Early Detection and Management of Mental Disorders

Early Detection and Management of Mental Disorders

Early Detection and Management of Mental Disorders

Edited by:
Mario Maj
Juan Jose´ Lo´pez-Ibor
Norman Sartorius
Mitsumoto Sato
Ahmed Okasha

Details
Hardcover: 316 pages
Publisher: Wiley; 1 edition (January 14, 2005)
Language: English
ISBN-10: 0470010835
ISBN-13: 978-0470010839

Product Description
From the Back Cover

The WHO has found that mental disorders rank in the top 10 of leading causes of disability in the world, creating a significant social, emotional and economic burden for young people, their families and society. Early detection of these potentially disabling disorders and appropriate treatment at the time of initial onset can reduce patient discomfort, duration and severity of illness and the costs associated with misdiagnosis.

Early Detection and Management of Mental Disorders is an unbiased and reliable reference point for mental health professionals to properly assess patients and treat disorders as early as possible.

The mental disorders and topics addressed in this volume include:

• Schizophrenia
• Bipolar Disorder
• Eating Disorders
• Depression
• Anxiety Disorders
• Alzheimer's Disease
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Children of parents with mental disorders
• Diagnosis of mental disorders in children

Early detection and management of a mental disorder implies the availability of a thorough description of the prodromal manifestations of the disorder, the existence of assessment and screening instruments with a satisfactory sensitivity and specificity, the feasibility of screening programmes in the general population or in vulnerable groups, the successful engagement of a significant proportion of the subjects found to be at high risk, and the availability of validated programmes of intervention focused on the early phases of the disorder. All these elements are currently being developed for most of the above-mentioned mental disorders, and are already part of clinical practice in several contexts for some of them (notably schizophrenia).

Contents:
List of Contributors
Preface

• Chapter 1 Prodromal Symptoms and Early Detection of Schizophrenia
• Chapter 2 The Management of Early Psychosis
• Chapter 3 Children of Persons with Schizophrenia: An Overview of Empirical Research
• Chapter 4 Detection and Management of Bipolar Disorder in Children and Adolescents
• Chapter 5 Detecting the Risk for Affective Spectrum Disorders in the Children of Bipolar Parents
• Chapter 6 The ‘‘Difficult’’ Child: Main Underlying Syndromes and Differential Diagnosis
• Chapter 7 Precursors, Prodromes and Early Detection of Eating Disorders
• Chapter 8 Precursors, Early Detection and Prevention of Anxiety Disorders
• Chapter 9 Early Recognition and Management of Depression in Primary Care
• Chapter 10 The Prodromes and Early Detection of Alzheimer’s Disease

Index

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Atlas of MIGRAINE AND OTHER HEADACHES Second Edition

Atlas of MIGRAINE AND OTHER HEADACHES Second Edition

Atlas of MIGRAINE AND OTHER HEADACHES Second Edition
Edited by
Stephen D Silberstein MD
M Alan Stiles DMD
William B Young MD

Product Description

Stimulating read that can be recommended for residents and students. All physicians need to learn to diagnose and manage head pain. However, there are many causes of headache: some are secondary to other conditions; others are disorders in themselves. These factors often make differential diagnosis and treatment a challenge. This didactic atlas approaches the problem of migraine and other headaches from a visual perspective. The contents cover the history of migraine and headache, their epidemiology, diagnosis and treatment. While the central emphasis is on migraine, all types of headache are addressed. The book includes some classic illustrations from historical texts as well as modern images that illustrate the disorders and current thinking.

Chronic head and face pain may be either a result of numerous disorders or a symptom of a more ominous secondary cause. Correct diagnosis is essential for proper treatment.

To assist the clinician, we include the history of headache, its epidemiology, diagnosis, and treatment. We address migraine, tension-type, and cluster headache, in addition to the rare or more unusual primary and secondary headache disorders. We have tried to include classic images from other texts, as well as new images that illustrate the disorders and reflect the most current thinking. This compilation of slides, images, graphs, paintings, and drawings has been obtained from physicians from all over the world.

Product Details
Hardcover: 138 pages
Publisher: Informa HealthCare; 1 edition (January 25, 2005)
Language: English
ISBN-10: 1842142739
ISBN-13: 978-1842142738


Contents
List of contributors
Acknowledgements
Preface
Foreword
1. Historical aspects of headache; Stephen D Silberstein
2. Headache classification; Elizabeth W Loder
3. Epidemiology of migraine; Mario F P Peres
4. Pathophysiology of headache; Michael L Oshinsky
5. Migraine; Mario F P Peres
6. Trigeminal-autonomic cephalgias; Todd D Rozen
7. Tension-type headaches; William B Young
8. Secondary headaches; Laszlo L Mechtler and M Alan Stiles
Index

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Handhelds in Medicine A Practical Guide for Clinicians

Handhelds in Medicine A Practical Guide for Clinicians

Handhelds in Medicine A Practical Guide for Clinicians
Editors
Scott M. Strayer, MD, MPH
Peter L. Reynolds, MD
Mark H. Ebell, MD, MS

Product Description

Handheld Computers in Medicine is an essential volume of information needed for all physicians, especially those in the primary care specialties. It is in the tradition of Mark Ebell's recent successful Springer book and CD-ROM, Evidence-Based Diagnosis: Handbook of Clinical Prediction Rules. (This enables the clinician to make an automatic calculation of risk assessment based on the patient's presenting symptoms, which are fed into the program. By working with the CD-ROM, a risk calculation can be made in seconds, all within the time period of a standard office visit.) Ebell is a renowned family physician and educator who has devoted his career to assessing and processing clinical information, which is to be used in making an accurate diagnosis and prescribing the correct therapeutics in the shortest time period. If this is to be done correctly, the physician must be able to implement a variety of electronic information bases effectively, and during the time period of a standard office visit. Nothing accomplishes this goal as efficiently as handheld PCs and Palm Pilots. This allows the physician to engage the patient, take a case history, perform a physical examination, access patient records, complete the diagnosis and prescribe the necessary therapeutics and process the bill coding, all without leaving the patient's side. Depending on the physician's degree of 'tech-savvy' skills, this can be an exhausting and intimidating process. It can be especially complicated to convert an entire office practice, then conform to a particular healthcare organization's plan of operation. Ebell's book and CD-ROM set operates as a concise guide to enable any physician and healthcare professional to implement the use of handheld computers into their practice. It is important to note that the spirit of this publication's goal is to eliminate error and thus raise the level of quality in all aspects of patient care.

Product Details
Paperback: 468 pages
Publisher: Springer; 1 edition (November 19, 2004)
Language: English
ISBN-10: 0387403299
ISBN-13: 978-0387403298


Contents
Preface
Contributors

• Registered, Trademarked, and Copyrighted Material
• Section I Getting to Know Your Handheld Computer
• Choosing a Handheld Computer: PDAs, MDAs, and the Alphabet Soup of Handheld Computers
• Getting to Know Your Handheld: Palm OS and Pocket PC
• Getting Software from Cyberspace to the Palm of Your Hand: Downloading and Installing Software on Your Palm OS or Pocket PC Handheld

Section II Medical Software

• “Where in the World Wide Web Do I Find All This Stuff?” Finding Medical Software and Information on the Web for Handheld Computers
• What Floor Is Mrs. Jones on, and What Does Her CBC Look Like Today? Patient Records on Handheld Computers
• Calculator Programs for Handheld Computers: Crunching the Numbers Made Easy
• Medical References: Information at Your Fingertips
• Getting Paid for What You Do:Avoid Losing Your Shirt by Using a Handheld Computer for Billing
• Electronic Prescribing: Drug Dealing Twenty-First Century Style
• Medical Documents in Your Pocket
• Capturing Life in the Palm of Your Hand: Getting Rid of the Yellow Stickies by Using a Handheld Database
• Software for Nursing: RNs Are Mobilizing
• Software for Other Healthcare Professionals: Hey,What About Me?

Section III Advanced Topics

• Evidence-Based Medicine and Handhelds
• Wireless 101
• Programmable Calculators
• How to Make Your Own Database: Programming a Simple Procedure Log
• Creating Your Own Programs
• Beyond the Beam: Server-Based Synchronization
• Teaching People to Use Handheld Computers

Appendix
Index

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Manual of Intensive Care Medicine: With Annotated Key References 4th Edition

Manual of Intensive Care Medicine: With Annotated Key References 4th Edition

Manual of Intensive Care Medicine: With Annotated Key References 4th Edition
Product Details

Paperback: 943 pages
Publisher: Lippincott Williams & Wilkins; Fourth Edition edition
October 1, 2005
Language: English
ISBN-10: 0781754976
ISBN-13: 978-0781754972

Edited By:
Richard S. Irwin M.D.
Professor of Medicine and Nursing
James M. Rippe M.D.
Associate Professor of Medicine (Cardiology)


Product Description

Completely rewritten and updated for the Fourth Edition, this Spiral(R) Manual remains the leading quick-reference guide to both medical and surgical intensive care. The essential principles, protocols, and techniques from Irwin and Rippe's Intensive Care Medicine, Fifth Edition have been distilled into a portable, practical manual that is ideal for rapid bedside consultation. The user-friendly format features numerous tables, illustrations, and annotated references. This edition has completely revamped sections on cardiovascular problems and coronary care, surgical problems, shock and trauma, endocrine problems, and hematology, plus expanded coverage of gastroesophageal balloon tamponade, aspiration of joints, hepatic dysfunction, and noninvasive mechanical ventilation.

Readers of the current edition of our Manual will immediately notice a significant change in format. We have adopted a more user-friendly, outline format to try to give busy house officers more direct and immediate access to the information they need to manage the complex and time-sensitive issues of the practice of critical care medicine. As with the previous edition, we have challenged the authors to emphasize critical concepts and pare down chapters to the key clinically relevant points. Annotated references are provided to guide the interested reader through key articles in the relevant literature.

The Manual of Intensive Care Medicine opens with an extensive section on Procedures and Techniques. The next seven sections are divided according to organ system. In each chapter, discussions of key entities that present in the intensive care or coronary care unit environment appear together with targeted discussions focusing on treatment.

Section IX presents a review of key Pharmacology, Overdoses, and Poisonings considerations recognizing that these remain important issues in intensive care. This section has been pared down from the previous edition of our Manual. We recognize this area as being so important that we have co-edited, along with our colleague, toxicologist Dr. Christopher Linden, an entire Manual of Overdoses and Poisonings, which can be used in conjunction with the current edition of the Manual of Intensive Care Medicine.

As in the previous edition, there are extensive sections on surgical issues in critical care as well as shock and trauma. The Manual closes with sections on Neurology; Transplantation; Rheumatology and Immunology; Psychiatry; and Moral, Ethical, Legal and Public Policy Issues in Intensive Care all of which are crucial to a comprehensive view of adult intensive care medicine.

Table of Contents:

1. Procedures and Techniques
2. Cardiovascular Problems and Coronary Care
3. Pulmonary Problems in the Intensive Care Unit
4. Renal Problems in the Intensive Care Unit
5. Infectious Disease Problems in the Intensive Care Unit
6. Gastrointestinal and Hepatobiliary Problems in the Intensive Care Unit
7. Endocrine Problems in the Intensive Care Unit
8. Hematologic Problems in the Intensive Care Unit
9. Pharmacology, Overdoses and Poisonings
10. Surgical Problems in the Intensive Care Unit
11. Shock and Trauma
12. Neurologic Problems in the Intensive Care Unit
13. Transplantation
14. Rheumatologic and Immunologic Problems in the Intensive Care
15. Psychiatric Issues in Intensive Care
16. Moral, Ethical, Legal Issues and Public Policy in the Intensive Care Unit

APPENDIX: CALCULATIONS COMMONLY USED IN CRITICAL CARE
Index

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Respiratory System and Artificial Ventilation: Paperback and Kindle Edition

Respiratory System and Artificial Ventilation: Paperback and Kindle Edition

Respiratory System and Artificial Ventilation: Paperback and Kindle Edition

Author by:
Umberto Lucangelo
Paolo Pelosi
Walter A. Zin
Andrea Aliverti

Format: Kindle Paperback and Edition
Print Length: 300 pages
Publisher: Springer; 1 edition (December 20, 2007)
Language: English
ASIN: B001CSG9TA
ISBN-10: 884700764X
ISBN-13: 978-8847007642

Books Description
This book reviews respiratory performance, selected mechanical ventilation modes, and treatment strategies. Fellows, other senior trainees, and practitioners managing critically ill patients with respiratory concerns are an appropriate audience for this work which comes from a multidisciplinary group of authors in Western Europe and a small number of presenters from the United States. Contemporary thinking is well represented in this collection of reviews on pulmonary physiology and selected clinical topics.

Contents
Contributors
List of Abbreviations
Properties of the Respiratory System

• Control of Breathing
  
• Elastic and Resistive Properties of the Respiratory System
  
• Flow Limitation and its Determination
  
• Intrinsic PEEP and its Determination
  

Interactions Between Pulmonary Circulation and Ventilation

• Interactions Between the Pulmonary Circulation and Ventilation: An Overview for Intensivists
  

Monitoring of the Respiratory Mechanics

• Monitoring of Respiratory Mechanics in the ICU: Models, Techniques and Measurement Methods
  

Acute Lung Injury–ARDS, Controlled Mechanical Ventilation in ARDS and the Open Lung Concept

• Pathophysiology of ARDS
  
• Ventilator-Associated Lung Injury
  
• Controlled Mechanical Ventilation in ARDS
  
• The Open Lung Concept in Cardiac Surgery Patients
  

Nosocomial Pneumonia

• Diagnosis and Treatment of Nosocomial Pneumonia
  

Prone Ventilation

• Prone Ventilation To Prevent Ventilator-Associated Pneumonia
  
• Prone Positioning of Patients with ARDS
  
• Prone Ventilation in Trauma Patients
  

Old and New Artificial Ventilation Techniques

• Advanced Modalities in Negative-Pressure
  
• High-Frequency Percussive Ventilation
  

Non-invasive Ventilation

• Non-invasive Ventilation in Patients with Acute Respiratory Failure and COPD or ARDS
  
• Non-invasive Respiratory Assistance in Paediatric Patients
  

Subject Index

Chapter 1
Properties of the Respiratory System
Control of Breathing
F.B. Santos, L.K.S. Nagato,W.A. Zin

Introduction
The physiological control of the respiratory system is unique among organ systems. Breathing is essential to life and must occur 24 h a day, 365 days a year, in the conscious or unconscious state, awake or asleep. At the same time, humans and other mammals need to be able to temporarily interrupt the normal pattern of breathing to perform other functions, such as eating and vocalising [1]. The voluntary and involuntary control of the respiratory system is unequalled and a very complex process. This chapter will appraise some relevant issues to improve clinicians’ understanding of the normal mechanism of breathing and its possible disorders in disease.

Respiratory Control Components
Ventilation is constantly monitored and adjusted to maintain appropriate arterial pH and PaO2. This homeostatic control system requires a set of sensors, a central controlling mechanism and an effector arm to carry out its commands (Fig. 1). Afferent information from sensors modulates the central command of respiratory muscles [2]. The brain constantly receives information from the upper airways, lungs and chest wall and decides how the ventilatory pump will respond.

Respiratory Sensors
Afferent input into the central system is provided primarily by groups of neural receptors, either mechanoreceptors or chemoreceptors. The latter respond to alterations in PaO2, PaCO2 and pH.

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ECG Interpretation: The Self-Assessment Approach

ECG Interpretation: The Self-Assessment Approach
Accurate interpretation of the ECG is an essential skill for all health professionals. Using a unique self-assessment format, this book presents a comprehensive, incremental approach to ECG interpretation, progressing from basic to advanced concepts in electrocardiography. Amply illustrated with electrocardiograms both in the main text and the self-assessments, ECG Interpretation is a must-have practical guide that features:

• An appealing, user-friendly format that will help with exam preparation
  
• Clearly defined learning objectives to guide readers efficiently through the intricacies of ECG interpretation
  
• Numerous practical examples of ECG strips to illustrate important concepts, including clean ECG strips to practice skills
  
• Multiple-choice questions to consolidate learning and emphasize pertinent facts
  

This second edition has been thoroughly revised from the original 12-lead ECG Interpretation: The Self-Assessment Approach, with fully updated text, additional electrocardiograms and new chapters covering a variety of arrhythmias and ion channelopathies. The book is an essential aid to structured learning for electrophysiologists cardiologists in training, Internists, emergency room physicians, , medical students, nurses and. cardiac technicians.
Author by:
Zainul Abedin, MD, FRCP (C), FHRS
Robert Conner, RN
Product Details
* Paperback: 240 pages
* Publisher: Wiley-Blackwell; 2 edition (November 28, 2007)
* Language: English
* ISBN-10: 1405167491
* ISBN-13: 978-1405167499
Contents

1. Complexes and intervals
   
2. Mean QRS axis determination
   
3. The normal electrocardiogram : Self-Assessment Test One
4. Intraventricular conduction defects
   
5. Myocardial ischemia and infarction:  Self-Assessment Test Two
   
6. Chamber enlargement and hypertrophy
   
7. Acute pericarditis
   
8. Sinus rhythm and its discontents:  Self-Assessment Test Three
   
9. Atrioventricular block
   
10. Atrial arrhythmias: Self-Assessment Test Four
11. Supraventricular re-entrant tachycardia
12. The Wolff–Parkinson–White syndrome: Self-Assessment Test Five
13. Junctional arrhythmias
14. Ventricular arrhythmias
15. The channelopathies
16. Electronic pacing: Self-Assessment Test Six

Further reading: Answers to self-assessment tests
Index

CHAPTER 1
Complexes and intervals

An electrocardiogram (ECG) is a recording of cardiac electrical activity made from the body surface and displayed on graph paper scored horizontally and vertically in 1 millimeter (mm) increments. Each millimeter on the horizontal axis represents 40 milliseconds (0.04 second) of elapsed time and each millimeter on the vertical axis represents 0.1 millivolt (mV) of electrical force. Each 5 millimeter mark on the paper is scored with a heavier line representing 200 milliseconds (msec) or 0.20 seconds on the horizontal axis or time line and 0.5 millivolt on the vertical axis or amplitude line. Recordings of electrical activity made from within the cardiac chambers are called intracardiac electrograms.
Paper used for routine cardiac monitoring is marked across the top by small vertical lines placed at 3-second intervals. Heart rate per minute can be rapidly estimated by counting the number of beats in a 6-second recording and multiplying that number by 10, or can be precisely calculated by counting the number of small squares between complexes and dividing that number into 1500. All monitoring systems currently marketed display the heart rate both on screen and on paper recordings.

The complexes
An electrocardiogram consists of only two elements: complexes and intervals. The normal complexes are (1) the P wave, (2) QRS complex, (3) T wave, and (4) U wave (Figure 1.1).
The P wave represents depolarization of the atrial myocardium. Normal P waves are rounded, do not exceed 0.25 mV (2.5 mm) in amplitude in any lead or exceed 110 milliseconds (0.11 second) in duration. Normal P wave axis is +15 to +75 degrees in the frontal plane leads. The amplitude of the P wave is measured from the baseline or isoelectric line to the top of the waveform. Because the right atrium is depolarized slightly before the left atrium, the first half of the P wave represents right atrial depolarization and the last half left atrial depolarization, but normally these events overlap, producing a single deflection.
Figure 1.2 correlates the features of the surface ECG with cardiac electrical events. It is essential to note that sinus node discharge (1) is electrocardiographically silent on surface tracings, as is conduction through the atrioventricular node (4), the bundle of His and bundle branches (5).
The recovery sequence can be divided into three phases: (1) the absolute refractory period (7), during which the conduction structures are unresponsive to any stimulus; the supernormal period (8), and the relative refractory period (9), during which the conduction tissues will transmit an impulse, but typically at a slower rate than is normally observed. Refractory periods shorten and lengthen incrementally as the heart rate accelerates or slows, i.e. as the cycle length changes. Therefore the exact length of the refractory periods will vary according to the heart rate and the health of the conduction system.

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Essential Guide to Acute Care

Essential Guide to Acute Care

Essential Guide to Acute Care

Product Description

Author by:
Paul Cramp
Kirsty Forrest

Paperback: 216 pages
Publisher: BMJ Books; 2 edition (August 21, 2006)
Language: English
ISBN-10: 1405139722
ISBN-13: 978-1405139724


What you really need to know, but no one told you.

The Essential Guide to Acute Care contains everything you really need to know about acute care that you can’t find in a standard textbook and have probably never been taught before.

Starting with the concept of patients at risk, the Essential Guide to Acute Care explains how to recognise and manage the generic altered physiology that accompanies acute illness.

The principles of acute care are explained simply yet comprehensively. Throughout the book ‘mini-tutorials’ expand on the latest thinking or controversies, and practical case histories reinforce learning at the end of each chapter. The chapters are designed to be read by individuals or used for group tutorials in acute care.

Extensively rewritten and updated, this second edition is essential reading for anyone who looks after acutely ill adults, including:


* Foundation Programme trainees and trainers
* Trainees in medicine, surgery, anaesthesia and emergency medicine
* Final year medical students
* Nursing staff and allied professionals working in critical care

Contents
Foreword
Introduction
Acknowledgements
Units used in this book
Chapter 1 Patients at risk
Chapter 2 Oxygen therapy
Chapter 3 Acid–base balance
Chapter 4 Respiratory failure
Chapter 5 Fluid balance and volume resuscitation
Chapter 6 Sepsis
Chapter 7 Acute renal failure
Chapter 8 Brain failure
Chapter 9 Optimising patients before surgery
Chapter 10 Pain control and sedation
Appendix Practical procedures
Index

CHAPTER 1
Patients at risk
By the end of this chapter you will be able to:
• Define resuscitation
• Understand the importance of the generic altered physiology that accompanies
acute illness
• Know about national and international developments in this area
• Know how to assess and manage an acutely ill patient using the ABCDE system
• Understand the benefits and limitations of intensive care
• Know how to communicate effectively with colleagues about acutely ill patients
• Have a context for the chapters that follo

What is resuscitation?

When we talk about ‘resuscitation’ we often think of cardiopulmonary resuscitation (CPR), which is a significant part of healthcare training. International organisations govern resuscitation protocols. Yet survival to discharge after in-hospital CPR is poor, around 6% if the rhythm is non-shockable (the majority of cases). Public perception of CPR is informed by television which has far better outcomes than in reality [1].

A great deal of attention is focused on saving life after cardiac arrest. But the vast majority of in-hospital cardiac arrests are predictable. Until recently, hardly any attention was focused on detecting commonplace reversible physiological deterioration and in preventing cardiac arrest in the first place. However, there have been an increasing number of articles published on this subject. As a Lancet series on acute care observed, ‘the greatest opportunity to improve outcomes for patients over the next quarter century will probably not come from discovering new treatments but from learning how to deliver existing effective therapies’ [2].

In one study, 84% of patients had documented observations of clinical deterioration or new complaints within 8 h of cardiopulmonary arrest [3]; 70% had either deterioration in respiratory or mental function observed during this time. While there did not appear to be any single reproducible warning sign, the average respiratory rate of the patients prior to arrest was 30/min. The investigators observed that the predominantly respiratory and metabolic derangements which preceded cardiac arrest (hypoxaemia, hypotension and acidosis) were not rapidly fatal and that efforts to predict and prevent arrest

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Vascular Disease: A Handbook for Nurses

Vascular Disease: A Handbook for Nurses

Product Description
Author by
Haytham Al-Khaffaf
Sharon Dorgan
Paperback: 270 pages
Publisher: Cambridge University Press; 1st edition (October 3, 2005)
Language: English
ISBN-10: 0521674514
ISBN-13: 978-0521674515

Caring for Patients with Vascular Disease: A Practical Approach for Medical and Nursing Staff offers a step-by-step guide to caring for patients in a variety of clinical settings. It follows a patient's path of care from management in the outpatient clinic, through to the hospital ward, theatre, recovery room and back to the follow-up outpatient clinic. A clear, concise format is used throughout the book, with reference to evidence-based interventions and the physiology underpinning them, and the use of simple line diagrams and treatment flow charts to illustrate the essential aspects of care. Edited by a nurse and a vascular surgeon, with contributions from a group of invited authors, the book reflects the multidisciplinary nature of patient care and will be a valuable resource for nurses, surgeons and other healthcare professionals involved in caring for this patient group.

Book Description

This account offers a practical, step-by-step guide to caring for patients with vascular disease in a variety of clinical settings. It follows a patient's path of care management in a clear, concise format that is used throughout the book. References to evidence-based interventions and the underpinning physiology, and the use of line diagrams and flowcharts illustrate the essential aspects of care. The book reflects the multidisciplinary nature of patient care and is a valuable resource for nurses, surgeons and other healthcare professionals involved in caring for this patient group

CONTENTS
List of Abbreviations
List of Contributors
Preface
OUTPATIENT DEPARTMENT

• Peripheral arterial disease
  
• Carotid artery disease
  
• Abdominal aortic aneurysm
  
• Upper limb ischaemia
  
• Raynaud’s phenomenon
  
• Vasculitis
  
• Thoracic outlet syndrome
  
• Hyperhydrosis
  
• Leg ulcers
  
• The diabetic foot
  
• Mesenteric ischaemia
  
• Varicose veins
  
• Deep vein thrombosis
  
• Managing lymphoedema: a clinic approach
  
• VASCULAR EMERGENCIES
  
• Ruptured abdominal aortic aneurysm
  
• Acute limb ischaemia
  
• Vascular trauma

VASCULAR INVESTIGATIONS

• The vascular laboratory
  
• Radiological investigation and intervention
  
• MANAGEMENT OF VASCULAR PATIENTS ON THE WARD
  
• Nursing care of patients with peripheral vascular disease
  
• Rehabilitation of amputees and artificial limb provision
  
• Pain management
  

THE PERI-OPERATIVE PERIOD

• The pre-assessment clinic and the role of the pre-assessment nurse
  
• Vascular anaesthesia
  
• Operative vascular surgery: common vascular operations
  
• The role of the vascular scrub nurse
  
• Post-operative care of vascular surgery patients
  

TRAINING AND PRACTICE ISSUES

• The role of the vascular nurse specialist
  
• Training for vascular nurses
  
• Integrated care pathways
  
• Clinical governance
  
• Audit
  
• Useful addresses
  

INDEX

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Kindle: Amazon's Wireless Reading Device

Kindle: Amazon's Wireless Reading Device

Product Overview

• Revolutionary electronic-paper display provides a sharp, high-resolution screen that looks and reads like real paper.
• Simple to use: no computer, no cables, no syncing.
• Wireless connectivity enables you to shop the Kindle Store directly from your Kindl—whether you’re in the back of a taxi, at the airport, or in bed.
• Buy a book and it is auto-delivered wirelessly in less than one minute.
• More than 230,000 books available, including more than 105 of 112 current New York Times® Best Sellers.
• New York Times® Best Sellers and New Releases $9.99, unless marked otherwise.
• Free book samples. Download and read first chapters for free before you decide to buy.
• Top U.S. newspapers including The New York Times, Wall Street Journal, and Washington Post; top magazines including TIME, Atlantic Monthly, and Forbes—all auto-delivered wirelessly.
• Top international newspapers from France, Germany, and Ireland; Le Monde, Frankfurter Allgemeine, and The Irish Times—all auto-delivered wirelessly.
• More than 1100 top blogs from the worlds of business, technology, sports, entertainment, and politics, including BoingBoing, Slashdot, TechCrunch, ESPN's Bill Simmons, The Onion, Michelle Malkin, and The Huffington Post—all updated wirelessly throughout the day.
• Lighter and thinner than a typical paperback; weighs only 10.3 ounces.
• Holds over 200 titles.
• Long battery life. Leave wireless on and recharge approximately every other day. Turn wireless off and read for a week or more before recharging. Fully recharges in 2 hours.
• Unlike WiFi, Kindle utilizes the same high-speed data network (EVDO) as advanced cell phones—so you never have to locate a hotspot.
• No monthly wireless bills, service plans, or commitments—we take care of the wireless delivery so you can simply click, buy, and read.
• Includes free wireless access to the planet's most exhaustive and up-to-date encyclopedia—Wikipedia.org.
• Email your Word documents and pictures (.JPG, .GIF, .BMP, .PNG) to Kindle for easy on-the-go viewing.
• Included in the box: Kindle wireless reader, Book cover, Power adapter, USB 2.0 cable

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Essentials of Anatomy And Physiology

Essentials of Anatomy And Physiology fifth edition
Product Details
Author:
Valerie C. Scanlon, PhD
College of Mount Saint Vincent
Riverdale, New York
Author:
Tina Sanders
Medical Illustrator
Castle Creek, New York
Formerly
Head Graphic Artist
Tompkins Cortland Community College
Dryden, New York

Paperback: 603 pages
Publisher: F. A. Davis Company; 5 edition (September 29, 2006)
Language: English
ISBN-10: 0803615469
ISBN-13: 978-0803615465

Contents
CHAPTER 1 Organization and General Plan of the Body
CHAPTER 3 Cells
CHAPTER 4 Tissues and Membranes
CHAPTER 5 The Integumentary System
CHAPTER 6 The Skeletal System
CHAPTER 7 The Muscular System
CHAPTER 8 The Nervous System
CHAPTER 9 The Senses
CHAPTER 10 The Endocrine System
CHAPTER 11 Blood
CHAPTER 12 The Heart
CHAPTER 13 The Vascular System
CHAPTER 14 The Lymphatic System and Immunity
CHAPTER 15 The Respiratory System
CHAPTER 16 The Digestive System
CHAPTER 17 Body Temperature and Metabolism
CHAPTER 18 The Urinary System
CHAPTER 19 Fluid–Electrolyte and Acid–Base Balance
CHAPTER 20 The Reproductive Systems
CHAPTER 21 Human Development and Genetics
CHAPTER 22 An Introduction to Microbiology and Human Disease
Appendixes
Glossary
Index

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Diabetes in Childhood and Adolescence

Diabetes in Childhood and Adolescence

Product Description:
Hardcover: 381 pages
Publisher: S. Karger AG (Switzerland); 1 edition (June 2005)
Language: English
ISBN-10: 3805577664
ISBN-13: 978-3805577663
Editors:
F. Chiarelli Chieti
K. Dahl-Jørgensen Oslo
W. Kiess Leipzig

Diabetes mellitus is one of the most frequent chronic diseases affecting children and adolescents. The number of young children being diagnosed with type 1 diabetes is increasing worldwide and an epidemic of type 2 diabetes already at a young age is being observed in most societies around the world. In this book, leading experts from the USA, Europe and Israel provide a state-of-the-art summary of today's knowledge in the field of pediatric and adolescent diabetes. A number of excellent chapters deliver insight into the basic understanding of which factors contribute to or prevent the development of diabetes in young people. Other contributions provide tools for the clinician to manage the care of the child and adolescent with diabetes. In addition, knowledge from the latest scientific studies on the molecular biology of diabetes is also presented. It provides a summary of the most recent scientific discoveries related to pediatric and adolescent diabetes.

Contents:
Preface

1. Etiopathogenetic Aspects of Type 1 Diabetes
2. Susceptibility to Type 1 Diabetes: Genes and Mechanisms
3. Autoimmunity in Type 1 Diabetes mellitus
4. Neonatal Diabetes mellitus
5. Diagnosis and Management of MODY in a Pediatric Setting
6. Diabetic Ketoacidosis
7. Insulin Treatment
8. Medical Nutrition Therapy of Children and Adolescents with Diabetes
9. Continuous Subcutaneous Insulin Infusion in Childhood and Adolescence
10. Quality Management in Pediatric Diabetology
11. Sports and Physical Activity in Children and Adolescents with Type 1 Diabetes mellitus
12. Invasive and Noninvasive Means of Diabetes Self-Management
13. Adolescence
14. Diabetic Nephropathy in Children and Adolescents
15. Diabetic Autonomic and Peripheral Neuropathy
16. Macrovascular Disease
17. Hypoglycemia in Children and Adolescents with Type 1 Diabetes
18. Diabetic Retinopathy in Children and Adolescents with Type 1 Diabetes
19. Complications and Consequences
20. Type 2 Diabetes mellitus in Childhood
21. Beta-Cell Function Replacement by Islet Transplantation and Gene Therapy

Author Index
Subject Index

Chapter 1:
Etiopathogenetic Aspects of Type 1 Diabetes
Mikael Knip
Hospital for Children and Adolescents, University of Helsinki, Helsinki, and Department of Paediatrics, Tampere University Hospital, Tampere, Finland

Type 1 diabetes is perceived as a chronic immune-mediated disease with a subclinical prodromal period characterized by selective loss of insulin-producing B-cells in the pancreatic islets in genetically susceptible subjects. The most important genes contributing to disease susceptibility are located in the HLA class II locus on the short arm of chromosome 6 [1]. Nevertheless, only a relatively small proportion, i.e. less than 10%, of genetically susceptible individuals progress to clinical disease. This implies that additional factors are needed to trigger and drive B-cell destruction in genetically predisposed subjects. Clinical type 1 diabetes represents end-stage insulitis, and it has been estimated that at the time of diagnosis only 10–20% of the insulin-producing B-cells are still functioning. Environmental factors have been implicated in the pathogenesis of type 1 diabetes both as triggers and potentiators of B-cell destruction [2–4], although the contribution of any individual exogenous factor has not been definitely proven so far.

Natural History of Type 1 Diabetes

The clinical presentation of type 1 diabetes is preceded by an asymptomatic period of variable duration [5]. Aggressive B-cell destruction may lead to disease manifestation within a few months in young children, while in other individuals the process will continue for years, in some cases even for more than 10 years, before the eventual presentation of clinical disease. The appearance of diabetes-associated autoantibodies is the first detectable sign of emerging B-cell autoimmunity. There are four disease-related

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Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management

Type 2 Diabetes Mellitus:: An Evidence-Based Approach to Practical Management
Contemporary Endocrinology)
Edited by
Mark N. Feinglos, md, cm
M. Angelyn Bethel, md



Product Description

As the global epidemic of diabetes continues to expand, the prevalence of type 2 diabetes is predicted to double in the next 20 years. Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management addresses this problem by expertly synthesizing the currently available evidence regarding specific issues in diabetes care. Written by an interdisciplinary team of scientists and medical professionals and comprising a wealth of information in a single resource, the book integrates the best evidence for the full range of clinical issues surrounding the evaluation and treatment of type 2 diabetes, including comorbid conditions such as hypertension, hyperlipidemia, and vascular disease. To quantify the strength of evidence supporting current practices, each chapter highlights related conditions, including fatty liver disease, pregnancy, and polycystic ovarian syndrome, and also addresses barriers to treatment, including stress, depression, and patient motivation.

Hardcover: 474 pages
Publisher: Humana Press; 1 edition (May 8, 2008)
Language: English
ISBN-10: 1588297942
ISBN-13: 978-1588297945

Contents:
Preface
Contributors
Color Plates

1. Epidemiology of Type 2 Diabetes;  Jonathan E. Shaw and Richard Sicree
2. Pathogenesis of Type 2 Diabetes Mellitus;  Jack L. Leahy
3. Metabolic Mechanisms of Muscle Insulin Resistance;   Deborah M. Muoio, Timothy R. Koves, Jie An, and Christopher B. Newgard
4. Fat Metabolism in Insulin Resistance and Type 2 Diabetes;  Hélène Duez and Gary F. Lewis
5. Detection and Diagnosis of Type 2 Diabetes;  Adrian Vella
6. Therapies for Delay or Prevention of Type 2 Diabetes;  Mary Angelyn Bethel
7. Postprandial Hyperglycemia;  Vasudevan A. Raghavan and Alan J. Garber
8. Medical Nutrition Therapy in Type 2 Diabetes;  Melinda D. Maryniuk and Mary Jean Christian
9. Exercise as an Effective Treatment for Type 2 Diabetes:  Leslie A. Consitt, Kristen E. Boyle, and Joseph A. Houmard
10. Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management: Noninsulin Pharmacological Therapies;  Ildiko Lingvay, Chanhaeng Rhee, and Philip Raskin
11. The Transition from Oral Agents to Combination Insulin/Oral Therapy;  Matthew C. Riddle
12. Intensive Insulin Therapy in T2DM;  Steven V. Edelman
13. Hypoglycemia in Type 2 Diabetes;  Philip E. Cryer
14. Type 2 Diabetes and Concomitant Illness: The Prepared Practice;  Kathleen Dungan, Elizabeth Harris, and Susan S. Braithwaite
15. Adherence to Practice Guidelines for People with Diabetes Mellitus;  Marideli Colón Scanlan and Lawrence Blonde
16. Treatment of Hypertension in Type 2 Diabetes;  David C. Goff, Jr. and William C. Cushman
17. Lipoproteins in Diabetes: Risk and Opportunity;  John R. Guyton
18. Management of Coronary Artery Disease in Type 2 Diabetes Mellitus;  John L. Petersen and Darren K. McGuire
19. Peripheral Vascular Disease and Stroke in Type 2 Diabetes;  Robert G. Mitchell and Brian H. Annex
20. Obesity and Its Treatment in Type 2 Diabetes; Frank L. Greenway and William T. Cefalu
21. The Liver in Type 2 Diabetes Mellitus; Anna Mae Diehl and Steve S. Choi
22. Developing Criteria for Defining Type 2 Diabetes in Pregnancy; Lois Jovanovic and Seanna Martin
23. Metabolic Complications of Polycystic Ovary Syndrome; Tracy L. Setji and Ann J. Brown 
24. Erectile Dysfunction in Diabetes; Andrew J. M. Boulton
25. Sexual Dysfunction in Women with Type 2 Diabetes; Ann J. Brown and Kathryn P. Lowry
26. Depression in Type 2 Diabetes; Miranda A. L. van Tilburg, Anastasia Georgiades, and Richard S. Surwit
27. Atypical Forms of Type 2 Diabetes; Vinaya Simha and Abhimanyu Garg
28. Diabetes Mellitus Type 2 and Stress: Pathophysiology and Treatment; Bryan C. Batch and Richard S. Surwit
29. Pharmacologic Factors Affecting Glycemic Control; Lillian F. Lien and James D. Lane
30. Influencing Self-Management: From Compliance to Collaboration; Martha M. Funnell and Robert M. Anderson

Index
 
Chapter 1:
Epidemiology of Type 2 Diabetes
Jonathan E. Shaw and Richard Sicree

CONTENTS
Introduction
Global and National Prevalence of Type 2 Diabetes
Summary
References

Summary

This chapter reviews a number of aspects of the epidemiology of type 2 diabetes, and the evidence relating to the major issues. There is strong evidence for a rising epidemic of diabetes in many countries of the world, although the prevalence and incidence of diabetes varies markedly among regions, countries within regions, and by ethnicity. Some of the increase in prevalence is attributed to increased survival with the condition, but it is likely that there is a genuine increase in incidence, associated with lifestyle changes, such as reduced exercise and particularly increased obesity. This also seems to be causing the appearance of type 2 diabetes in new groups, such as children and adolescents, although the older population remains the most affected.

The material linking obesity with type 2 diabetes is overwhelming, as prevalence and incidence studies have both shown strong associations among many ethnicities, and intervention studies have shown benefits of life style modification, through exercise and diet. Specific dietary factors: lower dietary fibre, higher total and lower polyunsaturated fat have all been linked to higher diabetes incidence. These lifestyle factors are closely linked with economic situation in the community, and there is a contrasting pattern between developed and developing countries, such that diabetes is more common amongst the least affluent in developed countries, but increased affluence currently seems to be associated with diabetes in developing countries.

Key Words: Diabetes epidemiology; obesity; ethnicity; adolescent; life style; complications.

INTRODUCTION

Over the last 50 yr, changes in lifestyle have led to a dramatic increase in the prevalence of type 2 diabetes in virtually every society around the world. Reductions in physical activity, increases in dietary intake, and the aging of the population are key factors in bringing about this rapid change. The westernization of diet and of other aspects of lifestyle in developing countries has uncovered major genetic differences in the susceptibility of different ethnic groups to type 2 diabetes. This is most readily apparent in Pacific islanders and indigenous populations in North America and Australasia, among whom type 2 diabetes has gone from being almost unheard of 100 yr ago, to affecting up to 30% of the adult population today. As the prevalence of type 2 diabetes has increased, the age of disease onset has also decreased. The traditional paradigm of type 1 diabetes affecting children or young adults and type 2 diabetes affecting the middle-aged and elderly is starting to change. The increasing numbers of young adults, and even children, who are presenting with type 2 diabetes is blurring the distinction between the 2 types of diabetes and heralds a much longer time for people with type 2 diabetes to develop debilitating complications.

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Essential Guide to Blood Groups

Essential Guide to Blood Groups

Product Description:

Essential Guide to Blood Groups is essential information on blood group systems. The main aim of the blood transfusion laboratory is to promote safe blood transfusion. The avoidance of errors, from sample receipt and laboratory testing through to the release of blood for transfusion, is of paramount importance. Knowledge of immunohaematology theory and its application to blood transfusion together with the principles of good laboratory practice are essential. Essential Guide to Blood Groups will be very valuable for medical laboratory scientists and for postgraduate scientists and medical practitioners training to specialise in transfusion and transplantation.

Author:
by Geoff Daniels , Imelda Bromilow

Paperback: 112 pages
Publisher: Wiley-Blackwell; 1 edition (November 28, 2006)
Language: English
ISBN-10: 1405153490
ISBN-13: 978-1405153492

Contents:
1. An introduction to blood groups

• What is a blood group?
• Blood group antibodies
• Clinical importance of blood groups
• Biological importance of blood groups
• Blood group systems
• Blood group terminology and classification

2. Techniques used in blood grouping

• Factors affecting antigen–antibody reactions: Temperature, Time and ionic strength, PH, Antigen density.
• Stages of haemagglutination reactions
• Direct agglutination
• Indirect agglutination: Enzyme techniques, Antiglobulin tests,
• Elution techniques
• Automation of test procedures
• Flow cytometry
• Molecular blood group genotyping

3. The ABO blood groups

• Introduction
• ABO antigens, antibodies, and inheritance
• A1 and A2
• Antigen, phenotype, and gene frequencies
• ABO antibodies
• The importance of the ABO system to transfusion and transplantation medicine
• The biochemical nature of the ABO antigens
• Biosynthesis of the ABO antigens and ABO molecular genetics
• H, the precursor of A and B
• ABH secretion
• H-deficient red cells
• Further complexities
• Acquired changes
• Associations with disease and functional aspects

4. The Rh blood group system

• Introduction – Rh, not rhesus
• Haplotypes, genotypes, and phenotypes
• Biochemistry and molecular genetics
• D antigen (RH1); Molecular basis of the D polymorphism, D variants, Clinical significance of anti-D, D testing, Prediction of RhD phenotype from fetal DNA.
• C, c, E, and e antigens (RH2, RH4, RH3, RH5); Clinical significance of CcEe antibodies, Molecular basis of the C/c and E/e polymorphisms.
• Other Rh antigens; Compound antigens: ce, Ce, CE, cE (RH6, RH7, RH22, RH27) and G (RH12), Cw, Cx, MAR (RH8, RH9, RH51), VS, V (RH20, RH10).
• Rh-deficient phenotypes – Rhnull and Rhmod
• Putative function of the Rh proteins and RhAG

5. Other blood groups

• The Kell system; The Kell glycoprotein and the KEL gene, Kell-system antigens, Kell-system antibodies, K0 phenotype, McLeod syndrome, McLeod phenotype, and Kx (XK1) antigen.
• The Duffy system; Fya (FY1) and Fyb (FY2), Anti-Fya and -Fyb, Fy3 and Fy5, The Duffy glycoprotein, a receptor for chemokines, Duffy and malaria.
• The Kidd system; Jka (JK1) and Jkb (JK2); anti-Jka and -Jkb, Jk(a-b-) and Jk3, The Kidd glycoprotein is a urea transporter.
• The MNS system; M (MNS1) and N (MNS2); anti-M and -N, S (MNS3) and s (MNS4); anti-S and -s, S- s- U- phenotype and anti-U, Other MNS antigens and antibodies.
• The Diego system; Band 3, the red cell anion exchanger, Dia (DI1) and Dib (DI2); anti-Dia and -Dib, Wra (DI3) and Wrb (DI4); anti-Wra and -Wrb, Other Diego-system antigens.
• The Lewis system.
• Some other blood group systems; P, Lutheran, Yt, Xg, Scianna, Dombrock, Colton, Landsteiner–Wiener (LW), Chido/Rodgers, Gerbich, Cromer, Knops, Indian, I.
• Antigens that do not belong to a blood group system

6. Clinical significance of blood group antibodies

• Antibody production and structure
• Factors affecting the clinical significance of antibodies: Antibody specificity.
• Haemolytic transfusion reactions; Intravascular red cell destruction, Extravascular red cell destruction.
• Haemolytic disease of the fetus and newborn; Cross-matching for infants under 4 months old.
• Autoantibodies.
• Tests to assess the potential significance of an antibody.
• Decision-making for transfusion.

7. Quality assurance in immunohaematology

• Achieving total quality.
• Frequency and specificity of control material.
• Quality requirements for safe transfusion practice.
• Checklist of critical control points.
• QC for molecular blood group testing.

8. Trouble-shooting and problem-solving in the reference laboratory

• ABO grouping.
• Rh grouping.
• Problems in antibody screening, identification, and cross-matching.

9. Frequently asked questions
Recommended reading
Index

Sampel Chapter 1:

What is a blood group?

In 1900, Landsteiner showed that people could be divided into three groups (now called A, B, and O) on the basis of whether their red cells clumped when mixed with separated sera from people. A fourth group (AB) was soon found. This is the origin of the term ‘blood group’.

A blood group could be defined as, ‘An inherited character of the red cell surface, detected by a specific alloantibody’. Do blood groups have to be present on red cells? This is the usual meaning, though platelet- and neutrophil-specific antigens might also be called blood groups. In this book only red cell surface antigens are considered. Blood groups do not have to be red cell specific, or even blood cell specific, and most are also detected on other cell types. Blood groups do have to be detected by a specific antibody: polymorphisms suspected of being present on the red cell surface, but only detected by other means, such as DNA sequencing, are not blood groups. Furthermore, the antibodies must be alloantibodies, implying that some individuals lack the blood group.

Blood group antigens may be:

• proteins;
• glycoproteins, with the antibody recognising primarily the polypeptide backbone;
• glycoproteins, with the antibody recognising the carbohydrate moiety;
• glycolipids, with the antibody recognising the carbohydrate portion

Blood group polymorphisms may be as fundamental as representing the presence or absence of the whole macromolecule (e.g. RhD), or as minor as a single amino acid change (e.g. Fya and Fyb), or a single monosaccharide difference (e.g. A and B).

Blood group proteins and glycoproteins are integral structures of the red cell membrane. Diagrammatic representations of some blood group proteins and glycoproteins in the membrane are shown in Fig. 1.1. Some pass through the membrane once. These generally have an external N-terminal domain and a cytoplasmic C-terminal domain (Type 1), though

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Paediatrics: A Clinical Guide for Nurse Practitioners

Paediatrics: A Clinical Guide for Nurse Practitioners
Edited by Katie Barners

Contents
Contributors
Preface
Part I Clinical Issues in Paediatrics:

1. A developmental approach to the history and physical examination in paediatrics
2. Anatomical and physiological differences in paediatrics
3. Care of the adolescent
4. General principles in the assessment and management of the ill child
5. Pharmacology in paediatrics
6. Internet resources for the nurse practitioner
7. Paediatric telephone advice and management for the nurse practitioner
8. Transcultural nursing care

Part II Common Paediatric Problems
Dermatological problems:

1. My child has a rash?
2. Acne
3. Atopic eczema
4. Birthmarks
5. Burns
6. Cellulitis
7. Food allergy
8. Fungal skin infections
9. Impetigo
10. Infantile seborrhoeic dermatitis (ISD) or infantile eczema (including cradle cap)
11. Nappy rash
12. Pediculosis humanus capitus (head lice)
13. Psoriasis
14. Scabies
15. Viral skin infections (warts and molluscua contagiosum)

Problems related to the head, eyes, ears, nose, throat or mouth:

1. Congenital blocked nasolacrimal duct
2. Eye trauma
3. The'red eye'
4. Common oral lesions
5. Common oral trauma
6. Acute otitis media
7. Amblyopia and strabismus

Respiratory and cardiovascular problems

1. Asthma and wheezing
2. Bronchiolitis
3. Pneumonia
4. Stridor and croup (laryngotracheobronchitis)
5. Syncope
6. Chest pain

Gastrointestinal and endocrine problems

1. Acute abdominal pain
2. Childhood constipation and encopresis
3. Acute gastroenteritis (vomiting and diarrhoea)
4. Jaundice
5. Threadworms
6. Diabetes mellitus
7. Delayed sexual development (delayed puberty)
8. Premature sexual development (precocious puberty)
9. Short stature
10. Ingestions and poisonings

Musculoskeletal problems, neurological problems and trauma

1. Limp and hip pain
2. Lacerations
3. Pain assessment and management
4. Febrile seizures
5. Head injury

Genitourinary problems and sexual health

1. Urinary tract infection
2. Enuresis
3. Vulvovaginitis in the prepubescent child
4. Adolescent contraception
5. Sexually transmitted infections
6. Painful male genitalia

Infectious diseases and haematology

1. Acute fever (<7 days duration)
2. Glandular fever (Epstein-Barr infection)

Product details
Paperback: 288 pages
Publisher: Butterworth-Heinemann (18 Aug 2003)
Language English
ISBN-10: 0750649577
ISBN-13: 978-0750649575


sampel Chapter 1
A Developmental Approach to the History and Physical Examination in Paediatrics
Katie Barnes And Fiona Smart

INTRODUCTION

Children are not miniature adults and as such, the nurse practitioner (NP) caring for children will require an appreciation of age and developmentrelated issues that impact the care of children. This includes an understanding of the anatomical and physiological differences across the age groups (see Ch. 2) and a working knowledge of child development (see Appendix 1). This section will outline the developmental springboard from which the paediatric history and physical examination are launched. Note that Chapter 3 (Care of the Adolescent) discusses this unique group in greater detail.

Flexibility is an important prerequisite to paediatric consultations; observe the child's response and let this guide your interactions.

Considerations of safety are likewise imperative when working with children. Think about the proximity of electrical outlets, equipment in the examination area (otoscopes, ophthalmoscopes) and other hazards that are easily reached by inquisitive fingers (electrical cords, lamps, needles). Never leave a, child unattended on the examination table.

Be organised (without forgetting about flexibility). Equipment should be accessible and in working order; things can easily slip into chaos, especially with toddlers or families with numerous children in the consultation room at the same time.

Table 1.1 summarises important developmental considerations.

INFANTS (BIRTH TO 12 MONTHS)

Attachment and trust are the key developmental issues of infancy and the infant-carer dyad is pivotal. Therefore, it is important that the NP respects this relationship and involves the parent(s) in all aspects of the physical examination. In addition, stranger and separation anxiety play an increasingly important role when assessing children older than 7 months. Stranger anxiety tends to peak at 9 months, whereas distress related to a separation from caregivers may continue to influence social interactions into the toddler period. Note however, that there are wide variations with both of these behaviours.

A birth history (gestational age at birth, birth weight, prenatal care, intrauterine exposures, problems during labour, delivery or the neonatal period) is particularly relevant in this age group as an assessment of potential vulnerability may be necessary (e.g. traumatic birth and risk for developmental delays). In addition, the parent's observations regarding the infant's growth, development and illness-related behaviours are required in order to assess the infant within a broader context. Lastly, information about the family's ability to cope with a sick infant is requisite for the negotiation of a realistic plan of care.

The physical examination of a young infant (less than 5 months of age) is relatively straightforward and can usually proceed in a cephalocaudal manner. The examination of older infants will likely require flexibility in the examination sequence. However, if presented with a sleeping infant, the NP should take advantage of the opportunity to assess the heart, lungs and possibly the abdomen. It is important to provide a warm, protective environment for the infant, as she will not be happy if the examination room is cold and she is undressed and exposed. Young infants can be examined on the table, whereas older infants (especially those that can sit) may be happier on the parent's lap. It is often helpful to position yourself opposite the parent (putting knees together) to form a 'human examination table.' Note that if the older infant does need to be placed on the examination table, be sure to keep the parent in full view and keep the infant in a sitting position (she will not like lying down). Smile at the infant—she'll smile back. Likewise, be sure to use a gentle touch and tone of voice. Cooperation can be assisted by the use of distracters such as rattles, snapping fingers or tongue depressors.

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Epidemiology of Pediatric and Adolescent Diabetes

 Epidemiology of Pediatric and Adolescent Diabetes

Edited by:
Dana Dabelea
University of Colorado HSC
Denver, Colorado, USA
Georgeanna J. Klingensmith
University of Colorado
Aurora, Colorado, USA

Contents
Preface
Contributors
1. Definition, Diagnosis, and Classification of Diabetes in Youth
Nancy A. Crimmins and Lawrence M. Dolan
2. Descriptive Epidemiology of Type 1 Diabetes in Youth: Incidence, Mortality, Prevalence, and Secular Trends
Anders Green
3. Genetic Epidemiology of Type 1 Diabetes
George S. Eisenbarth and Theresa A. Aly
4. Early-Life Diet and Risk of Type 1 Diabetes
Melissa D. Simpson and Jill M. Norris
5. Environmental Determinants: The Role of Viruses and Standard of Hygiene
Mikael Knip and Heikki Hy€oty
6. Tempo and Type 1 Diabetes: The Accelerator Hypothesis
Terence J. Wilkin
7. Epidemiology of Type 2 Diabetes in Children and Adolescents
Kristen Nadeau and Dana Dabelea
8. Obesity and T2DM in Youth
Ram Weiss and Sonia Caprio
9. Insulin Resistance and Insulin Secretion in the Pathophysiology of Youth Type 2 Diabetes
Fida Bacha and Silva Arslanian
10. High and Low Birth Weights as Risk Factors for Diabetes
Rachel Pessah, Lois Jovanovic, and David J. Pettitt
11. Monogenic Forms of Diabetes in the Young
Martine Vaxillaire and Philippe Froguel
12. Natural Evolution, Prediction, and Prevention of Type 1 Diabetes in Youth
Craig E. Taplin and Jennifer M. Barker
13. Prevention and Screening for Type 2 Diabetes in Youth
Phil Zeitler and Orit Pinhas-Hamiel
14. Chronic Complications of Childhood Diabetes
Kim C. Donaghue, Fauzia Mohsin, and Monique L. Stone
15. Cardiovascular Disease Risk Factors
R. Paul Wadwa, Elaine M. Urbina, and Stephen R. Daniels
16. Epidemiology of Acute Complications in Youth: Diabetic Ketoacidosis and Hypoglycemia
Arleta Rewers and Georgeanna J. Klingensmith
17. Dietary Factors in Youth with Diabetes
Elizabeth J. Mayer-Davis and Franziska K. Bishop
18. Health Care Cost and Utilization
Reena Oza-Frank, Ping Zhang, Giuseppina Imperatore, and K.M. Venkat Narayan
19. Treatment Patterns in Youth with Diabetes
Harvey K. Chiu and Catherine Pihoker
20. Psychosocial Issues in Childhood Diabetes
Barbara J. Anderson
Index . . . .

Publisher: Informa HealthCare
Number Of Pages: 376
Publication Date: 2008-02-08
ISBN-10 / ASIN: 1420047973
ISBN-13 / EAN: 9781420047974


Sample chapter 1
Definition, Diagnosis, and Classification
of Diabetes in Youth
Nancy A. Crimmins and Lawrence M. Dolan
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati School of Medicine, Cincinnati, Ohio, U.S.A.

HISTORICAL PERSPECTIVE: EARLIEST DESCRIPTIONS TO 1965
Early Descriptions of Diabetes

Ancient records up to 3000 years old describe a disease in youth that was sudden in onset, resulted in acute metabolic decompensation, and culminated in death. Although this clinical picture described millennia ago was likely that of diabetes, the first accepted description of diabetes as a disorder associated with increased urine output came from ancient Egypt (the Ebers papyrus) around 1550 B.C. It was not until the second century B.C. that the term ‘‘diabetes’’ was used. Credit for coining ‘‘diabetes’’ is given to Demetrios of Apamaia who derived the term from the Greek word diabeinein, meaning ‘‘siphon’’ or ‘‘pass through.’’

Aretaeus of Cappadocia reported the first clinical description of the disease in the second century A.D. using the term ‘‘diabetes.’’ Focusing on the polyuric aspect of diabetes, he wrote of the ‘‘melting down of flesh and limbs into urine’’ and stated that the disease was infrequent. Diabetes was recognized in Indian medicine in the fifth and sixth centuries as a disorder associated with the production of sweet urine that attracted insects. The term diabetes did not appear in an English text until 1425

In 1674, Thomas Willis, physician to England’s King Charles II, became the first European to discover the sweetness in the urine of those afflicted with diabetes. Perhaps the first English diabetes epidemiologist, Thomas, also noted the importance of lifestyle in the development of diabetes. He noted that the prevalence of diabetes was increasing because of ‘‘good fellowship and gusling down chiefly of unalloyed wine.’’ A century later, Matthew Dobson proved that the sweetness in urine was caused by sugar and was associated with sugar in the blood. John Rollo was the first person to coin the term ‘‘diabetes mellitus’’ (mellitus from Latin for honey) and distinguished this disease from another disease of polyuria, ‘‘diabetes insipidus’’ (insipidus from Latin for tasteless) around the turn of the 18th century.

Early Recognition of Two Distinct Phenotypes of Diabetes As early as the fifth and sixth centuries, Indian descriptions of the diabetes recognized two phenotypes: one that appeared in older, fatter people, and the other in thin people, which was more acute in presentation and quickly led to death. It was not until 1866 that this concept emerged again in a text written by George Harley. He wrote, ‘‘. . .I differ from my predecessors and contemporaries in believing that there are at least two different forms of the disease, requiring diametrically opposite lines of treatment. . . . one of which might be named Diabetes from excessive formation; the other Diabetes from defective assimilation (malnutrition)’’ (1). Etienne

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The Neurobiology of Autism

The Neurobiology of Autism
The Johns Hopkins Series in Psychiatry and Neuroscience


CONTENTS
List of Contributors
Preface

I CLINICAL OBSERVATIONS

1. The Epidemiology of Pervasive Developmental Disorders
2. Size of the Head and Brain in Autism: Clue to Underlying Biologic Mechanisms?
3. The Autistic Mind
4. Language and Communication Disorders in Autism Spectrum Disorders
5. Memory and Executive Functions in Autism
6. The Vagus: A Mediator of Behavioral and Physiologic Features Associated with Autism
7. Approaches to Psychopharmacology
8. Gastrointestinal Issues Encountered in Autism

II NEUROANATOMIC INVESTIGATIONS

1. Structural Brain Anatomy in Autism: What Is the Evidence?
2. The Brainstem in Autism
3. Myelin and Autism
4. Positron Emission Tomography Studies of Autism
5. The Orbitofrontal-Amygdala System in Nonhuman Primates: Function, Development, and Early Insult
6. An Animal Model of Virus-Induced Autism: Borna Disease Virus Infection of the Neonatal Rat

III GENETIC INITIATIVES

1. Gene Expression in Autism
2. Candidate Susceptibility Genes for Autism
3. Chromosome 15 and Autism
4. Chromosome 7
5. Fragile X Syndrome
6. Autism and Tuberous Sclerosis Complex
7. The Roles of Dopamine and Norepinephrine in Autism: From Behavior and Pharmacotherapy to Genetics

IV NEUROBIOLOGIC RESEARCH

1. Serotonin in Autism
2. The GABAergic System in Autism
3. The Cholinergic System in Autism
4. The Role of Reelin in Autism
5. Brain-Derived Neurotrophic Factor and Dopamine in Autism
6. The Immune System

Epilogue
Index

Publisher: The Johns Hopkins University Press
Number Of Pages: 424
Publication Date: 2004-12-01
ISBN-10 / ASIN: 0801880467
ISBN-13 / EAN: 9780801880469



Sample chapter 1
The Epidemiology of Pervasive
Developmental Disorders
Eric Fombonne, M.D., FRCPsych

Epidemiologic surveys of autism started in the mid-1960s in England (Lotter, 1966) and since then have been conducted in many countries. All epidemiologic surveys have focused on a categorical-diagnostic approach to autism that over time has relied on different sets of criteria; however, all surveys relied on a definition of autism that comprised severe impairments in communication and language, social interaction, and play and behavior. With the exception of recent studies, other pervasive developmental disorders (PDDs) falling short of diagnostic criteria for autism (PDD-NOS [not otherwise specified], Asperger syndrome) were generally not included in the definition used in the earlier surveys, although several epidemiologic investigations yielded useful information on the rates of these particular types of PDD. These data are summarized separately. This chapter reviews the methodologic features and substantive results of published epidemiologic surveys, then addresses the following questions: (1) What is the range of prevalence estimates for autism and related disorders? (2) What are the correlates of autism? (3) Is the incidence of autism increasing? (4) How many children have a PDD in the United States today?

Selection of Studies

The studies were identified through systematic searches of scientific literature databases (Medline, PsycINFO) and from prior reviews (Wing, 1993; Fombonne, 1999). Only studies published in the English language were included in this review. Overall, 37 studies published between 1966 and early 2003 were selected that surveyed PDDs in clearly demarcated, nonoverlapping samples.

Study Designs

The surveys were conducted in 14 countries, and half of the results were published during the past decade. Details on the precise sociodemographic compo-

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