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In one golden age of medicine epitomized by William Osler, the physician also aspired to mastery of gross and microscopic pathologic anatomy. Now another such age has dawned in which ultrastructure and immunopathology provide insights into mysterious diseases of the kidney, connective tissues, joints, and muscles, among other sites. Dr. Anil K. MandaI has a background in clinical nephrology, experimental pathology, and diagnostic pathology of renal diseases that suits him well for his chosen task. This is to explain clearly the clinicopathologic entities seen by nephrologists, using the full range of available morphologic techniques. His ap- proach is brisk and incisive. To read his monograph as a pathologist is to make oneself a better clinician, and as a physician is to improve one's grasp of pa- thology. Such correlative knowledge seems at present the means most likely to lead to the ultimate control of some crippling chronic renal diseases. Sheldon C. Sommers, M.D.
LOUIS TOBIAN There are many reasons for suspecting that the medulla of the kidney is involved in the pathogenesis of hypertension. Although our present knowledge does not permit the assignment of a precise and exact role for the medulla, there are so many indications of its involvement that this is an appropriate time for the subject to be thoroughly reviewed, as Drs. MandaI and Bohman have done in this volume. The involvement of the renal medulla in hypertension was first strongly indicated by the studies of Eric Muirhead. Studying renoprival hyperten sion, he demonstrated that the injection of extracts of renal medulla could prevent this type of hypertension in the dog, rabbit, and rat. Subsequently, a number of experiments showed that implants of renal medulla could not only prevent renoprival hypertension but also greatly reduce the level of blood pressure in Goldblatt hypertension in the rat and rabbit. It was later noted that the majority of the surviving cells in these medullary implants were interstitial cells. Pitcock and Muirhead were able to culture these interstitial cells, and implants of the cultured cells lowered blood pressure in renoprival hypertension and Goldblatt hypertension, particularly in the rat. We were able to confirm these general observations by employing implants of medulla in "postsalt" hypertension. The medullary implants did indeed bring the blood pressure down."
Diabetes is a prevalent disorder throughout the world; it has become a universal topic for conversation superseding topics like heart disease or cancer. Self-care and taking responsibility for the illness are integrally important in diabetes so that the patient stays healthy and complications do not develop. Self-care consists of the following: a prescribed diabetes diet, indulging in daily physical activities and taking prescribed doses of insulin. Self-care is promoted through repeated education by doctors and allied health professionals who are knowledgeable in diabetes, pathophysiology and clinical diabetes care. The Handbook of Diabetes for General Practitioners is written for doctors to apprise the fundamentals of diabetes including its recognition as an entity, the discovery of insulin for the treatment of diabetes, pathophysiology of diabetes, and the development and progression of diabetic complications and how to minimize or prevent the complications. Also, several chapters are written to focus on the common flaws in the diagnosis and improper treatment of diabetes. Incorrect diagnosis and treatment of drug-induced hyperglycemia leads to the development of overt diabetes with a range of complications. Diabetic complications are serious, disabling and economically disastrous for healthcare providers. By reading this book, doctors and allied health professionals will be better prepared to deal with the adversities of diabetes to ultimately help their patients live a complication-free life.
'Diabetes Mellitus: A True Life Story of How to Cope and Thrive' is written to educate people who have developed diabetes, who have concern that they may develop diabetes because of family history of diabetes, and those who are curious to know about diabetes. Diabetes is so prevalent that it has become a universal topic for gossip, super-ceding the gossip for heart disease or cancer. Diabetes is a disease associated with abnormally high sugar in the blood. By definition, high sugar in the blood is due to lack of a hormone called insulin produced from pancreas. Some are born with low insulin level, giving rise to diabetes in childhood; whereas others decrease insulin production over the years and develop overt diabetes. Notwithstanding a variety of insulin preparations, plethora of oral antidiabetic agents, and enormous funding for research, diabetes care is at a stake.
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