Ovarian Cancer Immunotherapy provides a broad overview of several aspects of basic sciences, and clinical and therapeutic aspects of immunotherapy for ovarian cancer, as well as state-of-the-art information on molecular genetics and biology. Chapters are written by a team of expert contributors from around the world and explore topics such as antibody therapeutics for ovarian carcinoma, emerging serum biomarkers, ovarian cancer immunity, adoptive cell immunotherapy, the biology of dendritic cells, the role of growth factors, and more. Readers will also gain a better understanding of the molecular and cellular events that underlie ovarian cancer immunology. This book is an ideal resource for clinicians, basic medical scientists, graduate basic medical science students, and medical students caring for patients with ovarian cancer, including attending surgeons and physicians, and clinical fellows and residents in the disciplines of gynecologic oncology, medical oncology, and surgical oncology.

This new edition of an acclaimed text reviews the evidence for best practice in obstetrics to present the reader with the right information, with appropriate use of proven interventions and avoidance of ineffectual or harmful ones. The information is presented in the right format by summarizing evidence succinctly and clearly in tables and algorithms. The aim is to inform the clinician, to reduce errors, and "to make it easy to do it right." The volume can be purchased separately or together with the companion volume on Maternal-Fetal Evidence Based Guidelines (set ISBN 9780367567033). The Series in Maternal-Fetal Medicine is published in conjunction with the Journal of Maternal-Fetal and Neonatal Medicine. From reviews of previous editions: Obstetric Evidence Based Guidelines is a text that will prove useful to residents and fellows as well as to practicing obstetric clinicians. Furthermore, it can be used as a source for the development of hospital policies for the management of these obstetric problems ... The major advantage of this text is that it provides guidelines for the management of commonly encountered obstetric issues in a single book. -JAMA This is a welcome addition to a physician's library. Its use of current studies and easy-to-read format allow for easy fact-checking and referencing. -Doody's Review Service

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

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.

The optimal function of the placenta and thus fetal well being largely depends upon the integrity of both the fetal and maternal circulations of the placenta. Intense basic research concerned with placental vascularization and blood flow has been performed for the past 30 years, beginning with the classical morphological descriptions of the placental vessels by Boe (1953) and Arts (1961), as well as with the radioangiographic studies of maternal placental circulation in the human by Borell (1958) and in the rhesus monkey by Ramsey (1962). The scientific framework presented by these investigators has been filled and completed by numerous investigators, leading to more morphological details, functional considerations, and pathological understanding. For an extended period of time, this research has been of primarily academic interest by increasing our insights into one important system of the placenta, yet having nearly no practical importance. Recently, this situation has changed dramatically: in vitro studies of the isolated, dually perfused human placenta and in vivo studies of placental circulation for diagnostic purposes have raised an enormous interest in basic research data. New methods like Doppler Ultrasound and NMR became available. These technics have enabled the obstetrician to study fetal and placental hemodynamics in vivo. Meanwhile, such methods are becoming incorporated into the daily obstetrical routine, to some degree without an adequate background knowledge of placental vascularization and blood flow, since such experience is currently available to only a small group of experts.

Operative Gynecologic Endoscopy, Second Edition is completely revised and expanded with 17 new chapters that provide, step-by-step, the latest operative techniques for both laparoscopic AND hysteroscopic procedures. New and updated chapters include: - laparoscopic assisted vaginal hysterectomy - vaginal prolapse and bladder suspension - ectopic pregnancy - tubal reconstructive surgery - assisted reproductive technologies - lymphadenectomy and urologic procedures - operative hysteroscopy. In addition, this volume includes comprehensive chapters on instrumentation, photo documentation, anesthesia, operating room personnel, credentialing, and legal issues. More than 350 superb illustrations - with many in full color - complement and clarify the operative techniques. For every surgeon and resident performing gynecologic procedures, this is the definitive, most up-to-date text on gynecologic endoscopy.

Based on the current edition of the bestselling Gabbe's Obstetrics: Normal and Problem Pregnancies, this new study guide is a useful resource for self-assessment and increasing your understanding of major concepts in the field, as well as a practical review tool for exam preparation. Gabbe's Obstetrics Study Guide contains nearly 650 questions and answers that cover the information you need to know, in a format that mimics the board exam and prepares you for the next steps in your education and your career. Includes short-form and vignette-style questions to fully prepare you for what you'll see on exams, as well as rationales for correct and incorrect answers and interactive self-assessment online. Offers teaching points with each question to help you identify core concepts and ensure that you thoroughly understand the material. Features nearly 1,000 full-color photos, line drawings, ultrasound images, and tables drawn from the parent text. Provides links to the parent text so you can quickly access a full review of relevant concepts, plus up-to-date reference at the end of each chapter for further reading. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

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.

The state of health care isreflected by perinatal and neonatal morbidity and mortality as weIl as by the frequencies of long-term neurological and developmental disorders. Many factors, some without immediately recognizable significance to childbearing and many still unknown, undoubtedly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and survivinginfant iscritical. Confounding analysesofpregnancy outcome, especially these past 2 or 3 decades, are the effects of newly undertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced without serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures character ized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an increase in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dosage, occasionally resulted in kernicterus. Prophy lactic sulfonamide use had a similar end result. More recent is the observation of bronchopulmonary dysplasia as a complication of re spirator therapy for hyaline membrane disease. The decade of the eighties opened with the all-time highest rate of cesarean section in the United States.

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.

This book describes key knowledge concepts, skills and up-to-date algorithms pertaining to common emergencies that can take place in a pediatric office, including: seizures, anaphylaxis and shock, and diabetic ketoacidosis. The authors supported by peer review from top specialists in Pediatric Emergency Medicine at the Baylor College of Medicine offer the first comprehensive educational resource on pediatric office emergency preparedness devoted exclusively to the practicing primary care health care provider and his/her team. During emergencies, providers and their staff are called on to work efficiently as a "code-team" which is a source of considerable apprehension for many primary care pediatricians. This unique reference guide contains a wealth of information and resources in a compact and practical form. It presents the most important knowledge, skills, office resources and team interactions required by practitioners to successfully treat pediatric emergencies in the office.

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.

A dramatic and worldwide increase is occurring in the prevalence of overweight and obesity in women of childbearing age. Obese women carry a significant excess risk of a variety of serious complications during pregnancy, and in addition, maternal obesity predisposes to obesity in the offspring. This book provides a timely update on the latest knowledge on maternal obesity and pregnancy. A very wide range of issues are covered, including macrosomia and associated shoulder dystocia; the risk of miscarriage, malformations, and complications of pregnancy; the impact of hyperglycemia; clinical management; consequences for anesthesia and ultrasound; impacts on breastfeeding, fertility, and childhood obesity; and pregnancy following gastric surgery. All of the authors are recognized experts in their fields, and the book has been designed to meet the practical needs of obstetricians, gynecologists, internists, and general practitioners.

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."

The first of its kind, this book describes pediatric palliative care in more than 23 countries. Each region in the world is covered and countries included are both resource poor and rich. Authors are multidisciplinary and regarded nationally and internationally in their field. Clinicians, advocates, policymakers, funders, and researchers will learn how programs were developed and implemented in each country. Authors describe children for whom pediatric palliative care is needed and provided for in their country. When applicable, a brief history of pediatric palliative care is included noting especially policy changes and legislative acts. For example, the chapter on Poland describes how pediatric palliative care grew from the Catholic church into a national movement spearheaded by several health care workers. The Pole national spirit that brought them through a change in political regime has also been a driving force in the pediatric palliative care movement. The chapter on South Africa, for example, illustrates how a resource poor country has been able to leverage philanthropic and government funding tomake its dream of having an infrastructure of pediatric palliative care a reality. These are just a few examples of the inspiring stories that are included in this book. Readers from countries who wish to start a pediatric palliative care program, or advance an existing program, will learn valuable lessons from others who have faced similar barriers. Introduction and concluding chapters highlight the strengths and weaknesses of the modern pediatric palliative care movement."

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.