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."

This book covers in detail contemporary hypotheses and studies related to the immunology of implantation and provides a practical approach for the application of basic reproductive immunology research to pregnancy complications such as preeclampsia, pre-term labor and IUGR. Provides complete and up to date review of current knowledge of the role of the immune system during pregnancy and the interactions between the placenta and the maternal immune system.

These two volumes are unique in that they take into consideration the enormous progress made in the field over the last few years. Expert knowledge is given by Professor Runnebaum, whose department was appointed WHO Collaboration Center for Research in Human Reproduction. These extensively illustrated books provide detailed information on the function and detection of new hormones and growth factors, on therapy with female sexual hormones, on environmental factors, and on the diagnostic and surgical techniques employed in reproductive medicine. This English edition of a standard German reference has been expanded to include an appendix containing a comprehensive list of pharmaceutical agents used in hormone therapy, including international and trade names and compositions.

Novel Approaches into the Origins of Neurodevelopmental Disorders: The Fetal Physiology Foundation Over the past two decades, autism, a neurodevelopmental disorder that is defined by behavior and was once believed to be rare, became recognized in increasing numbers of children and recently received distinction as an "epidemic" [1]. While numbers of affected children have steadily increased, our knowledge is still ins- ficient to explain autism's diverse causes and broad range of presentations. Despite remarkable progress in research, available medical diagnostic testing applies only to a small minority of affected children. Thus, scientifically based explanations with which physicians can diagnose and treat the majority of children with autism and advise their parents are quite limited. Our society and scientific community were unprepared for the rise in autism, which explains our present inability to understand most of its causes. Researchers in neurodevelopmental disorders have long been aware of other disorders that, despite extensive efforts, have not yielded clear genetic or environmental origins, and autism has become symbolic of the need for new approaches to research into these complex conditions. Although autism has captured our attention in recent years, the prevalence of other neurodevelopmental disorders such as attention de- cit hyperactivity disorder (ADHD) and bipolar disorder, among others, also has been increasing [2-4].

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.

Care for Children Born Small for Gestational Age is a comprehensive handbook that serves to synthesize the extensive recent literature in the area to provide a practical resource aimed at a wide range of healthcare professionals, including obstetricians, midwives, neonatologists, and primary care physicians. This comprehensive handbook includes an in-depth survey of the prevention, diagnosis, treatment and long-term monitoring of children born small for gestational age, as well as related conditions such as intrauterine growth restriction, metabolic syndrome and type 2 diabetes. Additionally, the short and long-term psychiatric and social consequences of this condition are addressed.

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

A synopsis of the use of lasers in gynecology is presented in this book; it is supported by more than 10 years of experience and backed up by studies inthe fields of experimental surgery, technical medicine and clinical gynecology. The authors show how laser-assisted preparation hasbroadened the spectrum of operative possibilities in gynecology. Major points of attention are experimental surgery and basic research, details of application with respect to specific indications, and future potential. Furthermore, the clear definition of the possibilities and limitations of laser technology puts an end to the highly stylized view of a patent wonder divorced from general operative standards. Thereis no doubt that users of laser technology stand on the threshold of a promising development and yet, despite the present elegant applications, thefirst steps to maturity are only now being taken.

The study of prenatal development provides many clues for understanding the physiology as well as the pathogeny of malformations and many diseases. I became interested in the analysis of human development as a young medical student more than 30 years ago, and I have stayed in this field all my life. In my studies, I always tried to compare the events of different disciplines such as genetics, anatomy, bio chemistry and physiology. I learned that the development of a structure is, under normal circumstances, strictly determined and that the development of structures always precedes their proper function. There are no changes in function without changes in structure. The life of every cell is genetically preprogrammed and the program may be modified by complicated interactions with environment. Recent progress in our knowledge is basicly related to technology. However, using all the tools of today's technology, we are still unable to understand the basic normal development. After almost thirty years of work, I am trying to present a subjective review of the development of the human endocrine glands. I am presenting an image emerging from my experience. I personally studied several hundred human embryos using mostly anatomical, histochemical and some biochemical techniques. I found much additional information in the literature."

Designed for easy revision of the key points, key references, and key management stages, the two volumes in this set review the evidence for best practice, presenting the reader with the right information, in the right format, summarized in easy-to-use tables and algorithms. Each guideline is designed to "make it easy to do it right", with appropriate use of proven interventions. The quality of evidence available is graded so that a well-informed clinician can improve the health of mother and baby by providing quality care. *Offers an easy-to-assimilate guide to the key points in maternal-fetal and obstetric practice *Supplies an invaluable resource for those revising topics for professional or clinical requirements *Ensures providers of care can locate the best intervention quickly and confidently

This title includes a number of Open Access chapters. Nutrition is not only a basic need that all humans have to sustain life, but it is also critical to successful early development. This research compendium lends deeper insights into the links between nutrition and healthy brain function-and from the reverse perspective, between nutrition and neurocognitive disorders. This well-organized and accessible compendium offers a vital research context for policymakers, educators, medical providers, and families. It underlines our urgent responsibility to give children a strong start by improving prenatal and early childhood nutrition.

This book explores the broad view on child well-being and the quality of life research. It starts with a discussion of the origin of the social indicator movement and a review of literature on the concepts of quality of life, (subjective) well-being and resilience. It then discusses the force of culture on child development, and shows how two prototypical environments favor either the independent or interdependent self-model. After an exploration of the shifts and changes in the child well-being indicator movement and trends of child well-being measurements, the book turns to research on Tsunami-affected children. The first part of the study gives these children and their caregivers a voice, formulating in their words what constitutes child well-being for them in the given circumstances. The concepts provided are processed in detail, contrasted, and then made into indicators. The second part of the study describes the introduction of a child well-being index based on these indicators. The book ends with four main conclusions reflected in a theoretical model of contextualized child well-being indicators.

The mechanisms that initiate labour (i. e., the conversion of the quies cent uterus to an active and reactive organ at term) are poorly under stood. Of considerable importance are the factors that control preterm labour and preterm birth, with their devastating effects on society. This problem is the leading obstetrical issue. Preterm labour affects ap proximately 10% of all pregnant women (even higher numbers are re- Abb. I. The participants of the workshop VI Preface ported for less developed countries or where prenatal healthcare is a low priority) and it is the leading cause of morbidity and mortality of babies. Current practices to arrest preterm labour, once initiated, are in effective. In addition, procedures to stimulate labour and dilate the cer vix at term may not be used effectively. On October 19th - 21 st, 1992, a Schering Foundation Workshop took place in Berlin to discuss the "Basic Mechanisms Controlling Term and Preterm Labour." Leading scientists from Europe and North America were assembled to consider the fundamental systems which regulate the uterus and cervix during pregnancy. The topics in the sym posium ranged from key cellular events governing uterine contractility and cervical dilatation during labour to clinical advances and applica tions. This book contains the proceedings of the workshop. We were pleased to have been part of the workshop and to have been responsible for its organization."

It is in the surgical aspect of their specialty that the gynecologists' work may be most frequently judged by their peers or by the litigious society that currently exists. Great and commendable progress has been made over the past 30 years in the basic scientific, endocrinologic and obstetric aspects of the specialty, but this has occurred with a commen surate de-emphasis of surgical procedures and surgical training, a decline in devotion to technical detail and perfection, and a tendency to take surgery for granted. Obstetric and gynecologic residency programs provide increasing numbers of specialists with average competence in the performance of the common, rather standardized gynecologic operations. In general, technical skill in the extirpative operations can be acquired far more readily than proficiency in the art of reconstructive surgery. At present, for a number of reasons, gynecologic surgical training is most deficient in regard to the surgical correction of severe forms of obstetrically damaged genital tract supports. The operations for pro lapse defy standardization and require great technical individualization; this must be based on the surgeon's judgment developed through expe rience, a thorough understanding of normal pelvic anatomy, and recog nition of the deficiency responsible for the prolapse in individual cases.

Many women have to spend one third of their lives in a postmenopausal state and they should have a good quality of life during this period. Althoug HRT is well accepted as the logical treatment of climacteric problems, the prevalence rate is very low in some countries. The reasons for not accepting HRT are manifold and complex. The objective of this book is to describe the essential advances in basic and clinical research that forms the basis of current HRT and to give an overview of the efficacy and safety of HRT.

Sixteen British specialists pool their extensive knowledge of spontaneous abortion in one source. Their discussion is directly applicable to clinical situations and helps identify areas of debate and alternative methods.

The introduction of colposcopy and exfoliative cytology as a means of examining the cervix uteri has opened up the possibility of studying the preceding and early stages of invasive carcinoma of the cervix and has also brought to light a number of conditions which are possibly only indirectly related, if related at all, to cervical neo with histological evaluation it is possible to plasia. Using these methods combined gain some insight into the natural history of cervical carcinoma. The importance of this is not confined to the cervix for, in this respect, the cervical lesions may prove a paradigm for those of the bladder, stomach and elsewhere. At present the broad outline of the natural history of these cervical lesions is emerging but the temporal and spatial relationships of the various phases is unclear, largely because of the number of possibilities envisaged which involves more vari ables than can be controlled in anyone investigation. In this monograph we have endeavoured to indicate the limitations of the various approaches and to stress the need for controlling the accuracy of assessment whether it be histological, cytological or colposcopic."

The events of September 11,2001 in the United States will always be r~membered with horror and sadness but also admiration for those who risked, and often lost, their lives attempting to save others. When the Fifth International Germ Cell Tumour Conference began, the US air space was closed and our American friends were unable to join us. We were faced with a programme that now had many gaps. What happened next was an illustration of the sense of community that prevails at the Germ Cell Tumour Conferences. Some of those who could not be there in person, such as Richard Foster and Craig Nichols, sent their slides by email, and we were indebted to those, such as Michael Jewett, Ben Mead and Malcolm Mason, who stepped into the breach to present them. Others gave impromptu, and often thought provoking, talks. The discussion periods were lively and it will come as no surprise to those who regularly attend the meeting that Tim Oliver won the prize for "Most Questions Asked", managing even to ask questions following his own presentations. The quality of the talks was outstanding. There was closer integration of the adult and paediatric sessions than in previous meetings. As a result, the differences and similarities between adult male, female and paediatric germ cell tumours became more apparent. This cross-fertilization of ideas from different groups will no doubt lead to further advances. As a result of all these efforts, the conference was a great success.

This book is a collection of preclinical and clinical reports on the appli cation of gene therapy to human disease. The focus of these studies is on cancer and cardiovascular disease. There are two fundamental technologies for delivering therapeutic genes to diseased ceHs: either viral vectors, as discussed by Dr. Bal main, or non-viral vector systems, as discussed by Dr. Felgner. The strengths and limitations of each of these delivery systems are charac terized. The use of a therapeutic gene to treat a disease has taken two general approaches. The first is to introduce anormal (i. e., wild type) gene into the patient that will restore normal gene function. Dr. Weiss man has characterized the tumor suppressor gene (pS3), and has shown that it can restore normal ceH function in cancer cells. The second ap proach is to treat the disease with antisense molecules. Abnormal gene expression can be down-regulated and selectively inhibited by anti sense molecules, which can reverse the pathologie process in cancer cells. Dr. Gewirtz has demonstrated this with anti sense genes on leuke mia, while Dr. Scanlon has applied this principle using ribozymes in human carcinomas. During this symposium, Dr. Engler described clinical studies of gene therapy using growth factors to stimulate new blood vessels in patients with cardiovascular disease. Several gene therapy strategies were used for cancer: overcoming drug resistance by Dr. Bertino, a pro-drug strategy with ganciclovir by Dr."

Professor Egon Diczfalusy, a pioneer in gynaecological endocrinology and in particular female contraception, celebrated his 80th birthday with a scientific symposium. The participants were scientists from all over the world who had been scholars and close collaborators at different points in time. The interdisciplinary meeting consisted of lectures on the epidemiological impacts of ageing, its challenge for the pharmaceutical industry, philosophical aspects of the future of mankind, and the history and future of contraception. Three round table discussions addressed the hormonal control of reproduction and ageing, new approaches and future perspectives of contraception for women and men, and hormone replacement in the elderly.

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 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.