General surgery consists ofa main corpus of propaedeutic elements and clinical problems, which has been modified over the years by the separate development of numerous sub-specialistic branches. Although a common basis on the physiopathology of surgical trauma and post operative complications persists, as a result of general knowledge of surgical diseases, there is no doubt that in the spheres of doctrine and application, both research and clinical medicine have distinguished themselves autonomously in many surgical fields (orthopedics, neurosurgery, cardiovascular surgery, thoracic surgery, urology, etc.). It is therefore difficult to define the present configuration ofgeneral surgery, but without question abdominal surgery occupies a position of pre-eminent importance within the general framework. We are dealing, in fact, with pathological pictures which occur in a section ofthe body ofvast proportions, in which structures, organs, and morphologically complex spaces are arranged to carry out important functions. They are, therefore, subject to considerably complex pathological alterations, such as to establish an interesting field of diagnostic discussion and an exciting training-ground for surgical activity. It can be affirmed that the diagnosis and cures ofabdominal surgical diseases constitute a test ofthe surgeon's experience. Diagnosis is often entrusted to a differential process, the results ofwhich may be confirmed today by complementary diagnostics. This, however, must be guided by predominating clinical considerations, the exaggerated use of diagnostic techniques, detached from clinical examination, being the cause of very serious errors, which can mislead decision making and human contact, which is the basis ofcorrect medical practice.

In the late 1980s, a promising new treatment for breast cancer emerged: high-dose chemotherapy with autologous bone marrow transplantation or HDC/ABMT. By the 1990s, it had burst upon the oncology scene and disseminated rapidly before having been carefully evaluated. By the time published studies showed that the procedure was ineffective, more than 30,000 women had received the treatment, shortening their lives and adding to their suffering. This book tells of the rise and demise of HDC/ABMT for metastatic and early stage breast cancer, and fully explores the story's implications, which go well beyond the immediate procedure, and beyond breast cancer, to how we in the United States evaluate other medical procedures, especially life-saving ones.
It details how the factors that drove clinical use--patient demand, physician enthusiasm, media reporting, litigation, economic exploitation, and legislative and administrative mandates--converged to propel the procedure forward despite a lack of proven clinical effectiveness. It also analyzes the limited effect of technology assessments before randomized clinical trials evaluated decisively the procedure and the ramifications of this system on healthcare today.
Sections of the book consider the initial conditions surrounding the emergence of the new breast cancer treatment, the drivers of clinical use, and the struggle for evidence-based medicine. A concluding section considers the significance of the story for our healthcare system.

Alessandro Condivilla of Bologna first attempted a resection of the head of the pan creas in 1898, but several decades of further trial-and-error attempts ensued before the prototype procedure of pancreatoduodenectomy (PD) was established by Whipple in 1935. In the half-century following that landmark, refinements of surgical technique, including pancreatico-and bilio-entero anastomosis as well as develop ment of new technology to support perioperative management and patient care have contributed to the decrease in mortality and morbidity rates for obstructive jaundice and pancreatic fistula. The improvement in mortality and morbidity rates associated with PD has led to an increase in the number of patients undergoing the procedure and in the number of institutions performing it. Indications for PD have also been expanded. In the early years after PD was established as a viable procedure, periampullary carcinoma was the most common indication; now PD is indicated for a number of benign and malignant diseases. Some surgeons believe that PD is the procedure of choice for certain types of chronic pancreatitis, pancreatico-biliary maljunction, and pancreatic and duodenal trauma. Other surgeons have reported the necessity of PD for lymph node dissection of gallbladder carcinoma. Consequently, the basic procedure has been greatly modi fied to accommodate the specific conditions of each disease. For patients with malig nancy, extended procedures have been developed to improve the curative resection rate and ensure complete lymph node dissection.

This text highlights the value of a team approach to appreciating the commplexity of spinal pain and a range of treatment approaches. Contributions from epidemiology, anatomy, pathology, biomechanics, clinical medicine orthopaedics, chiropractic, osteopathy and physiotherapy are presented. Each section is written by an experienced practitioner and provides a summary of pertinent material, seeking to improve the reader's understanding of the causes of cervical spine pain The volume is part of a series of three books bringing together a multidisciplinary approach to the management of mechanical spinal pain.

This first-of-its-kind text provides a multidisciplinary overview of a significant problem in hospital-based healthcare: patients who decline inpatient medical care and leave the hospital against medical advice (AMA). Compared to standard hospital discharges, AMA discharges are associated with worse health and health services outcomes. Patients discharged AMA have been found to have disproportionately higher rates of substance use, psychiatric illness, and report stigmatization and reduced access to care. By providing a far reaching examination of AMA discharges for a wide academic and clinical audience, the book serves as a reference for clinical care, research, and the development of professional guidelines and institutional policy. The book provides both a broad overview of AMA discharges with chapters on the epidemiology, ethical and legal aspects, as well as social science perspectives. For clinicians in the disciplines of hospital medicine, pediatrics, emergency medicine, nursing, and psychiatry, the book also provides a patient-centered analysis of the problem, case-based discussions, and a discussion of best practices. This comprehensive review of AMA discharges and health care quality will interest physicians and other health care professionals, social workers, hospital administrators, quality and risk managers, clinician-educators, and health services researchers.

Examining the history of arterial repair, Of Life and Limb investigates the process of surgical innovation by exploring the social, technological, institutional, and martial dynamics shaping the introduction and adoption ofa new operation. In 1880, patients suffering from vascular disease faced amputation -- or death. By 1960, a suite of revolutionary techniques and technologies empowered surgeons to remedy aneurysms, mend damaged vessels, and treat arteries cloggedwith cholesterol, saving the lives and limbs of patients around the world. Tracking this remarkable transformation, Of Life and Limb: Surgical Repair of the Arteries in War and Peace, 1880-1960 reveals how social, technological, institutional, and military dynamics interplay to catalyze modern surgical innovation. Author Justin Barr examines each of these phenomena through the complementary perspectives of academic historian andclinical surgeon, marshaling extensive research and incisive analysis into a broadly applicable model that helps frame, illuminate, and forecast change in surgery. Justin Barr received his PhD in History from Yale University and his MD from the University of Virginia. He is currently in residency for general surgery at Duke University.

Metabolic Bone Disease, Third Edition is the new, expanded edition of the classic text, featuring the latest advancements and research information in this fast-moving field. The Third Edition includes the most up-to-date information on molecular mechanisms, basic biology, pathophysiology, and diagnosis and management strategies of metabolic bone disease.
Key Features
* Edited by "fathers of the field"
* An expanded version of a classic AP text
* Complete coverage of a fast-growing field

This book covers lymphoproliferative disorders in patients with congenital or acquired immunodeficiencies. Acquired immunodeficiencies are caused by infections with the human immunodeficiency virus or arise following immunosuppressive therapy administered after organ transplantation or to treat connective tissue diseases such as rheumatoid arthritis. It was recently discovered that various diseases or therapeutic modalities that induce a state of immunosuppression may cause virally driven lymphoproliferations. This book summarizes for the first time this group of immunodeficiency-associated lymphoproliferations.

A definitive summary of novel techniques, this 1st volume in the New Technologies Series details the most current and multidisciplinary approach to new technologies used in general plastic, hand, peripheral nerve, microsurgery, breast, esthetic, and trauma surgery and provides an overview of the most important and clinically relevant plastic surgery research.

New surgical images of new surgical approaches are all accompanied with anatomical descriptions. In a novel way it contains endoscopic images from minimally invasive procedures and provides the most current overview of the leading trends in plastic surgery research.

Presenting newly developing clinically relevant techniques and technologies, this book aims to stimulate the reader to look at future advances and applications of research and their relevance to daily clinical practice.

Appropriate for different sub-specialties not only in plastic surgery but also in orthopedics and neurosurgery, this book will also be of great interest to trainee surgeons.

Hair transplantation is in demand worldwide, but because Asian hair tends to be more sparse and coarse than Caucasian hair, transplantation procedures need to be adapted to Asian patients. This book, exclusively devoted to Asian hair, is a complete and comprehensive text written by a group of authors sharing their experience in their specialized fields of hair restoration. Included are many practical tips as well as chapters on regional transplantation such as eyebrows, eyelashes, sideburns, beards, and mustaches, in addition to the usual scalp hair restoration. With its many illustrations, the book gives readers a complete knowledge of hair restoration surgery and provides a quick, easy-to-use reference on Asian hair and the differences in patients' demands. With an influx of new physicians in this challenging field of medicine, further education and training are imperative and must be available to provide a high standard of medical practice. This compilation meets that objective and ultimately makes the valuable contribution of restoring patients' self-confidence.

Back Pain and Spinal Manipulation: a practical guide presents a highly-illustrated, didactic guide to the diagnosis and manipulative treatment of back pain. Based on a diagnostic approach to back pain the text is extremely practical and includes how-to-do-it-yourself tips based on the authors' many years of practical experience. The second edition of this popular text has been extensively revised and updated to include the developments that have taken place within the field in recent years. New illustrations have been added, and the format has been redesigned to produce a text that makes the information more easily accessible. New for the second edition: * manipulation techniques for the thoracic spine * sacro-iliac disorders and treatment * muscle stretching techniques * muscle energy techniques Features includes: key check points, classification of techniques, charts on technique/directness/specificity and do's and don'ts, and position of the patient/position of the therapist. With an emphasis throughout on practical information that is easy to follow, the book is essential reading for all practitioners, physiotherapists, chiropractors and osteopaths involved in the diagnosis and treatment of back pain.

Therapeutic hypothermia has emerged as a very important treatment option for patients with cardiac arrest as it provides significant protection from developing neurologic injury once the patient has been successfully resuscitated. Studies have demonstrated over 15% absolute risk reduction in death and neurologic injury using this therapy. Although hospitals and medical centers have become familiar with this important intervention it still remains greatly under utilized due to an experience and lack of resources to safely and effectively deploy such a program. The objective of this book is to educate and familiarize both providers and institutions as to how to develop and deploy and provide therapeutic hypothermia to their patients. The current knowledge for this is provided by speakers and national experts and also by literature review. There are several courses being provided on this as well throughout the US. These are good venues for people to come and see and get hands on experience, but there still needs to be a concrete book with references on how to go about getting this program started.

This book, featuring more than 180 high spatial resolution images obtained with state-of-the-art MDCT and MRI scanners, depicts in superb detail the anatomy of the temporal bone, recognized to be one of the most complex anatomic areas. In order to facilitate identification of individual anatomic structures, the images are presented in the same way in which they emanate from contemporary imaging modalities, namely as consecutive submillimeter sections in standardized slice orientations, with all anatomic landmarks labeled. While various previous publications have addressed the topic of temporal bone anatomy, none has presented complete isotropic submillimeter 3D volume datasets of MDCT or MRI examinations. The Temporal Bone MDCT and MRI Anatomy offers radiologists, head and neck surgeons, neurosurgeons, and anatomists a comprehensive guide to temporal bone sectional anatomy that resembles as closely as possible the way in which it is now routinely reviewed, i.e., on the screens of diagnostic workstations or picture archiving and communication systems (PACS).

Designed to provide a highly visual reference for surgeons and other members of the patient management team, Atlas of Intestinal Stomas is based on the 1967 gold standard text, Turnbull and Weakly's Atlas of Intestinal Stomas. Additions include chapters on anatomy and physiology, biliary stomas, pediatric ostomies, the continent ileostomy, urostomy, laparoscopic stoma construction, stomas in trauma surgery, stomas for antegrade continence enema, percutaneous ostomies, and quality of life. There are also sections on ileostomy, colostomy, enterostomal therapy and on the management of complications of stomas such as management of the high output ostomy, enterocutaneous fistula, parastomal hernia, prolapse, and skin conditions. The Cleveland Clinic pioneered the entire practice of ostomies, beginning in 1858 and continuing to this day as the world's leading academic and clinical center. The editors and contributors are all current or former Cleveland Clinic physicians and instructors. The fundamental focus of the book is not only how to install ostomies, but how to avoid complications and how to treat complications when they arise. Atlas of Intestinal Stomas will be of great value to colorectal and general surgeons, both in practice and in training.

This book provides detailed, comprehensive and illustrative content to the surgical community in the areas of foregut oncologic surgery. The text contains an in depth review of all surgical aspects of oncologic diseases involving the stomach and esophagus. The main focus is on the minimally invasive techniques including potential complications and their management. The text also includes an online link for the videos for all minimally invasive foregut surgical procedures including animation content which provide a more comprehensive learning experience. Minimally Invasive Foregut Surgery for Malignancy: Principles and Practice is structured in a way that makes it useful at every level of training and will be of great utility to practicing surgeons, fellows in surgical subspecialty training and surgical residents.

Technical and Biological Components of Marrow Transplantation presents up to date information on the scientific and technological advances that will extend and improve the clinical application of bone marrow transplantation. The book includes the latest information on chronic myeloid leukemia and thalassemia; advances in supportive care: cytokines and progenitor expansion; and cord stem cell technology. Soon more of patients will receive marrow transplants as part of the therapy for solid tumors and metabolic disease than for the treatment of hematologic disease. The contributors to this volume describe some of these applications, hinting at yet further, exciting possibilities.

Reoperative surgery is a problem that is confronted by every surgeon and this book offers up-to-date information and techniques for critical cases in all of the pediatric surgical specialties. The book is comprehensive, covering the full spectrum of pediatric reoperation, and it addresses the complications of common pediatric surgeries. This book is an essential resource for both surgeons and non-surgeons involved in the care of pediatric patients.

A practical and richly illustrated step-by-step guide to successfully performing shoulder arthroplasty. The comprehensive text covers various topics, and also provides specific examples of complications and how to avoid and correct them.

Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management.

The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.

Leading transplant physicians critically review and interpret twenty-one key clinical challenges in bone marrow/hematopoietic cell transplantation, and offer their best personal recommendations for treatment. Topics range from transplant strategies to complications of bone marrow transplantation, including a discussion of the indications, benefits, and the risks for a variety of leukemias, lymphomas, and solid tumors. The authors debate such contentious issues as the appropriateness of transplants in older patients, how many stem cells are sufficient for engraftment, and the pros and cons of umbilical cord blood transplantation. Up-to-date and clinically focused, Current Controversies in Bone Marrow Transplantation offers clinical oncologists, hematology/oncology fellows in training, and residents in internal medicine today's best ready reference and management guide for all their critical oncologic problems arising from the use of bone marrow/stem cell transplantation.

Ethical rational, facts, and center techniques for choosing kidney donors all in one volume. This is the first book of its kind, devoted solely to preoperative issues for living kidney donors and those who counsel them. The eight chapters are devoted to vital areas that are comprehensively addressed by experienced professionals. The book presents a unified ethical and factual approach that is essential for all transplant centers to understand. It is a readable and understandable ethical foundation for living kidney donation that is free of jargon. It includes balanced, hard to find factual summaries that are essential for acceptable kidney donor counseling. As transplant centers increasingly turn to living kidney donors, this book is an essential step forward in the field.
The book will appeal to transplant physicians and surgeons, transplant coordinators and social workers, nephrologists who have patients on dialysis or who evaluate potential living kidney donors and to potential living kidney donors and their recipients. As a practical application of medical ethics to an important field, it will be of interest to medical ethicists as well.

Rotary blood pumps increasingly are being used in open heart surgery and in assisted circulation for patients with heart disease. These rotary devices include vortex (centrifugal) and axial pumps, which can be utilized in conditions where the use of conventional pulsatile pumps would entail problems of cost and size. Rapid progress is now being made in developing new devices for controlling blood flow within the heart and great vessels as well as extracorporeally for use in coronary and intensive care units and, in the future, for long-term use. This book provides information on the physiology of nonpulsatile circulation, the development of rotary pump engineering, and the clinical application of rotary blood pumps. It also presents an overview of future developments in this important field.