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A riveting and deeply human examination of the synthetic-drug epidemic - and in particular the rise of fentanyl, the newest and most deadly wave of the opioid crisis. A new crop of chemicals is radically changing the recreational-drug landscape. Known as Novel Psychoactive Substances (NPS), these chemicals include replacements for known drugs like cocaine, ecstasy, marijuana, and heroin. They are synthetic, made in a laboratory, and are much more potent than traditional drugs - and, all too often, they are tragically lethal. Fentanyl, Inc. is the first deep-dive investigation of a hazardous illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding the government agencies that are challenged to combat it. Drugs like fentanyl, with arcane acronyms like 4-ANPP, K2, and NBOMe, were all originally developed in legitimate laboratories for proper medicinal purposes. Their formulas were then hijacked by rogue chemists, largely in China but increasingly in other places, too, who change their molecular structures to stay ahead of the law, a process that makes the drugs' effects impossible to predict. Westhoff has infiltrated this shadowy world. In Fentanyl, Inc., he recounts how he tracked down a mysterious drug baron in New Zealand who unintentionally sparked one aspect of the synthetic-drug revolution. He visits the shady factories in China from which these drugs emanate, providing startling and original reporting on how China's vast chemical industry operates. He chronicles the lives of addicts and dealers, families of victims, law enforcement officers, and underground drug-awareness organisers in the U.S. and Europe. Together, they provide the shocking full picture of a calamity we are only just beginning to understand. And yet from its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many.
Nearly half of us at some point in our lives will suffer chronic pain. We go to the doctor, where the standard treatment on offer is either medication - which only masks the problem - or surgery - which can make things worse. For renowned osteopath Nick Potter, the reason why traditional medicine doesn't work is because chronic pain often has less to do with twisted muscles and more to do with far deeper-rooted anxieties. An expert on pain in all its forms, Potter has had nearly 30 years' clinical experience of treating people - ranging from elite athletes and hedge-funders to over-stretched families - who come to him with real symptoms and real physical pain for which there appears to be no root cause. In this fascinating book, he takes us on a journey into biology, evolution and contemporary social behaviour and anthropology to examine our relationship with pain. He presents his own roadmap for wellbeing (including his acclaimed theory of breathing), along with success stories from the consulting room, and shows us how to spot the signs and break the vicious cycle of stress, pain and anxiety before the damage is done.
Since the third edition of Grieve's Modern Manual Therapy was published in 2005, the original concepts of manipulative therapy have grown to embrace new research-generated knowledge. Expansions in practice have adopted new evidence which include consideration of psychological or social moderators. The original manual therapy or manipulative therapy approaches have transformed into musculoskeletal physiotherapy and this is recognized by the change in title for the new fourth edition - Grieve's Modern Musculoskeletal Physiotherapy. Grieve's Modern Musculoskeletal Physiotherapy continues to bring together the latest state-of-the-art research, from both clinical practice and the related basic sciences, which is most relevant to practitioners. The topics addressed and the contributing authors reflect the best and most clinically relevant contemporary work within the field of musculoskeletal physiotherapy. With this as its foundation and a new six-strong editorial team at its helm, the fourth edition now expands its focus from the vertebral column to the entire musculoskeletal system. For the first time both the spine and extremities are covered, capturing the key advances in science and practices relevant to musculoskeletal physiotherapy. The book is divided into five parts containing multiple sections and chapters. The first part of the book looks at advances in the sciences underpinning musculoskeletal physiotherapy practice. Here there is commentary on topics such as movement, the interaction between pain and motor control as well as neuromuscular adaptations to exercise. Applied anatomical structure is covered in addition to the challenges of lifestyle and ageing. A new section highlights the important area of measurement and presents the scope of current and emerging measurements for investigating central and peripheral aspects relating to pain, function and morphological change. Another section discusses some contemporary research approaches such as quantitative and qualitative methods as well as translational research. Part III contains sections on the principles of and broader aspects of management which are applicable to musculoskeletal disorders of both the spine and periphery. Topics include models for management prescription, communication and pain management and contemporary principles of management for the articular, nervous and sensorimotor systems. In recognition of the patient centred and inclusive nature of contemporary musculoskeletal practice, there is also discussion about how physiotherapists may use cognitive behavioural therapies when treating people with chronic musculoskeletal disorders. The final part of the book focuses on selected contemporary issues in clinical practice for a particular region, condition or the most topical approaches to the diagnosis and management of a region. A critical review of the evidence (or developing evidence) for approaches is given and areas for future work are highlighted. The only textbook which covers the breadth of musculoskeletal physiotherapy practice, bringing together the work and opinions of leading international experts Presents the latest science, research evidence and clinical practices for assessment and management of spinal and extremity disorders Uses contemporary knowledge in diagnostics and future directions to demonstrate how to manage both acute and chronic musculoskeletal pain Considers important aspects underpinning clinical practice across the biopsychosocial domains Now covers the musculoskeletal systems of the upper and lower limbs as well as the spine Title, topics, prominent editors and authors - all reflect the evolution in knowledge, models of diagnosis and contemporary practice Overviews of the latest advances in: the basic sciences relevant to musculoskeletal physiotherapy clinical science and practice imaging and measurement techniques Over 300 illustrations Colour plate section
This long-awaited follow-up to the New York Times bestselling The MELT Method introduces a unique, scientific-based proactive training program for improving overall balance, performance, and control while preventing pain and injury. Are you an athlete facing constant injuries that hold you back from achieving peak performance? Are you someone who wants to stay fit, but are dealing with aches and pains that make it more difficult to work out? Do you want to exercise or train without being sidelined by stress fractures, strained ligaments, and painful joints? If you answered yes to any of these questions, you need MELT Performance. The conditioning you do to stay in shape and perfect and improve performance-running on a treadmill, doing squats or bicep curls, practicing our backhand, even doing downward dog-requires repetitive movements. Yet 80% of orthopedic injuries are the result of repetitive motion, not trauma or accidents. In MELT Performance, nationally recognized educator, manual therapist, and exercise physiologist Sue Hitzmann introduces a revolutionary program centered on neurological joint stability or Neurostrength, that will revolutionize your health and performance. The foundation of MELT Performance is stability. To stay injury free, our joints must stable before we do repetitive motions. Acquiring stability allows the body to respond to the demands of motion. It's the way we were designed to function-and allows us to move more efficiently, improve coordination, and save our joints. Knowing how to check in, restore, and reintegrate joint stability before it's compromised gives an unparalleled advantage to anyone who trains hard to perform at their best. Hitzmann's techniques are proven to work-they're already used by world renowned professional athletes and fitness enthusiasts. If you're ready to improve your performance and prevent injury, MELT Performance is essential no matter what sport or activity you pursue. MELT Performance includes black-and-white instructional images throughout.
This handbook is a clinically-focused guide on the diagnosis and evidence-based treatment of migraine, the third most common medical condition on the planet. It is a concise yet thorough guide for management of migraine in clinical practice settings as informed by current scientific literature and clinical guidelines. This handbook incorporates diagnostic criteria from the most recent edition of the International Classification of Headache Disorders (ICHD-3). The first half of the handbook provides information on assessment of migraine (including headache red flags and indications for neuroimaging), screening for common comorbid conditions, and essential lifestyle recommendations for all migraine patients. The second half covers both acute and preventive headache medications and relevant treatment algorithms and indications, as well as other medical therapies and behavioral interventions for migraine. This clinician's manual is easy to read and includes numerous tables and other content valuable to all providers wanting a go-to resource on clinical management of migraine. It is an ideal companion for busy general practitioners and neurologists, nurses and mid-level providers, neurology trainees and residents, as well as patients wishing to gain a better understanding of their condition.
This book offers an insight into all aspects of pain in order to provide practitioners with a balanced and holistic approach to pain management. Supported by evidence and research throughout, Management of Pain uses real-life clinical scenarios. The book provides the reader with practical advice and knowledge of modern methods of pain management.
A STIRRING EXAMINATION OF A LOOMING CRISIS Virtually everyone has taken antibiotics. They can be lifesavers - or they can be useless. But what are they? How are they used? And what happens as the effectiveness of antibiotics begins to decline? Antibiotics: What Everyone Needs to Know (R) examines the personal and societal implications of our planet's most important - and arguably most overused - medications. In a question-and-answer format, it unpacks the most complicated aspects of this issue, including: * How antibiotics are used (and overused) in humans, plants, and livestock * The consequences to date, and the potential crisis ahead, as overuse of existing antibiotics breeds new resistance in bacteria * How the globalized world enables antibiotic resistance more quickly * Collateral damage, individually and societally, of antibiotic use * The difficult decisions ahead related to medical care and the food system Grounded in the latest scientific research and translated for general readers, Antibiotics: What Everyone Needs to Know (R) offers a clear-eyed overview of where we are, and what the future holds, as antibiotics lose their might.
Due to a wide-spread developing interest in ultrasound-guided pain intervention by clinicians, the demand for a practical reference material on this topic has grown simultaneously. This book thoroughly satisfies the need for such a reference, as it contains text written by experts in the field and a multitude of unique, educational illustrations. Spinal pain, the musculoskeletal system, and peripheral structures function as the fundamental items of discussion across three divided sections. In order to augment the reader's learning experience, the high-quality images found within each chapter provide step-by-step guidance on the various ultrasound scanning procedural processes. Additionally, tips and pearls for scan and injection supplement each chapter conclusion. Ultrasound for Interventional Pain Management: An Illustrated Procedural Guide is a pragmatic, indispensable resource that helps interested clinical practitioners enhance their visual memory and overall understanding of this method.
This book focuses on the features of pelvic pain in the different cancer diseases, the pain assessment tools, as well as the pharmacological and non-pharmacological approaches. Pelvic cancer pain is a common and debilitating symptom, and pain control is a one among the main therapeutic goals throughout the duration of the disease. Because pelvic cancer pain due to primitive cancer, recurrence or metastasis is a complex clinical pathology, no single technique is often guaranteed to produce a complete pain relief. Thus, there are many treatment options, but in most cases a correct approach to pain control should be provided by a multidisciplinary team under the responsibility of a pain specialist coordinating several professionals. This book will aid several figures of practitioners, like anesthesiologists, oncologists or surgeons, in making the correct decisions in individual patients affected by cancer pain due to pelvic diseases.
This concise and handy manual provides straightforward, up-to-date guidance for cardiologists and other practitioners on the management of cancer patients with cardiac problems, whether they be due to the cancer itself or to antineoplastic treatment. Detailed attention is devoted to the various forms of cardiotoxicity associated with chemotherapy and radiotherapy. The drugs commonly responsible for each toxicity are identified and clear advice is offered on monitoring techniques and treatment approaches. In addition, the issue of cardiotoxicity due to cancer treatment in particular patient groups - children, the elderly, and those with pre-existing cardiac disease - is addressed separately, with guidance on when and how antineoplastic (and/or cardiological) treatments should be modified. Further sections describe the correct responses to cardiac problems secondary to the cancer itself, including thromboembolic disorders and electrolyte imbalances, and the diagnosis, treatment, and follow-up of cardiac tumors. A closing section considers how to improve cooperation between oncologists, cardiologists, and general practitioners to ensure that cancer patients' cardiovascular needs are met in a multidisciplinary approach.
This comprehensive text is the definitive academic pain medicine resource for medical students, residents and fellows. Acting as both an introduction and continued reference for various levels of training, this guide provides practitioners with up-to-date academic standards. In order to comprehensively meet the need for such a contemporary text-treatment options, types of pain management, and variables affecting specific conditions are thoroughly examined across 48 chapters. Categories of pain conditions include orofacial, neuropathic, visceral, neck, acute, muscle and myofascial, chronic urogenital and pelvic, acute, and regional. Written by renowned experts in the field, each chapter is supplemented with high-quality color figures, tables and images that provide the reader with a fully immersive educational experience. Academic Pain Medicine: A Practical Guide to Rotations, Fellowship, and Beyond is an unprecedented contribution to the literature that addresses the wide-spread requisite for a practical guide to pain medicine within the academic environment.
Ethical issues facing anesthesiologists are more far-reaching than those involving virtually any other medical specialty. In this clinical ethics textbook, authors from across the USA, Canada and Europe draw on ethical principles and practical knowledge to provide a realistic understanding of ethical anesthetic practice. The result is a compilation of expert opinion and international perspectives from clinical leaders in anesthesiology. Building on real-life, case-based problems, each chapter is clinically focused and addresses both practical and theoretical issues. Topics include general operating room care, pediatric and obstetrical patient care, the intensive care unit, pain practice, research and publication, as well as discussions of lethal injection, disclosure of errors, expert witness testimony, triage in disaster and conflicts of interest with industry. An important reference tool for any anesthesiologist, whether clinical or research-oriented, this book is especially valuable for physicians involved in teaching residents and students about the ethical aspects of anesthesia practice.
A fully updated new edition of this definitive, unrivalled, no-nonsense textbook, Central Pain Syndrome: Pathophysiology, Diagnosis and Management provides new treatment guidelines that aid the reader in effective management. * Encyclopedic coverage of all drug and surgical therapies, including the hot field of non-invasive and invasive cortical stimulation * 26 totally rewritten chapters include expanded sections on deep brain, spinal and other forms of stimulation, and a chapter on the efficacy of alternative and complementary medicine * Critical analysis of all current competing theories, including an expanded account of the leading dynamic reverberation theory which now incorporates a cortical attractor-based model * Clear-cut indications on drug usage, with black boxes for ineffective or dangerous drugs A classic textbook widely hailed on patients' websites, this is key reading for medical specialists and trainees in pain management, neurology, neurosurgery and anesthesiology, as well as for patients
In recent years the field of regional anesthesia, in particular peripheral and neuraxial nerve blocks, has seen an unprecedented renaissance following the introduction of ultrasound-guided regional anesthesia. This comprehensive, richly illustrated book discusses traditional techniques as well as ultrasound-guided methods for nerve blocks and includes detailed yet easy-to-follow descriptions of regional anesthesia procedures. The description of each block is broken down into the following sections: definition; anatomy; indications; contraindications; technique; drug choice and dosage; side effects; potential complications and how to avoid them; and medico-legal documentation. A checklist record for each technique and a wealth of detailed anatomical drawings and illustrations offer additional value. Regional Nerve Blocks in Anesthesia and Pain Medicine provides essential guidelines for the application of regional anesthesia in clinical practice and is intended for anesthesiologists and all specialties engaged in the field of pain therapy such as pain specialists, surgeons, orthopedists, neurosurgeons, neurologists, general practitioners, and nurse anesthetists.
This book provides comprehensive coverage of small fiber neuropathy (SFN), from diagnosis to therapy. It focuses on nerve degeneration and neuropathic pain, and their underlying pathology, physiology, psychophysics, genetics and imaging. In particular, this book describes and discusses the major advances in diagnostic techniques for assessing SFN. These include skin biopsy, evoked potentials, quantitative sensory testing and functional studies, as biomarkers of SFN. SFN is a common peripheral nerve disorder, but was often overlooked due to a lack of objective and specific diagnostic tests for the assessment of small nerve fibers. These fibers mediate thermal sensation, pain detection (nociception), and autonomic regulation. Major symptoms of SFN include neuropathic pain, impaired sensation and autonomic dysfunction. Neuropathic pain poses a diagnostic challenge to clinicians, an essential step for selecting appropriate treatment to relieve suffering. SFN frequently develops in systemic diseases such as diabetes mellitus, following chemotherapy, infections etc., or presents as a major feature of various genetic neuropathies (e.g. channelopathy and familial amyloidosis). In addition to describing these conditions which lead to SFN, this book also describes related syndromes of neurodegeneration and pain, including fibromyalgia, visceral pain and hypersensitivity. This definitive book covers both clinical aspects and research progress, which provides in-depth and up-to-date information on SFN. It would be immensely useful for clinicians, neurologists, neuroscientists, diabetologists, and pain specialists. Dr. Sung-Tsang Hsieh is a professor at Department of Neurology and Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taiwan. He is also the associate dean of College of Medicine, National Taiwan University, Taiwan. Dr. Praveen Anand is a professor at Department of Clinical Neurology and head of Centre for Clinical Translation, Hammersmith Hospital, UK. Dr. Christopher Gibbons is an associate professor of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, USA. Dr. Claudia Sommer is a professor of Neurology at the Department of Neurology, Wurzburg University Hospital, Germany.
Edited by Sudhir Diwan, a former Director of Pain Medicine fellowship program at Ivy League Weill Cornell Medical College, and Timothy R. Deer, an internationally renowned expert in neuromodulation and minimally invasive spinal procedures, this atlas covers advanced procedures that normal residency and fellowship programs may not cover. It consolidates information pain fellows usually amass by traveling throughout the country to various specialized weekend courses. Advanced Procedures for Interventional Pain Management: A Step-by-Step Atlas is for physicians that know the fundamentals of pain medicine and want to push their knowledge further. Through easy-to-digest bullet points, extensive diagrams, hundreds of figures, and expanded legends beneath each illustration, this compendium covers techniques such as fluoroscopic guidance and radiation safety, endoscopic transforaminal discectomy, endoscopic direct-percutaneous discectomy, transforaminal myelogram, percutaneous facet fusion, percutaneous sacroplasty, vertebral augmentations, percutaneous tumor ablation, percutaneous spinal fusion, minimally invasive spinal decompression (MILD), Interspinous Spacer Placement and advanced neuroaugmentation techniques like high frequency stimulation and DRG stimulation. This book also has a dedicated section on Regenerative Medicine with chapters on platelet rich plasma, stem cell therapy, and intradiscal regenerative therapy. Each chapter has a strict chapter format that includes the indications and contraindications for each procedure, a list of equipment and drugs, a step-by-step illustration-focused how-to, a list of possible post-procedural complications, and bullet-pointed clinical pearls and pitfalls. Within each chapter the authors will also cover the variations of each procedure due to different equipment. This book is ideal for pain medicine fellows, spine surgeons, and interventional pain physicians who want access to the best minds and specialized procedures in a single package.
The highly successful Reviews of Physiology, Biochemistry and Pharmacology continue to offer high-quality, in-depth reviews covering the full range of modern physiology, biochemistry and pharmacology. Leading researchers are specially invited to provide a complete understanding of the key topics in these archetypal multidisciplinary fields. In a form immediately useful to scientists, this periodical aims to filter, highlight and review the latest developments in these rapidly advancing fields.
Designed and written by a team of clinically established academics, this is a unique book that is an excellent manual for physicians practicing pain medicine or treating pain in neurosurgery, orthopedic, neurology, or family practice clinics. As a practical resource, this book is written to be more accessible to the reader and is designed to be more clinically-focused and useful in day-to-day practice. This 102 chapter volume is divided into seven separate sections: Anatomy and Physiology of Pain, Psychology of Pain, Pharmacological Treatment of Pain, Interventional Treatment of Pain, Adjuvant Therapies for Pain and Suggested Reading. The calculated organization of this book is supplemented by key photos, drawings and a self-assessment of four key questions at the end of each chapter ------ thus making it an indispensable, pragmatic resource that will benefit anyone working in the pain management field. Deer's Treatment of Pain: An Illustrated Guide for Practitioners contains pearls for improving knowledge and improving one's practice as a physician.
Concentrating on techniques rather than pain pathology, Spinal Interventions in Pain Management is focused purely on the spine. This practical handbook covers anatomy and imaging, how to choose patients, how to undertake procedures, and includes advice on potential pitfalls. Perfect reading for pain interventionalists and trainees before doing a procedure or before an exam, the book covers the most common spinal interventions for pain that pain specialists undertake, including epidurals, diagnostic facet interventions, the intra-articular injection of the sacroiliac joint and radiofrequency denervation, cervical, thoracic and lumbar discography, and neuromodulation (spinal cord stimulation and intrathecal drug delivery). Extensive illustrations, both x-rays and figures, make the book accessible and help to provide a clear understanding of the anatomy, which underpins spinal interventions.
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