Now in its third edition, ''Clinical Research Methods in Speech-Language Pathology and Audiology'' is a valuable and comprehensive resource for understanding and conducting clinical research in communication sciences and disorders. Graduate students and practicing clinicians will benefit from the text's detailed coverage of various research topics. Specifically, readers will learn the strengths and weaknesses of different research methodologies, apply the results of research to clinical practice and decision-making, and understand the importance of research ethics. ''Clinical Research Methods'' is the only text to take into account qualitative research and evidence-based practice, and to provide a detailed discussion of research ethics. Key Features *Chapters begin with an outline of covered topics and learning objectives *End-of-chapter discussion questions apply concepts and incorporate real-life research situations *Numerous tables and charts display critical models and research procedures

This issue of Otolaryngologic Clinics, guest edited by Drs. Teresa M. O, Nate Jowett and Tessa Hadlock, is devoted to Facial Nerve Paralysis: Causes, Prevention, Reanimation, and Rehabilitation. Articles in this outstanding issue include: The Importance and Psychology of Facial Expression; General Approach to Facial Palsy; Outcomes Tracking in Facial Palsy; Medical Management of Acute Facial Palsy; Surgical Management of Acute Facial Palsy; Management of Flaccid Facial Paralysis for Less than Two Years; Management of Long-Standing Flaccid Facial Palsy: Periocular Considerations; Management of Long-Standing Flaccid Facial Palsy: Midface/Smile - locoregional muscle transfer; Management of Long-Standing Flaccid Facial Palsy: Midface /Smile and Static Sling; Management of Long-Standing Flaccid Facial Palsy: Brow, Midface, and Lower Lip; Medical Management of Post-Paralysis Facial Palsy/Synkinesis; Surgical Management of Post-Paralysis Facial Palsy/Synkinesis; Management of Facial Nerve Schwannoma; Management of Vestibular Schwannoma: Otologic and Facial Nerve Considerations; and Management of Bilateral Facial Palsy. CME is also available for Otolaryngologic Clinics of North America.

Everyday Audiology, Second Edition is an invaluable guide for clinicians involved in the care of patients with hearing impairment or balance disorders. Originally written for ENT residents, it has also become a useful resource for other health care professionals including otolaryngologists, family medicine physicians, pediatricians, medical students, audiologists, audiology students, teachers of the hearing impaired, hearing instrument specialists, speech-language pathologists who work with hearing- impaired children, and even physical therapists who provide rehabilitation to patients with balance disorders. The book contains clinically relevant norms and values that are extremely useful for clinical interpretation. Drawn from lectures given to otolaryngology-head and neck surgery residents and case reports conducted by clinical audiologists at West Virginia University School of Medicine, the book is designed for easy consumption of essential information. Key concepts are presented on left-hand pages and supporting and tabular material on the right.The book is divided into four parts: Part I: Evaluation of Hearing Disorders Part II: Evaluation of Balance Disorders PartIII: Rehabilitation of Hearing Disorders Part IV: Otologic/Audiologic Differential Diagnosis (new to this edition) Frequently used audiology terminology and significant clinical criteria are printed in bold. The Current Procedural Terminology (CPT) code, if available, is listed under each test procedure. In Part IV, the diagnostic code, commonly known as International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM), is also provided under each case as a reference.

MCQs for ENT: Specialist Revision Guide for the FRCS is a key resource for candidates preparing to sit the FRCS (ORL-HNS). It contains over 300 single best answer questions and over 70 extended matching questions to help candidates prepare for all aspects of ENT they may face in this challenging exam. Written by expert consultants who have succeeded in the exam, this resource provides comprehensive coverage of theory and practice, including new questions on challenging topics such as electroneurography and voice clinic procedures, and questions on rare topics such as oropharyngeal cancers. All answers have full explanations, providing candidates with high-quality self-assessment in order to maximize exam success. Providing a thorough assessment of the reader's ENT knowledge, this is an essential revision book for any candidate facing the FRCS ORL-HNS exam.

Otolaryngological conditions affect people of all ages from newborns to older members of society, and have serious consequences for daily functions such as breathing, taste, and communication. There is a constant desire to understand the best evidence for current practice in a constantly evolving field such as medicine, and key publications underpin this contemporary knowledge. Landmark Papers in Otolaryngology presents a distilled summary of 99 of the classic, ground-breaking, and significant publications in the field of otolaryngology that are of essential relevance to the speciality today. Each paper is described, critiqued, and brought into the context of modern-day practice by a carefully selected team of international authorities from each subspecialist area to provide the reader with a clear understanding of the key publications in otolaryngology. Whether your aim is to understand the origins of otolaryngology, to review advances in key areas, or to gain insight from experts, this book offers a wealth of knowledge for everyone in the field, from the new trainee to the senior clinician. Landmark Papers in Otolaryngology is an invaluable and easily accessible reference text for all practitioners in the field, as well as those in overlapping specialities such as maxillofacial surgery, neurology, and plastic surgery.

This issue of Otolaryngologic Clinics, guest edited by Drs. Natasha Mirza and Jennifer Y. Lee, is devoted to Geriatric Otolaryngology. Articles in this issue include: Economics of the Aging Population: The expected growth and demand for Otolaryngology services; Hearing: Presbycusis and innovations in hearing augmentation; Vertigo and Dizziness: Understanding and Managing Falls Risk; Head and Neck Cancer; Endocrine Surgery; Voice Alteration; Dysphagia; Gastroesophageal/LaryngoPharyngeal Reflux; The Aging Face; Rhinitis and Sinusitis; Smell and Taste; Sleep Apnea and Sleep Disordered Breathing; Medical and Preoperative Evaluation of the Elderly Patient; and The Emerging Field of Geriatric Otolaryngology.

This issue of Physician Assistant Clinics, guest edited by Laura A. Kirk, MSPAS, PA-C, is devoted to Otolaryngology. Articles in this issue include: Hyperparathyroidism: Workup and Treatment; "Sinus" Headaches: Sinusitis vs. Migraine; Sudden Sensorineural Hearing Loss; ENT Manifestations of Sarcoidosis; Pediatric Otitis Media; Evaluation and Management of Adult Neck Masses; Vestibular Migraine; Pediatric Sleep Disordered Breathing; Benign Paroxysmal Positional Vertigo (BPPV); Infectious and Inflammatory Salivary Disease; Evaluation and Management of Pediatric Neck Masses: An Otolaryngology Perspective; and Indications for Cochlear Implantation.

Singing has been a characteristic behaviour of humanity across several millennia. Chorus America (2009) estimated that 42.6 million adults and children regularly sing in one of 270,000 choruses in the US, representing more than 1:5 households. Similarly, recent European-based data suggest that more than 37 million adults take part in group singing. The Oxford Handbook of Singing is a landmark text on this topic. It is a comprehensive resource for anyone who wishes to know more about the pluralistic nature of singing. In part, the narrative adopts a lifespan approach, pre-cradle to senescence, to illustrate that singing is a commonplace behaviour which is an essential characteristic of our humanity. In the overall design of the Handbook, the chapter contents have been clustered into eight main sections, embracing fifty-three chapters by seventy-two authors, drawn from across the world, with each chapter illustrating and illuminating a particular aspect of singing. Offering a multi-disciplinary perspective embracing the arts and humanities, physical, social and clinical sciences, the book will be valuable for a broad audience within those fields.

This issue of Otolaryngologic Clinics, Guest Edited by Drs. Adrien A. Eshraghi and Fred F. Telischi, is devoted to Otosclerosis and Stapes Surgery. Articles in this outstanding issue include: Otosclerosis: Temporal Bone Pathology; Otosclerosis: From Genetics to Molecular Biology; Otosclerosis and Stapes Surgery, Historical Aspects; Clinical Evaluation of the Patient with Otosclerosis; Impact of Imaging in the Management of Otosclerosis; Medical Management of Otosclerosis; Otosclerosis: Audiological Evaluation and Hearing Aids; Stapes Surgery: Stapedectomy Versus Stapedotomy; Use of Lasers in Otosclerosis Surgery; The Stapes Prosthesis: Past, Present and Future; Endoscopic Stapes Surgery; Advanced Otosclerosis and Cochlear Implantation; Special Anatomical Considerations in Otosclerosis Surgery; Revision Surgery for Otosclerosis; Complication in Otosclerosis Surgery; The Potential of Robotic Surgery for Otosclerosis; and Controversies in Otosclerosis.

This issue of Otolaryngologic Clinics, guest edited by Drs. Teresa M. O and Milton Waner, is devoted to Congenital Vascular Lesions of the Head and Neck. Articles in this issue include: Classification and Pathology of Congenital Vascular Anomalies of the Head and Neck; Etiology and Genetics of Congenital Vascular Lesions; Radiological Evaluation of Congenital Vascular Anomalies; Congenital Vascular Tumors; The Role of Surgery in the Management of Infantile Hemangiomas; The Management of Airway Infantile Hemangiomas; Multidisciplinary Approach to the Management of Lymphatic Malformations of the Head and Neck; New Frontiers in Our Understanding of Lymphatic Malformations of the Head and Neck; Venous Malformations of the Head and Neck; Capillary Malformations of the Head and Neck; Arteriovenous Malformations of the Head and Neck; The Management of Vascular Malformations of the Airway; Role of Neurophysiological Monitoring in the Surgical Management of Congenital Vascular Lesions of the Head and Neck; Acquired Vascular Tumors of the Head and Neck; Orthognathic and Dental Considerations; Hereditary Hemorrhagic Telangiectasia; and Psychosocial Impact of Living with a Facial Vascular Lesion.

This issue of Otolaryngologic Clinics, Guest Edited by Murugappan Ramanathan Jr. and James Whitman Mims, is devoted to Allergy for the Otolaryngologist. Articles in this issue include: New Horizons in the Management of Allergy; The Role of the Sinonasal Epithelium in Allergy; The Role of Allergy in Chronic Rhinosinusitis; Manifestations of Inhalant Allergies Beyond the Nose; The Role of Allergy in Otologic Disease; Asthma Management for the Otolaryngologist; Rational Approach to Allergy Testing (in vitro/in vivo); Advances in Food Allergy; Contemporary Pharmacotherapy of Allergic Inflammation; Clinical Applications of SLIT; Efficacy of SLIT/SCIT; Immunotherapy: Treating with Fewer Allergens?; Management of Anaphylaxis; and Future Horizons in Allergy.

This issue of Otolaryngologic Clinics, guest edited by Dr. Sonya Malekzadeh, is devoted to Surgical Simulation in Otolaryngology. Articles in this issue include: Physical Models and Virtual Reality Simulators in Otolaryngology; Improving Rhinology Skills with Simulation; Simulators for Laryngeal and Airway Surgery; Advanced Pediatric Airway Simulation; Otologic Skills Training; Emerging Role of 3D Printing in Simulation; Assessment of Surgical Skills and Competency; Improving Team Performance Through Simulation-based Learning; Formal Debriefing in Simulation Education; Boot Camps: Preparing for Residency; Using Simulation to Improve Systems; and Economics of Surgical Simulation.

This issue of Otolaryngologic Clinics, guest edited by Dr. Maie St. John, is devoted to Multidisciplinary Approach to Head and Neck Cancer. Articles in this issue include: It Takes a Village - The Import of Multidisciplinary Care; The Role of the Patient: Shared Decision Making; A Story in Black and White: Radiologic Evaluation in the Multi-Disciplinary Setting; Beyond the Glass Slide: Pathology Review in the Multi-Disciplinary Setting; Surgical Innovations; It Takes Two - One Resects, One Reconstructs; Advances in Radiation Oncology: What to Consider; Precision Medicine: Genomic Profiles to Individualize Therapy; The Role of Systemic Treatment Before, During, and After Definitive Treatment; Decision Making for Diagnosis and Management: A Consensus Comes to Life; On Pain; Psychosocial Distress and Screening; First We Eat, Then We Do Everything Else: Nutrition; Functional Assessment and Rehabilitation: How to Maximize Outcomes; Survivorship - Morbidity, Mortality, Malignancy; and Immunotherapy: Who is Eligible?

Basic Fundamentals in Hearing Science is a practical textbook written primarily for college undergraduates preparing for graduate programs in speech-language pathology or audiology. Using Newtonian physics, the authors present a novel approach to the subject of hearing science enabling students to develop their understanding of the subject while building their knowledge of scientific concepts as they move through the text. Students progress from the basics to more difficult concepts in a graduated process. The text encourages thinking and problem solving rather than learning by rote memorization and clarifies obscure concepts in a writing style that promotes greater understanding and comprehension. Pedagogical elements include key terms listed for each chapter, bulleted chapter summaries, and review questions at the end of each chapter. For undergraduate hearing science students without hard science backgrounds, this text aims to decompress and facilitate the comprehension of difficult and often cumbersome concepts in order to master the basic concepts in hearing science.This textbook is also a useful supplemental or recommended reference for speech and hearing combined courses that require more coverage of hearing science than currently available in speech-oriented textbooks. "'Key features of "Basic Fundamentals in Hearing Science" include:"' * An extensive number of figures and illustrations for improved overall comprehension of the subject matter * Clear descriptions of the many and various forms of sound wave phenomenon, and of auditory anatomy and physiology--from the outer ear to the auditory cortex * An overview of scientific measurement scales and notation including the use of logarithms, exponential and scientific notation, and the metric system * An opening chapter that defines and elucidates the meaning, practice, and philosophy of science--with an emphasis on theory-driven research--including a practical guide for the writing of a scientific manuscript * Chapters devoted to the basic terminology used in hearing science and the application of those basic principles and terms, as well as a chapter that addresses basic nervous system terminology and describes the structure and function of the twelve pairs of cranial nerves * A chapter that deals exclusively with the structure and function of the auditory system ================================================================== "The text is written with meticulous and thorough attention to detail and accuracy.This is especially apparent with regard to the formulas and tables provided for the computations of the Bel, decibel, and RMS amplitude. An additional feature that adds to the attractiveness and flair of the book is the frequent reference to historic discoveries and to those who made them. Concepts presented in the text are beautifully complemented by illustrations, graphs, and equations. This is a book I wish I had had when I was a student, and I believe it will become a first choice textbook among undergraduate and graduate students. It will provide quick answers to questions, both simple and complex, and will provide ever-deepening insights into hearing science when knowledge of details is the goal." -- From the Foreword by James A. Kaltenbach, PhD, Director of Otology Research, The Cleveland Clinic

This issue of Otolaryngologic Clinics of North America, devoted to Endoscopic Ear and Eustachian Tube Surgery, is guest edited by Drs. Joao Flavio Nogueira and Muaaz Tarabichi. Articles in this outstanding issue include: Anatomy of the Eustachian Tube; Physiology of the Eustachian Tube; Eustachian Tube Function and Testing; Radiology of the Eustachian Tube; Middle Ear and Eustachian Tube Dysfunction; Endoscopic Eustachian Tube Transnasal Surgery; Endoscopic Anatomy of the Protympanic Space; Outcomes Following Endoscopic Ear Surgery; Endoscopic Management of Superior Semicircular Canal Dehiscence; Endoscopic Management of Tumors in Middle Ear and Mastoid; Outcomes Following Endoscopic Stapes Surgery; Transtympanic Balloon Dilation of the Eustachian Tube; Selective Dysventilation Syndrome; Restoring Petrous Bone Ventilation; and Endoscopic Techniques in Tympanoplasty.

This issue of Otolaryngologic Clinics, guest edited by Drs. Jean Anderson Eloy and Michael Setzen, is devoted to the Contemporary Management of Frontal Sinusitis. Articles in this outstanding issue include: Overview of Frontal Sinus Management; Evaluation and Decision-Making in Patients with Frontal Sinusitis; Medical Management of Frontal Sinusitis; Surgical Anatomic Consideration in Frontal Sinus Surgery; Instrumentation in Frontal Sinus Surgery; Preventing and Managing Complications in Frontal Sinus Surgery; Frontal Sinus Balloon Dilation; Utility of Image-Guidance in Frontal Sinus Surgery; Standard Endoscopic Approaches in Frontal Sinus Surgery: Technical Pearls and Approach Selection; Modification of the Standard Frontal Sinus Endoscopic Approaches; Outcomes after Frontal Sinus Surgery: An Evidence-Based Review; Management of Frontal Sinus Cerebrospinal Fluid Leaks and Encephaloceles; Management of Frontal Sinus Tumors; and Open Frontal Sinus Surgery.

Laryngology: Clinical Reference Guide is a portable reference guide that fills the void of an easy-to-read, concise, but comprehensive book encompassing all aspects of laryngology. Each chapter follows a uniform outline to facilitate quick review of a topic, and the comprehensive nature of each chapter provides depth. This clinically relevant resource is organized into ten sections that are broken down into their most important and fundamental parts by chapter, including the History of Laryngology; Embryology, Anatomy, and Physiology; Evaluation and Physical Examinations; Laryngologic Disorders; Neurolaryngology; Laryngologic Manifestations of Systemic Diseases; Pediatric Laryngology; Surgery; Swallowing Disorders; and Therapy. As a review book, it is ideal for residents and fellows in training and those preparing for board and in-service training examinations, as well as medical students looking for a "deeper dive" into the world of laryngology. However, it is also excellent for the practitioner who wants to get a succinct update on the latest, cutting-edge knowledge in all areas of laryngology. The information is authored by a collection of "who's who" in laryngology. Formatted like the bestselling "Pasha" (Otolaryngology-Head and Neck Surgery) pocket guide, this text provides a condensed amount of high-yield information with a multidisciplinary approach to bring a broad range of insight into complex clinical challenges.

Self-Assessment in Otolaryngology, by Drs. James Paul O'Neill and Jatin P. Shah, covers the entire field of otolaryngology, offering 24 comprehensive chapters filled with questions and answers, bulleted information, case histories, and much more. Written by specialists from around the world, this one-of-a-kind self-assessment tool showcases today's international, expert knowledge and judgment in the practice of otolaryngology Includes a variety of questions in every chapter (true/false, multiple choice, and "best answer") followed by high-yield information, case histories, management issues, images, scans, and recommended readings. Every question is followed by a bulleted list of the minimum core knowledge required for that particular area. Offers the most current information on new technologies, outcomes data, results of clinical trials, and future directions. Contains both U.S. and European-style board questions. Allows you to test your expertise on hundreds of day-to-day issues encountered in the practice of otolaryngology. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.

This issue of Neuroimaging Clinics of North America focuses on Imaging of Tinnitus. Articles will include: Neuroscience of Tinnitus; Clinical Evaluation of the Patient with Tinnitus; Arterial Abnormalities Leading to Tinnitus; Paragangliomas and Other Vascular Skull Base Tumors; Dural AV Fistulae: Imaging and Management; Venous Abnormalities Leading to Tinnitus: Imaging Evaluation; Endovascular Intervention in Venous Tinnitus: New Horizons and Future Directions; Emerging Role of Surgical Treatments in the Treatment of Tinnitus; Role of Advanced Neuroimaging and Future Directions; Imaging Interpretation of Temporal Bone Studies in a Patient with Tinnitus: A Systematic Approach; and much more!

This issue of Otolaryngologic Clinics of North America, devoted to Parotid Disease, is guest edited by Drs. Babak Azizzadeh and Babak Larian. Articles in this outstanding issue include: Parotid Gland and Facial Nerve Anatomy; Parotid Gland Imaging; Evaluation of Parotid Lesions; Benign Parotid Tumors and Management; Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland; Parotitis and Sialoendoscopy of the Parotid Gland; Parotidectomy for Benign Parotid Tumors; Parotidectomy for Parotid Cancer; Parotid Tumors and the Facial Nerve; Loco-Regional Parotid Reconstruction; Free Tissue Transfer in Parotid Reconstruction; Facial Paralysis Reconstruction; Periocular Reconstruction in Patients with Facial Paralysis; Rare Parotid Diseases; and Management of Frey's Syndrome.

Imaging of Paranasal Sinuses is explored in this important Neuroimaging Clinics issue. Articles include: Current trends in sinonasal imaging; Normal anatomy and anatomic variants of the paranasal sinuses on CT; Pre-treatment imaging in inflammatory sinonasal disease; The role of CT and MRI in imaging of fungal sinusitis; Imaging approach to sinonasal tumors; The role of CT and MRI in imaging of sino-nasal tumors; The role of CT and MRI in the skull base in evaluation of sino-nasal disease; Post-treatment imaging of the paranasal sinuses following endoscopic sinus surgery; Post-treatment imaging of the paranasal sinuses following treatment for sinonasal neoplasia; and more!

This issue on endoscopic cranial base and pituitary surgery is led by experts in the field of Otolaryngology and Neurosurgery. Otolaryngologists/Head and Neck surgeons Dr. Raj Sindwani and Dr. Troy Woodard join with Neurosurgeon Dr. Pablo Recinos to present a comprehensive clinical approach. Topics include: Building an endoscopic skull base program (room setup and key equipment / IGS); Skull Base Anatomy (corridors, intra and extradural); Imaging in skull base surgery - CT, MRI, CT cisternogram, intraop CT; Sellar lesions / pathology; Principles of endoscopic pituitary surgery ; Reconstruction of skull base defects - free graft, pedicle, TPF, alloderm; Lumbar drain utility (role of intrathecal fluorescein); Hemostasis in Skull Base Surgery (control of smaller vessels, maneuvers to minimize bleeding - warm irrigations, HOB up, embolization); Management of ICA Injury (intraop options, late complications); Meningioma; Esthesioneuroblastoma; Cordoma; Sinonasal Malignancies of Skull Base; Craniopharyngioma; Endonasal approaches to the craniocervical junction; Medical complications of Pituitary/skull base surgery - (ie. SIADH, DI, Hypopit); Post-op management of skull base patient (postop Abx, imaging, debridements, topical irrigations, more...). Articles cover surgical procedure, surgical complications, and surgical anatomy as relevant to the clinical discussion.

Historically, research on spoken language testing dates back to the late 1920s with the majority of work starting around the time of World War II. In contrast, signed language assessment research is a young area, nested within signed language linguistics, deaf education, and applied linguistics. To this day, very few signed language tests that can be used in applied contexts are available for learners of a signed language. This volume addresses issues that are inherent to language assessment development, regardless of the modality of the language. Comprised of 36 chapters, the book takes a new approach to exploring theoretical and practical issues related to assessment of signed and spoken languages by bringing together well known experts from both fields to engage in stimulating discussions about key issues related to language assessment. Grouped around twelve topics, the volume editors present different perspectives to emphasize the points of similarity and chart a path for future interdisciplinary collaborations .

Laryngology: A Case-Based Approach is an invaluable new text for clinicians and students covering evidence-based assessment and management of a full range of laryngological conditions. This unique text examines 55 common and rare cases and covers pediatric and adult patients. The cases are separated into four sections: pediatric, voice and airway, general/systemic, and dysphagia/swallowing. Key Features: * More than 300 figures, most in full color, including surgical photos, endoscopic images, pathological micrographs, and various process charts/diagrams and decision trees. * More than 30 video and audio files * Laryngology's leading experts have contributed their knowledge, expertise and experience to discuss the varied management options as they see it. The exciting new text also comes with access to a PluralPlus companion website, where readers can access video and audio files to enhance their understanding of cases in the book. With its multitude of cases and related multimedia, Laryngology: A Case-Based Approach is must-have resource for otolaryngologists, laryngologists, phoniatricians, speech-language pathologists, as well as anesthesiologists with an interest in managing the difficult airway.

Cancers of the larynx, while survival outcomes increase, result in massive treatment damage from radiation and surgery. Patients often lose ability to speak and to eat. Preserving the larynx is a fine balance of cancer eradication, life extension, and quality of life. This issueof Otolaryngologic Clinics led by Dr Babak Sadoughi should be of interest to Otolaryngologists, Oncologists, Radiologists, and Speech Therapists. The issue approach reaches all the most important aspects of diagnosing and treating the patient with laryngeal cancer with a focus on preserving the voice in early laryngeal cancer and preserving and restoring function in advanced laryngeal cancer. Topics include: Functional Anatomy and Oncological Barriers of the Larynx; Evaluation of the Dysphonic Patient; Role of Advanced Laryngeal Imaging in Glottic Cancer; Laryngeal Function after Radiation Therapy; Management of Dysphonia after Radiation Therapy; Contemporary Surgical Management of Early Glottic Cancer; Voice Prognosis after Transoral Laser Microsurgery of the Larynx; Voice Rehabilitation after Transoral Laser Microsurgery of the Larynx; Quality of Life after Conservation Surgery for Laryngeal Cancer; Salvage Conservation Surgery of the Larynx; Airway Preservation in Ablative Laryngeal Surgery; Voice Restoration after Total Laryngectomy. A special article for Residents, written by a Resident, emphasizes essential "take home messages" for laryngeal function preservation diagnosis and treatment.