Anemia in the Elderly

Anemia in the Elderly








Anemia in the Elderly

Anemia in the Elderly
Editor:
Lodovico Balducci
William B. Ershler
John M. Bennett

Anemia in the Elderly

From the reviews: “This multiauthored monograph on anemia in older persons discusses the nature of aging and red cell levels in the body as well as the various causes of anemia in older persons. Its purpose is to review the nature of anemia in older persons. The book succeeds admirably. The audience is hematologists and physicians treating older persons and researchers of blood physiology. … Because anemia is common in older persons, this book is important and timely. It points the way to the future studies.” (David O. Staats, Doody’s Review Service, May, 2008) “Anemia in the Elderly offers a thoughtful overview of a common yet underdiagnosed medical condition. this book carries tremendous clinical relevance for its intended audience physicians and other clinicians who care for older adults. The major contribution of this text is the elegant integration of geriatrics throughout. By offering a thoughtful approach to anemia that takes functional status into account, this book is an important addition to the fields of geriatrics and hematology.”

Anemia in the Elderly

Anemia in the elderly has been properly defined as the silent epidemic, representing 3 million people in the United States aged 65 years and older. Incidence and prevalence of this condition increase with age. It differs in its etiology, pathogenesis and treatment from anemia in children and younger adults. Anemia is associated with reduced survival, increased risk of functional dependence and hospitalization, increased risk of congestive heart failure and stage renal disease and cognitive disorders. Approximately 70% of anemia in older individuals is reversible.

Anemia in the Elderly
Details

* Paperback: 146 pages
* Publisher: Springer; 1 edition (August 28, 2008)
* Language: English
* ISBN-10: 0387097910
* ISBN-13: 978-0387097916
* Product Dimensions: 9.1 x 6 x 0.4 inches

Anemia in the Elderly

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Clinical Manifestations and Assessment of Respiratory Disease

Clinical Manifestations and Assessment of Respiratory Disease (Des Jardins,Clinical Manifestations and Assesments of Respiratory Disease) (Paperback)

Clinical Manifestations and Assessment of Respiratory Disease
Author by:

• Terry Des Jardins MEd RRT
• George G. Burton MD FACP FCCP FAARC

Clinical Manifestations and Assessment of Respiratory Disease
Book Description
Current, comprehensive coverage in an easy-to-read format

Clinical Manifestations and Assessment of Respiratory Disease Book Description

The new edition of this popular text has been extensively revised to reflect the latest changes in the field. The introductory chapters address the fundamental skills and protocols necessary for clinical assessment. Each disease is presented in relation to one of six clinical scenarios: atelectasis, consolidation, increased alveolar-capillary membrane thickness, bronchospasm, excessive bronchial secretions, and distal airway and alveolar weakening. Students are provided with an illustration of the major alterations of the lungs, the etiology of the disease, an overview of clinical manifestations, a discussion of management, and a series of self-assessment questions.

• Emphasis on clinical scenarios that allows the student to better understand the diseases. It shows them why they are seeing what they are seeing and why certain treatment modalities are being used.
• Focus on assessment and therapist-driven protocols (TDPs) so students can incorporate this into their care of patients.
• Full-color insert that aids the reader in visualizing and understanding the pathophysiology of the diseases.
• Clinical Manifestation Overview boxes that enable students to easily refer back to the most important information about the pathophysiologic mechanisms for each disorder of the lung and confirm that they have learned the key information.
• Case studies that aid the student and the instructor in applying the fundamental information to the assessment and treatment of respiratory patients.
• Twelve easily accessible appendices featuring commonly needed information such as abbreviations, equations, medications, hemodynamic measurements, and more.

• Two color design that engages the reader by highlighting different elements of the text and details within the line drawings.
• Access to the Evolve Learning System that includes additional case studies, a PowerPoint presentation of lecture material, a test bank, an image collection, and Weblinks

Clinical Manifestations and Assessment of Respiratory Disease
books Details

• Paperback: 688 pages
• Publisher: Mosby; 5 edition (November 10, 2005)
• Language: English
• ISBN-10: 0323028063
• ISBN-13: 978-0323028066

Clinical Manifestations and Assessment of Respiratory Disease (Des Jardins,Clinical Manifestations and Assesments of Respiratory Disease)

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Acute Respiratory Distress Syndrome: Second Edition (Lung Biology in Health and Disease: Hardcover)

Acute Respiratory Distress Syndrome

Acute Respiratory Distress Syndrome
Editor: Augustine M. K. Choi

Acute Respiratory Distress Syndrome Book Description
The only available text to focus primarily on Acute Respiratory Distress Syndrome (ARDS).
Thoroughly revised content and ten new chapters provide pulmonologists with the latest developments and applications of pharmacological and mechanical therapies needed to treat the debilitating and difficult condition of ARDS.

Acute Respiratory Distress Syndrome
REVISION OF A BESTSELLER-Updated content and ten new chapters cover the latest developments and applications physicians need to treat ARDS

EVALUATION OF CURRENT THERAPIES-Surfactant therapy, glucocorticoid therapy, invasive and non-invasive prone position forms of mechanical ventilation, and mesenchymal stem cells helps clinicians give patients the best possible care

INTERNATIONAL TEAM OF EDITORS AND CONTRIBUTORS-Key opinion leaders with diverse backgrounds and experience provide authoritative guidance physicians want and trust

A COMPLETE STAND-ALONE GUIDE-the only available comprehensive volume to tackle this pertinent issue and cover both its pathophysiology and pathogens

Acute Respiratory Distress Syndrome Book Details

• Hardcover: 472 pages
• Publisher: Informa Healthcare; 2 edition (November 16, 2009)
• Language: English
• ISBN-10: 1420088408
• ISBN-13: 978-1420088403

Acute Respiratory Distress Syndrome, Second Edition (Lung Biology in Health and Disease)

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Infection and Rheumatic Diseases: Mimicking and Complicating Effects on Rheumatic Disorders

Infection and Rheumatic Diseases: Mimicking and Complicating Effects on Rheumatic Disorders

Author by:
Georg Schett
Jochen Zwerina

Books Details
Hardcover: 200 pages
Publisher: Springer; 1 edition (January 1, 2010)
Language: English
ISBN-10: 3211792813
ISBN-13: 978-321179281

Books Description

Autoimmune and rheumatic diseases are two close allies. Differential diagnosis of both disease groups can be cumbersome since the clinical signs of rheumatic and infectious disorders are very similar. This book addresses the fact that infectious disease can either mimic or complicate rheumatic diseases. In the first part, cases of with standard rheumatic symptoms patients triggered by infections and differential diagnosis are presented. The second part is dedicated to the complications of rheumatic disease infections. Standard patient cases are presented as well as risk factors, clinical features and microbial spectra. Further chapters inform about the impact of anti-rheumatic and immunomodulatory drug therapies (incl. biological agents) on infectious risk, the specific aspects of vaccination during immunosuppressive therapy and issues about the infectious risk and chemoprophylaxis during orthopedic surgery. This book provides clinicians a detailed insight between rheumatic and infectious disease.

Written for:
Rheumatologists, immunologists, internists, clinicians

Keywords:
Arthritis
Complicating
Infection
Mimicking
Rheuma
Rheumatic Diseases

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Current Medical Diagnosis and Treatment 2009

Current Medical Diagnosis and Treatment 2009

Current Medical Diagnosis and Treatment 2009
Product Details:
Author by:
Stephen McPhee
Maxine Papadakis (Author)
Paperback: 1728 pages
Publisher: McGraw-Hill Professional; 48 edition (October 2, 2008)
Language: English
ISBN-10: 0071591249
ISBN-13: 978-0071591249

The first annually updated text in internal medicine — trusted, authoritative, and essential to daily practice CMDT delivers the most current insights into signs, symptoms, epidemiology, etiology, and treatment for over 1,000 diseases and disorders. Turn to any topic, and you’ll find on-the-spot, evidence-based answers that reflect the most recent developments in diagnosis and treatment. This concise, authoritative reference gets you up to speed–fast–on the latest medical advances, prevention strategies, cost-effective treatments, and more.

Comprehensive coverage of inpatient and outpatient care, focusing on the diagnostic tools relevant to your day-to-day practice.

• Full review of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, toxicology, and urology.
• Only text with an annual review of advances in HIV treatment.
• Essentials of Diagnosis? for most diseases/disorders.
• Hundreds of quick-access drug treatment tables, with indexed trade names and updated drug prices.
• ICD codes featured on inside covers.
• Diagnostic and treatment algorithms present important information in an at-a-glance style.
• Up-to-date references provide peer-reviewed, evidence-based information

New to this Current Medical Diagnosis and Treatment 2009 edition:

• Color insert expanded to 16 pages.
• Latest developments in HIV infection, including new drugs, recommended treatment regimens, and antiretroviral drug resistance.
• All new chapter on hemostasis and antithrombotic therapy.
• Completely revamped End of Life Chapter, now called Palliative Care And Pain Management to reflect its new emphasis.
• Sections on asthma (includes 2007 NAEPP guidelines) and palpitations.
• More algorithms throughout and increased coverage of Canadian and International Guidelines

CURRENT Medical Diagnosis & Treatment 2009 CONTENTS:
Chapter 1 Disease Prevention & Health Promotion
Chapter 2 Common Symptoms
Chapter 3 Preoperative Evaluation & Perioperative Management
Chapter 4 Geriatric Disorders
Chapter 5 Palliative Care & Pain Management
Chapter 6 Dermatologic Disorders
Chapter 7 Disorders of the Eyes & Lids
Chapter 8 Ear, Nose, & Throat Disorders
Chapter 9 Pulmonary Disorders
Chapter 10,11 Heart Disease, Systemic Hypertension
Chapter 12 Blood Vessel & Lymphatic Disorders
Chapter 13 Blood Disorders
Chapter 14 Disorders of Hemostasis & Antithrombotic Therapy
Chapter 15 Gastrointestinal Disorders
Chapter 16 Liver, Biliary Tract, & Pancreas Disorders
Chapter 17 Breast Disorders
Chapter 18 Gynecologic Disorders
Chapter 19 Obstetrics & Obstetric Disorders
Chapter 20 Musculoskeletal & Immunologic Disorders
Chapter 21 Fluid & Electrolyte Disorders
Chapter 22 Kidney Disease
Chapter 23 Urologic Disorders
Chapter 24 Nervous System Disorders
Chapter 25 Psychiatric Disorders
Chapter 26 Endocrine Disorders
Chapter 27 Diabetes Mellitus & Hypoglycemia
Chapter 28 Lipid Disorders
Chapter 29 Nutritional Disorders
Chapter 30 Common Problems in Infectious Diseases & Antimicrobial Therapy
Chapter e1 Anti-infective Chemotherapeutic & Antibiotic Agents
Chapter 31 HIV Infection & AIDS
Chapter 32 Viral & Rickettsial Infections
Chapter 33 Bacterial & Chlamydial Infections
Chapter 34 Spirochetal Infections
Chapter 35 Protozoal & Helminthic Infections
Chapter 36 Mycotic Infections
Chapter 37 Disorders Due to Physical Agents
Chapter 38 Poisoning
Chapter 39 Cancer
Chapter e2 Basic Genetics
Chapter 40 Clinical Genetic Disorders
Chapter 41 Complementary & Alternative Medicine
Chapter e3 Diagnostic Testing & Medical Decision Making
Chapter e4 Information Technology in Patient Care: The Internet, Telemedicine, and Clinical Decision Support
Appendix: Therapeutic Drug Monitoring & Laboratory Reference Intervals

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The Financial Management of Hospitals and Healthcare Organizations

The Financial Management of Hospitals and Healthcare Organizations

The Financial Management of Hospitals and Healthcare Organizations
Book Description
A clear introduction to healthcare financial management Using the same nontechnical approach as previous editions, this book introduces nonfinancial managers to the fundamental concepts and skills necessary to cost-effectively manage operations. Revised to include new developments in the field New and revised material includes: The financial impact of patient safety, The public s concern about accounting integrity, The costs associated with charity care policies resulting from the rising number of uninsured, The growing need to reduce operating expenses due to Medicare margins, How to bridge the gap between, strategic planning and budgeting, The consumer movement and the impact on pricing policies, How Medicare and Medicaid have been affected by the Deficit Reduction Act of 2005 and the Tax Relief and Healthcare Act of 2006, Various state proposals for healthcare reform

Author:
Michael Nowicki

Product Details

Hardcover: 350 pages
Publisher: Health Administration Press; 4th edition (November 1, 2007)
Language: English
ISBN-10: 1567932770
ISBN-13: 978-1567932775


CONTENTS
PART I Financial Management
1 Financial Management in Context
2 Organization of Financial Management
3 Tax Status of Healthcare Organizations
PART II Operating Revenue
4 Third-Party Payment
5 Medicare and Medicaid
6 Cost Accounting
7 Setting Charges in Healthcare
PART III Working Capital
8 Managing Working Capital
9 Managing Accounts Receivable
10 Managing Materials
PART IV Resource Allocation
11 Strategic and Operational Planning
12 Budgeting
13 Capital Budgeting
PART V Financial Analysis
14 Financial Analysis and Management Reporting
PART VI Healthcare’s Future
15 Future Trends

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Dementia: WPA Series in Evidence and Experience in Psychiatry

Dementia WPA Series in Evidence and Experience in Psychiatry

Dementia
Editor by:
Mario Maj
Norman Sartorius

Product Details
Paperback: 412 pages
Publisher: Wiley; 2 edition (February 21, 2003)
Language: English
ISBN-10: 0470849630
ISBN-13: 978-0470849637

Book Description

It is a great compendium of up-to-date facts and opinions..." (British Journal of Psychiatry, April 2001) --This text refers to an out of print or unavailable edition of this title.

Dementia is most frequently associated with aging and is, at present, under diagnosed and under-represented all over the world. Discrepancies in the diagnostic procedures and therapeutic interventions implemented in the various clinical contexts are significant and consequently, the need for a review of the currently available research evidence and a discussion of different clinical practices is urgently needed. This book provides a much needed review of the diagnostic procedures and the implementations of therapeutic interventions.

knowledge of dementia has significantly increased. The diagnosis of the dementia syndromes has been considerably refined. New types of the disorder, such as the Lewy body dementia, have been described. Our understanding of the risk factors and the pathogenesis of Alzheimer's disease has considerably improved. Clinical and neuropsychological tools for the early diagnosis and the staging of dementia have been developed, and their usefulness in ordinary practice has been demonstrated. Promising leads for pharmacological treatment have been developed, and much has been done to facilitate the life and work of carers, by increasing training and support programmes in numbers and quality in many countries. Psychosocial interventions have also been developed and seen to be helpful in maintaining a person with dementia at a particular level of functioning without further loss and in improving the quality of life of the patients and their caregivers.

The WPA series Evidence and Experience in Psychiatry has been initiated as part of the effort of the World Psychiatric Association to bridge the gap between research evidence and clinical practice concerning the most prevalent mental disorders. Because of its increasing frequency, severity and ubiquity, and because the application of knowledge is so limited, dementia should be a priority for research, teaching and care. We hope that this volume will contribute to making it such.

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Fungal Infection: Diagnosis and Management

Fungal Infection: Diagnosis and Management

Fungal Infection: Diagnosis and Management
Author by:
Malcolm D. Richardson
D. W. Warnock

Product Details
Paperback: 249 pages
Publisher: Blackwell Publishers; 2nd edition (January 15, 1997)
Language: English
ISBN-10: 0865427240
ISBN-13: 978-0865427242

Books Description
Fungal Infection: Diagnosis and Management summarises the clinical manifestations, diagnosis and management of fungal infection. Infections are dealt with according to the affected system and clinical presentation rather than individual fungal infection making this a problem-orientated book designed to help clinicians make the best use of the often time-consuming laboratory
Noticeably larger than the previous edition and covers several new areas, The introductory chapters have been updated and The next chapter on antifungal drugs has been undergone extensive changes The newly licensed antifungal drugs are also covered For the first time in this edition relevant references have been included at the end of each chapter, which provide a useful starting point if further information is required ... . This book is ideal to dip into for specific pieces of information Overall, the book is very useful and one to which many people will refer regularly. It succeeds in its stated aim of being “concise and up to date” and for those who have to deal with fungal infections in clinical practice, it is a valuable source of information.
Mycoses Newsletter, International Society for Human and Animal Mycology

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Principles Of Clinical Gastroenterology

Principles Of Clinical Gastroenterology

Principles Of Clinical Gastroenterology

EDITED BY:

Tadataka Yamada, MD

ASSOCIATE EDITORS:

David H. Alpers, MD

Anthony N. Kalloo, MD

Neil Kaplowitz, MD

Chung Owyang, MD

Don W. Powell, MD

Product Details:

Hardcover: 672 pages

Publisher: Wiley-Blackwell; 1 edition (June 23, 2008)

Language: English

ISBN-10: 1405169109

ISBN-13: 978-1405169103

A Concise, Symptom-Based Textbook for Diagnosis and Decision Making in Clinical Practice

Over the past twenty years, thousands of physicians have come to depend on Yamada’s Textbook of Gastroenterology. Its encyclopaedic discussion of the basic science underlying gastrointestinal and liver diseases as well as the many diagnostic and therapeutic modalities available to the patients who suffer from them was—and still is—beyond compare. This new textbook, Principles of Clinical Gastroenterology, is designed to inform practitioners on the features of the major clinical disorders in gastroenterology and hepatology from the point of view of the clinician observing signs and symptoms of a patient under care and management.

It is a practical guide to diagnosis and decision making in clinical practice and provides a rich source of information on diseases of the gastrointestinal tract and liver. Covering the full range of examinations in gastroenterology and hepatology, with extremely timely chapters on patients with dyspepsia, eating disorders, jaundice, hepatitis, cirrhosis, and on screening, Principles of Clinical Gastroenterology gives you easy access to approaches that a clinician might take to common symptoms and signs presented by patients with such disorders. The chapters include the epidemiology, history, signs and symptoms, diagnosis, treatment, and prognosis of the most commonly encountered disorders in gastroenterology and hepatology.

Contents

Contributors

Preface

1. Clinical decision making; Philip S. Schoenfeld
2. Economic analysis in the diagnosis and treatment of gastrointestinal diseases; John M. Inadomi
3. Psychosocial factors in the care of patients with functional gastrointestinal disorders; Bruce D. Naliboff, Jeffrey M. Lackner, Emeran A. Mayer
4. Approach to the patient with dyspepsia and related functional gastrointestinal complaints; Nicholas J. Talley, Gerald Holtmann
5. Approach to the patient with dysphagia, odynophagia, or noncardiac chest pain; Chandra Prakash Gyawali, Ray E. Clouse
6. Approach to the patient with gastroesophageal reflux disease; Joel E. Richter
7. Approach to the patient with dyspepsia and peptic ulcer disease; Andrew H. Soll, David Y. Graham
8. Approach to the patient with gross gastrointestinal bleeding; Grace H. Elta, Mimi Takami
9. Approach to the patient with occult gastrointestinal bleeding; David A. Ahlquist, Graeme P. Young
10.  Approach to screening for colorectal cancer; Graeme P. Young, James E. Allison
11. Approach to the patient with unintentional weight loss; Andrew W. DuPont
12. Approach to the patient with obesity; Louis A. Chaptini, Steven R. Peikin
13. Approach to the patient with nausea and vomiting; William L. Hasler
14. Approach to the patient with abdominal pain; Pankaj Jay Pasricha
15. Approach to the patient with gas and bloating; William L. Hasler
16. Approach to the patient with acute abdomen; Rebecca M. Minter, Michael W. Mulholland
17. Approach to the patient with ileus and obstruction; Klaus Bielefeldt, Anthony J. Bauer
18. Approach to the patient with diarrhea; Don W. Powell
19. Approach to the patient with suspected acute infectious diarrhea; John D. Long, Ralph A. Giannella
20. Approach to the patient with constipation; Satish S.C. Rao
21. Approach to the patient with abnormal liver chemistries; Richard H. Moseley
22. Approach to the patient with jaundice; Raphael B. Merriman, Marion G. Peters
23. Approach to the patient with ascites and its complications; Guadalupe Garcia-Tsao
24. Approach to the patient with central nervous system and pulmonary complications of end-stage liver disease; Javier Vaquero, Andres T. Blei, Roger F. Butterworth
25. Approach to the patient with acute liver failure; Ryan M. Taylor, Robert J. Fontana
26. Approach to the patient with chronic viral hepatitis B or C; Sammy Saab, Hugo Rosen
27. Approach to the patient with a liver mass; John A. Donovan, Edward G. Grant
28. Approach to gastrointestinal and liver diseases in pregnancy; Willemijntje A. Hoogerwerf
29. General nutritional principles; David H. Alpers, Beth Taylor, Samuel Klein
30. Approach to the patient requiring nutritional supplementation; David H. Alpers, Beth Taylor, Samuel Klein
31. Genetic counseling for gastrointestinal patients; Cindy Solomon, Deborah W. Neklason, Angela Schwab, Randall W. Burt

Index

Sample

Chapter 1 Clinical decision making

What is evidence-based medicine?

David Sackett, the “father” of evidence-based medicine (EBM) stated that EBM is “the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients” [1]. Terms used in this definition can be explained as follows

Conscientious use implies that physicians review articles

about clinical research and apply this information to clinical

decision making.

• Current best evidence from clinical care research implies that physicians systematically appraise the methods and results of clinical research articles using EBM tools. With these tools, physicians can separate the “wheat from the chaff” when reading medical journals and identify poorly designed studies that will produce biased results and should be discarded before being applied to patient care. This chapter will focus on techniques to identify and interpret the best evidence from properly designed research articles.

• Judicious use implies that a physician’s experience and patient’s preferences are crucial components of decision making and that these judgments must be balanced with the data from best evidence.

Judicious use of best evidence is a particularly important concept to understand [2]. Many critics state that the practice of EBM is “cookbook” medicine that devalues the judgment of a clinician and the values of an individual patient. This interpretation is inaccurate. Physicians must consider a patient’s preferences about the potential benefits and side effects and costs of a medication when deciding a specific

treatment. Also, a specific patient may not fit the criteria for enrollment of patients into a randomized controlled trial (RCT). For example, an RCT demonstrated that rifaximin, a nonabsorbable antibiotic, improved bloating in Lebanese patients [3]. Will bloating (and other gastrointestinal symptoms) improve if rifaximin is used in patients with irritable bowel syndrome (IBS) in the United States? If we assume that these results are applicable to patients with IBS in the United States, then is it worthwhile to use a treatment that may only produce a temporary relief of symptoms? What if the patient had a past history of Clostridium difficilecolitis after a course of ciprofloxacin? Would the patient be willing to risk another case of C. difficile colitis? What if the patient does not have insurance and would have to pay $200 for this prescription? These questions are qualitative questions that require clinical judgments on the part of the patient and the physician [4]. Although the best evidence from an RCT [3] may identify an effective treatment for bloating, both physician judgment and patient preferences must also be used for effective clinical decision making. Thus, EBM and a reliance on best evidence is not intended to be “cookbook” medicine [2].

Nevertheless, EBM is a helpful tool for the quantitative aspect of clinical decision making, which arises from a systematic examination of study methodology and study results [2]. The medical literature is expanding at an exponential rate [5], and the time available for reading may be hurried and fragmented. Physicians need tools to build a framework for the rapid evaluation of the methodology and results of published studies, and EBM provides these tools (Tables 1.1 and 1.2). With these frameworks, physicians can rapidly identify well-designed studies that produce accurate and unbiased results and should be applied to patient care. Studies using improper methodology and biased results are quickly identified and ignored.

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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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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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