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Cutting to the Core
Surgery inevitably inflicts some harm on the body. At the very least, it damages the tissue that is cut. These harms often are clearly outweighed by the overall benefits to the patient. However, where the benefits do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery. When, if ever, do the benefits of these surgeries outweigh their costs? May a surgeon perform dangerous procedures that are not clearly to the patient's benefit, even if the patient consents to them? May a surgeon perform any surgery on a minor patient if there are no clear benefits to that child? These and other related questions are the core themes of this collection of essays.
Field of Vision
A comprehensive survey on the use of bedside skills and perimetric devices to the test visual fields, and how to interpret the results. To develop the clinician's interpretative skills, the authors include a chapter on visual anatomy and an atlas of 100 real-life cases arranged in anatomic order from retina to striate cortex. By placing a brief clinical vignette with a visual field on one side of the page and a description of the field and its causal lesion on the opposite side, the reader will be able to learn interpretation in a simulated clinical setting. An additional quiz section of twenty randomly arranged visual fields provides readers with an opportunity to test their newly acquired skills.
Myasthenia Gravis and Related Disorders
Advances in the study and understanding of myasthenia gravis have led to the need for the publication of this important new edition. The goal of Myasthenia Gravis and Related Disorders, Second Edition is identical to the first -- to provide the clinician and the scientist with a common resource for understanding this complex disorder. This new edition begins with discussions of neuromuscular junction structure and function and follows with updated chapters covering a wide range of topics, such as the acetylcholine receptor, clinical presentation, diagnostic evaluation, and treatment. Importantly, new supplemental chapters have been added; these discuss rigorous clinical assessments of patients for research trials and the epidemiology and genetics of myasthenia gravis. The discussion of the most challenging aspects of myasthenia gravis, its impact on patients’ psychological make-up, has been expanded as well. Myasthenia Gravis and Related Disorders, Second Edition retains the “personal approach” of the authors regarding treatment and is a valuable resource for meeting the many and varied needs of patients with myasthenia gravis.
The Prenatal Person
This text addresses the host of ethical questions that has arisen recently in response to the development of new reproductive technologies. Addresses the ethical questions which have arisen in response to new reproductive technologies. Helps students of theology, philosophy and health studies, as well as lay readers tackle these issues. Provides readers with relevant medical and scientific facts. Explains how different metaphysical frameworks affect the ways in which people solve these ethical problems. Topics covered include human embryo and embryonic cell stem research, infertility and its treatments, and prenatal screening and diagnosis. The author takes a balanced approach, acknowledging his loyalty to Catholicism, yet exploring freely the new options provided by advancing biological science.
Multiple Sclerosis
A synthesis of current concepts about the evaluation, treatment, and future directions in MS. On the evaluation side, the authors review the use of MRI, magnetic resonance spectroscopy, functional MRI, and three-dimensional MRI, and consider the rapidly developing body of pathologic information they have yielded. On the treatment side, the focus is on recently approved medications (Novantrone), new indications for medications (CHAMPS Trial), medications in development (Oral Interferon Tau, Oral Copaxone, and Oral Cellcept), immunosuppressive therapy for both progressive disease and symptomatic therapy; the current medications for treating relapsing-remitting MS (Avonex, Betaseron, and Copaxone) are also discussed. For future directions, the authors present the current best thinking, as well as the latest discoveries in immunology relating to MS, including groundbreaking B-cell research and its applications to specific immunotherapies, and the use of immune markers for tracking the disease.
Parkinson's Disease and Nonmotor Dysfunction
Parkinson’s Disease and Nonmotor Dysfunction fills a major gap in the current rapidly growing body of knowledge concerning Parkinson’s disease. Drs. Pfeiffer and Bodis-Wollner have correctly perceived that many nonmotor features of Parkinson’s disease are given insufficient attention in the medical literature. Unfortunately, they are often also given insufficient attention by the practicing neurologists who see these patients. As recently pointed out, there is clearly much more to Parkinson’s disease than depletion of the nigrostriatal dopamine system (1). Parkinson’s disease (not just m- tiple system atrophy) is a multisystem disorder, both pathologically and in its clinical manif...
Thrombolytic Therapy for Acute Stroke
It often takes time for a new therapeutic modality to mature into an accepted treatment option. After initial approval, new drugs, devices, and procedures all go through this process until they become “vetted” by the scientific community as well as the medical community at large. Thrombolysis for treatment of stroke is no exception. Thrombolytic Therapy for Acute Stroke, Second Edition comes four years after the first edition and provides a very comprehensive, updated perspective on the use of intravenous rt-TPA in acute stroke. The authors provide longer term follow-up on the pivotal clinical trials that led to Food and Drug Administration approval, data concerning phase 4 trials in lar...
Sleep Disorders in Women: From Menarche Through Pregnancy to Menopause
Increasing attention is currently being directed to a variety of health disorders that are either unique to or more common among women than men. This volume adds sleep disorders to the list of those in which important gender differences have been neglected. Sleep Disorders in Women: A Guide to Practical Management - plores the reasons for gender bias in this area of research and provides a comp- hensive and in-depth review of what is currently known and what still remains to be studied concerning this important topic. As several contributors to this volume indicate, numerous misconceptions exist due, not surprisingly, to a shortage of reliable data in the field. As an example, obstructive sl...
Inflammatory Disorders of the Nervous System
A cutting-edge review of the fundamental biological principles underlying the more common inflammatory disorders of the nervous system. The authors provide extensive updates on the latest findings concerning the mechanisms of inflammation and introduce such new concepts and methodologies as "endothelial and leukocyte microparticles" and "gene microarray technology" to help explain important links between the central nervous system (CNS) and general inflammatory processes. Among the diseases examined from an inflammatory perspective are multiple sclerosis, acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, CNS vasculitis, neuropsychiatric systemic lupus erythematosis, Alzheimer's disease, and Parkinson's disease. The role of the immune system in neuroinflammation is also explored in such disorders as neurosarcoidois, HIV-Associated dementia, and HTLV-associated neurological disorders.
Seizures in Critical Care
A panel of international ICU and epilepsy physicians and researchers detail the epileptic phenomena that occur in the complex environment of the ICU. Focusing on the central nervous system, the authors systematically examine the most up-to-date evidenced-based data regarding ICU seizures, including their most frequent causes, their pathophysiology, their clinical presentation, and the diagnostic evaluation needed to confirm their presence. They also discuss the challenges and specifics of the management of ICU seizures, reviewing the new antiepileptics and their interaction with other ICU medications, drugs with epileptogenic properties used in the ICU, and the role of the new enterally available antiepileptics in treating seizures. Numerous tables summarize drug interactions, neuroimages reveal common ICU seizure etiologies, and multiple electroencephalographic recordings demonstrate clinical or subclinical seizures in ICU patients.
