Experimental and clinical researchers from a wide range of disciplines present a wealth of fresh scientific information on the biochemistry, molecular biology, pharmacology, and clinical activity of SERMs. The basic science chapters of the book focus-with an eye to the development of the ideal SERM-on the complex mechanisms of estrogen action, including ligand-dependent conformational changes in alpha and beta, and the recruitment of co-activators and co-repressors which modulate the estrogen receptor transcriptional activity and contribute to its crosstalk with growth factor signaling. The clinical presentation reviews the data accumulated on currently available SERMs, primarily tamoxifen and raloxifene, in cancer treatment and prevention, as well as their effects on the reproductive, vascular, skeletal, and central nervous systems. A tentative approach to menopause-related health issues is also provided for women with and without a previous diagnosis of localized breast cancer.

Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology focuses and highlights the pivotal role these two techniques play in modern obstetrics and gynaecology. Taking a problem-orientated approach, the book includes sections on menorrhagia, postmenopausal bleeding, endometrial malignancy, urogynaecology, ovarian masses, endometriosis, early pregnancy complications and infertility. A multi-contributed book with short, practical chapters, the book is well illustrated with more than 60 colour illustrations. Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology uniquely combines these two fields to demonstrate management of common gynaecological conditions based on accurate ultrasound diagnosis and minimal access treatment. An authoritative practical 'how-to' guide, this book will be invaluable for practitioners to learn and perfect both techniques and use them to their maximum potential.

In this definitive new text, the major medicines, devices and vaccines used by women worldwide are brought together for the first time in a single volume. Written and edited by international experts with an evidence-based approach, the book offers a comprehensive summary of all the key areas of women's medicines. In the first part, issues relating to female drug exposure and considerations for prescribing for subgroups of women - for example during pregnancy and lactation - are presented in the context of contemporary clinical practice. In the second part, specific groups of pharmaceutical products are reviewed, including oral contraceptives, emergency contraception, treatment of chronic pelvic pain, hormone replacement therapy, bisphosphonates, herbal medicines for women, contraceptive devices and human papilloma virus (HPV) vaccines. Every chapter reviews and summarises the efficacy and safety of each group of products and concludes with a useful set of clinical take home messages. In the third part, broader perspectives are presented - from a primary care overview of prescribing for women, through to regulatory, political and religious aspects, including issues with women's medicines in developing countries. The final two chapters focus on risk communication and conclude that women themselves should be placed at the centre of all discussions about their medicines. The book is aimed at prescribers, other healthcare professionals and students in the field of women's health throughout the world. It is an extremely valuable resource for all in clinical practice, for students of medicine, nursing, pharmacy and related sciences, and also for those in medicines regulation, pharmacovigilance and the pharmaceutical industry.

A discussion of all the key issues in the use of human pluripotent stem cells for treating degenerative diseases or for replacing tissues lost from trauma. On the practical side, the topics range from the problems of deriving human embryonic stem cells and driving their differentiation along specific lineages, regulating their development into mature cells, and bringing stem cell therapy to clinical trials. Regulatory issues are addressed in discussions of the ethical debate surrounding the derivation of human embryonic stem cells and the current policies governing their use in the United States and abroad, including the rules and conditions regulating federal funding and questions of intellectual property.

Improvements in the detection of fetal and neonatal brain injuries, advances in our understanding of the pathophysiology, cellular and molecular bases of encephalopathy, and new treatment options have all combined to produce significant changes in the management of neonatal brain disorders in the past few years. This new edition of Fetal and Neonatal Brain Injury brings the reader fully up to date with all advances in clinical management and outcome assessment. Updated material includes inflammation focusing in particular on chorioamnionitis and fetal brain injury; genetic brain injury; and expanded sections on cholestasis, diabetes, and thyroid disease. An updated, highly illustrated chapter on structural and functional imaging of the fetal and neonatal brain is also included. An outstanding international team of highly experienced neonatologists and maternal-fetal medicine clinicians have produced a practical, authoritative clinical text that gives clear management advice to all clinicians involved in the treatment of these patients.

This book provides an overview of the latest knowledge of the psychological aspects of polycystic ovary syndrome (PCOS), and paves the way for advances in this rapidly evolving field. Taking an evidence-based approach, the book elucidates the ways in which PCOS causes anxiety and depression, impacts Quality of Life (QoL), and is associated with other psychological issues. The psychological impact of key features of PCOS are explored too, with a special focus on insulin resistance / diabetes, and fertility issues. The book concludes with a chapter on practical recommendations on how best to help with anxiety and depression in PCOS. An important feature of this book is its identification of the ways in which testosterone, a defining characteristic of PCOS, impacts psychology. In doing so it fills a lacunae in current research and offers evidence that maps out the complex ways in which biology impacts psychology in PCOS, and also how psychology can be harnessed to impact biology in a positive way. It will appeal in particular to scholars and clinicians in the fields of health psychology and women's health.

This authoritative volume describes the role of free radicals and antioxidants in prenatal and perinatal disorders currently explored in clinical and pre-clinical trials. In twenty-two inclusive chapters, the book covers the gamut of oxidative stress and its relation to a variety of factors, including fertility, metabolism, redox biomarkers, antioxidant defense and protection, gene polymorphisms, angiogenesis, cell signaling, mutations and oxidative damage involving lipids, proteins and nucleic acids, membrane trafficking, inflammation, mitochondrial dysfunction, alterations in immunological function, hypoxia, and post-natal stressors. This comprehensive source will keep clinicians and research scientists up-to-date on translational research into medical applications. Perinatal and Prenatal Disorders is a significant addition to the well-known Oxidative Stress in Applied Basic Research and Clinical Practice series.

This book offers a critical review of the pelvic sciences past, present and future from an anatomical and physiological perspective and is intended for researchers, medical practitioners and paramedical therapists in the fields of urology, gynecology and obstetrics, proctology, physiotherapy, as well as for patients.

The book starts with a construction plan of the pelvis and shows its structural consequences. The historical background of pelvic studies proceeds from medieval and early Italian models to the definitive understanding of the pelvic anatomy in the Seventeenth century. During these eras of pelvic research, concepts and approaches developed that are illustrated with examples from comparative anatomy and from mutations, also with regard to the biomechanics of pelvic structures. Perceptions of the pelvis as an important element in sexual arousal and mating conduct are discussed, as well as attitudes to circumcision, castration and other mutilations, in its anthropological, social context.

The anatomy and physiology of the pelvic wall and its organs as well as the development of these pelvic organs are covered as a prerequisite to understanding, for example, the spread of pelvic carcinoma and male and female bladder muscle function. Connective pelvic tissue is examined in its reinforcing capacity for pelvic structures, but also as a hiding place for infections. Innervations and reflexes relayed through the pelvic nerves are discussed in order to explain incontinence, sphincter function and the control of smooth and striated muscles in the pelvis.

Catheters and drugs acting on pelvic function are described, and a critical review of alternative clinical methods for treating pelvic dysfunctions is provided."

With insight and research from world-renowned experts, this book provides specific approaches to diagnosis and treatment, addressing pharmacologic and non-pharmacologic management. Specific conditions examined include asthma, rhinitis and sinusitis, anaphylaxis, atopic and contact dermatitis, urticaria and angioedema, hereditary angioedema, drug allergies, and primary immune deficiency. An overview of obstetric management of the high risk asthmatic and allergic patient is provided, and the book concludes with a discussion of the prevention of asthma and allergic diseases during childhood.

Nurse Barb provides a wealth of advice to guide readers through the hormonal roller coaster of menopause.

The discipline of obstetrics and gynaecology, which dates back many centuries, is unique in that care is extended to every stage in a woman's life. More recently there have been significant scientific advancements and technological inventions that have transformed the health and care of women. Essential Gynaecology aims to deliver core knowledge aligned with clinical application for the treatment of relevant gynaecological conditions. Essential Gynaecology is written by various specialists from South African obstetrics and gynaecology departments. Each chapter is written with dedication and has been carefully selected to fulfil curriculum requirements. Topics covered include gynaecological history and examination, contraception, abnormal uterine bleeding, gynaecological infections, benign and malignant gynaecological conditions, infertility, female urinary incontinence and pelvic organ prolapse, menopause, sexual violence against females and termination of pregnancy. In addition to covering basic content, the text also includes colour photos and multiple choice questions for self-assessment. Essential Gynaecology offers fundamental information for the MBChB programme in gynaecology and responds to a need for a defined focus area. It is recommended for medical students, medical officers, associate clinicians, interns, medical practitioners and OB-GYN registrars.

The present book on Molecular & Diagnostic Imaging and Treatment Strategies of ovarian cancer is one of two companion books with the second one being focused on Cell and Molecular Biology of Ovarian Cancer. Both books include new exciting aspects of ovarian cancer research with chapters written by experts in their respective fields who contributed their unique expertise in specific ovarian cancer research areas and include cell and molecular details that are important for the specific subtopics. Comprehensive and concise reviews are included of key topics in the field.

Hormonal influences, both natural and iatrogenic, are implicated in the most frequent health issues of women. Endometrial cancer is now the most common gynecologic cancer in the United States and the industrialized world. This cancer is strongly related to hormonal and metabolic factors. In addition, breast cancer treated with hormone therapy (Tamoxifen) may, in some cases, be associated with uterine pathology. Hormone therapy is used to improve the physiological effects and counteract abnormal and deleterious effects of "natural" hormonal activity. Millions of women receive hormone therapy at some point of their life: using oral contraceptives, reproductive technology, treatment for post-menopausal symptoms, among other uses. This book addresses a range of women's health issues, from fertility to neoplasms, and their relationship with natural and iatrogenic hormonal effects. Chapters include clinical and pathological descriptions, theoretical and practical medical issues, and original studies and cases. Controversial issues in certain hormone therapies are presented with updated concepts based on clinical studies and novel statistical methods. The book will be useful for specialized and general physicians, oncologists, endocrinologists, researchers, medical students, and others in the field of women's health.

This detailed volume provides a robust set of methods to understand variation between patients with ovarian cancers, in vitro models to better study different stages of the disease, and in vivo models to test therapies. Beginning with clinical perspectives to orient basic scientists, the book continues with sections exploring methods to characterize features of the tumor microenvironment (TME), techniques to isolate cells for in vitro study, and in vitro and in vivo models to study the disease. Written for the highly successful Methods in Molecular Biology series, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and practical, Ovarian Cancer: Methods and Protocols serves as an ideal guide for researchers seeking to improve their study of ovarian cancer and find new therapeutic approaches.

This book highlights the impact of nutrients on early placentation processes and their relevance for fetal growth and pregnancy outcome. The role of maternal nutrition on fetal growth and development has been evidenced in many epidemiological studies that included infamous Dutch famine, Helsinki Birth cohort and others. Fetal programming hypothesis states that the nutritional and other environmental conditions under which an individual develops from pre-conception to birth has a major impact on the future health of the newborn child. The developmental environment of the fetus is primarily dependent on two major factors that are maternal nutritional state (excess/low/imbalance) and placental function. Placentation is characterized by the extensive remodeling of the maternal uterine vasculature producing low-resistance blood vessels that facilitate the exchange of nutrients and wastes between the mother and the fetus. Cellular and molecular mechanisms involved in human placental blood vessel formation, which are now well established, are discussed.

Extensive reviews have been published on the mor aspects, anatomy, ultrastructure, physiology, bio phology, anatomy, and physiology of the mam chemistry, endocrinology, pharmacology, and physiopathology of the mammalian ovary. The malian ovary. However, little attention has been given to the gaps between the physiological, endo contributors, who prepared their chapters metic ulously, are recognized experts in their respective crine and histochemical parameters of the ovary as disciplines and their writings reflect extensive per it relates to clinical aspects. There is a wealth of sonal experience and unpublished data of both publications concerning the biology of the ovary: basic and clinical sciences. Without the assistance of the purpose of this volume is to integrate this information with emphasis on modern concepts in good friends and permission to draw extensively microanatomy, physiology, methodology, clinical from investigations, this volume would not have complications, and therapeutic approaches. An been possible. attempt is made to place fundamental research in Thanks are due to G. F. Franchitto, F. Barberini, clear perspectives. P. Stoops. Lori Rust and J. Squiers for their editorial It is hoped that this volume will fulfil a long skills and for checking the references to the original standing need and serve as an important source for sources. Thanks are particularly due to 1. K. Smith investigators and clinicians concerned with the of Martinus Nijhoff Publishers BV for his excellent physiopathology of the ovaries for years to come. It cooperation during the production of the book."

The last decade has seen significant advances in the study of tubal physiology using novel methods, and our understanding of the involvement of Fallopian tubes in the development of ovarian cancer has changed fundamentally. At the same time success rates of IVF have improved significantly, with the aid of better understanding of tubal function. This volume will present a fully comprehensive update of Fallopian tube physiology and provide a practical guide to the clinical aspects related to them. The first part of the book will consist of chapters on basic science of the Fallopian tubes, which will explain how specific aspects relate to infertility and contraception. In the second half, assessment of tubal function, conditions that compromise tubal function, surgical and non-surgical management approaches to various types of tubal pathology, fertility control (contraception) and future aspects of tubal research will be covered in chapters written by world-renowned experts in these fields. Fallopian Tube: Physiology and Clinical Aspects will be of tremendous interest and utility to both basic scientists and clinicians who are involved in the management of infertility and contraception.

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.

This volume comprehensively focuses on polycystic ovary, metabolic syndrome and obesity and their impact on women's health, reproduction and quality of life from adolescence to old age. PCOS is analyzed form the early origins - highlighting the importance of diagnosis, management and treatment starting from the high-risk period of adolescence - throughout infertility PCOS-related issues, pregnancy and menopause transition. All aspects of this syndrome are covered also in relation with endocrine and metabolic features that affects women's health. This book is a very useful tool for gynecologists, endocrinologists, obstetricians, reproductive medicine and general practitioners and is an important resource for all physicians involved in women's health.

Gynaecological practice has changed fundamentally in the last three decades and a large proportion of major pelvic operations has been replaced by minimally invasive approaches. This book will cover minimally invasive approaches in all aspects of gynaecology including general gynaecology, oncology, urogynaecology and reproductive medicine. The chapters are written at a level appropriate for trainees/residents and general gynaecology specialists but enough details and additional resources will be provided for those who require further information. Specific aim of the book is to provide direct to the point surgical pearls which can be adapted to the daily practice instantly by the target audience. The book includes chapters on relevant surgical anatomy, principles of MIS, management of camera systems, video/image editing, initiating a successful MIS practice, improving efficiency of current MIS program, how to develop successful teaching techniques in academic setting, avoiding & managing MIS related surgical complications and preoperative/postoperative care before covering MIS for individual conditions including intensive care managements. Chapters are written by world renown authorities. ACOG guideline recently published a statement recommending vaginal hysterectomy and endoscopic hysterectomy should be considered as a first step of surgical choice. Current practice has been shifting from open cases to laparoscopic/ robotic assisted cases while vaginal cases stays steady. This shift has created an urge among gynaecologists to learn, improve or adapt laparoscopic/ robotic techniques in their practice.

The book provides detailed information on breast cancer and covers all the aspects of this rapidly spreading disease, such as applied anatomy and physiology, causative factors, various Investigations to reach a concise, definitive and complete diagnosis. The management of breast cancer involves multi-modality treatment and the book describes all the modalities in a very clear manner. It also discusses in a very lucid and practical way. the multi-prong treatment that the patient requires . Additionally, the book covers lesser-known areas of the subject like rehabilitation, management of lymphoedema, Extravasation of chemo-Infusion, organization of breast cancer management group, breast cancer awareness and patient education, follow up of the patient, and psychological support to these patients who have undergone mutilation of their organ. Edited by experts the chapters are contributed by renowned onco-sugeons from high volume and reputed centers in India such as, PGIMER, Chandigarh, AIIMS, New Delhi, and TMH, Mumbai among others. The book serves as a useful resource for surgeons, medical oncologists, radiotherapists, pathologists, radiologists and many other specialists interested in the field of breast cancer and actively working in this area. It is useful for practitioners and residents as well as for those who want to learn the different aspects of this disease.

This easy-to-understand pocketbook in the highly respected Clark's stable of diagnostic imaging texts is an invaluable tool for students, sonographers and other ultrasound practitioners, providing practical guidance on clinical ultrasound procedures, summarising current relevant literature and professional body guidelines. The content is arranged by anatomical system and organ for ease of reference, with each section comprising a short introduction, the indications for the procedure, patient preparation, the imaging procedure itself, along with an image analysis, supported throughout by positioning photographs and clinical images. Clark's Essential Guide to Clinical Ultrasound is ideal for all users of clinical ultrasound at both undergraduate and postgraduate level and will also provide a convenient distillation of the latest best practice and guidelines for sonographers, midwives, vascular technologists, ECG technologists, medical doctors, sports injury specialists, paramedics, and other health professionals.

Meningitis and Encephalitis are associated with high rates of mortality and neurological sequelae. The differential diagnosis includes a wide spectrum of infectious and non-infectious etiologies, some requiring urgent therapy for survival. The current management challenges in patients with meningitis and encephalitis include a low sensitivity of meningeal signs, overutilization of unnecessary screening cranial imaging, delays in diagnosis of urgent treatable causes, a large proportion of unknown etiologies, low sensitivity of current microbiological techniques especially in the setting of previous antibiotic therapy, underutilization of available molecular diagnostic tests, and empiric antibiotic therapy and hospitalization for viral meningitis cases. Even though there are published guidelines, compliance with them is not optimal and physicians do not follow standardized algorithms in their empirical approach. As meningitis and encephalitis is associated with high rates of adverse clinical outcomes, prevention, when feasible is of upmost importance. Adherence to protocols to prevent health-care associated meningitis and ventriculitis are effective but compliance with them is not uniformly performed. This book seeks to improve outcomes for meningitis and encephalitis cases handled by physicians who may or may not be thoroughly trained for these challenges. The text introduces the current guidelines but also discusses the gaps that leave clinicians struggling to implement the most appropriate approaches for these particular neurological infections. Each chapter delivers the tools necessary to identify and adhere to the most appropriate diagnostic technique, management protocols, and prevention approach for each situation. All chapters conclude with discourse on future directions in research and quality improvement. Written by experts in infectious diseases, the book covers topics that are the most devastating, including healthcare-acquired infections, autoimmune encephalitis, and infections as they present in HIV patients. Meningitis and Encephalitis is a well-rounded resource for all medical professionals encountering these neurological syndromes, including infectious disease specialists, neurologists, primary care physicians, and immunologists.

This cutting-edge text for surgeons specializing in Reproductive Medicine details how the latest minimally invasive developments impact on operations in their repertoire. Illustrated with color photographs and surgical videos, this will be an essential reference in a fast-moving field.