Atlas of Uncommon Pain Syndromes 4th Edition PDF Free Download

Preface:

It has been said that the three most dangerous things in medicine are: (1) a medical student with a sharp object; (2) a resident armed with a recently published study from NEJM, and; (3) an attending physician with an anecdote. One must suspect that #2 was at play when in the 1940’s, while on rounds at the University of Maryland Hospital in Baltimore, Maryland, Theodore Woodward, MD, stated that “If you hear hoof beats out on Green Street, don’t look for zebras”! How this admonition to aspiring physicians morphed into “when you hear hoof beats, look for horses, not zebras” is anybody’s guess. (My son who was an ophthalmology resident in Baltimore suggests that this sage piece of advice was most likely accompanied by a long-winded and confusing anecdote—see #3 above). On the surface, most of us would agree with Dr. Woodward’s logic that the most common things are the most common. Occam agreed, when in the 14th century he put forth the philosophical tenant of parsimony that proposed that simpler explanations are, all things being equal, almost always better than more complex ones. He used a razor to “shave away” unnecessary or extraneous data to get to the simplest solution. When you think about it, a razor was all the rage as a medical instrument in the 14th century, so it is not surprising that Occam chose it as his preferred medical device. Occam’s razor certainly has a nice ring to it—better than Occam’s MRI—which would no doubt be the name of his maxim if he had lived in the 21st century, given that the MRI is certainly our most current popular medical device for “shaving away” extraneous data.

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Hardcover: 488 pages
4 edition (November 11, 2019)
Language: English

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Nutrition and Skeletal Muscle PDF Free Download

Preface:

Skeletal muscle (SM) increases during postnatal development through a process of hypertrophy of the individual muscle fibers; a similar process may be induced in adult SM in response to contractile activity like strength exercises, and to androgens and β-adrenergic agonists [1]. SM remains relatively constant during the third and fourth decades of life but begins to decline at B45 years of age in both genders [2]. In other words, age exerts a strong influence on SM, but gender does as well [38]. Several studies have demonstrated the effects of age and gender on SM, and some have examined the effects on its distribution [2,56]. Perhaps the most relevant study on this issue was published by Janssen et al. [2], who used an in vivo method to study body composition using, particularly, magnetic resonance imaging (MRI) to provide precise and reliable measurements of SM and its distribution in a broad sample of Caucasian men and women. The results of this study reported new findings on the behavior of SM mass during the lifecycle in both men and women subjects. Due to the growing awareness of the importance of SM on functionality and other clinical entities in older age groups [916], there is a need to establish reference values for relative SM in young adult populations using the most precise and accurate methods available, and considering the factors of age, gender, and ethnicity. It is important to stress that few countries have been able to conduct national-level studies of this kind [10,1719]. Some published works based on small samples of healthy young adult subjects reported data on SM [2,6,2021] and proposed cutoff points for diagnosing sarcopenia—i.e., low SM mass—and sarcopenia syndrome [9,10,17,2242].

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Print Length: 418 pages
1 edition (October 24, 2018)
Language: English

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Practical Problems in Assisted Conception PDF Free Download

Preface:

Considering life as an in vitro fertilization (IVF) doctor leads one to think that IVF has always been readily available, but this is not so. I did my first infertility clinic in 1959 as a Senior House Officer in Australia; it had already been differentiated from the gynecology clinic because of the number of patients. A hysterosalpingogram provided evidence for tubal macrosurgery, semen analysis was not standardized and there was no endocrine test for ovulation nor any means to stimulate it. A patient went abroad for donor insemination. After extensive clinical training and research in endocrinology, I ran an infertility clinic in Wales in 1969, although tubal surgery was still the only treatment used. Urinary total estrogen and pregnanediol assays in 24-hour urine samples became possible and clomiphene and human menopausal gonadotropin (hMG) were introduced.Multiple pregnancies followed in spite of urinary estrogen monitoring that used the postal service to send samples to a distant lab, the results being phoned through the following day. In 1973 I established my infertility clinic in Sheffield, by which time it was possible to measure serum hormones. Prolactin measurement led to a search for pituitary microadenomas, and bromocriptine was extensively used before it was fully appreciated that prolactin was also a stress hormone. Laparoscopy was developed into an important diagnostic tool and became essential to define peritubal and periovarian adhesions, better dealt with by microsurgery, as was tubocornual obstruction. Sperm cryopreservation using slow freezing became practical after earlier use in animal husbandry and sperm donation then became feasible. Sperm banks developed, so donors were screened, interviewed and counseled, as were the couples; it was recognized that counselors had a role and needed specific training. Sperm banks made donations available for sale to other clinics and trade flourished. During this time the World Health Organization (WHO) developed its Task Force on the Diagnosis and Treatment of Infertility, began optimizing semen analysis and structured a formal evaluation of both female and male history, physical examination and investigation.

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BNF for Children 2019-2020 PDF Free Download

Preface:

BNF for Children aims to provide prescribers, pharmacists, and other healthcare professionals with sound up-to-date information on the use of medicines for treating children. A joint publication of the British Medical Association, the Royal Pharmaceutical Society, the Royal College of Paediatrics and Child Health, and the Neonatal and Paediatric Pharmacists Group, BNF for Children (‘BNFC’) is published under the authority of a Paediatric Formulary Committee which comprises representatives of these bodies, the Department of Health for England, and the Medicines and Healthcare products Regulatory Agency. Many areas of paediatric practice have suffered from inadequate information on effective medicines. BNFC addresses this significant knowledge gap by providing practical information on the use of medicines in children of all ages from birth to adolescence. Information in BNFC has been validated against emerging evidence, best-practice guidelines, and crucially, advice from a network of clinical experts. Drawing information from manufacturers’ literature where appropriate, BNFC also includes a great deal of advice that goes beyond marketing authorisations (product licences). This is necessary because licensed indications frequently do not cover the clinical needs of children; in some cases, products for use in children need to be specially manufactured or imported. Careful consideration has been given to establishing the clinical need for unlicensed interventions with respect to the evidence and experience of their safety and efficacy; local paediatric formularies, clinical literature and national information resources have been invaluable in this process. BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing, dispensing and administration of medicines. Less detail is given on areas such as malignant disease and the very specialist use of medicines generally undertaken in tertiary centres. BNFC should be interpreted in the light of professional knowledge and it should be supplemented as necessary by specialised publications. Information is also available from Medicines Information Services (see inside front cover).

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Paperback: 1120 pages
1 edition (September 2, 2019)
Language: English

CSA Scenarios for the MRCGP 4th Edition PDF Free Download

Preface:

This new updated edition is the result of countless hours of navigating through the latest clinical evidence, national guidelines, and medical literature, so that you can concentrate your efforts on passing the CSA exam itself. It’s hard to believe that it’s been ten years since the first edition was published in 2008. At that time the CSA exam was fairly new and there were very few books and resources available to help those preparing for the new MRCGP exam. Since then a variety of other resources have become available, but I am delighted to see that this publication has stood the test of time. Its several editions have helped thousands of candidates pass the CSA. I have therefore tried to keep to the original’s vision of creating a concise “need-to-know” guide to passing the CSA, with the emphasis on successfully completing a case in the allotted 10 minutes using a structured consultation framework that works. The existing cases have been updated and new topics added. Where appropriate I have added summaries of national guidelines to further supplement the cases. Section 1 has been reworked to reflect current practice and encourage the reader to build upon their own consultation style. As with the rest of life, we must use what works for us and build upon the skills and knowledge we already possess. I wish you every success, both in the CSA and beyond!

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Print Length: 290 pages
4 edition (May 29, 2018)
Language: English

The Glioma Book 1st Edition PDF Free Download

Preface:

It is uncommon that an author spends two years writing a book with the fervent hope that it will be rendered obsolete in short order, but that is the goal of this book. In this book, I summarize my current approach and experience with glioma surgery, which numbers about 1,000 surgeries at the time of writing. However, unlike most books in our field which aim to be a “How I Do It” tome from the master, this book aims more to be provocative, with the hope of generating a new field of thought in glioma surgery. This book is built around the idea that we can achieve better outcomes in glioma patients by updating our models of how the cerebrum works by thinking about glioma surgery in terms of large-scale brain networks, and by realizing that regardless of how we perform a glioma surgery, we are cutting around or across the parts of networks whether we are aware of it or not. A few key principles/biases which are fundamental to this book and its philosophy are outlined below. Concept 1: Our surgical models of the cerebrum are embarrassingly outdated A quick look at images of the functional anatomy of the brain with a critical eye reveals the limitations of the anatomic models locating function in the human brain used to teach people how to avoid problems in the cerebrum. Broca and Wernicke have been dead for over a century, yet we have not updated their language model very much. Wernicke’s area is defined imprecisely and can span a part of the STG or most of the left temporal lobe depending on the artist. Most of the brain is considered non-eloquent, implying it doesn’t do anything. The subcortex is mostly ignored. Most surgeons have caused a neurologic deficit that they couldn’t immediately explain. I would suggest that this results from using bad models of the brain. A better model involves more specific localization of functions, acknowledges that functionally connected areas are usually physically connected and that this is essential for them to work together, and incorporates the whole brain into its world view: the so-called non-eloquent areas are not there to soak up CSF. A large part of this book is dedicated to making more updated models of the brain relevant to neurosurgery and explaining how to utilize them.

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Print Length: 350 pages
1 edition (October 25, 2019)
Language: English