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This book provides a thorough overview of the detection of PCNs
using modern imaging techniques and a clear guide to the
recognition of the different subtypes of PCN based on their
radiologic and histopathologic features. This volume will serve as
an excellent aid to the selection of optimal therapeutic strategies
based on preoperative diagnosis. A further important feature is the
emphasis placed on radiologic, clinical, and surgical correlations.
Pancreatic cystic neoplasms (PCNs) have been increasingly
recognized during the past decade, mainly because of the widespread
use of modern imaging modalities for the investigation of often
unrelated abdominal symptoms. The three most common subtypes of PCN
are serous cystic neoplasms, mucinous cystic neoplasms, and
intraductal papillary mucinous neoplasms. These subtypes have
distinct radiologic and histopathological features, and their
biological behavior differs greatly. Accurate preoperative
diagnosis is of prime importance in selecting the optimal
therapeutic strategy: while serous cystic neoplasms are almost
always benign, and may be treated conservatively, mucinous cystic
neoplasms and intraductal papillary mucinous neoplasms have
malignant potential, warranting an aggressive surgical approach,
i.e., pancreatectomy. Pancreatic Cystic Neoplasms will be of great
interest to surgeons, gastroenterologists, radiologists,
oncologists, and pathologists, and also to internists and residents
in these specialties.
Sepsis is one of the most frequent complications in the surgical
patient and one of the leading causes of mortality in intensive
care units. During the past two decades, a great deal has been
learned about surgical bacteriology, antibiotic prophylaxis,
supportive management, and the host response to microbial invasion.
Sepsis can be caused by infection with gram-negative bacteria,
gram-positive bacteria, fungi (and particularly Candida), or
viruses. Sepsis may also occur in the absence of detectable
bacterial invasion, and in these cases, microbial toxins,
particularly gram-negative bacterial endotoxin (lipopolysaccharide,
LPS), and endogenous cytokine production have been implicated as
initiators and mediators. Although activation of the immune system
during microbial invasion is generally protective, septic shock
develops in a significant number of patients as a consequence of a
poorly regulated immune response to the offending organism. Sepsis
can be presented with a spectrum of severity. Septic shock
represents the most severe form of host response to infection. The
aim of this monograph is to summarise the currently available data
regarding epidemiology, pathogenesis, and optimal management of
septic shock, with a particular emphasis on the role of source
control in sepsis. Emerging therapies for septic shock are also
discussed.
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