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Managing the Complications of Cirrhosis: A Practical Approach is a simple pocket guide for the community gastroenterologist and primary-care provider who manages liver disease.While there are other books available on the market regarding the management of cirrhosis, this reference includes information geared toward the busy practitioner, allowing the reader to reference a chapter that easily addresses the clinical issue at hand. Dr. Atif Zaman provides essential and current information on the management of cirrhosis for the nonhepatologist.Each chapter in Managing the Complications of Cirrhosis: A Practical Approach is broken down into four sections, including a summary of the issue at hand, a diagnosis of the problem, a treatment algorithm, and what to do if the treatment algorithm is ineffective. In addition, each chapter highlights complex cases that have no standard treatment, but have emerging concepts or data.Chapter topics include: Preventative health issues in patients with cirrhosis Nutrition in patients with cirrhosis Management of hepatocellular carcinoma Pulmonary issues in patients with cirrhosis Timing of referral for liver transplant With algorithms and tables, Managing the Complications of Cirrhosis: A Practical Approach is the perfect book for all community gastroenterologists, primary-care practitioners, medical residents and fellows, physician assistants, and nurse practitioners who provide care in the area of liver disease.

The present volume is the third in a trilogy that documents naturally occurring organohalogen compounds, bringing the total number — from fewer than 25 in 1968 — to approximately 8,000 compounds to date. Nearly all of these natural products contain chlorine or bromine, with a few containing iodine and, fewer still, fluorine. Produced by ubiquitous marine (algae, sponges, corals, bryozoa, nudibranchs, fungi, bacteria) and terrestrial organisms (plants, fungi, bacteria, insects, higher animals) and universal abiotic processes (volcanos, forest fires, geothermal events), organohalogens pervade the global ecosystem. Newly identified extraterrestrial sources are also documented. In addition to chemical structures, biological activity, biohalogenation, biodegradation, natural function, and future outlook are presented.

- NEW! Coverage of high-flow nasal oxygen therapy and both core and advanced concepts for mechanical ventilation helps you deliver high-quality care to patients with respiratory failure. - NEW! Chapters on current critical care topics include Assessment of Intravascular Volume, Urine Osmolality and Electrolytes, and Infectious Disease Control in the ICU. - NEW! Chapters on novel procedures offer coverage of tracheal stents, urinary diversion techniques, and an in-depth review of point-of-care ultrasound with extensive figures and images. - NEW! Coverage of increasingly prevalent problems seen in the intensive care unit includes coagulation disorders of the critically ill patient, feline aortic thromboembolism, oxygen toxicity, and treatment of severe hypertension. - NEW! Chapters on shock fluid therapy and transfusion therapy provide cutting edge information on how to prevent complications and maximize resources. - NEW! Prevention of Compassion Fatigue and Burnout chapter addresses this major challenge currently affecting the veterinary profession. - NEW! Algorithms and figures throughout the text clarify key concepts and aid in diagnosis and treatment. - NEW! Enhanced eBook, included with the purchase of a new print copy of the book, provides online access to a fully searchable version of the text and makes its content available on various devices. - UPDATED! Coagulation section includes chapters on hemostasis, management of the bleeding patient, coagulation and platelet monitoring, and viscoelastic monitoring. - EXPANDED! Pharmacology section offers coverage of cannabis, trazadone, gabapentin, pimobendane, and appetite stimulants.

Understanding and addressing the current opioid crisis requires knowledge of endogenous opioids (endorphins and enkephalins), but there is now evidence for a benzodiazepine crisis. Are there endogenous benzodiazepine-like substances—and what do they do? How do they affect antianxiety drugs and their adverse effects? Do they explain enigmatic prolonged benzodiazepine withdrawal syndrome? This book raises important questions about the clinical consequences of ignoring the existence of or understanding the potential influence of endogenous benzodiazepines on the therapeutic effect of benzodiazepines, their adverse effects, and the problems of withdrawal from them and other benzodiazepine receptor agonists.FEATURES Discusses endogenous benzodiazepine-like substances—what do they do, and do they affect antianxiety drugs and their adverse effects? Presents information on enigmatic prolonged benzodiazepine withdrawal syndrome Describes the compounds acting at the BDZ binding sites, both exogenous (classical BDZ drugs and BDZ from food and plants) and endogenous (endozepines) Assesses the putative interactions in physiology, pathology, and pharmacology of the compounds acting at the BDZ binding sites Dr. Raffa is Adjunct Professor at the University of Arizona College of Pharmacy and Professor Emeritus at Temple University School of Pharmacy. He has co-authored or edited several books on pharmacology and thermodynamics, is a co-editor of two journals, is a past president of the Mid-Atlantic Pharmacology Society, and is the recipient of research and teaching awards. Dr. Amantea is Associate Professor of Pharmacology at the Department of Pharmacy, Health and Nutritional Sciences of the University of Calabria (Italy), where she is the leader of the Stroke Research Unit at the Section of Preclinical and Translational Pharmacology operating in the frame of the Italian Stroke Organization (ISO) Basic Science. She is a member of the Editorial Board and the Guest Editor of the 2016 Neuroscience section of Current Opinion in Pharmacology (Elsevier), and the founder and the editor of the CRC Press Frontiers in Neurotherapeutics series.

The latest edition of this textbook provides a comprehensive, state-of-the-art overview of the major issues specific to the field of pediatric gastroenterology, hepatology, and nutrition. The textbook begins with a section on gastroenterology and nutrition that presents the overall scope of issues encountered in children suffering from disorders of the gastrointestinal tract, pancreas, and/or presenting nutritional issues, as well as current and future prospects on the use of prebiotics, probiotics, and postbiotics. The second section is centered around hepatology, reviewing congenital and acquired disorders of the biliary tract and liver, as well as analyzing available diagnostic and therapeutic procedures and future perspectives.Written by experts in the field, Textbook of Pediatric Gastroenterology, Hepatology and Nutrition: A Comprehensive Guide, Second Edition is an indispensable resource for students, trainees, and clinicians, sure to distinguish itselfas the definitive reference on this topic.

Biofilms are complex and dynamic communities of surface-attached microorganisms held together by a self-produced extracellular polymeric matrix, forming a highly hydrated structure. It is known that there is considerable heterogeneity within biofilms with respect to local environments, which may result in spatial and temporal patterns of gene expression. Advances in Medicine and Biology. Volume 132 begins by discussing the use of GFP to explore these microbial communities, presenting the most recent developments associated with GFP variants and novel applications of this molecule in biofilm research. Next, the authors discuss the fibrinolytic and its important role in reproduction. Plasminogen Activator Inhibitor-1 (PAI-1) is one of the primary regulators of thefibrinolytic system and is expressed in various cells including ovarian granulosa and theca cells, endometrial cells and trophoblasts. This overview provides the current knowledge on the role of PAI-1 and PAI-1 gene mutations in reproduction. Green fluorescent protein (GFP) is a bio-luminous fluorescent phosphoprotein which was originally isolated from the luminous organ of the jellyfish Aequorea Victoria. At the molecular level, it is composed of 238 amino acids with an approximate molecular weight of about 27 kDa. The authors discuss the role of GFP in animal diagnostic technologies, molecular tracking techniques using GFP as fusion tags in studying protein–protein interactions and real time monitoring of host pathogen interactions. In the authors'Immunoallergology Department, a recent study of 64 CSU patients treated with omalizumab provided pertinent information. Overall, the patients had a reduction of the UAS7 score of 5.82% per omalizumab administration (pOa) and of the DLQI score of 6.69% pOa (data not published). However, when patients were divided according to their baseline serum total IgE levels (STIgE), patients with higher STIgE had a much faster response to omalizumab. The results of this study are discussed in detail. The subsequent chapter aims to explore the diagnosis and management of gastrointestinal stromal tumours (GISTs) that arise from the small bowel in both metastatic and non-metastatic disease. GISTs account for two per cent of all neoplasia of the gastrointestinal tract. They represent the most common GI mesenchymal tumour with a worldwide incidence of 11-15 per million and a median age of presentation of 55-60 years. Diabetes insipidus (DI) is examined as one of the major clinical syndromes characterized by the excretion of copious volumes of diluted urine (polyuria) together with persistent intake of abnormally large volumes of fluid (polydipsia). Investigation of the chronological changes of hyper intensity (HI) distribution over the pituitary stalk and the posterior lobe after transsphenoidal surgery on MR images might enable to predict how frequently postoperative diabetes insipidus occurs and how long it persists, and to elucidate an underlying mechanism for the appearance of the HI in the pituitary stalk. In the following chapter, the authors discuss salient aspects of central nervous system effects of methionine and methionine metabolites in relation to behavioural, neurochemical and possible structural alterations. The possibility of the evolution of conventionally-approved clinical applications of oral methionine, and the potential limitations to its utilisation in such capacity are also considered. Later, this collection considers the functions of Gamma-Aminobutyric acid (GABA) in pharmacology and diseases. The authors aim to address what GABA is, how GABA reacts, and what GABA-related diseases and agents exist. GABA is the principal inhibitory neurotransmitter of the vertebrate central nervous system, acting at inhibitory synapses in the brain. In the concluding chapter, the authors address how gabapentin, a synthetic analog of GABA, may be an effective analgesic used to treat different types of neuropathic pain syndromes, includi

The most important and reliable resource for treating diseases of the liver For more than 55 years,'Schiff'has been acclaimed as the most outstanding liver book in the world. This new 12th edition brings the field completely up to date and includes a companion website that features a wide-variety of accessory materials. The text is evidence-based to offer hepatologists and gastroenterologists treating patients with liver disease a comprehensive and essential resource. The text highlights clinical practice and covers anatomy, pathology, testing, imaging, and the effects of liver disease on other organs. The book is written in clear and accessible terms and key features include: Treatment guidelines and management algorithms for every disease Full-color attractive design throughout the text Informative section overviews for each section Concise key concepts box in every chapter A full liver transplant section This 12th edition is thoroughly revised with the latest clinical information. The new edition offers: Information on acute and chronic liver failure and infections in cirrhosis Over 100 MCQs Downloads for Powerpoint™ making the content ideal for presentations Schiff's Diseases of the Liver is designed to be a first-stop reference for dealing with today's demanding clinical situations.

This volume provides a comprehensive, state-of-the-art overview of hepatic encephalopathy. Through a case-based approach, the text reviews new data and studies about the role of microbiota in liver disease and hepatic encephalopathy, explores the burden of hepatic encephalopathy on readmissions, costs, and patient care, and highlights management strategies for patients in differing stages of hepatic encephalopathy. Exploratory new therapies and treatment targets are also discussed in the guide.Written by experts in the field, Diagnosis and Management of Hepatic Encephalopathy: A Case-based Guide is a valuable resource for physicians and researchers who deal with this challenging complication of cirrhosis.

Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent clinical developments, this revised edition by Drs. Arun J. Sanyal, Thomas D. Boyer, Norah A. Terrault, and Keith D. Lindor, provides an in-depth, comprehensive look at the pathophysiology, diagnostic, and treatment information related to the liver. More than 1,100 figures and tables, many new and in full color, highlight completely updated content throughout. - Expert, international authorship and comprehensive, easy-to-access information makes this edition the gold standard in the field of hepatology. - Includes new information on the rapid changes in treatment paradigms for acute liver failure, the latest treatments for primary biliary cholangitis, full coverage of the gut microbiome and its role in liver disease, the newest developments in drug-induced liver injury, and changes in hepatitis C virus treatment and hot-button concerns about access to care. - New summary boxes at the end of each chapter and a newly streamlined table of contents make it easier to find and understand the information you're looking for. - Hundreds of brand-new illustrations clearly present key aspects of liver disease.

Flavonoids are abundant secondary metabolites found in plants and fungi that have various roles in these organisms, including pigmentation, cell signalling, plant defence and inter-organism communication. Due to their abundance in nature, flavonoids are also important components of the human diet, and the last four decades have seen an intense study focused on the structure characterization of flavonoids and on their roles in mammal metabolism. This book reviews most of the well-established activities of flavonoids, and we also present more recent research studies on the area of flavonoids, including the chemical aspects of structure characterization of flavonoids, the biosynthesis of flavonoids in model plants as well as their role in abiotic stress situations and in agriculture, the role of flavonoids in metabolism and health and their importance in foods, from consumption to their use as bioactive components.

Since publication of the first edition in 1994, the second edition in 1999, and the third edition in 2009, many new advances in sleep medicine have been made and warrant a fourth edition. This comprehensive text features 19 additional chapters and covers basic science, technical and laboratory aspects and clinical and therapeutic advances in sleep medicine for beginners and seasoned practitioners. With the discovery of new entities, many new techniques and therapies, and evolving basic science understanding of sleep, Sleep Disorders Medicine, Fourth Edition brings old and new knowledge about sleep medicine together succinctly in one place for a deeper understanding of the topic. Neurologists, internists, family physicians, pediatricians, psychiatrists, psychologists, otolaryngologists, dentists, neurosurgeons, neuroscientists, intensivists, as well as those interested in advancing their knowledge in sleep and its disorders, will find this edition to be an invaluable resource to this bourgeoning field.

Updated and expanded to provide the neurologic, intensive and critical care communities a comprehensive guide to common critical care illnesses and seizures, this third edition remains the premier resource on seizures in critical care. In addition to covering etiology, pathophysiology, diagnosis, differential diagnosis and treatment options, chapters feature the latest technologies and treatments and integrate current literature. This unique and specialized text offers neurologists, intensivists, neurosurgeons, trauma surgeons, epileptologists, electrophysiologists and residents in various specialties clarity on this challenging set of comorbidities.

Cirrhosis: a practical guide to management provides gastroenterologists and hepatologists with an up-to-date clinical guide presenting the very best evidence-based practice in the diagnosis, treatment and management of liver cirrhosis and its many complications. Designed to offer practical guidance at all times, it provides doctors with an extremely useful tool in the clinical setting, with each chapter featuring diagnostic/management algorithms, key points and other pedagogic features. Divided into 2 parts, a diagnosis and pathophysiology section and a management of complications section, key topics include: - Diagnostic laboratory tests - Diagnostic imaging modalities - Acute-on chronic liver failure - Agents and drugs to avoid - End stage liver failure: liver transplant evaluation - Hepatocellular carcinoma Aimed at the specialist, as well as the practicing trainee at the top-end of specialty training, the emphasis throughout is on providing optimum clinical management guidance most relevant to practicing hepatologists and gastroenterologists, and is an invaluable guide to this increasingly common condition.

This textbook provides a comprehensive and state-of-the-art overview of the major issues specific to the field of pediatric gastroenterology, hepatology, and nutrition. The first part of the book, Gastroenterology and Nutrition, presents in a systematic way the overall scope of issues encountered by children (newborn to teenagers) suffering from disorders of the gastrointestinal tract, pancreas and/or presenting nutritional issues. These chapters are structured in logical sections to facilitate consultation and include major topics ranging from congenital disorders to gastrointestinal problems of the newborn, infectious diseases of the gastrointestinal tract, and approach to nutritional problems in the various pediatric ages. The second part of the book, Hepatology, is articulated in a series of chapters which present a comprehensive review of congenital and acquired disorders of the biliary tract and liver. This section also includes a critical analysis of available diagnostic andtherapeutic procedures and future perspectives.Written by experts in the field, Textbook of Pediatric Gastroenterology, Hepatology and Nutrition: A Comprehensive Guide to Practice constitutes a much needed, innovative resource combining updated, reliable and comprehensive information with agile consultation for a streamlined approach to the care of children with such disorders.

This is the premier evidence-based textbook in critical care medicine. The Third Edition features updated and revised chapters, numerous new references, streamlined content, and new chapters on key topics such as the new paradigm in critical care medicine, cardiac output monitoring, surgical optimization, vital signs, and arterial blood gas analysis. The book maintains the author's trademark humor and engaging writing style and is suitable for a broad and diverse audience of medical students, residents, fellows, physicians, nurses, and respiratory therapists who seek the latest and best evidence in critical care. From reviews of previous editions: “This is an excellent introduction to the concept of evidence-based medicine...The writing is clear, logical, and highly organized, which makes for fast and enjoyable reading. I believe this book will get daily use in most intensive care units, by a wide range of readers.” –Respiratory Care “This is one of the most comprehensive handbooks on critical care medicine with a strong emphasis on evidence base…Overall, this book should be useful for junior doctors or intensive care trainees who are starting their term in an intensive care unit.” –Anaesthesia and Intensive Care

The perioperative neuroscience is a specialty that is continuously evolving. This specialty depends on the integration of neuroanesthesiology, neurology, neurointensive care, neuroradiology, neurointeventional radiology and neurosurgery. This book provides in-depth information for the most recent evidence-based advances in perioperative neurosciences. It includes research on postoperative cognitive dysfunctions, the effect of anesthetics on the growing brain, the new theories for the development of cerebral aneurysm and cerebral vasospasm, and many more. A unique feature of the book is the world-renowned authorities in anesthesiology, neurosurgery, neurointensive care, neurology, and neuroradiology and neurointeventional radiology who helped compile it. Consequently, this book will give the reader a unique opportunity to have in-depth coverage for the most recent advances in this very important specialty.

Saving lives through organ transplantation has become increasingly possible thanks to advances in research and care. Today, the complex field of transplantation continues to develop rapidly, fuelled by demographic change and further evolutions in scientific understanding. The Oxford Textbook of Transplant Anaesthesia and Critical Care has been written and edited by pioneers in the field of organ transplantation with an international team of authors, in order to equip anaesthetists and intensivists with the knowledge and training necessary to provide high quality and evidence-based care. The text addresses fundamentals aspects of scientific knowledge, care of the donor patient, transplant ethics and special considerations. Dedicated sections address each of the major organs; kidney, pancreas, liver, heart and lung, intestinal and multivisceral. Within each organ-based section, expert authors explore underlying disease, planning for transplantation, specialized procedures, perioperative and critical care management as well as post-transplant considerations. Focus points for future developments in transplant immunology are also set out, inspiring current practitioners to engage with current clinical research and help participate in the further advancement of the science of transplantation. The print edition of the Oxford Textbook of Transplant Anaesthesia and Critical Care comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables.

Proceedings of an international symposium held in Valencia, Spain, November 27--29, 1989

Once again the gastroenterologists of northwestern Canada have come out with a series of essays advancing important modem concepts. As indefatigable as ever, they bring together the latest in clinical-pathophysiological considera­ tions for the clinician. The topics run the gamut from the lovely liver to HIV infection, from the pathophysiology of bile flow to comments on antigens in colorectal cancer. It is always easy to publish a first volume, for enthusiasm is high and everyone is anxious to win a place. Bringing out a second volume, the carrying forward of a good idea, is so much harder. In many ways this second volume in the series marks the coming of age of Canadian gastroenterology, as 11 of the 21 contributors currently reside in Canada. Still, the contributions from the United Kingdom and the United States make this an Anglo-American festival. Reading the chapters will make you appreciate the care with which the contributors have garnered recent references to give up-to-date practical infor­ mation for us all. I enjoyed all that I read. My congratulations to Drs. Shaffer and Thomson for a job well done. Howard M. Spiro, M.D. New Haven, Connecticut ix Preface This book is based on papers presented at the third symposium on Recent Ad­ vances in Gastroenterology held by the Canadian Association of Gastroenter­ ology. The proposed audience for this volume is the internist and the general surgeon, as well as those in the specialties of gastroenterology and hepatology.

The first edition of this book was well received by readers and reviewers and we are very grateful for the positive reactions. We were convinced then, and even more now, that MRI and MRS have much to offer in diagnosis, therapy monitoring and research of hereditary and acquired myelin disorders. In the last few years, a great deal of new information has come available, concern­ ing the genetic basis of inborn errors of metabolism and neurodegenerative disor­ ders, the role of subcellular structures, the enzyme biochemistry, the pathophysio­ logical mechanisms of posthypoxic-ischemic cerebral damage, and the inflammato­ ry processes in infectious and inflammatory disorders. MR images of many rare disorders have become available, either in our own experience or published by other groups. MR spectroscopy could confirm its role in certain clinical applica­ tions. Because of these developments, it was necessary for us to rewrite the book almost completely. In some fields developments are so fast that we may not have caught all the latest developments. The pattern of the new approaches has, however, been established, making the assimilation of newly available information easy. We are extremely grateful for the help of colleagues to make this book as com­ plete as possible. The positive reactions of those from whom we requested MR pictures or other forms of support were of enormous encouragement to us during our efforts to complete this project. We hope this work will be as warmly welcomed by our colleagues as the first edition.

In sechs Kapiteln werden die Grundlagen des menschlichen Proteinstoffwechsels, neueste Erkenntnisse über die bei verschiedenen Krankheitsbildern auftretenden Stoffwechselveränderungen und die daraus resultierenden Kriterien bezüglich der Wahl geeigneter Nahrungsproteine für eine adäquate klinische Ernährung vermittelt. Das Buch bietet sowohl dem an Ernährungsfragen interessierten Kliniker als auch dem reinen Ernährungswissenschaftler die Möglichkeit, sich in die Grundlagen des menschlichen Proteinstoffwechsels einzuarbeiten und Kenntnisse über Stoffwechselveränderungen bei bestimmten Krankheitsbildern zu erwerben. Aufgrund dieses Wissens wird es dem Kliniker erleichtert, das richtige Nahrungsprotein für die Ernährung der Patienten auszuwählen.

Compiled by internationally recognized experts in trauma critical care, this set discusses the entire gamut of critical care management of the trauma patient.

Die 9. Auflage dieses internistischen Standardwerkes liegt nun in aktualisierter und erweiterter Form vor. In übersichtlicher und an der Praxis orientierter Darstellung werden Therapieempfehlungen gegeben, die dem gegenwärtigen Stand wissenschaftlicher Erkenntnis und der eigenen Erfahrung der Autoren entsprechen. Dabei wird umfassend auf die Wahl der Medikamente, auf Dosierungen, Nebenwirkungen und Kontraindikationen eingegangen. Mit besonderer Sorgfalt wurden Notfallpläne für die Erstversorgung bei akuten Krankheitszuständen aufgearbeitet.

Das Ereignis des Frühjahres: die Therapie innerer Krankheiten als vollständig überarbeitete Neuauflage. Ein solches Standardwerk sichert qualitative Kontinuität, trägt aber auch dem steten Wandel in der inneren Medizin Rechnung: An die Seite von Professor Riecker ist Professor Paumgartner als international renommierter Gastroenterologe getreten. Viele neue Autoren sind hinzugekommen, fast alle Kapitel wurden völlig neu verfaßt. Und noch ein Novum - das Buch ist jetzt zweifarbig und somit noch übersichtlicher.

Chronic and excessive alcohol consumption disrupts a number of biologic sys­ tems. Central nervous system pathology, associated with long-standing alcohol ingestion, has particularly deleterious consequences to the individual. Compro­ mising brain functional integrity ultimately militates against psychosocial ad­ justment, and this process is inevitably reflected as a substantial economic loss to society in the form of costs for providing medical and social services, as well as disability and absenteeism from work. This book marshals the literature pertinent to the effects of chronic alcohol abuse on brain structure and functioning. The material is divided into two parts: basic research and clinical issues. In the first section, the manifest neurologic consequences are described across the different levels of biologic organization, these being brain morphology, neurochemistry, neurophysiology, and neuro­ psychology. In recognition of the multifactorial etiology of alcohol-related brain pathology, the influence and role of hepatic, endocrine, and nutritional factors are also examined. The second section addresses clinical syndromes and dis­ orders. It will be noted that evidence accrued from recent research suggests that neurologic disturbances may actually antedate the onset of drinking in some alcoholics. Other clinically important issues discussed are the effects of alcohol on neurologic development, aging, and dementia. The book concludes with a discussion of the alcohol withdrawal syndrome, its mechanisms and manifes­ tations. A fundamental objective of the editors was to illustrate that the consequences of chronic alcohol excess can be comprehensively understood within the per­ spective of interrelated hierarchical systems of brain organization.

A practical neurosurgical resource rich with answers to questions commonly encountered in clinical practicePresented in a highly efficient question-and-answer format, The Essential Neurosurgery Companion is a portable handbook for quick referencing of key concepts encountered in neurosurgical practice. With a strong focus on the realities residents face each day, the book covers practical issues such as how to apply to residency programs, what to do during rounds, and how to examine patients, as well as more advanced issues in all areas of neurosurgical management.Key Features:More than 5,000 individual questions with corresponding answers in tabular format distill large amounts of information Detailed color illustrations create visual summaries of complex content A logical progression of difficulty, from basic concepts to high-level surgical topics Reviews both key fundamentals and more advanced clinical concepts in neurosurgery Includes a helpful appendix highlighting surgical anatomy pearlsResidents involved in the practice of neurosurgery around the globe will want this compelling guide in their armamentarium whether for daily rounds or preparing for boards. Clinicians will find it a valuable resource to consult in everyday practice.

A comprehensive reference standard for the discipline, Canine and Feline Gastroenterology covers the biology, pathobiology, and diagnosis and treatment of diseases of the gastrointestinal, pancreatic, and hepatobiliary systems. An international team of experts, including 85 authors from 17 different countries, led by Robert Washabau and Michael Day, covers everything from minor problems such as adverse food reactions to debilitating inflammatory, infectious, metabolic, and neoplastic diseases of the digestive system. This authoritative text utilizes an evidence-based approach to reflect the latest science and research, complemented by principles of problem solving, algorithms to improve clinical diagnoses, and extensive full-color illustrations. For generalists and specialists alike, this gastroenterology reference should be part of every serious practitioner's professional library. - A comprehensive, 928-page reference standard covers the discipline of canine and feline gastroenterology. - An international focus is provided by 85 authors from 17 different countries, including renowned experts in veterinary gastroenterology, internal medicine, pathology, clinical pathology, radiology, and infectious disease. - Coverage of the entire breadth and depth of gastroenterology ranges from biology to pathobiology, as well as diagnosis and treatment of diseases of the gastrointestinal, pancreatic, and hepatobiliary systems. - Current information on GI microflora, immunology, cellular growth, and systems integration provides a foundation for treating clinical problems. - Coverage of diseases in dogs and cats includes the oral cavity, esophagus, stomach, small intestine, large intestine, colon, anorectum, liver and biliary tract, exocrine pancreas, peritoneum, and associated vasculature. - A focus on patient management examines the full range of procedures and techniques essential to diagnosis and treatment from clinical signs and diagnosis to nutritional support and pharmacologic management of disease. - Clear explanations of current diagnostic modalities include laboratory tests, molecular methods, diagnostic imaging, endoscopy, and histopathology, also showing how to interpret and utilize results. - A strong clinical approach emphasizes need-to-know information for managing the common and not-so-common G.I. clinical problems of everyday practice. - Full-color photographs and illustrations depict concepts, conditions, and procedures. - An evidence-based medicine perspective reflects the latest research as well as the modern practice of veterinary medicine. - Logical, coherent, and consistent internal organization makes this a reader-friendly edition. - Problem-based algorithms help in diagnosing every G.I. clinical problem from A to Z. - A stand-alone section on the pharmacologic approach to G.I. disease offers quick and easy drug reference.

Questo volume nasce dall'idea di redigere un'opera ad ampio respiro sull'anestesia dei piccoli animali che includesse anche l'Anestesia nelle specie non convenzionali senza trascurarne alcun aspetto, sia teorico che pratico e che, per quanto possibile, coinvolgesse in qualità di coautori i più significativi esponenti dell'Anestesiologia veterinaria italiana. Anestesia. Cane, gatto e animali non convenzionali è infatti l'espressione di un gruppo di lavoro che si è dedicato in questi anni alla crescita di questa importante branca della Medicina e chirurgia veterinaria.

Zakim and Boyer's Hepatology—the defining work in hepatology—presents comprehensive coverage of both basic science and clinically relevant developments so you can provide the best possible patient care. Drs. Thomas Boyer, Michael Manns, and Arun Sanyal have reorganized and updated the contents of this trusted global reference to reflect today's more clinical approach to hepatology. They bring you up to date on hot topics including HIV Co-Infection Drug Toxicity, Hepatocellular Carcinoma (HCC), and much more. This new streamlined edition is now a single volume making it easier to find the treatment information you need. Effectively treat all liver diseases currently seen in clinical practice with authoritative guidance from leading international authorities. Reinforce your foundation in basic science with the concise Pathophysiology of Therapeutic Targets section. See clear presentations of liver disease through hundreds of detailed, color illustrations. Explore topics further with up-to-date references that direct you to the significant literature. Stay current on new developments in the field through five new chapters on Pathogenesis Liver Injury in HBV, HCV; HCC; Imaging and Non-Invasive DX Liver Disease CT, US, Fibroscan, MRI; HIV Co-Infection Drug Toxicity; and HBC, HCV in Non-Liver Transplant Patients, plus comprehensive updates throughout. Apply best practices with reorganized and updated content that reflects today's need for a more clinical approach to hepatology.

Hepatology has come of age in the last decades. Biology of the liver has flour­ ished long before. As the largest homogeneous organ of the body the liver served as useful model in the development of biochemistry and related discip­ lines. Only gradually were these biological investigations applied to the clinical study of liver disease. This was particularly stimulated by the recognition that in the greater part of the world, the developing countries and what we now call the Third World, liver disease represents a major threat to overall public health. It leads to morbidity and mortality of persons in their productive years from liver cancer, cirrhosis and parasitic disease, particularly, schistosomiasis. Moreover, the growing emphasis on the social impact of diseases focused on disorders of the liver because malnutrition, poverty, and drug addiction contrib­ ute greatly to their spread. This is compounded by the increase of alcohol abuse, recently on the rise even in the developing countries. Concern with envi­ ronmental pollution has also raised the interest in liver diseases, in part because the liver acts as a guardian against polluting chemicals and in part because it is considered, possibly to an exaggerated degree, a vulnerable target of such chemicals.

Evoked potentials are potentials that are derived from the peripheral or central nervous system. They are time locked with an external stimulus and can be influenced by subjective intentions. Evoked potentials have become increasingly popular for clinical diagnosis over the last few years. Evoked potentials from the visual system are used by ophthalmologists in order to localize the abnormalities in the visual pathway. The otologists are mainly involved in brainstem auditory evoked potentials, while the pediatricians, neonatologists, neurologists and clinical neurophysiologists make use of multimodal stimulation. The psychiatrists and psychologists, generally, examine the slow potentials such as P300 and CNV. Anesthesiologists use short latency somatosensory and visual evoked potentials in order to monitor the effectiveness of the anesthesia. Pharmaco evoked potentials are very promising measures for the quan­ tification of the effectiveness of drug action on the cerebral cortex. Urologists are more and more involved in pudendal somatosensory evoked potentials and in the intensive care unit evoked potentials are used in order to monitor the functional state of the central nervous system of the patient. This overwhelming number of examinations and exam ina tors clearly demonstrates the need for guidelines and standardization of the methods used. The evoked potential metholody is restricted by the relative poor signal to noise ratio. In many diseases this signal to noise ratio decrease rapidly during the progression of the illness. Optimal technical equipment and methodology are therefore essential.

The regenerative capacity of the liver cell is almost unlimited. Therefore after acute liver damage, be it viral, toxic, hypoxic, or surgical in origin, restitutio ad integrum is the usual outcome. In two forms of liver disease, however, this is not the case: in fulmi­ nant hepatic failure, liver regeneration often is not fast enough to keep the organism alive; in end-stage cirrhosis, regeneration is dis­ turbed by a hypertrophic architecture of fibrotic tissue. For these extreme forms of liver disease and for critical situations before and after liver surgery, artificial liver support is needed. This book contains the latest results in this area of research pre­ sented by scientists from allover the world at an international symposium held in Celle, Germany, June 2-4, 1980. Exciting new methods like continuous membrane plasma sepa­ ration and liver cell transplantation into the spleen have been de­ veloped. The older methods of hemoperfusion and dialysis have been improved. Enzymological methods and liver transplantation have made good progress. We hope that this volume will help the clinician in his decision-making and stimulate ingenious new re­ search for the benefit of our liver patients.

Encephalopathy and Nitrogen Metabolism in Liver Failure contains research reports and state-of-the-art reviews that were presented at the 11th International Symposium on Hepatic Encephalopathy and Nitrogen Metabolism in relation to liver disease, that was held in Amsterdam, The Netherlands from 30 May to 1 June, 2002. Themes covered include the metabolism of ammonia and amino acids in relation to liver disease, the assessment of hepatic encephalopathy (HE), minimal HE, animal models of HE, neuropsychiatric dysfunction in patients with chronic liver disease, the pathogenesis of HE, the astrocyte in liver disease, acute liver failure and cerebral edema, treatment of HE and artificial liver support systems. This volume provides an indispensable source of important new research findings and ideas for clinicians and biomedical scientists working in the field of HE and nitrogen metabolism in relation to liver disease.

Small Animal Soft Tissue Surgery Small Animal Soft Tissue Surgery is a comprehensive, in-depth resource for well-referenced, current information on small animal soft tissue surgery. Offering detailed surgical techniques in a well-illustrated, easy-to-follow format, the book covers the full range of surgically treated diseases and syndromes, with video clips and slideshows to demonstrate surgical procedures on an accompanying website. Chapters are written by the leading experts in surgery, internal medicine, radiology, and critical care, presenting information based on a review of the most recent literature. Divided into chapters by body system, each section begins with a brief review of the anatomy and physiology, with pathophysiology, diagnosis, treatment, and prognosis described in detail. Original illustrations and clinical photographs accompany the description of surgical techniques, and an evidence-based approach is incorporated throughout. Small Animal Soft Tissue Surgery is an essential reference for small animal surgeons, residents, and practitioners performing soft tissue surgery. KEY FEATURES Offers a detailed, evidence-based reference entirely focused on small animal soft tissue surgery Relies on the very latest literature to present the current state of the art Draws on information from surgery, internal medicine, radiology, and critical care, with contributions from experts in each area Provides detailed surgical techniques with specially commissioned, high quality line drawings Includes a website with video clips and slideshows demonstrating soft tissue procedures.

'The eBook discusses how the special physiology of the liver must be considered when applying functional molecular imaging in hepatology. The main topics of the eBook include the clinical and scientific use and possibilities of functional molecular imaging for investigations of hepatic blood perfusion, substrate metabolism, and biliary secretion as well as for cancer diagnostics (primary and secondary liver cancers). Functional imaging of changes in cerebral blood perfusion and metabolism in patients with liver diseases is also covered. The eBook is written by internationally renowned experts and is intended for everyone who is interested in hepatology or functional molecular imaging.'--Introduction, p. i.

during the past few years increasing interest has been focused on the role of gamma-aminobutyric acid (GABA) outside the central nervous systems (CNS).Biochemical, pharmacological, histochemical, physiological approaches have all been employed to investigate the role of GABA in themammalian periphery. The International Symposium on Peripheral GABAergic Mechanism held in Rome, July 1990, was devoted to gather scientists from allover the world in order to summarize and sythesize their most recent results and conceptions on the significance of GABA outside the CNS. Written in a thought-provoking style, this proceedings volume is an overviewof the timely knowledge about GABA in the peripheral nervous system and in non-neuronal tissues. Chapters of the book provide many examples for the diverse functions of this amino acid in the periphery as neurotransmitter, hormone, humoral or even trophic factor from the autonomic ganglia to the endocrine stomach and pancreas, from the tubular epithelium of the kidney to the spermatozoa.

For over 50 years covering 10 previous editions, Schiff's Diseases of the Liver has provided hepatologists with an outstanding evidence-based clinical reference work covering all aspects of liver disease, and is without doubt one of the world's leading hepatology textbooks. Now fully revised and updated, it will serve as your first-stop reference for today's demanding clinical situations. With a strong clinical focus, Schiff's Diseases of the Liver covers anatomy, pathology, testing, imaging, and effects of liver disease on other organs, before moving on to sections that address specific diseases and clinical syndromes. Its enormous appeal has been due to the clarity of text, combined with the sheer thoroughness of its breadth of content. Key features include: An attractive full color design throughout Informative section overviews for each section Concise key concepts box in every chapter Treatment guidelines and management algorithms for every disease A full liver transplant section This 11th edition sees all existing chapters fully revised and refreshed with the very latest in clinical information from the world's leading hepatologists. Also new to this edition is a companion website containing a variety of important extra materials, including: Approximately 100 multiple choice questions of the standard used in ABIM board exams in gastroenterology, to allow the user to self-assess their clinical knowledge All 450+ figures from the book in a high-quality, fully transportable and downloadable electronic format High-quality video clips of a variety of surgical procedures, all fully linked to the text 35 case studies featuring real-life clinical scenarios. Schiff's Diseases of the Liver remains the key textbook for all gastroenterologists and hepatologists, in training or fully qualified, managing patients with liver disease.

The advances in science and medicine we are now experiencing are unprec­ edented and exciting. Life expectancy is prolonged, and quality of life is much improved. We learn of fabulous new discoveries made at the bench or the bedside every week. Many diseases have been totally eliminated, others can be significantly improved by new therapeutic formulations. Much of the success can be attributed to a better understanding of disease processes and the specific targeting of new and more effective medications. As is the case in many areas of successful human endeavour, there can be a downside. In the case of drugs and chemicals it is their adverse effects which are of concern. Of course, every effort is made to devise medications that are safe, and the need to elucidate and understand mechanisms are crucial, yet adverse effects remain a problem. They can be unpredictable and diverse. Drugs have been shown to induce virtually the whole gamut of human liver pathology from acute fulminant hepatitis to chronic active hepatitis to cirrho­ sis and even malignancy. Hence the possibility of adverse drug effects must be considered in the differential diagnosis of many patients with liver disease. This is well recognized and is very important; indeed, removal of the offending agent can often lead to reversal of the adverse effect. This is an area of hepatology where we can really make a difference.

Continuing progress has been made since the first edition of Artificial Liver Support was published. Liver transplantation has however become an estab­ lished therapy for a relatively small number of patients who remain patients for life. There therefore continues to be a great need for the development of other forms of artificial liver support. Improved intensive care utilizing improved plasma exchange, dialysis, sclerotherapy, and intracranial pressure monitoring have improved survival in fulminant hepatic failure. Progress has also been made in lipid membrane detoxification, in cell cultures, and in cell transplantation, and the isolation of various liver cell growth factors has led to deep insight into the mechanisms of liver regeneration. This book gives the clinician and the researcher detailed information about established new methods of clinic work and laboratory research, and describes new experimental approaches indicating the direction of future research. G. BRUNNER M. Mno Preface to the First Edition The regenerative capacity of the liver cell is almost unlimited. Therefore after acute liver damage, be it viral, toxic, hypoxic, or surgical in origin, restitutio ad integrum is the usual outcome. In two forms of liver disease, however, this is not the case: in fulminant hepatic failure, liver regeneration often is not fast enough to keep the organism alive; in end-stage cirrhosis, regeneration is disturbed by a hypertrophic architecture of fibrotic tissue. For these extreme forms of liver disease and for critical situations before and after liver surgery, artificial liver support is needed.

In March 2000 leading scientists gathered at the Centro Seminariale Monte Verità, Ascona, Switzerland, for the Third International Symposium on'Fractals 2000 in Biology and Medicine'. This interdisciplinary conference was held over a four-day period and provided stimulating contributions from the very topical field Fractals in Biology and Medicine. This Volume III in the MBI series highlights the growing power and efficacy of the fractal geometry in understanding how to analyze living phenomena and complex shapes. Many biological objects, previously considered as hopelessly far from any quantitative description, are now being investigated by means of fractal methods. Researchers currently used fractals both as theoretical tools, to shed light on living systems` self-organization and evolution, and as useful techniques, capable of quantitatively analyzing physiological and pathological cell states, shapes and ultrastructures. The book should be of interest to researchers and students from Molecular and C

Over the last twenty to thirty years the progressivcly increasing availability of averaging machines has made evoked potential testing available not only in the major neurological diagnostic centers but also in the office of many neuro­ logists in private practice. This rapid devclopment was closely paralleled by clinical research in evoked potentials and the publishing of books covering in detail the basic techniques necessary to obtain evoked potentials and the main clinical applications of evoked potentials. Less work was done, however, to define some of the general principles underlying the recording of evoked potentials or to analyze critically the recording techniques or the actual prac­ tical value of the information provided by evoked potential testing. In this book an attempt has been made to cover this gap. It is assumed that the reader has a good understanding of basic recording techniques and is familiar with the main applications of clinical evoked potentials. The main emphasis of the first two chapters is to define with more precision some of the physical principles that inftuence the volta ge distribution and are used for defining the generator sources of evoked potentials. This is followed by a critical analysis of recording techniques and of its main clinical applications. Finally there is one chapter that gives an overview on application of evoked potentials for surgical monitoring. This is a rapidly growing field that also has been covered only incomplctcly in previous publications.

In recent years alcohol abuse has received increased international attention. Such attention is justified by the enormous negative impact that this disorder has on health, as well as on economic and social well-being. Governmental and other sources of research support have promoted substantial investigation into the negative consequences of alcohol, examining both animal models and human subjects. Consequently, there has been a virtual explosion of preclinical and clinical data, much of it focused on alcohol's pharmacologic effects. However, there have been few efforts to integrate this wealth of new information into a single, manageable volume. This volume provides an up-to-date, in-depth treatment of the phar­ macology of alcohol, particularly as it relates to alcohol abuse. The over­ riding theme of the book is the interplay between the preclinical and clinical domains. Increasingly, these areas of investigation have served to inform one another, a trend that can be expected to grow with time. The topics covered include the effects of alcohol on biological systems and the impact of medications on those effects. In addition, recent insights obtained from molecular biological investigations are discussed in terms of their relevance for understanding the effects of alcohol at the cellular level and the implica­ tions of these for the development of medications. Consideration is also given to important methodological issues that influence the evaluation of medications in the context of clinical trials.

This volume contains the papers presented at the International Symposium on'Cirrhosis, Hyperammonemia and Hepatic Encephalopathy', held in Valencia, Spain, January 24th-27th, 1994. Liver cirrhosis and other hepatic dysfunctions such as fulminant hepatic failure and congenital defects of urea cycle enzymes can lead to hepatic encephalopathy, coma and death. Hepatic encephalopathy is one of the main causes of death in western countries. The ability to detoxify ammonia by its incorporation into urea is diminished by impaired liver function, resulting in increased ammonia levels in blood and brain. Hyperammonemia is considered one of the main factors in the mediation of hepatic encephalopathy and the classical clinical treatments are directed towards reducing blood ammonia levels. However, the molecular bases of the pathogenesis of hepatic encephalopathy and the role of hyperammonemia in this process remain unclear and several hypotheses have been proposed. To clarify the mechanisms involved in hepatic encephalopathy and hyperammonemia suitable animal models are necessary. The animal models available and the ideal features of an animal model are presented in the initial part of the book.

This book presents current research in the biology, diagnosis and treatment of cancer. Topics discussed include breast cancer knowledge, risk factors and screenings; uterine neoplasms; dendritic cell immunotherapy for the treatment of malignant melanoma; role of effectors on hypoxia due to nitric oxide production in human alveolar epithelial cells; complementary and alternative medicine approaches in the treatment of cancer; intrinsic and extrinsic mechanisms of drug resistance and adjuvant chemotherapy for resected colorectal cancer.

This book addresses the synthesis of photosensitizers, the main emphasis being on the new methods of synthesis such as microwave, sonochemistry and the use of ionic liquids. It also addresses the photochemistry and photophysics of the photosensitizers alone and in combination with nanoparticles, the use of the photosensitizers in environmental control, safety and medicine. It discusses the common structures of the photosensitizers which are beneficial to these applications.