The polymerase chain reaction (PCR) is one of the most important molecular biological methods ever devised, with numerous applications to cli- cal molecular medicine. Since its description in 1985, PCR has undergone tremendous improvements, and many variations on the basic PCR theme have been published. With such a large volume of PCR-related literature, a clinical scientist wishing to use the technique will have a difficult task loc- ing the relevant information to implement it effectively. There is thus clearly a need for an up-to-date volume with detailed protocols to facilitate the setting up of those techniques most relevant to clinical applications. Unlike some other books on this topic, Clinical Applications of PCR includes only methods that are of direct relevance in clinical settings. The book is organized in three parts: an introductory section, a section on general methodology, and a final section with specific clinical applications. The first section covers the basic principles of PCR and is most useful to those new to molecular diagnosis. The next chapter includes useful tips for setting up a PCR laboratory. Section 2 then outlines some of the most commonly used PCR-based techniques in molecular diagnosis. Section 3 includes carefully chosen examples that represent typical applications of PCR in diverse clinical fields, encompassing hematology, oncology, genetics, and microbiology.

Preventing Misdiagnosis of Women is a crucial resource for all therapists who treat women. Not only will the information further the well-being of women clients, but it could literally save lives. Interesting, readable, and well-organized, this book belongs on the shelf next to the DSM-IV. The case examples will grip the reader whether professional or lay audience. --Natalie Porter, Ph.D., California School of Professional Psychology "I am greatly impressed with the book. It is a brand new idea, one that is long overdue." --Hannah Lerman, Ph.D., Clinical Psychologist, Los Angeles Some clients don't respond to a therapist's chosen treatment for a specific mental disorder. Could there be a physical disorder that is causing psychiatric symptoms? How can a therapist distinguish between similar psychiatric and physical disorders to arrive at the correct diagnosis, refer on, and/or suggest appropriate treatment? Preventing Misdiagnosis of Women gives the therapist the foundation for identifying those physiological disorders that may be at the root of the mental problems presented by women clients. Hyperthyroidism, for example, can result in depression and anxiety, and temporal lobe epilepsy can manifest itself with the same symptoms as bipolar disorder. This special guidebook sorts out potential mix-ups by providing detailed cases and illustrations, a quick reference table for checking symptoms, and a glossary. Making technical information clear and concise, the authors cover endocrinological--including thyroid, adrenal, pituitary, and parathyroid systems--and brain seizure problems as well as other diseases--such as multiple sclerosis, mitral heart valve prolapse, and lupus erythematosus. They offer a basic overview of the systems and organs involved and focus on how particular malfunctions can result in serious behavioral problems. A guide to providing the best and most effective care to women clients, Preventing Misdiagnosis of Women presents important information about assessment and interfacing with medical professionals. All mental health and helping professionals will find this book invaluable, as will students in clinical/counseling psychology, health psychology, social work, and gender studies. "This book is informative and interesting to read. This is a text that can be read more than once and be that much more helpful in subsequent readings. . . . Preventing Misdiagnosis of Women will certainly have an impact on feminist assessment, theory, and therapy. In a broader context, it provides a foundation to spawn research hypotheses on women's health and to reconnect the mind and body. Written accessibly even for reader without a background in physiological psychology, it fills a gap in the clinical and counseling literature. This text has far-reaching implications about the origin of psychiatric symptoms and possibly for explaining some differential rates in sex ratios for prevalence of certain psychologically based clinical syndromes. I found the text a humbling reminder of how easy it can be to miss the obvious and how easy it can be to attribute psychological explanations to symptom clusters one doesn't understand. This book could easily become a 'required' text for graduate students in mental health professions and mental health professionals. . . . This text will undoubtedly have an impact." --Maria P. P. Root, Ph.D., University of Washington "Preventing Misdiagnosis of Women is very good and will make an important contribution to the field. . . . The book's message--that it is critical that differential diagnosis include consideration of both psychiatric disorders--is convincing and important to emphasize to students in graduate programs." --Helene Jackson, Ph.D., The Columbia University School of Social Work

Transcranial Doppler (TCD) ultrasound, first introduced more than a decade ago, has steadily evolved into a dynamic, reliable, reproducible, and practical diagnostic tool. Clinical neuroscientists have found TCD to be an indispensable technique in the management of many types of patients. This book is designed to provide basic instruction in the perfor mance and interpretation of transcranial Doppler ultrasonography for technologists, nurses, and physicians. The information included in the text is critical for the development of a strong knowledge base. It is not intended to be all inclusive, and the TCD novice is likely to use it as the platform upon which to build his/her experience in the application of TCD. This book is organized as a step-guided approach for the performance of TCD, and it includes specific guidelines for interpretation of the TCD save forms. We hope that the reader finds it useful during what we think is the most difficult phase of this technique-the learning curve. John P. McCartney, R.V.T. Kathleen M. Thomas-Lukes, R.N., M.N."

There is now increasing awareness by the general public in European countries that prostate cancer is a serious threat to health, and this has created higher expectations for improved and more effective methods for detecting and treating the disease. However, urologists are very conscious of the limitations of the diagnostic methods that are available and are even more concerned about the apparent lack of therapeutic advances made during the past 50 years since Huggins discovered the fundamental principles of endocrine treatment for is theo prostate cancer. Recent efforts to detect the disease when it retically "curable" have been successful, certainly in the USA, but this has highlighted our uncertainty about the best treatment for early stage prostate cancer, and there is no doubt that radical pro statectomy is sometimes carried out on men who may not be threa tened by their illness. While it is generally accepted that many men with prostate cancer will die of old age rather than this malignancy, it cannot be ignored that this disease kills many others in a process that is frequently lingering, miserable, and humiliating, not only for the victim but also his family. There are many important issues about prostate cancer that remain unclear at the present time, some of which are addressed by the reviews in this book. The debate about early detection and screening can arouse considerable heat in otherwise placid urological mee tings."

M. K. Gospodarowicz, P. Hermanek, and D. E. Henson Attention to innovations in cancer treatment has tended to eclipse the importance of prognostic assessment. However, the recognition that prognostic factors often have a greater impact on outcome than available therapies and the proliferation of biochemical, molecular, and genetic markers have resulted in renewed interest in this field. The outcome in patients with cancer is determined by a combination of numerous factors. Presently, the most widely recognized are the extent of disease, histologic type of tumor, and treatment. It has been known for some time that additional factors also influence outcome. These include histologic grade, lymphatic or vascular invasion, mitotic index, performance status, symptoms, and most recently genetic and biochemical markers. It is the aim of this volume to compile those prognostic factors that have emerged as important determinants of outcome for tumors at various sites. This compilation represents the first phase of a more extensive process to integrate all prognostic factors in cancer to further enhance the prediction of outcome following treatment. Certain issues surround ing the assessment and reporting of prognostic factors are also considered. Importance of Prognostic Factors Prognostic factors in cancer often have an immense influence on outcome, while treatment often has a much weaker effect. For example, the influence of the presence of lymph node involvement on survival of patients with metastatic breast cancer is much greater than the effect of adjuvant treatment with tamoxifen in the same group of patients 5]."

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Written by world-renowned experts, this book addresses immunological and molecular methodologies of diagnosis as well as clinical aspects of diseases. It book discusses DNA and RNA amplification methods, explains ELISA approaches, and introduces rapid diagnosis techniques, biosensors, and flow cytometry. The book examines bacterial and parasitic infections, including M. tuberculosis, Borrelia burgdorferi, Streptococcus pyogenes, chlamydia and schistosomes, and describe viral infections such as hantaviruses, hepatitis C., cytomegalovirus, herpes virus, and HIV. It also covers syndromes with infections origins, including prions, chronic fatigue syndrome, and superantigens, and much more.

Alzheimers Disease (AD), the most frequent cause of mental decline in the elderly represents one of the major health problems facing modern society. Despite considerable progress in the clinical diagnosis, epidemiology, structural basis, biochemistry, molecular genetics, and pharmacological aspects of AD, its etiology, molecular backgrounds, and treatment challenges are still poorly understood. This volume based on the 2nd International Symposium of EBEWE Research Initiative in October 1993 in Salzburg, Austria, is conceived as a review of our current knowledge of morphology, diagnostic clinical and imaging techniques, methodological approaches of cognitive assessment, trial designs, outcome variables and possibilities of therapy of AD and other neurodegenerative disorders. The books coverage is broad and it should be of interest for investigators, clinicians, and researchers involved in the problems of AD."

Taking an interdisciplinary approach that emphasizes the adaptability of immunochemical and related bioanalytical methods to a variety of matrices, Immunoassay and Other Bioanalytical Techniques describes the strength and the versatility of these methods in a wide range of environmental and biological measurement applications. With contributions from leading authors drawn from varied disciplines in academia, industry, and government institutions, the book discusses the evolution of the technology and explores the wide spectrum of chemicalimmuno methods available, including multiplexed immunoassays. It presents standard and innovative applications of immunochemical and related methods, such as microarrays and sensors, examines quality assurance guidelines, and offers insight into recently developed products and procedures. Meeting the continuing and pressing need for economical analytical methods that can detect trace levels of hazardous compounds in complex environmental and biological media, this text reviews breakthrough research, including the impact of nanotechnology. It describes the strength and versatility of immunochemical and related bioanalytical methods while highlighting other areas of applied bioanalytical methods. The book provides both a basic understanding of the field and an update on important technological advances such as new platforms and detection systems. It demonstrates how significant time and cost savings can be achieved for studies requiring repetitive analysis or having high sample loads.

This volume contains the proceedings of the thirteenth biennial International Conference on Information Processing in Medical Imaging (IPMI XIII), held on the campus of Northern Arizona University in Flagstaff, Arizona, in June 1993. This conference was the latest in a series of meetings where new developments in the acquisition, analysis and utilization of medical images are presented, discussed, dissected, and extended. Today IPMI is widely recognized as a preeminent international forum for presentation of cutting-edge research in medical imaging and imageanalysis. The volume contains the text of the papers presented orally atIPMI XIII. Over 100 manuscripts were submitted and critically reviewed, of which 35 were selected for presentation. In this volume they are arranged into nine categories: shape description with deformable models, abstractshape description, knowledge-based systems, neural networks, novel imaging methods, tomographic reconstruction, image sequences, statistical pattern recognition, and image quality.

When John Thompson and I first began talking about finding a way to measure and cost the output of hospitals in the 1960s. we really had no concept of the need for this kind of result. In fact. if we had listened to others in the health services research community. we would rrever have begun or persisted in the task. But it seemed important to us to begin to understand what up until then seemed unexplainable - the rather strange cost behavior of hospitals. We had the benefit of Professor Martin Feld stein's observation that case-mix was certainly an important factor. but we had literally no guidance on how to make some sense out of the very large number of illnesses that beset the human race. and the very large number of different processes that obtain in our hospitals as they attempt to cope with those illnesses. We were fortunate to find a small number of curious and capable graduate students to join us in this effort. for without them we would not have had a chance of success. While many contrib uted to the ultimate outcome. it is important to single out Ronald E. Mills. Richard F. Averill. Youngsoo Shin. and Jean L. Freeman for their efforts over many years. The diagnosis-related groups (DRGs) constitute a way of identifying the normal output of hospitals in a consistent and exhaustive manner."

Present and potential future applications of new diagnostic strategies basedon the direct or indirect detection of cancer genes are delineated in this volume. Among the methodological aspects covered are enzymatic target amplification by the polymerase chain reaction and related techniques, DNA fingerprinting, transfer of putative cancer genes in appropriate receipient cells, and recent developments inthe application of monoclonal antibodies in immunohistochemistry and immunoscintigraphy. The diagnostic and functional implications of mutations in cancer genes such as ras and p53 are described. The characterization of cancer genes and their products is correlated with growth control anddissemination of tumour cells by in vitro or clinical evidence. The contributions in the present volume uptdate the information available on established or newly described cancer genes, and may help manage the transition from basic research to clinical practice.

Carpenito's best-selling, Handbook of Nursing Diagnosis, now in an impressive sixteenth edition, is the ideal quick reference for nursing diagnosis information. This handbook offers practical guidance on nursing diagnoses and associated care. The quick-reference type scope of content, makes it easy for students to use while in clinical, in the classroom or simulation lab. From goals to specific interventions, Handbook of Nursing Diagnosis focuses on nursing. It provides a condensed, organized outline of clinical nursing practice designed to communicate creative clinical nursing. It is not meant to replace nursing textbooks, but rather to provide nurses who work in a variety of settings with the information they need without requiring a time-consuming review of the literature. It will assist students in transferring their theoretical knowledge to clinical practice. This is a must-have reference that nursing students will use throughout their curriculum and into their professional career.

Biochemical monitoring of the fetus has been in the back of every perinatologist's mind. Technological advancements have been made in the last ten years but not to the expected level. A continued interest in the subject can only be maintained by symposiums of this nature where perinatologists from different countries can share their experience. Laserspectroscopy of the fetus is a valuable addition to this volume. The future of biochemical monitoring of the intrapartum fetus depends on the continued collection of scientific data and further technological advances. This successful symposium was held in October, 1990, in Albuquerque, New Mexico, USA. I would like to thank Hewlett Packard for their generous support without which this publication would not have been possible. My sincere thanks goes to my secretary, Nancy Whalen, who has done a tremendous job with the word processing, organization, and layout of the chapters. Molly S. Chatterjee, M. D. Associate Professor University of New Mexico Department of Obstetrics & Gynecology CLINICAL IMPORTANCE OF BIOCHEMICAL MONITORING OF THE FETUS DURING LABOR WITH DEMONSTRATION OF TYPICAL CASES E. SALING, J. BARTNICKI Institute of Perinatal Medicine, Free University of Berlin, Berlin, Germany The biochemical monitoring of the fetus during labor is historically the oldest part of prenatal medicine. The very first direct approach to the human fetus took place on June 21, 1960 when the first blood samples were taken from the fetal scalp in our labor room (3).

Early detection of cancer has been recognized as an important area of preventive medicine for quite some time. In a few sites, such as the cervix, the breast, and the skin, it has been shown beyond doubt that early detection and secondary prevention of cancer are realistic goals. However, the general success of this approach is limited and re- quires substantial additional effort in research and public health education. The present volume is based on an International Symposium on Cancer Diagnosis - Early Detection, which was organized by the Committee Coordinating Cancer Research in GroBforschungsein- richtungen of the Federal Republic of Germany. The meeting was held at the German Cancer Research Center in Heidelberg, June 3-15, 1991. I am grateful to all members of the Scientific Committee who gave valuable advice in preparing the program of the conference: Gunther Bastert (Heidelberg), John Collins (Braunschweig), Heinz Hofler (MunichINeuherberg), Ernst Jung (Mannheim), Gerhard van Kaick (Heidelberg), Stefan Meuer (Heidelberg), Michael Wannenmacher (Heidelberg), and Wolfgang Wilmanns (Munich/ Neuherberg). I am obliged to Volker Diehl (Cologne), Gunther Bastert (Heidelberg), Hans K. Miiller-Hermelink (Wiirzburg), Manfred Schwab (Heidelberg), and Georg Dhom (Homburg/Saar) for serving as chairmen of the sessions. I am also grateful to Horst Metzler and the administration of the German Cancer Research Center for all their efforts to guarantee a smooth running of the Conference.

The Structured Clinical Interview for DSM-5 -Clinician Version (SCID-5-CV) guides the clinician step-by-step through the DSM-5 diagnostic process. Interview questions are provided conveniently along each corresponding DSM-5 criterion, which aids in rating each as either present or absent. The SCID-5-CV is an abridged and reformatted version of the Research Version of the SCID, the structured diagnostic interview most widely used by researchers for making DSM diagnoses for the past 30 years. A unique and valuable tool, the SCID-5-CV covers the DSM-5 diagnoses most commonly seen in clinical settings: depressive and bipolar disorders; schizophrenia spectrum and other psychotic disorders; substance use disorders; anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder); obsessive-compulsive disorder; posttraumatic stress disorder; attention-deficit/hyperactivity disorder; and adjustment disorder. It also screens for 17 additional DSM-5 disorders. Versatile in function, the SCID-5-CV can be used in a variety of ways. For example, it can ensure that all of the major DSM-5 diagnoses are systematically evaluated in adults; characterize a study population in terms of current psychiatric diagnoses; and improve interviewing skills of students in the mental health professions, including psychiatry, psychology, psychiatric social work, and psychiatric nursing. Enhancing the reliability and validity of DSM-5 diagnostic assessments, the SCID-5-CV will serve as an indispensible interview guide.

Apathy is characterized by loss of motivation, decreased initiative, and emotional blunting. It is highly prevalent in neurological, and psychiatric disorders like Alzheimer's disease, traumatic brain injury, schizophrenia, Parkinson's disease, Huntington's disease, cerebrovascular disorders, and mild behavioural impairment. It has negative outcomes including impairments in activities of daily living, caregiver burden, and higher rates of institutionalization and mortality. The definition of apathy has changed over the years alongside the development of diagnostic criteria and apathy scales and measurements. Apathy is emerging as a treatment target with interest in pharmacological, non-pharmacological, and neuromodulatory treatments for apathy. There is also an increased understanding of the neurobiology of apathy with functional and structural neuroimaging research studies. This book is a comprehensive, in-depth review from experts in neurology and psychiatry. It reviews the current state of apathy in these various disorders while also summarizing apathy diagnostic criteria, scales and measurements, neuropathology, and treatments.

In writing this book, I have attempted to provide information about the relative value of particular investigations in various neurological disorders. The book is divided into sections dealing with the methods of investigation, the investigation of particular symptoms, the investigation of specific neurological conditions and neurological emergencies. Finally, the assessment of certain disorders suggesting a particular anatomical localization, for example isolated optic atro phy, is considered. Following an appraisal of the literature, each section ends with a recommendation regarding appropriate investigation. In some in stances this is supported by an algorithm. Specific recommendations have been attempted despite the risk of producing over-dogmatic criteria for patient management. A small amount of illustrative material is included. I am grateful to colleagues at Charing Cross Hospital who have provided some of the illustrations. Figs 1. 4, 2. 1 and 10. 2 are reproduced from Atlas of Clinical Neurology, by G. D. Perkin eta/. , Gower Medical Publishing, 1986, courtesy of the publishers. Fig. 3, in Chapter 4, is reproduced from Brain, vol. 2 104, 753-78, 1981, courtesy of the editor and Dr. R. S. J. Frackowiak. Fig. 6, in the same chapter, is reproduced from Fig. 62 in the Atlas of Positron Emission Tomography, edited by E-D. Heiss et al. , Springer-Verlag, 1985, courtesy of the publishers and Dr. J. C. Maziotta. Fig. 3 in Chapter 6 is reproduced from Fig.

The DSM-5 Handbook of Differential Diagnosis is the preeminent guide to differential diagnosis for both clinicians and students learning psychiatric diagnosis. Based closely on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, it offers a rich selection of perspectives in an easy-to-use format. The author, an expert on psychiatric diagnosis and assessment, recognizes that psychological distress cannot be reduced to a rubric. The clinician must have empathy, listening skills, the ability to identify symptoms and contextualize them, and a familiarity with the body of knowledge represented by DSM-5. The handbook brings these critical skills together in a well-written, accessible, and reader-friendly volume that is grounded in the latest research and standard of practice. The handbook offers an assortment of approaches to differential diagnosis, and a number of features designed to benefit clinicians in the exam room, including: * A six-step framework for diagnosing patients that proceeds from determining if the symptom is real to establishing the boundary between disorder and normality, with intermediary steps to rule out substance etiology and medical conditions, as well as to determine the primary disorder and to differentiate adjustment disorders from other mental disorders.* Twenty-nine symptom-oriented decision trees that provide detailed decision points to facilitate the process of generating the differential diagnosis based on the presenting symptoms and eliminate formulating premature conclusions.* Sixty-six differential diagnosis tables, one for each of the most important DSM-5 disorders, cross-referenced with the terminal branches of the decision trees presented in the handbook to provide a head-to-head comparison of each disorder, highlighting similarities and differences.* The DSM-5 classification, to facilitate coding and to provide an overview of all of the DSM-5 diagnoses that must be considered in formulating a differential diagnosis.* Alphabetical indexes of the decision trees and differential diagnosis tables to help readers readily locate desired material. DSM-5 Handbook of Differential Diagnosis provides a comprehensive overview of the process of diagnosing DSM-5 disorders while serving as a reference guide to assist in the differential diagnosis of individual patients. The handbook is an invaluable addition to the DSM-5 collection and an important contribution to the mental health profession.

This pioneering book investigates how biographical evidence has been variously used, misused, or not used at all, by clinicians entirely reliant on biographical evidence for the influential posthumous diagnoses they have produced of Winston Churchill as a manic-depressive. Attention is paid, also, to the distinct question of Churchill and "nerves," otherwise known as neurasthenia. This question has a place alongside the manic-depression issue because, by ensuring there is a marked contrast between two lines of biographical inquiry, it facilitates a significant move in the direction of a more rounded, a more securely founded, understanding of how Churchill functioned psychologically, and how he did not. That goal of a more rounded understanding is important, and the contribution Diagnosing Churchill makes towards its achievement is worthwhile, because accuracy in the depiction of key elements in the functioning of a major historical figure, one of the heroes of Western democratic civilization, is enjoined by a principle Churchill expressed thus: "the meanest historian owes something to the truth."

Recognition and diagnosis of child abuse and neglect creates an important foundation for the protection of children. Physicians and other healthcare providers have a fundamental role in this process, and need to be confident that they can identify correctly the signs and symptoms that provide clues to non-accidental injuries resulting from child maltreatment. Diagnosis of Non-accidental Injury: Illustrated Clinical Cases is an invaluable tool to aid prompt and appropriate diagnosis, presenting various types of findings and challenging the reader with both common and not-so-common manifestations that may result from - or be confused with - child abuse and neglect. The book describes various clinical scenarios through a brief clinical history accompanied by high-quality clinical images. Questions focus on the important concepts to be learned from each case. The answers are revealed after a turn of the page, sometimes with additional images to explain critical aspects, and feature a diagnosis, the 'ruling out' of abuse or neglect, further diagnostic options where relevant, and helpful treatments.

This book is the fourth edition of a highly regarded text which was first published in 1988. It introduces the reader to the interpretation of routine laboratory biochemical test results and covers all aspects of interpretative chemical pathology (including reproductive endocrinology, which was not covered previously).

The approach is based on case material from the authors' laboratory and employs algorithms and similar aids for interpretation. The material is structured so that it is comprehensible to beginners as well as being useful for the more experienced practitioners. The envisaged audience is medical undergraduates, general practitioners, clinical biochemists and laboratory technicians.