There are approximately 55,000 practicing ob/gyns in the United States. The obstetrics and gynecology residency training authority (the Accreditation Council for Graduate Medical Education) has now pushed ambulatory primary and preventative care to the top of its list for residency training. Interest in the area of ambulatory gynecology is not just growing in the field of ob/gyn, however; family and primary care practitioners, emergency room physicians, and advance practice nurses all must know how to diagnose, manage, and treat gynecological conditions. Since office technology has expanded and decision-making has become increasingly complex, physicians need a guide through the endless list of treatment options for commonly presenting gynecologic disorders. Ambulatory Gynecology gives practitioners tools for diagnosis, investigation and management of these disorders, including decision-making algorithms. The text is evidence-based. From endocrine disorders to breast disease, preventative measures for osteoporosis to management of an abnormal pap smear, from adolescent gynecology to menopause, this book is crucial for office-based physicians to feel confident practicing in all areas of gynecology.

Preeclampsia: Risk Factors, Pathogenesis and Potential Treatments investigates the clinical, anamnestic, and biochemical predictors of preeclampsia. As such, a prognostic model based on the co-use of the studied predictors has been developed for the early prediction of late-onset moderate preeclampsia. The authors summarize some theories suggested to explain the pathogenesis of preeclampsia. The pathogenesis of preeclampsia has not yet been fully clarified and it remains a disease of theories. Furthermore, as it is a human-specific disease, the lack of one-on-one animal modeling and many other factors contribute to poor understanding of the disease pathophysiology. Additionally, this collection explores the possibilities of the maternal and fetal heart rate variability usage at all stages of management among pre-eclamptic women in a three-stage system. The concluding review includes sources of literature on the pathogenesis, management and long-term consequences of pre-eclampsia.

Providing the latest evidence-based information on etiology, evaluation and treatment, this unique text provides an in-depth, comprehensive discussion of the epidemiology, genetic and endocrinologic factors and medical and surgical management of recurrent pregnancy loss (RPL). Taking a multidisciplinary approach including psychological treatment and patient perspectives, all aspects of current RPL prevention and treatment are elucidated. Detailed chapters provide real-world illustrative material and cover the set-up and management of RPL clinics and databases, containing practical tips. Recurrent Pregnancy Loss will be an excellent resource for OB-GYN specialists, general and reproductive endocrinologists, radiologists, hematologists, psychiatrists, psychologists, and any other investigators or clinicians treating patients confronted with this emotionally and physically trying condition.

Providing a comprehensive review of the interactions between exercise and human reproduction, this unique text focuses on both the positive and negative consequences of sport and physical activity on male and female fertility and infertility and the biological mechanisms and processes behind them. Beginning with a review of the structure and function of the male and female reproductive systems as well as fertilization and gestation, the discussion then turns to the physiology and endocrinology of sport and exercise, which is further elaborated in subsequent chapters on the impact of physical activity, hormonal changes, pathologies, and consequences of drug use for active men and women. Additional chapters address related topics, such as the impact of sport on young athletes and developing reproductive potential, physical activity and pregnancy, the use of oral contraceptives in athletes, oxidative stress, and the impact of nutritional deficiencies on athletes' fertility, with a final chapter providing recommendations and therapeutic guidelines for exercise-related reproductive disorders. Covering everything from the fundamental principles of sports physiology and human reproductive potential to the interaction between physical exercise and the endocrinology of the reproductive system, Exercise and Human Reproduction is an authoritative resource for helping clinicians understand how the reproductive system adapts to activity and exercise and offers strategies to avoid potential harm to human reproduction.

Presenting the most current and relevant information on the diagnosis and management of primary ovarian insufficiency, also known as premature ovarian failure (POI/POF), this book presents two equally important voices. The first is the scientific, evidence-based voice discussing the latest information on POI/POF in a concise and logical fashion: etiologies, symptoms, genetics, mechanisms, associated conditions, as well as psychological and lifestyle considerations. The second voice presents the first-person stories of affected women, who are often faced with a diagnosis of irreversible infertility at a very young age and who somehow learn to live with great uncertainty about their ability to create a family - a core identity issue for many women. It is thus not simply a clinical, case-based presentation, but a more collaborative effort between clinicians who are well-versed in the field and women who have POI/POF. Primary Ovarian Insufficiency: A Clinical Guide to Early Menopause will therefore be an excellent practical yet personal reference for OB/GYNs, reproductive medicine specialists, and any clinician, nurse or health care worker treating women living with POI/POF.

This is a highly illustrated, practical book covering the obstetric and surgical procedures used in intrapartum care, including commonly used procedures and more rare techniques. The authors take a step-by-step approach to each technique and includes 'tips' and 'pointers', whilst contextualising this with the history of obstetric practice. Authoritative, world-known editors and author team. Presents a contemporary and pragmatic summary ofrecent developments in operative obstetrics. Contextualises practice in the history of obstetric practice. Accurate line drawings throughout clearly demonstrating relevant procedures and equipment. Advice and management for obstetricians working in resource-limited areas New chapter to cover labour and delivery in high-BMI women Extensive coverage of Caesarean section to reflect current critical thinking New chapters exploring assisted vaginal delivery in greater depth Management areas and guidelines fully updated (e.g. for fetal monitoring in labour). Covers significant new research, e.g. the WOMAN trial. New editor, Michael Robson

This book presents expert opinions on a variety of key topics related to the management of breast cancer, with a focus on the implications of recent advances and research findings for clinical practice. It also explores the controversy regarding mammography screening and reviews the contribution of new imaging modalities. Considerable attention is paid to developments in surgical procedures, including the potential for the safe and effective use of sentinel lymph node dissection alone-even in patients with positive nodes-and to the advantages and contraindications of new radiotherapy techniques. Genetic aspects are discussed in detail, including an assessment of the role of genetic testing and the potential impact of genetic signatures on breast cancer management. New systemic strategies, such as anti-HER2 therapy, endocrine agents, and agents to reverse endocrine resistance, are considered, and the optimal use of chemotherapy for early-stage and advanced-stage disease is addressed. In closing, the book shares important new insights into lifestyle risk factors, risk reduction strategies, and survivor issues, including sexual dysfunction and fertility maintenance.

The menopause is a natural event, but for many women it represents a time of hormonal upheaval and uncomfortable symptoms. It can happen at any age, and the journey through it may feel a bit rocky.

Menopause: The One-Stop Guide explains the changes which are occurring and advises on steps one can take to make life easier during this time of change. With clear and sensible information about recognising symptoms, getting help, treatment and staying positive, this guide will help those who are going through menopause, and family members who wish to better understand and offer their support.

This book evaluates the best approaches to the menopause and offers women all the information they need to determine whether medication, holistic remedies or other forms of treatment will work best for them, and helps them to take charge of their health.

Kathy Abernethy is the chair of the British Menopause Society with over 20 years of clinical experience.

This practical resource has easily accessed emergency management plans to deal with critical conditions in obstetric care, in which maternal health or life is threatened. Decision algorithms and summary boxes are featured throughout for ease of reading.

This comprehensive volume covers all aspects of nutrition in different scenarios of maternal diabetes, including the Type 1 or Type 2 diabetic mother, gestational diabetes, and postpartum diabetes. The volumes offer a comprehensive, yet thorough, overview of the subject, from the prevalence, risk factors, and insulin requirements of the mother; to possible outcomes and effects on the infant; to dietary advice in general and specific scenarios; and information on macro and micronutrient supplements. There is also a special section on international perspectives on maternal diabetes, with ten chapters that each focus on a different country. Nutrition and Diet in Maternal Diabetes: An Evidence-Based Approach offers an overview of the Type 1 and type 2 diabetic mother, maternal and offspring aspects of gestation diabetes, and breastfeeding and maternal gestational diabetes.

This book presents an overview of the diagnostic performance of non- or semi-invasive tests for endometriosis in peripheral blood, endometrium, saliva, peritoneal fluid and urine. The value of existing and emerging systems biology technologies for biomarker development is addressed in several chapters on genetics, microarrays, proteomics and metabolomics. Although tests with high sensitivity and acceptable specificity have been developed, sometimes validated in independent populations and seem promising, more research is needed to translate these data into clinical benefit for patients and coordinate efforts internationally to standarize analysis, reports and operating procedures. The gold standard to diagnose endometriosis is currently through laparoscopic inspection with histological confirmation, a surgical procedure with rare but significant potential risks for the patients. A non-invasive test for endometriosis would be critical for the early detection of endometriosis of symptomatic women with pelvic pain and/or subfertility with normal ultrasound. This would include nearly all cases of minimal-mild endometriosis, some cases of moderate-severe endometriosis without a clearly visible ovarian endometrioma and cases with pelvic adhesions and/or other pelvic pathology, who might benefit from surgery to improve pelvic pain and/or subfertility. Such a test would also be useful in symptomatic women with ultrasound imaging suspicious for endometriosis, since it may be difficult to differentiate an ovarian endometrioma from other ovarian cysts and since the quality of ultrasound imaging is highly variable worldwide.

This new edition is a comprehensive and updated resource on antiphospholipid syndrome (APS), which is an autoimmune disorder. In APS, the body recognizes certain normal components of blood and/or cell membranes as foreign substances and produces antibodies (antiphospholipid antibodies) against them. APS is associated with recurrent clotting events (thrombosis) including premature stroke, repeated miscarriages, phlebitis, venous thrombosis, and pulmonary thromboembolism. It is also associated with low platelet or blood elements that prevent bleeding. Recently, however, even more disease states have been linked with APS, including premature heart attack, various cardiac valvular abnormalities, skin lesions, kidney disease, abnormal involuntary movement/chorea, diseases that mimic multiple sclerosis, and vascular diseases of the eye that can lead to visual loss and blindness. The International Congress on Antiphospholipid Antibodies, held every 3 years, is the venue where representatives from different disciplines gather to discuss the recent advances in APS. The conference intends to cover basic aspects of APS, such as pathogenesis, origins, genetics, intracellular and molecular events, the role of infections, as well as traditional and non-traditional clinical manifestations associated with antiphospholipid antibodies. The 15th Congress took place in September 2016. A novel aspect of the Congress was that multiple teams, chaired by Scientific Planning Committee members, used evidence-based literature reviews and expert discussions to answer specific pre-defined APS-related questions. These teams included points of view from experts in rheumatology, hematology, cardiovascular medicine, obstetrics, neurology, and immunology. The Scientific Planning Committee members also chaired the congress sessions and supervised completion of the reports that are the bases of the chapters of this book. In addition, there are two chapters included specifically written for APS patients. Much like the previous volume, dedicated to the 13th International Congress on Antiphospholipid Antibodies (April 2010), this up-to-date and comprehensive work gathers invaluable insights from a multidisciplinary team of world-renowned experts and represents the authoritative resource on causes, symptoms, diagnosis, and treatment of APS.

This book contains the proceedings of the Serono Symposia USA interna tional symposium on Genetic Models of Immune and Inflammatory Dis eases held on October 20 to 23, 1994, in Savannah, Georgia. The advent of methods for introducing genes into the germlines of mice, and for targeted disruption of particular genes by homologous recombination, has provided scientists in many disciplines with an extraordinarily powerful set of analyti cal tools. Some of the most informative applications of transgenic and gene knockout technology have been in studies of lymphocyte development and activation. The goal of this symposium was to bring together investigators using these genetic approaches for analyzing the immune system, with a view to defining common themes and novel directions. Transgenic mice have a wide variety of important applications in immu nology. Defined proteins can be expressed in selected tissues throughout development, thus acquiring the essential characteristic of "self" antigens. Such models have been used to study how immune responses to these artificially created "self" antigens are controlled. Antigen receptors of lym phocytes have been expressed as transgenes, and because lymphocytes are endowed with the unique property of allelic exclusion, such transgenic mice become essentially monospecific. Immunomodulatory agents have been expressed in defined tissues or throughout the body, providing tools for studying the functional consequences of dysregulated expression of biologi cal response modifiers."

Translational Advances in Gynecologic Cancers straddles the bench and bed divide by highlighting important and interesting research that is translatable to the clinic. The contents of this book cover the entire spectrum, from promising laboratory based research, to clinical trial efforts. Further, new therapeutic indications based upon randomized phase III trials are also included. Clinicians will learn about lab-based science that is about to enter the clinic, along with the rationale behind translational endpoints in trials. Researchers will be able to identify and understand the clinical needs of patients with these types of tumors to improve their research focus.

This book traces the evolution of caesarean delivery from postmortem ritual to the most commonly performed operation on women worldwide: from religious and legal edicts to the controversy of caesarean birth by maternal choice.

Sexual Dysfunction in Women is a concise yet detailed clinical guide to the treatment of sexual difficulties in women. Written with the general psychologist and therapist in mind and being published with a companion volume on Sexual Dysfunction in Men, it takes the novel position that most clinicians interested and willing to help female clients with sexual concerns can do so effectively, even if they do not primarily consider themselves as sex therapists. Many women will experience difficulties with desire, arousal, orgasm, or pain with intercourse at some point in the course of their lives, yet most clinicians feel less equipped to treat sexual dysfunction than far less prevalent disorders. This book empowers general psychologists, therapists, and other practitioners to actively engage in the multidisciplinary treatment of sexual disorders and broaden their knowledge base about sexuality, an important component of most clients' quality of life. It is both a go-to resource for professional clinicians in their daily work and an ideal resource for students and practice-oriented continuing education.

This book is a point-of-care resource for effective sexual and reproductive healthcare for patients of all ages, sexual orientations, gender identities and medical backgrounds in the primary care setting. This useful guide is divided into three parts, and other than part three, which deals exclusively with transgender and gender diverse patients, all content will relate to patients of all gender identities. Part one presents sexual and reproductive health (SRH) using a lifespan approach, including chapters on pediatrics, adolescents and young adults, adults, and older adult patients. Part two presents an approach to common SRH issues that span multiple age groups, including contraception and family planning, sexually transmitted infections and cancer screenings as well as sexual and reproductive health in the setting of common medical conditions. Part three is dedicated to sexual and reproductive health for transgender and gender non-binary patients, including psychosocial, medical, surgical and legal aspects of health. This book provides primary care clinicians with a framework for providing effective sexual and reproductive healthcare to patients of all ages, sexual orientations and gender identities in a way that is inclusive, focuses on health, and addresses the needs unique to specific populations.

Ultrasonography is a crucial tool in successful assisted reproduction but requires a steady hand and can often be difficult for unconfident clinicians. A comprehensive ultrasound imaging reference, this is an essential guide for trainee clinicians, ultrasonographers, and nurses working in the field of assisted reproductive technology. Providing the reader with an overview of the process and a foundation to direct their ultrasound assessment of each patient, it contains highly practical tips and tricks for obtaining the best images. Heavily illustrated with example images, the role of ultrasound in fertility treatment is explained, as well as how to identify the uterus and ovaries, measure the endometrium, count follicles and recognize pathology. The role of ultrasound in assisted reproduction is covered, including transvaginal oocyte collection, embryo transfer, early pregnancy, miscarriage and ectopic pregnancy. This is an indispensable reference for clinicians new to ultrasound in assisted reproduction.

The new edition of this atlas integrates all significant advances made in the past 15 years in molecular pathology,tumor virology,and genetics of cervical cancer. It emphasizes the importance of these advances in facilitating its pathological diagnosis and in op- mizing clinical management and prognosis. A new chapter on immunohistochemistry has been added,which includes refined detection methods,e. g. ,the overexpression of INK4a p16 as a molecular marker in the early differential diagnosis of premalignant - sions. The section on etiology and pathogenesis in human papillomavirus-induced neoplasia has been incorporated to represent new insights into the sequences of cel- lar and nuclear deregulation at the molecular level. All chapters have been revised to - clude the newest advances and relevant experiences in how to interpret and manage cervical disease; they are supported by the addition of 35 new microphotographic ill- trations. The tumor nomenclature is adapted to the latest edition of the WHO classi- cation; the morphology code of the international classification of diseases for oncology (ICD-O) has been added. We have also updated the list of references by adding recent relevant publications. Again,the staff of Springer-Verlag deserve our thanks for their patience and skill in preparing the manuscript and in reproducing the microphotographs. Heidelberg,February 2005 Gisela Dallenbach-Hellweg, Magnus von Knebel Doeberitz, and Marcus J. Trunk Heading2 Preface to the First Edition During the past decade our understanding of the histopathology of the cervix uteri has changed greatly.

This book focuses on the state of the art in fully grasping precocious puberty and its consequences, incorporating advances in the areas of endocrinology, genetics, imaging and therapeutics to offer an indispensable tool for all physicians interested in the latest advances in this field. The authors present the latest findings on early puberty in girls and boys. The dynamic process of maturation is influenced by many signals and reshapes growing children's role within their environment. Readers will benefit from the educational value and level of depth of the individual chapters; written by respected experts and in a self-contained format, they can also be read separately to address specific interests.

Nutrition in Infancy: Volume 2 is a very useful resource for all clinicians treating and preventing nutritional problems in infants. This volume covers a wide range of topics that support wellness in infants through the prevention and treatment of infectious diseases, malnutrition, and developmental and genetic abnormalities. A variety of chapters deal with nutrients for infants with disabilities, surgery, and other special needs. The sections in this volume discuss GI Tract Considerations, Formulas, probiotics, hormones and lipids in the health and disease of infants, and the growth and development of infants. In Nutrition in Infancy: Volume 2, a wide range of nutritional and food related therapies to prevent or ameliorate disease, growth retardation and promote health are outlined. The latest developments in diagnostic procedures and nutritional support are also included. Written by a group of international experts, this volume is an indispensable new reference for clinicians with an interest in the nutrition and health of pregnant mothers and their infants.

Management of the Patient at High Risk for Breast Cancer provides a state-of-the art review of patients who are at high risk for breast cancer, how to identify them, the tools available for risk assessment and quantification and indications for genetic counseling and testing. The book summarizes the high risk breast imaging options, including newest techniques and schedules. Pathologic evaluation of high risk lesions are featured as well as the management issues surrounding these lesions. The volume also covers the management of concomitant cancer risk and screening strategies. A concise, yet comprehensive overview of the current status of the topic, Management of the Patient at High Risk for Breast Cancer serves as a useful resource for physicians and researchers dealing with and interested in patients at high risk for breast cancer.

Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse provides a detailed insight into "when, why, what and how" of various minimally invasive surgical procedures for surgical management of SUI, OAB & POP. The volume provides detailed diagrammatic and pictorial step-by-step descriptions of the techniques and management of complications related to these procedures. This book also presents an up to date, one-stop reference for anything pertaining to MIT of these pelvic disorders. Written by experts in the field, Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse is a comprehensive resource designed for both the urologist and urogynecologist treating patients with urinary disorders and pelvic organ prolapsed, as well as for residents in training.

Management of the modern reproductive endocrinology and infertility clinic has become very complex. In addition to the medical and scientific aspects, it is crucial that the modern director be aware of of incongruent fields such as marketing, accounting, management, and regulatory issues. Reproductive Endocrinology and Infertility: Integrating Modern Clinical and Laboratory Practice was developed to assist the practicing reproductive endocrinologist and/or laboratory director by providing an overview of relevant scientific, medical, and management issues in a single volume. Experts in all pertinent areas present concise, practical, evidence-based summaries of relevant topics, producing a key resource for physicians and scientists engaged in this exciting field of medicine. As novel technologies continue to amplify, Reproductive Endocrinology and Infertility: Integrating Modern Clinical and Laboratory Practice offers insight into development, and imparts extra confidence to practitioners in handling the many demands presented by their work.

This book focuses on putting successful molecular strategies into practice for the treatment of gynecologic cancer. It approaches research into the pathology and treatment of gynecologic oncology from both clinical and experimental perspectives. New insights made possible by the introduction of advanced technologies into the field are presented. This new volume will be necessary reading for clinicians and experimental researchers alike.