The sixth edition of Ellestad's classic text on cardiac stress testing has been extensively updated and re-written to communicate contemporary understanding of the classical principles of stress testing to clinicians and researchers, students and seasoned practitioners alike. The current techniques for performing stress tests presented herein reflect major technologic advances in imaging, physiologic monitoring and the assessment of cardiovascular risk, addressing fundamental paradigm shifts in interventional, surgical and medical treatment of heart disease. Moreover, the text addresses the dramatic changes that are occurring in patient demographics and the environmental, socioeconomic, gender and genomic factors that crucially impact heart disease and warrant attention when performing cardiac stress testing. Chapters on the physiology of exercise testing including practical details regarding protocols for conducting the stress test, proper supervision, important parameters to be monitored, and the diagnostic and prognostic information to be gleaned from the electrocardiogram set the stage for expanded chapters on the use of cardiac imaging in conjunction with stress testing. Physiologic and metabolic considerations during stress testing are covered in detail. Application of stress testing to special populations, such as women, children, athletes, and individuals in both high and low risk groups are covered in new chapters. Finally, the authors address the use of stress testing in limited resource environments and discuss global changes in the incidence of atherosclerosis, and suggest how stress testing may evolve.

The accurate and reliable diagnosis of transmissible diseases is the most powerful weapon available to ensure their control, and in some cases eradication. The detection of parasites in clinical cases, companion and farm animals, and in the environment is relatively easy since many of them are visible to the naked eye, and those that are not are readily detected by light microscopy. Fungal infections can similarly be determined. Bacteria are somewhat harder to detect. Although their presence can frequently be detected by light microscopy, differential diagnosis, beyond their gross morphology, is almost always impossible. However, most bacterial pathogens can be cultured in the laboratory and can be accurately identified by combinations of a series of simple tests such as morphology, staining, antibiotic sensitivity, biochemical analyses, nutrient dependence, and phage sensitivity. Viruses, however, have proved much more difficult; their size and absolute dependence of the host cell for propagation have rendered useless the methods traditionally used for other microorganisms. Until the development of tissue culture in the middle of this century, diagnosis was entirely dependent on the skill and experience of the clinician. But this was an unreliable process since many of the common virus infections exhibit similar clinical symptoms, such as coryza, exanthema, vomiting, diarrhea, neuralgia, and lethargy. Indeed many viral infections display clinical signs that are indistinguishable from bacterial or parasitic infections.

100 Diagnostic Challenges in Clinical Medicine is composed of one hundred well-illustrated clinical scenarios and their appropriate investigations. A wide variety of specialties are covered including cardiology, neurology, dermatology, endocrinology, tropical medicine, haematology, metabolic medicine, radiology, ophthalmology, venereology, and infectious diseases. Presenting the relevant investigations corresponding to each case in an interesting and easy-to-read Q&A format concerning diagnosis and management, this book serves as an ideal, and hopefully enjoyable, study aid for medical students and junior doctors who are preparing for clinical examinations in medicine. By solving the problems proposed by these challenging clinical cases, the reader will gain additional practice in diagnosis and treatment strategies.

This book describes the latest methods of oncological and hematological diagnostics such as immunological, molecular genetic and histological essays. All methods are described in principle in their different variations and compared in their effectiveness and cost. At the end of each chapter a detailed description of the "how-to-do" is given. The book is written for scientists, clinicians and personnel from research laboratories, specialised laboratories and routine diagnostic laboratories in hospitals. It satisfies the increased demand for information on new methods in hematology and oncology.

Objective Biometric Methods for the Diagnosis and Treatment of Nervous System Disorders provides a new and unifying methodological framework, introducing new objective biometrics to characterize patterns of sensory motor control underlying symptoms. Its goal is to radically transform the ways in which disorders of the nervous system are currently diagnosed, tracked, researched and treated. This book introduces new ways to bring the laboratory to the clinical setting, to schools and to settings of occupational and physical therapy. Ready-to-use, graphic user interfaces are introduced to provide outcome measures from wearable sensors that automatically assess in near real time the effectiveness of interventions. Lastly, examples of how the new framework has been effectively utilized in the context of clinical trials are provided.

This is a guide for psychiatry residents, medical students, and trainees in clinical psychology, social work and nursing. Druss examines the challenges and rewards of establishing a work alliance with patients and demonstrates how therapy can provide a safe means for them to handle their experiences. Chapter topics include: creating a working alliance, initial sessions, conversation reactions, body image, the spiritual life of patients, the goals of patients and therapists, and patients who return to therapy.

There are numerous advantages to using Bayesian methods in diagnostic medicine, which is why they are employed more and more today in clinical studies. Exploring Bayesian statistics at an introductory level, Bayesian Biostatistics and Diagnostic Medicine illustrates how to apply these methods to solve important problems in medicine and biology. After focusing on the wide range of areas where diagnostic medicine is used, the book introduces Bayesian statistics and the estimation of accuracy by sensitivity, specificity, and positive and negative predictive values for ordinal and continuous diagnostic measurements. The author then discusses patient covariate information and the statistical methods for estimating the agreement among observers. The book also explains the protocol review process for cancer clinical trials, how tumor responses are categorized, how to use WHO and RECIST criteria, and how Bayesian sequential methods are employed to monitor trials and estimate sample sizes. With many tables and figures, this book enables readers to conduct a Bayesian analysis for a large variety of interesting and practical biomedical problems.

The "information explosion" in recent decades has made it impossible for practicing physicians (even specialists) to keep up with all the information potentially at their disposal. As a result, it is not surprising that empirical studies have shown that physicians do not always make optimal decisions. Thus, medical expert systems are now available to support - not replace - physicians and healthcare providers in their goal of providing the best possible healthcare to every patient. Knowledge Engineering in Health Informatics is a guide to the creation of such systems. Presenting the core material for courses such as Medical Knowledge Engineering and Expert System Development, it allows non-experts to make diagnostic decisions with the precision and accuracy of medical experts thanks to the help of the computer.

This unique reference provides a pragmatic approach to the development of successful commercial immunodiagnostic products based on enzyme immunoassay technology. Presenting both basic and applied principles, Enzyme Immunoassays gathers information on all aspects of this process, from the initial conceptualization to the introduction of the product to the market. Skillfully organized into two parts, this comprehensive resource begins by discussing basic concepts, such as the classification, structure and function of antibodies and the properties and characteristics of the most widely used enzymes in immunoassays. The second section examines the industrial product development process, including a detailed outline of various protocols and points to be considered for designing a successful product. Described in this section are the various formats available for product development, reagent formatting and assay development, data processing, standardization, scale up, and commercial manufacture of the product. Also included are the various regulatory requirements, the importance of good laboratory and manufacturing (GLP and GMP) practices, and international requirements such as the ISO 9000 certification process. Finally, information is presented for the benefit of entrepreneurs who would like to venture into this exciting field with their own company. With over 75 illustrations and 40 tables, Enzyme Immunoassays is an incomparable reference for scientists, technologists, and analytical chemists working in the field of immunodiagnostics at all levels, as well as for upper-level undergraduate and graduate students in life sciences fields in order to understand the basic concepts and principlesinvolved in developing rapid assay techniques.

There are certain phenomena, such as hypnosis, hysteria, multiple personality disorder, recovered memory syndrome, claims of satanic ritual abuse, alien abduction syndrome, and culture-specific disorders that, although common, are difficult to explain completely. The purpose of this volume is to apply a model of social relations to these phenomena in order to provide a different explanation for them. Wenegrat argues that they are socially-constructed illness roles or purposive behavior patterns into which patients fall while receiving either unintentional or intentional cues during interactions with caretakers and authority figures. The application of the social-relations model raises some important, yet previously overlooked, questions about these phenomena, illustrates some important aspects of human nature and consciousness, places illness behaviors in their larger, cultural context, and shows the way to a new and different view of mental life.

Widely accepted as the most reliable medical reference on impairment evaluation since its inception in 1971, the Guides is highly valued by physicians who use its authoritative chapters to determine how to assess for impairment. The new edition of the Guides continues to build from this legacy by focusing on physician interrater reliability through an updated consensus approach that considers the latest evidence and patient function. The result is a new standard that seeks to evaluate impairment using a series of uniform grids for each chapter. Covering every body system, Guides Sixth Edition provides a standardized approach to determine impairment assessment using patient history, physical examination and clinical tests. Uniformity and ease of use is stressed to provide a consistent rating for conditions in each of the body systems using evidence based methodologies and, when lacking, a consensus approach. The Guides was developed with open deliberations from participating national medical specialty societies and state medical associations. An oversight advisory panel was established to broaden fuller participation of stakeholders. An Editorial Panel was created to review past editions and make recommendations and oversee the development of the Sixth Edition. An expansive stakeholder review was implemented to ensure consensus based content and expert medical review.

GERD: A New Understanding of Pathology, Pathophysiology, and Treatment transforms the assessment of gastroesophageal reflux disease (GERD) from its present state, which is largely dependent on clinical definition and management, to a more objective scientific basis that depends on pathologic assessment. Sequential chapters in this single-author book describe the fetal development of the esophagus, the normal adult state, and the way exposure to gastric juice causes epithelial and lower esophageal sphincter damage at a cellular level. It allows recognition of the pathologic manifestations of lower esophageal sphincter damage and develops new histopathologic criteria for quantitating such damage. This understanding provides new pathologic criteria for definition and diagnosis of GERD from its earliest cellular stage. Algorithms based on measurement of sphincter damage can identify, even before the onset of clinical GERD, persons who will never develop GERD during life, those who develop GERD but remain with mild and easily controlled disease, and those who will progress to severe GERD with failure to control symptoms, Barrett esophagus and adenocarcinoma. Aggressive early intervention in the last group with the objective of preventing disease progression to its end points of uncontrolled symptoms and adenocarcinoma becomes feasible.

Endocrine Biomarkers: Clinical Aspects and Laboratory Determination covers all the pre-analytical variables that can affect test results, both in the clinic and laboratory. Biomarkers of endocrine and bone diseases are discussed from both clinical and laboratory perspectives, and the authors elaborate on the teamwork-based app+roach between the clinician and the laboratory professional in the diagnosis and management of endocrine and bone disorders. Discussions include test utilization, laboratory measurement methods, harmonization and standardization, interpretation of results, and reference intervals. Each chapter ends with a discussion of one or two relevant cases with shared opinions from both a clinician and a clinical chemist. Each chapter also includes a summary box outlining key points and common pitfalls in the use of specific disease biomarkers and tests.

This book highlights all aspects of laboratory informatics, with a focus on information management and the corresponding hardware and technical processes involved. In addition to a comprehensive introduction on laboratory informatics, the book emphasizes the importance of information and resource management as opposed to simply covering the role of computers that support the information system. As a Professor of Pathology and the Director of Laboratory Information Services at the University of Texas Medical Branch at Galveston, Dr. Cowan has witnessed the shift in focus in the laboratory from the information generation to information management, and increasing resource limitations demand a higher level of management precision than can be gained from manual methods. The American Board of Pathology now requires an increasing sophistication in information management from candidates for certification. Thus, this book is intended for pathologists and residents in pathology, clinical laboratory scientists, and laboratory and information managers. Following the broad-based introduction on laboratory informatics, the book's topics include: computer basics; development and validation of the laboratory information system; computer networks; security and confidentiality on computer systems and networks; total cost of ownership; essential software; interfaces; process modeling; artificial intelligence and expert systems; bar coding in the laboratory; image analysis and computer-assisted quantitation; and telepathology.

Atlas of Human Body: Central Nervous System and Vascularization is a multidisciplinary approach to the technical coverage of anatomical structures and relationships. It contains surface and 3D dissection images, native and colored cross sectional views made in different planes, MRI comparisons, demonstrations of cranial nerve origins, distribution of blood vessels by dissection, and systematic presentation of arterial distribution from the precapillary level, using the methyl metacrylate injection and subsequent tissue digestion method. Included throughout are late prenatal (fetal) and early postnatal images to contribute to a better understanding of structure/relationship specificity of differentiation at various developmental intervals (conduits, organs, somatic, or branchial derivatives). Each chapter features clinical correlations providing a unique perspective of side-by side comparisons of dissection images, magnetic resonance imaging and computed tomography. Created after many years of professional and scientific cooperation between the authors and their parent institutions, this important resource will serve researchers, students, and doctors in their professional work.

The aim of this book is to provide a comprehensive and practical guide for developing and implementing an Objective Structured Clinical Examination (OSCE) for the medical educators/health sciences educators/tutors/faculty/clinicians/OSCE planners, who are involved in clinical teaching and assessment of students, trainees and residents. The book starts with the essential theoretical foundation before progressing to the practical implementation steps. It contains a good balance of medical education research and practical tips to provide readers an easy to digest, yet comprehensive, guide for the implementation of OSCE as an appropriate assessment tool.

The aim of this book is to provide a comprehensive and practical guide for developing and implementing an Objective Structured Clinical Examination (OSCE) for the medical educators/health sciences educators/tutors/faculty/clinicians/OSCE planners, who are involved in clinical teaching and assessment of students, trainees and residents. The book starts with the essential theoretical foundation before progressing to the practical implementation steps. It contains a good balance of medical education research and practical tips to provide readers an easy to digest, yet comprehensive, guide for the implementation of OSCE as an appropriate assessment tool.

Coding and Documentation Compliance for the ICD and DSM provides professionals, professors, and students with a logical and practical way of understanding a difficult topic in healthcare for the clinician: coding. Established professionals will find the tools they need to comply with the ICD series, HIPAA, and integrated care models. Professors and students will appreciate having a systemized, standardized approach to teaching and learning the more complex aspects of ICD compliance. The interplay between the ICD and DSM manuals is also explicated in clear terms.

This is a new edition of a well-established textbook covering the diagnosis and management of disease symptoms frequently encountered in practice and how to establish whether referral to a medical practitioner is necessary. The sixth edition has been thoroughly revised with updated advice and also features the current most updated products available in the market.

Coding and Documentation Compliance for the ICD and DSM provides professionals, professors, and students with a logical and practical way of understanding a difficult topic in healthcare for the clinician: coding. Established professionals will find the tools they need to comply with the ICD series, HIPAA, and integrated care models. Professors and students will appreciate having a systemized, standardized approach to teaching and learning the more complex aspects of ICD compliance. The interplay between the ICD and DSM manuals is also explicated in clear terms.

To advance the epidemiological analysis of social inequalities in health, and of the ways in which population distributions of disease, disability, and death reflect embodied expressions of social inequality, this volume draws on articles published in the "International Journal of Health Services" between 1990 and 2000. Framed by ecosocial theory, it employs ecosocial constructs of "embodiment"; "pathways of embodiment"; "cumulative interplay of exposure, susceptibility, and resistance across the lifecourse"; and "accountability and agency" to address the question; and who and what drives current and changing patterns of social inequalities in health.

Dr. Sharon Norling, a medical doctor authority, tells the untold medical truths. "Your Doctor is Wron"g is a survival guide if you have been dismissed, misdiagnosed, or your symptoms have just been treated like the tip of the iceberg with pharmaceutical drugs. Dr. Norling's book may be seen as controversial because some people will not like what she has to say. They will find it hard to believe until they see all of the facts as Dr. Norling presents them. Her thought provoking evidence challenges our traditional thinking about 'right and wrong' choices in maintaining a healthy lifestyle. Everyone will benefit from "Your Doctor is Wrong."
"Your Doctor is Wrong" is filled with patients' stories, life saving information, and is documented with medical journal citations. It is also tainted with humor. If you are still suffering after years of medical care and pharmaceutical drugs, "Your Doctor is Wrong" will help you to get your life on the healthy track. Read "Your Doctor is Wrong" if your symptoms of fatigue, insomnia, anxiety, depression, allergies, joint pain, lack of motivation, headaches, hormonal imbalances and intestinal issues are just not going away. When you read "Your Doctor is Wrong" you will find the facts. Your will find the answers. You will find the hope.

Dr. Kaye and Dr. Dhor have assembled top experts to write about facility planning and management in Part I of their two issues devoted to Infection Prevention and Control in Healthcare. Articles in this issue are devoted to: Building a Successful Infection Control Program: Key Components, Processes and Economics; Hand Hygiene Sterilization; High Level Disinfection and Environmental Cleaning; Environement of Care; Infection Control in Alternative Healthcare Settings (Long Term Care and Ambulatory); Antibiotic Stewardship; Outbreak Investigations Water Safety in Healthcare/Legionella in the Healthcare Setting; Construction and Renovation; Bloodborne and Body Fluid Exposures - prevention and management of Occupational Health Issues; and Informatics and Statistics in Infection Control. Part II is devoted to clinical management of infections.

Genetic Diagnosis of Endocrine Disorders, Second Edition provides users with a comprehensive reference that is organized by endocrine grouping (i.e., thyroid, pancreas, parathyroid, pituitary, adrenal, and reproductive and bone), discussing the genetic and molecular basis for the diagnosis of various disorders. The book emphasizes the practical nature of diagnosing a disease, including which tests should be done for the diagnosis of diabetes mellitus in adults and children, which genes should be evaluated for subjects with congenital hypothyroidism, which genetic tests should be ordered in obese patients or for those with parathyroid carcinoma, and the rationale behind testing for multiple endocrine neoplasias.

This book presents an authoritative overview of the emerging field of person-centered psychiatry. This perspective, articulating science and humanism, arose within the World Psychiatric Association and aims to shift the focus of psychiatry from organ and disease to the whole person within their individual context. It is part of a broader person-centered perspective in medicine that is being advanced by the International College of Person-Centered Medicine through the annual Geneva Conferences held since 2008 in collaboration with the World Medical Association, the World Health Organization, the International Council of Nurses, the International Federation of Social Workers, and the International Alliance of Patients' Organizations, among 30 other international health institutions. In this book, experts in the field cover all aspects of person-centered psychiatry, the conceptual keystones of which include ethical commitment; a holistic approach; a relationship focus; cultural sensitivity; individualized care; establishment of common ground among clinicians, patients, and families for joint diagnostic understanding and shared clinical decision-making; people-centered organization of services; and person-centered health education and research.