhesion formation as well as the available methods for their prevention and control. Experts in the field contribute to clinical standards for preventive measures to control the formation of postoperative adhesions

On the subject of stomach and gastric diseases, current cli- nical, morphological, pharmacological, biochemical as well as cellular and molecularbiological aspects will be presen- ted. The articles of the first part of this book will discuss the normal functions of the stomach (such as motility, secre- tion, tissue regeneration etc.). The second part deals with pathophysiological aspects (such as inflammation, ulceration and tumor formation) and modern possibilities of treatment. The authors aim at gaining a deeper knowledge of the sto- mach, its physiology and pathophysiology in order to use this knowledge for the better of their patients.

An experienced pathologist, radiologist and clinician combine forces to review the recent literature on coloproctology and give a precis of the results. Their Highlights in Coloproctology are the ideal source for a clinician or researcher who wants a quick overview of the subject. The book highlights the papers that have had an impact on developments in the field and brings the reader up to date with modern references.

The anastomotic technique plays a predominant role in gastrointestinal surgery. A feared complication is leakage due to the sutures. Such leakage cannot be detected early; consequently, infection spreads locally and systemically. An anastomotic method is generally evaluated according to its rate of leakage, related to the localization, bur real scientific comparisons, i.e., controlled studies, are almost totally lack ing. The criteria of evaluation include the type of suture, the localization, the auxiliary technical tools, practicability, the different forms of wound healing, angiogenesis, and vascularization, among others. The postoperative criteria are complications shortly after surgery, such as bleeding, ruptures, and stenoses of the anastomosis. A standard comparison is made difficult by the variety of cytophysiological and biochemical factors that influence wound healing. In the comparison of larger series one must always take into account differences of auxiliary tools, strategies, and inhomogeneity of patients. A change of one auxiliary tool or of one strategy implies the modification of various target criteria. Often enough, however, one does not sufficiently consider the surgeon's most. important role."

"Updates in Colo-Proctology" covers the proceedings of the Anglo-Swiss Colo-Proctology Meeting held in St Moritz in 1990. The book contains the papers which were presented and dis cussed there by physicians of the various specialties concerned with the care of patients with diseases of the colon, rectum and anus. The authors, each distinguished in a particular field, have contributed across a wide range of subjects and different dis ciplines. The topics covered include surgical and investigative techniques, cancer, inflammatory bowel disease and specific infections. Being familiar with the previous literature, it is clear that little was really new among the themes presented in St Moritz, but few will deny that many of the techniques and methods of treatment described in this book are truly modern. Some contribute an entirely new dimension to the approach to well known colo-proctological conditions, while others may open up new paths for future research. In addition, in colo-proctology as in other disciplines, advances in treatment almost always bring new problems in the complications which attend them. These are the subject of some of the papers. Although it would be invidious to pick out individual contributions when there is so much that is new to talk about and so much that is old to be looked at in a new light, we should like to record how much we have enjoyed reading and collating these chapters. We hope that others will share our enthusiasm and pleasure.

The articles in Issue 4 of JOURNAL OF INHERITED METABOLIC DISEASE, Volume 16 (1993) contain the main lectures presented at the 30th Annual Symposium of the Society for the Study of Inborn Errors of Metabolism (SSIEM), Leuven, Belgium, 1992, which was dedicated to Inherited Metabolic Diseases and the Brain'. Topics discussed included: Inborn errors and brain fluids, neurotransmitter disorders, inborn errors and demyelination, and recent developments. Participants from many countries provided a state-of-the-art review which will be of interest to clinicians and research workers alike in many different disciplines.

Fleur Brown, Functional Nutritionist for nearly 25 years, shares her experience of helping thousands of clients with chronic health problems recover their health, vitality and well-being. She shows you how to: Become your own health detective to investigate the root causes of your problems; Take charge of your health holistically; Take steps to regain your well-being and live a full life without pain or excessive fatigue. Fleur explains the principles of functional nutrition and how to apply them so that her readers can understand and overcome their condition(s) based on her extensive clinical experience. She draws on detailed case histories to illustrate these principles and writes: 'Over the years, I have learnt and fine-tuned a new approach to helping my clients recover their health. This approach explores a wide range of the possible contributory factors that may be causing your health problems - not just diet. Using the clinical knowledge I have gained over many years, I would like to show you how to get back on the road to living a full life - a life without pain, a life with renewed vitality and energy, and with hope and a healthy future to look forward to.' Exploring the issues for you using Fleur Brown's personally developed protocols is what makes this book a unique resource for all those seeking answers.

The author of the bestselling Plant Paradox series takes a fresh look at one of the top health issues plaguing Americans-fatigue-and offers a revolutionary plan for boosting energy and revitalizing mental and physical stamina. In his bestselling books, The Plant Paradox and The Longevity Paradox, Dr. Steven R. Gundry offered game-changing perspectives on our wellbeing. In The Energy Paradox, Dr. Gundry expands upon his previous discussions of gut, microbiome, and mitochondrial health, linking immune malfunction to the mental and physical symptoms of fatigue-including exhaustion, brain fog, depression, anxiety, and low metabolism. As Dr. Gundry explains, feeling tired, moody, and zapped of energy is not normal, no matter your workload or age. Fatigue is an SOS flare from the body, one that is intended to alert us that something is wrong. In his clinical work, Dr. Gundry has found that his patients who complain of feeling sick and tired all the time almost always have something in common: the inflammation markers of a leaky gut. In The Energy Paradox, Dr. Gundry will offer readers the information and tools necessary to quiet the autoimmune battle raging within-a battle that depletes precious energy reserves, leaving you drained and prone to mood disorders and weight gain. With new guidelines on how to increase mitochondrial energy production and nourish the microbiome; 30 new Plant Paradox-approved recipes; and lists of energy-boosting foods to consume and energy-depleting foods to avoid, The Energy Paradox will help readers take back their lives, giving them the energy they need to feel, look, and be their best.

Environmental, genetic, psychological, and societal factors interact to produce obesity, a chronic condition of epidemic proportions. The Handbook of Obesity Intervention for the Lifespan guides professionals in meeting this complex challenge with a multidisciplinary palette of evidence-based interventions that can be tailored to men and women across the lifespan, regardless of background. This unique reference combines salient research data and hands-on clinical applications for use with overweight patients, from the very young to the very old, and includes a "treatment resources" section with extra materials to bolster therapy-all geared toward respectful, encouraging treatment and lasting weight-loss results.

Autobiography of a Disease documents, in experimental form, the experience of extended life-threatening illness in contemporary US hospitals and clinics. The narrative is based primarily on the author's sudden and catastrophic collapse into a coma and long hospitalization thirteen years ago; but it has also been crafted from twelve years of research on the history of microbiology, literary representations of illness and medical treatment, cultural analysis of MRSA in the popular press, and extended autoethnographic work on medicalization. An experiment in form, the book blends the genres of storytelling, historiography, ethnography, and memoir. Unlike most medical memoirs, told from the perspective of the human patient, Autobiography of a Disease is told from the perspective of a bacterial cluster. This orientation is intended to represent the distribution of perspectives on illness, disability, and pain across subjective centers-from patient to monitoring machine, from body to cell, from caregiver to cared-for-and thus makes sense of illness only in a social context.

Das Buch enthalt alle Aspekte der modernen Rehabilitation in Orthopadie und Unfallchirurgie. In der 1. Auflage mit dem Carl-Rabl-Preis ausgezeichnet, liegt nun die 2. Auflage dieses Standardwerks in komplett uberarbeiteter und aktualisierter Form vor. Die funktionsunterstutzenden und - aktivierenden Methoden der Rehabilitation sind praxisorientiert dargestellt. Die spezifischen Behandlungsstrategien sind nach anatomischen Gesichtspunkten gegliedert. Neben der klassischen orthopadisch ausgerichteten Rehabilitation berucksichtigt die 2. Auflage die vor allem in der Unfallchirurgie relevante Fruhrehabilitation und die komplexe Rehabilitation - z.B. von Osteoporose-, Rheuma- und Diabetes-Patienten.

We all want to be healthy and live well so take charge of your health by learning the connection between our evolutionary past and our future well-being with this practical guide to personalized health and nutrition-from distinguished physician Dr. Sharad Paul. Recognized as one of the best in his field, surgeon, academic, and philanthropist Dr. Sharad Paul brings together everyday health with evolutionary biology and shows how it shapes who we are and what our bodies individually need. Starting with our brains, this book covers everything from our skin and muscles, to hearts, diets, and stress management. Throughout, Dr. Paul will share key information and steps to improve our daily well-being-impacting everything from our energy levels to memory retention to our overall longevity. To achieve better health, we need to understand our evolutionary past. Within our evolutionary biology and genetics, bodily systems, diet, and psychology is the story of how and why your body works the way it does and how it all combines to make you who you are. Through a blend of medical mysteries, patient stories, and science, Dr. Paul takes us on "an exhilarating journey through the shifting landscape of genetics, health, and evolution" (Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of Maladies: A Biography of Cancer).

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 gauge 3ml lamination with sealed edges and two metal eyelets for hanging makes chart highly durable. Write-on/wipe-off with dry erase marker (not included).

In this volume there is a strong emphasis on translational science, with preclinical approaches suggesting new directions for development of new treatments. Individual chapters describe how neuroimaging, neuroendocrine, genetic and behavioral studies use powerful research tools that are offering a completely new understanding of the factors that increase vulnerability to ADHD. The clinical impact of co-morbid problems, especially obesity and substance misuse, are highlighted and explain what such problems can tell us about the etiology of ADHD, more generally. Reviews of the pharmacology of established drug treatments for ADHD justify an exciting novel theory for their therapeutic actions and address questions about the effects of their long-term use.

The Gunner Goggles Series is the first exam prep resource written by a high-scoring peer group of medical students, ensuring the most practical and efficient study guidance. It organizes topics around the USMLE and NBME content outlines for the required shelf exams and features state-of-the-art Augmented Reality (AR) mobile application to extend learning beyond the book. This innovative series features AR opportunities throughout the text for an integrated print-mobile experience that maximizes learning and test preparation. The Gunner Goggle function allows you to scan pages for integrated AR links, unlocking animations, visuals, and 3D models that clarify complex anatomy, conditions, and concepts in a remarkably effective and unique manner. Gunner Goggles Series: Medicine is one of seven authoritative exam preparation guides that use cutting-edge AR technology to fully prepare you for the NBME clinical shelf exams, the USMLE Step 2 Clinical Knowledge (CK) exam, and successful clinical rotations. Topics are organized around the USMLE and NBME content outlines for specific shelf exams, and information is presented in a highly templated, concise manner. The Augmented Reality application allows you to efficiently study and learn using an integrated print-mobile approach. In addition to unlocking animations and other visuals, AR app access also includes additional content, links to provide feedback to the authors, community pages, and more. All test topics are covered in just enough detail to help you hone in on key points you must know for exam success. Unique! Every disease is described by its stem clues (buzzwords that appear in question stems) and prophylactic measures (PPx), mechanism (MoD), diagnostic tests (Dx) and treatment/management principles (Tx/Mgmt) - the four "Physician Tasks" that the NBME requires students to know about each disease. You'll also get real-world tips for your clinical rotations from your peers - information that won't show up on the shelf exam but is ideal for maximum impact when on rounds (knowing the prognosis for a specific disease, for example). Plus . effective study techniques, sample study schedules, tips and tricks to better retain information learned from review questions, and methods to self-generate mnemonics. Edited, written, and crowdsourced by high-performing medical students and residents and reviewed by experts in the field to ensure accuracy, relevancy, and accessibility. Titles in the Gunner Goggles series: Family Medicine . Print ISBN: 978-0-323-51034-9 . e-Book ISBN: 978-0-323-52756-9 Medicine . Print ISBN: 978-0-323-51035-6 . e-Book ISBN: 978-0-323-52758-3 Neurology . Print ISBN: 978-0-323-51036-3 . e-Book ISBN: 978-0-323-52760-6 Ob-Gyn . Print ISBN: 978-0-323-51037-0 . e-Book ISBN: 978-0-323-52768-2 Pediatrics . Print ISBN: 978-0-323-51038-7 . e-Book ISBN: 978-0-323-52763-7 Psychiatry . Print ISBN: 978-0-323-51039-4 e-Book ISBN: 978-0-323-52765-1 Surgery . Print ISBN: 978-0-323-51040-0 . e-Book ISBN: 978-0-323-52767-5

Part of the What Do I Do Now? Pain Medicine series, Psychological and Psychiatric Issues in Patients with Chronic Pain presents a variety of succinct case studies and "curb-side" consults on the complexity of chronic pain and its successful management. Chapters present models for understanding issues related to chronic pain within a psycho-social context, including cases on specific psychological or psychiatric issues, as well as broad considerations such as selecting among behavioral therapies options and the use of complementary therapies and non-opioid analgesics. Recognizing that most clinicians do not always have the time or resources to conduct the type of psychological assessment that each case may require, chapters focus on the key elements of each diagnosis, covering background information, assessment approach, treatment recommendations, and key points to remember.

The fully updated and revised sixth edition of the definitive guide to clinically tested and proven methods for effectively managing all of the symptoms characteristic of MS and MS treatment.

Based on the most up-to-date disease management strategies, medical and research breakthroughs, and latest drug therapies, Dr. Randall T. Schapiro provides the information you need to manage both the disease and symptoms, and make everyday life easier.

"Managing the Symptoms of Multiple Sclerosis" features comprehensive treatment options for: Fatigue Spasticity Weakness Tremor Spasms Pressure Sores Incontinence Stutters Blurry Vision Pain Dizziness Numbness Sexual Difficulties Cognitive Difficulties