The body of any animal can be viewed as a society or ecosystem whose individual members are cells, reproducing by cell division and organized into collaborative assemblies or tissues. In this ecosystem, the cells are born, live and die under various forms of selection pressure such as territorial limitation, population size, source of nutrients provided, infectious agents, etc. The body is a highly organized society of cells whose main task is the maintenance of homeostasis of the whole organism. The failure of control mechanisms which make the cell the unit of society, marking the beginning of its asocial behaviour, is most frequently a malignant alteration. This process is not abrupt, nor is it based on a single event. It is, rather, a long-term process characterized mainly by mutation, competition and natural selection operating within the population of cells. The basic mechanisms controlling the cell sociability represent the first defence line against the altered cells, while the second line of defence is supposed to be made up of the immune system cells.Speaking in Darwinian terms, within the ecosystem of an organism, cells of the immune system operate as predators of the altered and mutated cells or cells infected by the intracellular parasites. The biological phenomena whose mechanisms are, at present, explored and largely understood, certainly had their own evolution. Searching for the origin and details of the evolution of advanced solutions as well as selection pressures that might justify their emergence and existence, we often fail to see that many such phenomena are, in fact, co-evolutionary by-products of evolutionary innovations. In other words, the evolutionary emergence of advanced solutions is sometimes, if not always, accompanied by certain by-products and by the co-evolution of compensatory mechanisms acting as a counterbalance to these. An example of the evolution of advanced solutions is the evolution of adoptive immunity, and co-evolution of auto-immunity and alloimmunity. Alongside the diversification of the mechanisms of adoptive immunity, auto-immunity and alloimmunity gain attributes of the evolutionary by-products and become sources of selection pressure.To that effect, alloimmunity could be a source of very strong selection pressure in mammals, simply because it is directly connected with the reproductive efficacy. At the same time, new forms of selection pressure that are connected with adoptive immunity gave rise to new mechanisms controlling killer machinery of the immune system. Finally, the last in a line of by-products in the processes of evolutionary modelling and re-modelling of vertebrate immune systems can be regarded as the failure of anti-tumor immunity. There is now much evidence that tumors can be immunogenic. Tumor cells very often express antigens in a form recognizable by the host immune system, but most frequently without consequences on tumor progression. This has been shown in many experimental models and different experimental conditions. Immediate mechanisms for the escape of tumors from the immune response are very similar to mechanisms for the escape of the fetoplacental unit (as allograft) from the maternal immune response. The similarity between these two mechanisms is so significant that any randomness must be banished.Mechanisms of anti-tumor immunity in mammals are probably substantially different from mechanisms of anti-tumor immunity in other classes of vertebrates. Moreover, the type of most frequent tumors in non-mammalian vertebrates is also significantly different. Finally, the incidence of malignant tumors in non-mammalian vertebrates is significantly lower than the incidence of malignant tumors in mammals. These facts indicate that the mammalian immune system during the anti-tumor immune response is tricked by the similarity between tumor cells and trophoblast or other placental cells. From this aspect, anti-tumor immunity failure in mammals can be defined as an immunoreproductive phenomenon, which is developed under the evolutionary pressure of auto-immunity and alloimmunity/reproductive effectiveness. It may be a specific evolutionary approach in the rendering of anti-tumor immunity failure in mammals, and a new possibility for anti-tumor immunotherapy.

Almost every aspect of energy and nutrient metabolism is altered by hormonal and other physiological changes during pregnancy and lactation. While it is evident that hormonal adjustments affect nutrient requirements, these are rarely considered when nutrient recommen dations are made for pregnant or lactating women, and often neglected during evaluation of nutritional status. In addition, changes in nutrient metabolism during the stages of pregnancy and oflactation are usually considered separately, while in reality events during pregnancy can have a major influence on nutritional status and nutrient requirements during lactation. The purpose of this volume is to describe changes in the metabolism of important nutrients during pregnancy and lactation, including the physiological basis for these changes and their implications for nutrient requirements and assessment. Authors have considered such issues as inter-relationships between endocrine changes and nutrient metabolism at the tissue, cellular and molecular level; alterations in nutrient binding proteins; the efficiency of nutrient absorp tion and retention; and the impact on maternal as well as fetal nutritional status. Another unique aspect of this book is the focus on pregnancy and lactation as a continuum."

For out of olde hokes, in good feyth, Cometh all this newe science that men lere. Geoffrey Chaucer The Parliament of Fowls During the past two decades knowledge of the human menstrual cycle and of normal and abnormal reproduc- tive function has increased at a dramatic rate. As rec- ognized in this volume, this explosion of knowledge is due in large measure to the development of radio- immunoassays for the measurement of the minute quantities of reproductive hormones found in the cir- culation. Yet the foundations for the many recent developments were laid well in advance. The concepts and hypotheses tested were often suggested even be- fore the hormones involved were identified and iso- lated. A consideration of the historic aspects of re- search in this field places recent research in the appropriate perspective. Moreover, as presented by Drs. vii viii FOREWORD Gruhn and Kazer, the history of progress in this field makes fascinating reading. A review of the history of reproductive endocri- nology should be required reading for all students of the subject and reproductive endocrinologists in train- ing. Dr. Griff T. Ross, a noted reproductive endocri- nologist, often instructed his students that every hy- pothesis he tested could be found in some form in the publications of previous scientists. The answers to present and future questions are often hidden in the lessons of the past.

Surgical Diseases in Pregnancy explores the special problems confronted by the gynecologic surgeon treating pregnant patients. These problems include acute appendicitis, inflammatory bowel disease, breast cancer, carcinoma of the cervix, ovarian tumors, renal stones, and incompetent cervical os. Other topics discussed are induced abortion; septic abortion and septic thrombophlebitis; ectopic pregnancy; surgical disease of the endocrine glands during pregnancy; gastroduodenal, hepato-biliary and pancreatic emergencies during pregnancy; pregnancy in the kidney transplant recipient; and pregnancy and cardiac prosthetic valves.

Ovulation: Evolving Scientific and Clinical Concepts presents the proceedings of the International Symposium on Ovulation: Evolving Scientic and Clinical Concepts held in Salt Lake City, Utah. Internationally recognized experts provide new insights in the most recent developments in the area of mammalian ovulation, incorporating basic scientific and clinical concepts in the process. Topics include an overview of 37 years of research on ovulation, the follicle, the gonadotropin surge, the intraovarian steroid microenvironment, putative periovulatory intraovarian regulators and messengers, and clinical frontiers. More than 80 illustrations round out the text. The book is essential for all reproductive endocrinologists and Ob-Gyns.

Since 2005 a dozen states and more than 15 specialties have reported a physician shortage or anticipate one in the next few years. This anticipated shortage and a worsening of physician distribution are compounded by a projected increased demand for women's healthcare services.

Women's healthcare is particularly vulnerable, because the obstetrician-gynecologist workforce is aging and is among the least satisfied medical specialists. Furthermore, fellowship training in women's healthcare in internal medicine and in maternal child health in family and community medicine involves only a small portion of general internists and family physicians.

In response to this challenge, the Association of American Medical Colleges called for an expansion of medical schools and graduate medical education enrollments. As we cope with significant and rapid changes in organizations and reimbursement, academic departments of obstetrics and gynecology, family and community medicine, and internal medicine have opportunities to create a unified women's health curriculum for undergraduate students, share preventive health and well-woman expertise in training programs, provide improved continuity of care, instill concepts of lifelong learning to our graduates, and better develop our research programs.

This volume's chapters focus on strategic planning on behalf of academic faculty who will train the anticipated additional load of students, residents, and fellows in women's healthcare.
-changing demographics of faculty
-expanding roles of clinician educators
-physician investigators and their future
-the hidden value of part-time faculty
-faculty salaries
-required skillsets of academic leaders
-the meaning of tenure and faculty satisfaction and retention.

Recommendations presented here from authors with distinguished leadership skills indicate a consensus, but not unanimity. In furthering these goals, we summarize in the final chapter our collective expertise and offer ways to implement recommendations to better prepare for tomorrow's needs in academic women's healthcare.

Reproductive tract infections (RTis) have become a silent epidemic that is devastating women's lives. Each year, thousands of women die needlessly from the consequences of these infections, including cervical cancer, ectopic pregnancy, acute and chronic infections of the uterus and the fallopian tubes, and puerperal infections. For many women, this happens because they receive medical attention too late, if at all. The terrible irony of this tragedy is that early diagnosis of and treatment for many RTis do not require high-technology health care. For the hundreds of millions of women with chronic RTis acquired from their sexual partners, life can become a living hell. Infection is a major cause of infertility, and it leads to scorn and rejection in many countries. These women may experience constant pain, have festering lesions of the genital tract, be at enhanced risk of second ary diseases, and endure social ostracism. The problems associated with RT s have grown even greater in the past decade with the emergence of human immunodeficiency virus (HIV) and AIDS. Preexisting sexually transmitted disease, particularly when associated with genital tract ulcers, raises women's vulnerability to the transmission of HIV 3-5 fold."

Discrimination of self from nonself is the major function of the immune system and understanding the mechanism(s) involved a main employer of immunologists. Hence, the age-old puzzle of why a fetus that contains a panel of major histocompatibility (MHC) antigens derived from its mother and its father is not rejected (spontaneously aborted) by lymphocytes from its mother who should theoretically recognize foreign MHC molecules from the father has remained of great interest. This dilemma has enticed immunologists and developmental biologists for many years. This volume was created to present the information currently on hand in this subject to the scientific public. The guest editor, Professor Lars Olding, has a long and distinguished history of contributions in this field, having been one of the main propo nents of the argument that lymphocytes from the fetus play an active role in this process by suppressing lymphocytes from the mother from proliferating and thereby acting as killer cells. His work has defined the phenomenon and identified suppressor molecules (factors) involved in the process. In a different but related chapter, Margareta Unander extends such observations to the clinical study of women with repeated "habitual" mIS carriages."

Selected as a Doody's Core Title for 2022! Essential for ob/gyn physicians, primary care physicians, and any health care provider working with pregnant or postpartum women, Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 12th Edition, puts must-know information at your fingertips in seconds. An easy A-to-Z format lists more than 1,400 of the most commonly prescribed drugs taken during pregnancy and lactation, with detailed monographs designed to provide the most essential information on possible effects on the mother, embryo, fetus, and nursing infant. Each templated monograph includes: Generic US name (trade names in index) Risk factors Pharmacologic class Pregnancy and breastfeeding recommendations Pregnancy, fetal risk, and breastfeeding summaries Updated references NEW in the 12th Edition: 100 new drugs, with thorough updates of all existing drugs Subheadings with each review for faster reference List of cross-referenced combination drugs List of drugs contraindicated in breastfeeding women List of drugs contraindicated in pregnancy List of drugs that affect human development Quarterly updates, available online, to keep you at the forefront of the field Greatly improved eBook searchability Enrich Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

"Drugs During Pregnancy and Lactation, 3rd Edition" is a quick and reliable reference for all those working in disciplines related to fertility, pregnancy, lactation, child health and human genetics who prescribe or deliver medicinal products, and to those who evaluate health and safety risks. Each chapter contains twofold information regarding drugs that are appropriate for prescription during pregnancy and an assessment of the risk of a drug when exposure during pregnancy has already occurred. Thoroughly updated with current regulations, references to the latest pharmacological data, and new medicinal products, this edition is a comprehensive resource covering latest knowledge and findings related to drugs during lactation and pregnancy.
Provides evidence-based recommendations to help clinicians make appropriate recommendationsUniquely organized and structured according to drug class and treatment indications to offer authoritative clinical content on potential adverse effects Highlights new research developments from primary source about working mechanism of substances that cause developmental disorders
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In Vitro Fertilization, Embryo Transfer and Early Pregnancy is undoubtably the most exciting and onwardly progressing field in reproductive medicine today. It forms the major subject matter of this the second volume of the Proceedings and the first book of Related Communication papers given at the XI International Federation of Fertility Societies World Congress on Fertility and Sterility held in Dublin, Ireland from June 26th to July 1st 1983. The papers have been grouped into closely allied topics covering sequentially in three parts: Follicle and Ovum in the Human, Follicle and Ovum in the Animal Model, and Semen and Spermatozoa. Preceding a timely reminder on Ethical and Legal Aspects of IVF are some of the remarkable clinical results now been obtained throughout the world. The final section concerns various aspects of Pregnancy in Animals and Humans and is included in this volume because of its close relationship to the main subject matter. Related Communications sessions often produce the largest amounts of up-to-date information to be given on a particular subject during a Congress. IFFS Dublin '83 proved to be no exception. So although scientific and medical endeavour will ensure that knowledge and progress in the field will soom overtake many of the conclusions reached in these papers, nevertheless we hope you will agree in the merit of producing such a record of the state of the art at this time. Robert F. Harrison John Bonnar William Thompson Dublin 1983.

Male Reproductive Function gives an up-to-date review on the physiology and disease processes associated with the male reproductive system. The first few chapters describe the regulation of the functions of the testis and the integration of its components: germ cells, Sertoli cells and Leydig cells. This is followed by a description of puberty and aging, and the disorders or dysfunction that may be associated with these physiological processes. Discussions on the current methods for the diagnosis and treatment of male hypogonadism, male infertility and male sexual dysfunction follow, with detailed descriptions of types of androgen replacement and the benefits and risks of such treatment. The book concludes with the development of male contraception and the possible influence of the environment on the male reproductive system. Male Reproductive Function represents a conglomeration of the efforts of experts in andrology from all over the world, both in basic cellular/molecular biology as well as in clinical science and practice. This book is suitable for endocrinologists, urologists, general internists, gynecologists and other students in the field of male reproduction.

Pregnant women and their partners often ask healthcare professionals whether sex is safe during pregnancy, and what consequences may result from sexual activity. Many clinicians can also be unsure of the answers to these type of questions, leading to both patient and clinician resorting to the internet for advice, which can be inaccurate and anxiety-inducing. Here, the authors provide clinicians with an insight into the information offered by 'Dr Google' so that they can reassure and advise their patients as necessary. Aimed at obstetricians and other physicians caring for pregnant women, this book reviews the implications of sex during pregnancy such as those complicated by medical conditions, those at risk of preterm birth and multiple pregnancies. Other chapters cover physiological changes during pregnancy that may affect sexual function and intimacy, as well as the differing guidelines provided by various global obstetric societies.

Proceedings of the 9th International Conference of the International Society for Research in Human Milk and Lactation (ISRHML), October 2-6, 1999, Bavaria, Germany. The quality of infant feeding is of major importance for child health development and well being, and breast feeding is the natural form of supplying food to the infant and is considered to be ideally adapted to the needs of both mother and child. This contributed volume therefore, brings together the research on the physiological foundations and on the biological effects of breast feeding, both short and long term. This book contains the work of scientists from over thirty countries, many of whom are leading researchers in their fields, and details papers presented by the invited speakers of the conference and short summaries of presentations of original research results.

Published in association with NASPAG, this updated second edition gives quick access to the essential information. The authors combine their clinical experience with a complete review of the literature, placing it in an easy to consult format with photographs, figures, and algorithms.

This practical handbook provides detailed guidelines on prescribing drugs in all classes and for a wide variety of diseases and disorders during pregnancy, with numerous boxes and tables to assist understanding. CONTENTS: Introduction to Drugs in Pregnancy * Antimicrobials during Pregnancy: Bacterial, Viral, Fungal, and Parasitic Indications * Cardiovascular Drugs during Pregnancy * Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy: Embryotoxic versus Fetal Effects * Antiasthma Agents during Pregnancy * Anesthetic Agents and Surgery during Pregnancy * Antineoplastic Drugs during Pregnancy * Analgesics during Pregnancy * Anticonvulsant Drugs during Pregnancy * Psychotropic Use during Pregnancy * Antihistamines, Decongestants, and Expectorants during Pregnancy * Nutritional and Dietary Supplementation during Pregnancy * Use of Dermatologics during Pregnancy * Drug Overdoses during Pregnancy * Miscellaneous Drugs during Pregnancy: Tocolytics, Immunosuppressants, and Biologic Therapeutics * Substance Abuse during Pregnancy * Online Support Material

The most common abnormal growth of the female reproductive system, fibroids, are thought to affect the majority of women at some point during their reproductive years. This text from leading fibroid experts looks at the latest evidence on how the problem impinges on reproduction and the most up-to-date management and treatment options available to help patients with fibroids hoping to conceive. Print versions of this book also include access to the eBook version with links to procedural videos.

course, also aware that many who use this volume One in every three slides examined by a general diagnostic pathologist in the United Kingdom, and will be well familiar with the classical, or 'textbook', in most other countries, comes from a gynaecological appearances of most of the more common conditions patient. Few pathologists can hope, therefore, to and have therefore often chosen an example which, escape a constant exposure to gynaecological path whilst being typical, is not necessarily classical. ology, and it is the aim of this atlas to lessen the We have deliberately chosen not to include any difficulties of this diagnostic burden by acting as an illustrations of gross specimens. This is partly because illustrated guide to the histological diagnosis of of ou r view that such illustrations are of I ittle real value female genital tract abnormalities. to any but the least experienced of pathologists, and Gynaecological pathology does, however, pose a partly because their inclusion would have narrowed number of specific problems: the range and scope of still further our selection of histological figures.

This concise, truncated version of Nagy, Varghese and Agarwal's Practical Manual of In Vitro Fertilization is comprised of select clinical chapters for a portable, affordable and up-to-date resource. Gamete Assessment, Selection and Micromanipulation in ART covers a variety of topics, including: - Human oocyte evaluation - Sperm evaluation and selection - Micromanipulators and micromanipulation - Biopsy procedures on oocytes and embryos - Molecular insights in IVF Practical for both clinicians and researchers alike, Gamete Assessment, Selection and Micromanipulation in ART brings together all of the need-to-know information about these important topics in reproductive medicine.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters, successfully bring to the attention of physi cians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, patho anatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years and over this period, neurosurgeons have ob tained special training in pediatric neurosurgery and then dedicated them selves primarily to its practice. Centers, Chairs, and educational pro grams have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's ner vous system."

This book is designed primarily for anatomic pathologists to facilitate their task of accurately diagnosing embryos and fetuses. A detailed examination of the products of spontaneous and induced abortions is necessary for accurate genetic counseling and for establishing the risk for specific abnormalities or another spontaneous pregnancy loss in the future. The growing interest in the defects of early development reflects the profound change in general life-style. In the past, spontaneous abortions were considered a common, usually sporadic event in a patient's reproductive history. Only reassurance and encour agement were given to the patient and scant attention was paid to the detailed pathology of the abortus. Nowadays, however, as a result of reliable methods of contraception and of the availability of reliable prenatal diagnosis for chromosome abnormalities more frequent in advanced maternal age, significant numbers of parents plan to have pregnan cies later in their reproductive life. Consequently, in a case of spontaneous abortion, the question of "cause" and of "future risk" of recurrence of abortion or an abnormal infant is particularly important. In the era of more elaborate and accurate prenatal diagnostic tests, the pathologist examining products of conception has a primary responsibility to detect, in both spontaneous and induced abortions, any developmental abnormality that would indicate an increased risk of multifactorial, chromosomal, and single gene disorders in a subsequent child.

This book is based on presentations by some of the world's leading experts at the Sixth International Conference on Clinical Cancer Prevention, held in St. Gallen, Switzerland, during March 2010. The main themes are the latest advances in the prevention of breast and prostate cancer and the role of infection in the development of liver and gastric cancer. Special emphasis is given to perspectives on the chemoprevention of breast cancer, as the conference included an international consensus meeting on this subject. New research findings are presented and potentially more effective cancer prevention strategies are discussed, with careful consideration of controversies. The expertise of the contributors encompasses genetics and microbiology, epidemiology, and health economics, as well as clinical cancer prevention. This book will be of interest to all who wish to learn about the most recent progress in combating the development of cancer.

Perinatal problems in thyroid gland physiology are common but complicated and present a diagnostic dilemma for the primary clinician. In December 1990, an international group of basic and clinical investigators gathered in Longboat Key, Florida to address these issues. The participants included internists, obstetricians, pedia tricians, neurologists, pathologists and basic scientists in cellular metabolism, endocrine physiology, and molecular biology. The presentations contained within this book bring together their most current and vital research related to the field of perinatal thyroidology. This book is based on the dynamic and fruitful exchange of the participants at the symposium. We are indebted to these individuals whose valuable insights and efforts are contained within this text. Barry B. Bercu Dorothy I. Shulman vii CONTENTS Session I Mechanism of Thyroid Hormone Action 1 Leslie J. DeGroot Thyroid System Ontogeny in the Sheep: A Model for Precocial Mammalian Species * . . * * 11 Delbert A. Fisher Pathologic Studies of Fetal Thyroid 27 Development * * * * * * * Douglas R. Shanklin Thyroid Hormone Control of Brain and Motor Development: Molecular, Neuroanatomical, 47 and Behavioral Studies * * * * * * * S. A. Stein, P. M. Adams, D. R. Shanklin, G. A. Mihailoff, and M. B. Palnitkar The Thyroidectomized Pregnant Rat: An Animal Model to Study Fetal Effects of Maternal Hypothyroidism 107 Susan P. Porterfield and Chester E.