This book discusses the effects of emerging technologies on surgeons and surgical practice. The book opens with an overview of disruptive technologies, and their economic, scientific, ethical and social implications. Next comes a section describing how the Internet, virtual reality and simulation technology will change training and education. A section on Robotics covers computer-guided surgery, robotics and endoluminal therapies. Innovations in surgical instruments, including MEMS and Nanotechnology are outlined, as well. Next, the book reviews tissue engineering and artificial organs, genetic engineering, stem cells, emerging transplantation technologies and the brain-machine interface. A concluding section discusses ways of adapting to future technologies.

The use of human tissue for transplantation is becoming a billion-dollar business. This book is the first comprehensive exploration of the American tissue transplantation industry. It traces the chain of distribution of musculoskeletal tissue (e.g. bones and ligaments) and skin from the generous donation of grieving families to its transplantation into hundreds of thousands of persons each year. Commodification, commercialization, and the occasional use of tissue for "cosmetic" surgery have raised ethical questions about the acceptability of "markets" in human body parts that have been altruistically donated by families. Inevitably, questions about the informed consent and the need for responsible stewardship by the industry have been raised, often in the Press.

The book provides a comprehensive background to these ethical problems by explaining the historical development, breadth, and organization of the tissue industry, including the technical developments that have made it simultaneously clinically relevant and an attractive market for investment capital. It explores the similarities and differences in how government regulates other tissues and solid organs (such as hearts and kidneys). Contributions to the book come from an interdisciplinary group of scholars, industry representatives, government regulators, and, not least, families who have donated tissue from their dead loved ones.

Trigeminal nerve injuries present complex clinical challenges and can be very distressing for patients, resulting in abnormal sensations of the oro-facial region, yet surgeons may lack the knowledge required for optimal patient management based upon the specific nerve injury. This textbook is the first to be devoted to the diagnosis and management of trigeminal nerve injuries. A wide range of topics are covered, including historical perspectives, demographics, etiology, anatomy and physiology, pathophysiology, clinical neurosensory testing, nonsurgical management, and surgical management and principles of microneurosurgery, specifically involving the inferior alveolar and lingual nerves. Algorithms and a glossary are provided that will assist in the clinical management of these complex scenarios. The authors include surgeons with considerable experience and expertise in the field who have previously published on the subject. This book will serve as an ideal clinical reference for surgeons with patients who sustain trigeminal nerve injuries.

Whilst preparing for his travel adventures into a world he had yet to explore, Christopher Yeoh was involved in a road traffic accident and experienced something few others would be "privileged" to witness. Eight days in a coma, more than a year in and out of hospital and a gradual re-introduction to the world of work. A Different Perspective After Brain Injury: A Tilted Point of View is written entirely by the survivor, providing an unusually introspective and critical personal account of life following a serious blow to the head. It charts the initial insult, early rehabilitation, development of understanding, the return of emotion, moments of triumph and regression into depression, the exercise of reframing how a brain injury is perceived and a return to work. It also describes the mental adjustments of awareness and acceptance alongside the physical recovery process. Readily accessible to the general public, this book will also be of particular interest to professionals involved in the care of people who have had significant brain injuries, brain injury survivors, their families and friends and also those who fund and organise health and social care. This unique author account will provide a degree of understanding of what living with a hidden disability is really like.

Whilst preparing for his travel adventures into a world he had yet to explore, Christopher Yeoh was involved in a road traffic accident and experienced something few others would be "privileged" to witness. Eight days in a coma, more than a year in and out of hospital and a gradual re-introduction to the world of work. A Different Perspective After Brain Injury: A Tilted Point of View is written entirely by the survivor, providing an unusually introspective and critical personal account of life following a serious blow to the head. It charts the initial insult, early rehabilitation, development of understanding, the return of emotion, moments of triumph and regression into depression, the exercise of reframing how a brain injury is perceived and a return to work. It also describes the mental adjustments of awareness and acceptance alongside the physical recovery process. Readily accessible to the general public, this book will also be of particular interest to professionals involved in the care of people who have had significant brain injuries, brain injury survivors, their families and friends and also those who fund and organise health and social care. This unique author account will provide a degree of understanding of what living with a hidden disability is really like.

We are in an exciting era in the war against cancer, with real prospects for novel anticancer drugs that are cancer cell-specific without the toxicities that have been the hallmark of conventional cytotoxic cancer chemotherapy. Advances in cancer cell biology fueled by the molecular biology revolution have resulted in the uncovering of many novel potential molecular targets for cancer therapy. New anticancer drug discovery and development is now largely focused on exploiting these new molecular targets, which encompass oncogenes, tumor s- pressor genes, and their gene products, as well as targets involved in tumor angiogenesis, metastasis, survival, and longevity mechanisms. Exploitation of some of these targets has already yielded fruits and introduced new paradigms of molecularly targeted cancer therapy into the clinic, namely, protein kinase in- bition by antibodies or small molecules, exemplified by Herceptin (R) (trastuzumab), a humanized antibody targeted against the HER-2 growth factor receptor tyrosine kinase for the treatment of metastatic breast cancer; and Gleevec, a small molecule bcr-abl kinase inhibitor for the treatment of chronic myel- enous leukemia.

Moving beyond the debate over whether and to what degree mild head injury has lasting neuropsychological sequelae, this book is predicated on the assumption that it does cause some problems in some circumstances for some people. It focuses on the practical questions of who is injured, how injuries manifest themselves, and what evaluation and treatment strategies are optimal, for families as well as patients. The distinguished authors bring to their task not only scientific expertise but extensive day-to-day clinical experience. This book will be widely welcomed as the first comprehensive overview of what we have learned from research and clinical experience about these difficult cases.

Emphasizing a team approach that includes the practicing podiatrist, endocrinologist, diabetologist, vascular surgeon, orthopedist, and infectious disease specialist, The High Risk Diabetic Foot provides a thorough and detailed resource on the management of complex diabetic foot problems. This comprehensive text is an essential tool that will enable physicians to reduce infections and amputations through careful examination, diagnosis, treatment, and prevention. Key features in The High Risk Diabetic Foot include: A full section devoted to the prevention of amputation High-quality images for accurate diagnosis Chapters organized by epidemiology, classification and staging, diagnosis, special studies, and medical and surgical management Summary tables and flow charts for quick reference A discussion of the co-morbidities associated with diabetic foot pathology, including sensory neuropathy, painful neuropathy, peripheral vascular disease, food wounds, and more Identification of the level of medical evidence associated with treatment recommendations

The only available text to focus primarily on Acute Respiratory Distress Syndrome (ARDS). Thoroughly revised content and ten new chapters provide pulmonologists with the latest developments and applications of pharmacological and mechanical therapies needed to treat the debilitating and difficult condition of ARDS. Highlights include: the definition, epidemiology, pathology, and pathogenesis of ARDS complications such as transfusion-related injury, and endothelium and vascular dysfunction the long-term outcomes of ARDS host defense and infection the latest developments in ARDS therapy: glucocorticoid therapy, surfactant therapy, mechanical ventilation, and mesenchymal stem cells predictive factors: gene expression profiling and biomarkers, and chemokines and cytokines advances in management strategies: fluid management, non-pulmonary and non-sepsis management, and glucose control

The case studies in this book use authentic injury assessment examples to help readers link theory and clinical practice with the goal of becoming competent clinicians. The situations are realistic and present more than 130 of the injuries that athletic trainers may encounter in the real world. The questions that accompany the cases ask readers to identify clinical and differential diagnoses, critique the evaluating clinician's actions, recommend treatment, comment on ethical choices, and make many of the decisions they will face in the field. The cases encourage readers to think and problem solve; evidence-based answers (for select cases in the text and for all cases in the instructor's manual) ensure that the recommended clinical decisions are based on the best available research, clinical expertise, and patient preferences rather than on anecdotal practice.

'Principles and Practicalities of ENT' ensures that doctors of all levels are well equipped to approach common clinical scenarios encountered in ENT with confidence. Each section covers how to prepare for patients, includes key points in the history and examination, and how best to investigate and manage a wide variety of common ENT presentations and conditions. The material is structured to provide an easy reference including red flag and primary care sections to enable readers to know what to look out for when considering referrals. Inaddition to being a revision tool for medical students, doctors pursuing MRCS (ENT) examinations and higher surgical training in ENT, this book also serves as a useful aid for primary care physicians in their everyday diagnostics and referral practices.

This volume provides a full explanation and technical details to perform surgical techniques properly on small and large animal models. The first six chapters of Experimental Neurosurgery in Animal Models focus primarily on the brain, while the next six chapters concern the spinal cord in rodents. The last four chapters provide a description of operative procedures in large animals. Written for the popular Neuromethods series, chapters include the kind of detail and key implementation advice that ensures successful results in the laboratory. Authoritative and practical, Experimental Neurosurgery in Animal Models aims to ensure successful results in the further study of this vital field.

Keyhole surgery has been made possible through the rapid development of various medical technologies, first pioneered in the 1970s. Revolutionary in the way it reduced the risk, surgical complications, healing time and scarring compared to open surgery, keyhole surgery soon became the preferred method throughout many surgical specialities.Here, John Wickham, the 'godfather' of robotic surgery, reflects on a life spent in research, discovery and struggle for innovation in order to make keyhole surgery widespread, accessible and available to patients. An Open and Shut Case tracks the evolution of surgery in the later parts of the 20th century, from initial surgical training in the 1960s to the rapid growth in the field of minimally invasive techniques throughout the 1970s and 80s in many specialities, precursors to the techniques used today. It concludes with a look at the effect of the National Health Service on the practice of medicine and nursing in the UK throughout this time.Perfect for surgeons and those interested in the history of surgery and surgical techniques, it also focusses on lessons learnt, both good and bad, when dealing with the management of public health.

Keyhole surgery has been made possible through the rapid development of various medical technologies, first pioneered in the 1970s. Revolutionary in the way it reduced the risk, surgical complications, healing time and scarring compared to open surgery, keyhole surgery soon became the preferred method throughout many surgical specialities.Here, John Wickham, the 'godfather' of robotic surgery, reflects on a life spent in research, discovery and struggle for innovation in order to make keyhole surgery widespread, accessible and available to patients. An Open and Shut Case tracks the evolution of surgery in the later parts of the 20th century, from initial surgical training in the 1960s to the rapid growth in the field of minimally invasive techniques throughout the 1970s and 80s in many specialities, precursors to the techniques used today. It concludes with a look at the effect of the National Health Service on the practice of medicine and nursing in the UK throughout this time.Perfect for surgeons and those interested in the history of surgery and surgical techniques, it also focusses on lessons learnt, both good and bad, when dealing with the management of public health.

1. Features recent developments like 3-D surgery, telescopic IOL, bionic implants and robotic surgery. 2. Highlights case selection and important precautions to be taken by vitreoretinal surgeons and senior residents. 3. Covers the controversies surrounding primary VR versus RD surgery in Phakic, fresh retinal detachments; Positioning after macular hole/ VR surgery; and to peel or not peel ILM in non-macular hole retinal surgery.

The introduction of a new technology in a consolidated field has the potential to disrupt usual practices and create a fertile ground for errors. An example is robotic surgery that is now used in most surgical specialties, pushed by technology developers and enthusiastic surgeons. To analyze the potential impact of robotic surgery on patient safety, a consortium of major European Universities started the project SAFROS whose findings are summarized and further elaborated in the three parts of this book. Part one describes safety in complex systems such as surgery, how this may disrupt the traditional surgical workflow, how safety can be monitored, and the research questions that must be posed. Part two of the book describes the main findings of this research, by identifying the risks of robotic surgery and by describing where its ancillary technologies may fail. This part addresses features and evaluation of anatomic imaging and modeling, actions in the operating room, robot monitoring and control, operator interface, and surgical training. Part three of the book draws the conclusions and offers suggestions on how to limit the risks of medical errors. One possible approach is to use automation to monitor and execute parts of an intervention, thus suggesting that robotics and artificial intelligence will be major elements of the operating room of the future.

Surgeons start their career in the expectation that it will bring personal satisfaction through an unparalleled sense of achievement and professional growth. Nonetheless, a career in surgery carries with it serious challenges: surgical training is rigorous, both emotionally and physically, and demands that the surgeon adjust to unpredictability. Chronic levels of stress can affect surgical performance, the quality of family relationships, and even the nature of the doctor-patient relationship. Unmanaged stress has been shown to contribute to physical illness, emotional problems, absenteeism, poor job performance, drug abuse, and negative social attitudes. With a background in both surgery and psychological medicine, Dr Shiralkar examines the psychosocial burden of being a surgeon and offers insights into the role of intra-human factors in surgery. He reveals surgical performance from a psychological perspective and highlights the factors that cause unsatisfactory performance. He also offers solutions to rectify the problem and prevent burnout. The book will be invaluable to all those embarking on a surgical career, as well as to established surgeons in all specialties who wish to understand how to identify and manage the factors that could lead to career-limiting levels of stress.

This book explores the non-interventional aspects of interventional pulmonology, focusing on diseases of the central airways. As the field of bronchology and interventional pulmonology expands, newer conditions involving the central airways are being recognized with increasing frequency. Current literature has mainly focused on technical aspects of the subspecialty, but this book illuminates what else interventional pulmonology has to offer the pulmonologist, including diagnosis and alternate therapeutic options. Diseases of the Central Airways: A Clinical Guide presents techniques for the diagnoses, management and treatment of patients with intriguing central airway conditions such as: black bronchoscopy, tracheobronchomalacia, endobronchial tuberculosis, and tracheobronchopathia osteochondroplastica. In-depth chapters are written by international experts and are up-to-date and comprehensive reviews. This important new book will contribute significantly to the welfare of patients with lung ailments of the central airways.

LA WRENCE G. RAISZ, MD Division of Endocrinology and Metabolism, University of Connecticut Health Center. Farmington. CT The rapid transfer of new knowledge concerning the pathogenesis, diagnosis, preven tion, and treatment of disease into clinical practice has always been a major challenge in medicine. This challenge is particularly difficult to meet in osteoporosis, not only because has been so much new knowledge generated in recent years, but also because this there disorder has not caught the attention of many practicing physicians. The goal of this volume is to help primary care physicians develop a better understanding of osteoporosis and a more effective approach to diagnosis, prevention, and treatment. As primary care physicians become more and more responsible for the maintenance of health and the prevention of disease, osteoporosis must become one of their important concerns. The magnitude of the problem of osteoporosis has been widely publicized. Within the next 30 years, the cost of hip fractures alone is expected to exceed $40 billion a year in the United States and will be a major cause ofincreased mortality. In addition, vertebral crush fractures will cripple more and more of our elderly population, both men and women. This enormous toll is not inevitable. Current methods of identifying individuals at risk and applying preventive programs could reduce the incidence offractures by 50% or more. This should be the minimum goal of clinicians."

Pain is an unfortunate daily experience for many individuals. Chronic pain -- lasting six or more months -- is suffered by approximately 30% of the population in the United States. These individuals wake up, function during the day and go to sleep, trying to keep pain at a minimum while, at the same time, maintaining some quality of life. They may make frequent visits to the doctor and the pharmacy. When they find relief, it is usually short-lived and comes at a cost such as dependence on narcotic medications or complete limitation of activity. Pain often becomes the central point of their existence. This practice guide describes an approach to psychological evaluation of the chronic pain patient who is being considered for surgery. A large body of research is accumulating which demonstrates that the outcome of surgical procedures aimed at chronic pain relief can be strongly influenced by psychological and emotional factors. This approach, termed "presurgical psychological screening" (PPS) uses interview and testing techniques to identify emotional, behavioral, and psychosocial difficulties which have been demonstrated to negatively impact surgical outcome. Studies show that even patients with clearly identifiable pathophysiology may respond poorly to surgery, due to issues such as pain sensitivity, medication dependence, rewards for pain behavior and personality style. Thus, some insurance carriers, rehabilitation nurses and state worker's compensation systems are encouraging, or even requiring, presurgical psychological screening in cases of surgery designed to relieve chronic pain. The first to present a comprehensive, unified approach to PPS in chronic pain syndromes, this text is designed to provide the behavioral health practitioner, as well as the trainee, with all the tools and information necessary to conduct PPS evaluations. It identifies a multitude of risk factors for poor surgical outcome and reviews research associated with each risk factor. Hands-on techniques for eliciting information from the patient about risk factors is also detailed. Toward this end, the practice guide also contains a number of forms and session outlines which can be directly utilized, or which can be altered to fit readers' needs. Models for weighing and combining surgical outcome risk factors are also provided. Thus, practitioners are able to reach valid and reliable predictions of surgical results. Finally, the text provides outlines of psychological interventions which can facilitate surgical outcome as well as surgical treatment alternatives. Upon completion of this practice guide, readers should be able to begin providing PPS evaluations which are scientifically valid, clinically sound, and which result in significant overall improvement in the treatment of chronic pain syndromes.

are g rowing among core specialists in the aesthetic field, aesthetic medicine is advancing exponentially. The two authors of this text have worked together to provide a knowled- able and practical approach to the male patient in aesthetic medicine. April 2009 Timothy Corcoran Flynn, M.D. Clinical Professor, University of North Carolina at Chapel Hill Medical Director, Cary Skin Center, Cary, NC 27608, USA Preface Men are different from women in many ways. Male aesthetics are different from female aesthetics. Most readers would agree with this statement. However, as the majority of our patients are still female, even cosmetic physicians may tend to treat their male patients like female patients. This can lead to dissatisfaction of the patient and consequently of the cosmetic physician. As the demand for aesthetic procedures in male patients is rising, there is a need for good textbooks on this subject. The aim of this book is to explain the specifities of the ageing process and facial aesthetics in men and to present the treatments available. In addition, common skin conditions and diseases that also influence the male aesthetic appearance will be discussed. The book written from the perspectives of a plastic surgeon and a dermatologist should enable us to treat our male patients better, and by that increase the satisfaction of our patients and, last not least, our satisfaction as the treating physicians.

This book introduces readers to the latest developments regarding pressure injury wounds, diabetic wounds, and negative pressure wound therapy. The first part exclusively deals with wounds from pressure ulcers, describing in detail their prevention, classification, and treatment. In turn, chapters addressing diabetic wounds form the middle part of the book. Here, the authors provide guidance on the medication and treatment (e.g. stem cells, laser) of patients suffering from this disease. The book's last part, which focuses on negative pressure wound therapy, addresses all major aspects of this approach, reflecting the latest research. Illustrated with a wealth of high-quality pictures throughout, the book offers a unique resource for both beginners and experienced plastic surgeons.

This is a new account, of how, in the early 1900s, the French-born surgeon Alexis Carrel (1873-1944) set the groundwork for the later success in human organ transplantation, and gained America's first Nobel Prize in 1912. His other contributions were the first operations on the heart, and the first cell culture methods. He was prominent in military surgery in WW1, and in the 1930s, gained further fame when collaborating with the aviator Charles Lindbergh on an organ perfusion pump.But controversy followed his every move, including concerns over scientific misconduct, notably his claim to have obtained 'immortal' heart cells, now shown to be fraudulent. In 1934, he authored a best-selling book Man, the Unknown based on his strongly-held conservative, spiritual, political and eugenic views, adding a belief in faith healing and parapsychology. He settled in Paris in WW2 under the German occupation, believing that the conditions would allow him to refashion the degenerate Western civilization. His extremist views re-emerged in the 1990s when they proved interesting to right-wing politicians, and in a bizarre twist, jihadist Islamists now laud his criticisms of the West.

This is a new account, of how, in the early 1900s, the French-born surgeon Alexis Carrel (1873-1944) set the groundwork for the later success in human organ transplantation, and gained America's first Nobel Prize in 1912. His other contributions were the first operations on the heart, and the first cell culture methods. He was prominent in military surgery in WW1, and in the 1930s, gained further fame when collaborating with the aviator Charles Lindbergh on an organ perfusion pump.But controversy followed his every move, including concerns over scientific misconduct, notably his claim to have obtained 'immortal' heart cells, now shown to be fraudulent. In 1934, he authored a best-selling book Man, the Unknown based on his strongly-held conservative, spiritual, political and eugenic views, adding a belief in faith healing and parapsychology. He settled in Paris in WW2 under the German occupation, believing that the conditions would allow him to refashion the degenerate Western civilization. His extremist views re-emerged in the 1990s when they proved interesting to right-wing politicians, and in a bizarre twist, jihadist Islamists now laud his criticisms of the West.

This is a stunningly well-written account of the life of a surgeon: what it is like to cut into people's bodies and the terrifying - literally life and death - decisions that have to be made.There are accounts of operations that go wrong; of doctors who go to the bad; why autopsies are necessary; what it feels like to insert your knife into someone.