Thursday, December 12, 2013

Soy in Health and Disease Prevention EBOOK PDF

This book was written to introduce “the world of the soybean” with respect to its myriad health benefits. A number of excellent review articles and books are available that cover the nutritional and physiological functions of soybean and its products. The editor is, however, not aware of a book in English devoted to the study of soybean, written fully or mostly by Japanese. As many varieties of soybean products have been consumed for many years in East Asia, much knowledge has accumulated there documenting the health benefits of these products. Japan may be the most experienced country in the use of soybean for fermented foods. Advances in analytical methodologies have disclosed the full details of the chemical composition of soybean, and most soybean ingredients exert diverse physiological functions.
Numerous Japanese researchers have been working for many years in every aspect of soybeans, and the Fuji Foundation for Protein Research has been established to support these studies. As a consequence
of this research, various soybean books and reviews written in Japanese are available in Japan, and at present soybean is considered to be among the most healthy food items.
Five components of soybean are now incorporated in officially approved functional foods called Foods for Specified Health Uses (FOSHU) and they are contributing much to our health. Thus, Japan must be considered a leader in the state-of-the-art of the health aspects of soybean functions.
It seems appropriate to publish a volume in English dealing with soybean as a source of functional and healthy foods. In editing this book, Soy in Health and Disease Prevention , it was an easy job to compose its content, as there are many examples available.
This book includes several topics that are characteristically studied in our country. Those include FOSHU issues and physiological functions of soybean peptides. The most difficult issue encountered in the preparation of the book was to select contributors, as there are so many top researchers in this field. In other
words, I was able to freely select the best contributors. Consequently, I am convinced that the contributors represent the cream of the crop. In addition to the research by Japanese scholars, I asked the most distinguished researchers in their respective fields to contribute. Those are cholesterol-lowering effects of soybean protein and anticancer effects of the trypsin inhibitor. Fortunately, two well-known researchers
in these fields, Cesare Sirtori and Ann Kennedy, respectively, accepted my proposal and contributed these chapters. Also important is the chapter by David Kritchevsky that deals with the perspectives of soybean study.
This book encompasses all aspects of soybean from a viewpoint of health benefits. As all the contributors are experts in their respective fields, the latest information is available to understand the diverse health effects of soybean. It also is a good opportunity to learn how Japanese studies are proceeding in this field and how
consumers are satisfied with diverse healthy soybean products. The multifunctional properties of soybean will surely bring health to all mankind. Enjoy the world of soybean dispatched from Japan.
This book is recommended for researchers of functional foods and for those who are in functional food industries who have always shown a great deal of interest in new materials for this purpose. The book also is recommended to graduate students to cover fundamental knowledge on functional food study in Japan.
Michihiro Sugano


Wednesday, October 23, 2013

Interpersonal Communication Second edition Peter Hartley PDF Ebook

Interpersonal communication does not simply involve the exchange of messages. It essentially involves the creation and exchange of meaning. One important implication of the linear model of communication follows
from its concern with ‘the message’. This implies that we can arrive at an accurate and unambiguous statement of whatever was communicated. And it also suggests that we shall be able to verify that statement by checking with the participants as well as any observers present. In fact, this is extremely difficult if not impossible to achieve. Whereas we might not agree that ‘all human behaviour is ambiguous’,10 just about anything anyone says could be interpreted in a number of ways. Luckily this does not happen all of the time or we would live in a chaotic world. For example, how would you interpret the following question from neighbour A: ‘Did you have a good time last night?’ This could be a casual, friendly gesture. But
what could it mean?
• Is your neighbour behaving genuinely? Perhaps he is being cynical and deliberately trying to ‘soften you up’ so that he can come and borrow something from you?
• On the other hand, is it a subtle accusation of rowdy behaviour? Is it a warning to be less intrusive next time you have a party?
• Is it a deliberate play on the fact that A was not invited, designed to make you feel uncomfortable?
• Is it a more dejected expression of A’s loneliness?

All of these are possible interpretations of A’s message

Monday, August 26, 2013

The Epidemiology of Diabetes Melitus Ebook PDF

Diabetes mellitus is a disease that was recognized in antiquity. Polyuric states resembling diabetes mellitus were described as early as 1550 BC in the ancient Egyptian papyrus discovered by George
Ebers (1). The term ‘diabetes’, which is from the Ionian Greek meaning ‘to pass through‘, was first used by Aretaeus of Cappadocia in the second century AD as a generic description of conditions causing increased urine output (2). The association of polyuria with a sweet-tasting substance in the urine was noted in the fifth to sixth century AD by two Indian physicians, Susruta and Charuka (1,2). The urine of certain polyuric patients was described as tasting like honey, sticky to the touch and attracting ants. Two forms of diabetes could be distinguished in the Indians’ descriptions: one affected older, fatter people and the other thin people who did not survive long; this strongly reminds us the present clinical description of Type 2 and Type 1 diabetes.
The term diabetes mellitus, an allusion to the honeyed taste of the urine, was first used in the late
eighteenth century by John Rollo and others (3) to distinguish it from other polyuric states in which
the urine was tasteless. The concept that diabetes was a systemic disease arising in the blood was
elaborated a century before (in the seventeenth century) by Matthew Dobson, a physician in Liverpool (England) who published a series of experiments showing that the serum of a patient
with diabetes, as well as the urine, contained a sweet-tasty substance namely sugar (4). The nineteenth century is the key century that has greatly contributed to the understanding of diabetes. Claude Bernard made numerous discoveries in the field of metabolism and diabetes.
He described the storage of glucose in the liver as a glycogen and the acute hyperglycemia that
followed experimental damage of the medulla oblongata known as ‘piqiire’ diabetes (5). Oskar
Minkowski and Josef Von Mering noted that total pancreatectomy produced diabetes in dogs (6). The pancreatic islets were named after Paul Langerhans by Edouard Lafresse. Langerhans had suggested that pancreatic isfets produced a giucose-lowering substance. This substance was named insulin by Jean de Meyer in 1909, almost a decade before insulin was discovered (7). Although diabetes mellitus has been recognized for many centuries and major advances have been accomplished since the discovery of insulin in the understanding of diabetes and metabolism, there was no clear or widely accepted definition of the diabetic state until the early 80s.
In 1980, the World Health Organization (WHO) Expert Committee on diabetes mellitus (8) defined the diabetic state as a state of chronic hyperglycemia which may result from many environmental and genetic factors often acting jointly.
Hyperglycemia is due to defects in insulin secretion, insulin action or both. This imbalance leads
to disturbances of carbohydrate, fat and protein metabolism. The major effects of diabetes mellitus
include long-term damage, dysfunction and failure of various organs. Diabetes mellitus may present with characteristic symptoms: thirst, polyuria, polydypsia, blurring of vision, weight loss, and infections. In its most severe forms, ketoacidosis or a non-ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death. Most of the time, symptoms are not severe, or may be absent, and consequently hyperglyceniia of sufficient degree to cause pathological and functional changes may be present for a long time before the diagnosis is made. The longterm complications of diabetes mellitus include progressive development of disease of the capillaries of the kidney and retina, damage to the peripheral nerves and excessive atherosclerosis.
The clinical manifestations of these complications therefore include nephropathy that may lead to
renal failure, retinopathy with potential blindness, neuropathy with risk of foot ulcers, amputation,
Charcot joints, and features of autonomic dysfunction, including sexual dysfunction.
People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular
disease. Diabetes mellitus is thus defined as a set of abnormalities characterized by a state of sustained hypgerglycemia. It is a clinical description with a clienucal definition. Pathogenic mechanisms and various explanations, to be found, lie behind the sustained hyperglycemia. Processes which destroy the beta-cells of the pancreas with consequent insulin deficiency, and others that result in resistance to insulin action are part of a possible group of to insulin action are part of a possible group of processes involved


Problem-Based Behavioral Science and Psychiatry PDF EBOOK

Welcome to Problem-Based Behavioral Science and Psychiatry. In this chapter, our aims are to illustrate how the problem-based learning process works so that you can apply it to the other cases in this textbook.
The goals of this chapter are:
1. To provide the reader with a guided experience on “how to use this textbook”
2. To review basic principles of problem-based learning and the rationale for why
this approach is used
3. To illustrate, with a sample case, the processes of
(a) “Progressive disclosure”
(b) Identifying facts/problems, hypotheses/differential diagnoses, additional
clinical information needed, and learning issues
(c) Thinking about underlying neurobiology and other physiological mechanisms
to understand the signs and symptoms of a case
4. To review the more generic process of bio-psycho-social-cultural-spiritual formulation,
in order to understand the various perspectives offered by patient cases

Because a textbook is not the same as a patient encounter or face-to-face smallgroup discussion, we are not claiming to represent problem-based learning (PBL) in a pure or “authentic” form (Barrows, 1986,2000). However, we hope to integrate many of the principles and potential benefits of PBL into this textbook.
PBL, as described by Norman and Schmidt (1992), aims to endow learners with the skills of clinical reasoning, cooperative learning, and patient-based integration of knowledge. In its ideal form, it begins with an initial free-inquiry process, in which learners explicitly discuss hypotheses and additional lines of investigation.

This is followed by a period of self-directed learning and a synthesis and application of information back to the case. The student then has an opportunity to critically evaluate the initial clinical reasoning process. Because PBL attempts to integrateinformation from multiple disciplines, all phases of the process emphasize attentionto the biological, behavioral, and populational aspects of the case. Certain articles (Guerrero, 2001; Guerrero et al., 2003) have discussed how certain learning tools can be used to ensure that beneficial PBL processes actually occur in the course of studying a case.We will illustrate these tools, including “mechanistic case diagramming,” as part of this sample case.

When compared to traditional learning methods, PBL may enhance the application of concepts to clinical situations, long-term retention of knowledge, and lifelong interest in learning (Norman and Schmidt, 1992). It has been shown to improve student and faculty satisfaction and educational outcomes in numerous
clinical disciplines, including family medicine, pediatrics, obstetrics, and psychiatry (Washington et al., 1999; McGrew et al., 1999; Kaufman and Mann, 1999; Curtis et al., 2001; Nalesnik et al., 2004; McParland et al., 2004). Furthermore, we believe that psychiatry and the behavioral sciences, because of the inherently integrative and holistic approaches of these subject areas, are particularly well suited for study in a PBL format (Frick, 2005; Zisook, 2005). Peters et al. (2000) reports on the longitudinal outcomes of a randomized controlled trial and concludes that the New Pathways Program at Harvard Medical School—of which PBL is one important component—improved students’ interpersonal skills and humanistic approach to
patient care, with no loss in medical knowledge.

We will illustrate the problem-based learning process as applied to cases in this textbook. Typically, each chapter will begin with an introductory paragraph for a case.

Tuesday, August 20, 2013


Dengue fever (DF) is an old disease; the fi rst record of a clinically compatible
disease being recorded in a Chinese medical encyclopaedia in 992. As the global ship-
ping industry expanded in the 18th and 19th centuries, port cities grew and became
more urbanized, creating ideal conditions for the principal mosquito vector, Aedes
aeg ypti. Both the mosquitoes and the viruses were thus spread to new geographic areas
causing major epidemics. Because dispersal was by sailing ship, however, there were
long intervals (10–40 years) between epidemics. In the aftermath of World War II,
rapid urbanization in Southeast Asia led to increased transmission and hyperendemicity.
The fi rst major epidemics of the severe and fatal form of disease, dengue haemorrhagic
fever (DHF), occurred in Southeast Asia as a direct result of this changing ecology. In
the last 25 years of the 20th century, a dramatic global geographic expansion of epidemic
DF/DHF occurred, facilitated by unplanned urbanization in tropical developing coun-
tries, modern transportation, lack of effective mosquito control and globalization. As
we go into the 21st century, epidemic DF/DHF is one of the most important infectious
diseases affecting tropical urban areas. Each year there are an estimated 50–100 million
dengue infections, 500 000 cases of DHF that must be hospitalized and 20 000–25 000
deaths, mainly in children. Epidemic DF/DHF has an economic impact on the com-
munity of the same order of magnitude as malaria and other important infectious dis-
eases. There are currently no vaccines nor antiviral drugs available for dengue viruses;
the only effective way to prevent epidemic DF/DHF is to control the mosquito vector,


Friday, April 26, 2013

Metabolic Syndrome and Cardiovascular Disease Ebook PDF

The term “metabolic syndrome” denotes a clustering of traditional and emerging risk factors for atherothrombotic cardiovascular disease. Moreover, individuals who satisfy the current diagnostic criteria that define the syndrome are also at substantially increased risk of developing Type 2 diabetes—itself a coronary heart disease risk equivalent. Central obesity and insulin resistance are core features
of the syndrome, which has come to be recognized as a major global threat to vascular health in the 21st century. The time is optimal for a textbook dedicated to this important issue.
The metabolic syndrome has adverse implications for many aspects of vascular function ranging from endothelial function, the microvascular tree, medium-sized arteries, and large conduit vessels. Furthermore, gathering evidence suggests that interactions between small and large vessel disease may be
more important than perhaps has previously been appreciated.
There are fears that the successes in reducing cardiovascular mortality in recent decades may soon be reversed. Fueled by the explosion of obesity, the syndrome is characterized by the clustering of classic and emerging risk factors for cardiovascular disease. No longer is it appropriate to regard obesity, glucose
intolerance and diabetes, hypertension, and dyslipidemia as separate entities to be treated in individual clinical settings (e.g. the diabetes clinic, hypertension clinic, etc.). If one of the components of the metabolic syndrome is discovered, then steps should be taken to determine whether others are also present, and for
implementing comprehensive approaches aimed toward treating the constellation of metabolic risk factors. This can be accomplished by simple clinical and biochemical tests and a multidisciplinary team approach implementing lifestyle and pharmacologic treatment.
This new paradigm presents challenges for clinicians involved in the assessment and management of individuals with metabolic syndrome. This rapidly moving area is being driven by advances in clinical and basic science. The latter are informing strategies for risk stratification and optimization of
nonpharmacologic and drug-based treatment.

Our objective in bringing this book into print has been to present a stateof-the-art account of the salient issues for a clinically-oriented readership. In this endeavor, we are pleased to have been joined by an international team of experts, each recognized in his or her field. Various chapters cover epidemiology, diagnosis, risk assessment, vascular biology, lifestyle measure, management of hyperglycemia, dyslipidemia, and hypertension, and strategies for maximizing compliance to treatment recommendations. We hope that the book will not only be of academic interest but will provide helpful practical guidance to primary care physicians, diabetologists, cardiologists, dietitians, and other healthcare professionals involved in the prevention and treatment of vascular disease.
A better understanding of the mechanisms that cause cardiovascular risk factors to cluster together to the long-term detriment of so many individuals should facilitate more effective measures for prevention and treatment. Scientists working in epidemiology, basic science, drug discovery, and clinical trials each have roles to play in unraveling what is proving to be a major public health crisis.
It has been a pleasure working with colleagues from around the world and with the staff of Informa Healthcare. We welcome feedback from readers in the expectation that the text will require updating in the future, given the rapidly increasing scientific knowledge and developments in the field.

Thursday, April 25, 2013

Brunner and Suddarth's Textbook of Medical Surgical Nursing Ebook PDF

The first edition of Brunner & Suddarth’s Textbook of Medical-Surgical Nursing was published in 1964 under the leadership of Lillian Sholtis Brunner and Doris Smith Suddarth. Lillian and Doris pioneered a medical-surgical nursing textbook that has become a classic. Medical-surgical nursing has come a long way since 1964 but continues to be strongly influenced by the expansion of science, medicine, surgery, and technology, as well as a myriad of social, cultural, economic, and environmental changes throughout
the world. Nurses must be particularly skilled in critical thinking and clinical decision-making as well as in consulting and collaborating with other members of the multidisciplinary health care team.
Along with the challenges that today’s nurses confront, there are many opportunities to provide skilled, compassionate nursing care in a variety of health care settings, for patients in the various stages of illness, and for patients across the age continuum. At the same time, there are significant opportunities for fostering health promotion activities for individuals and groups; this is an integral part of providing nursing care.
Continuing the tradition of Lillian’s and Doris’s first edition, this 12th edition of Brunner & Suddarth’s Textbook of Medical-Surgical Nursing is designed to assist nurses in preparing for their roles and responsibilities within the complex health care delivery system. A goal of the textbook is to provide balanced attention to the art and science of adult medical-surgical nursing. The textbook focuses on physiologic, pathophysiologic, and psychosocial concepts as they relate to nursing care, and emphasis is placed on integrating a variety of concepts from other disciplines such as nutrition, pharmacology, and gerontology. Content relative to health care needs of people with disabilities, nursing research findings, ethical considerations, and evidence-based practice has been expanded to provide opportunities for the
nurse to refine clinical decision-making skills.

Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 12th edition, is organized into 16 units. Units 1 through 4 cover core concepts related to medical-surgical nursing practice. Units 5 through 16 discuss adult health conditions that are treated medically or surgically. Each unit covering adult health conditions is structured in the following way, to facilitate understanding:
• The first chapter in the unit covers assessment and includes a review of normal anatomy and physiology of
the body system being discussed.
• The subsequent chapters in the unit cover management of specific disorders. Pathophysiology, clinical
manifestations, assessment and diagnostic findings, medical management, and nursing management are
presented. Special “Nursing Process” sections, provided for selected conditions, clarify and expand on
the nurse’s role in caring for patients with these conditions
Applying Concepts from NANDA, NIC, and NOC. Each unit begins with a case study and a chart presenting examples of NANDA, NIC, and NOC terminologies related to the case study. Concept maps, which provide a visual representation of the NANDA, NIC, and NOC chart for each case study, are found on the accompanying Web site to this book at This feature introduces
the student to the NIC and NOC language and classifications and brings them to life in graphic form.

Sunday, April 14, 2013

Problem based behavioral science psychiatry ebook pdf

The term behavioural sciences encompasses all the disciplines that explore the activities of and interactions among organisms in the natural world. It involves the systematic analysis and investigation of human and animal behaviour through controlled and naturalistic observation, and disciplined scientific experimentation. It attempts to accomplish legitimate, objective conclusions through rigorous formulations and observation.[1] Examples of behavioural sciences include psychology, psychobiology, and cognitive science. The term behavioural sciences is often confused with the term social sciences. Though these two broad areas are interrelated and study systematic processes of behaviour, they differ on their level of scientific analysis of various dimensions of behaviour. Behavioural sciences abstract empirical data to investigate the decision processes and communication strategies within and between organisms in a social system. This involves fields like psychology, social neuroscience and cognitive science. In contrast, social sciences provide a perceptive framework to study the processes of a social system through impacts of social organisation on structural adjustment of the individual and of groups. They typically include fields like sociology, economics, public health, anthropology, demography and political science.[1] Obviously, however, many subfields of these disciplines cross the boundaries of behavioral and social. For example, political psychology and behavioral economics use behavioral approaches, despite the predominant focus on systemic and institutional factors in the broader fields of political science and economics. Behavioural sciences includes two broad categories: neural — Information sciences and social — Relational sciences. Information processing sciences deals with information processing of stimuli from the social environment by cognitive entities in order to engage in decision making, social judgment and social perception for individual functioning and survival of organism in a social environment. These include psychology, cognitive science, psychobiology, neural networks, social cognition, social psychology, semantic networks, ethology and social neuroscience. On the other hand, Relational sciences deals with relationships, interaction, communication networks, associations and relational strategies or dynamics between organisms or cognitive entities in a social system. These include fields like sociological social psychology, social networks, dynamic network analysis, agent-based model and microsimulation. Insights from several pure disciplines across behavioural sciences are explored by various applied disciplines and practiced in the context of everyday life and business. These applied disciplines of behavioural science include: organizational behavior, operations research, consumer behaviour and media psychology. (wikipedia)

Saturday, March 23, 2013

Evidence Base Infectious Desease PDF Ebook

Infectious diseases, also known as transmissible diseases or communicable diseases comprise clinically evident illness (i.e., characteristic medical signs and/or symptoms of disease) resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism. In certain cases, infectious diseases may be asymptomatic for much or even all of their course in a given host. In the latter case, the disease may only be defined as a "disease" (which by definition means an illness) in hosts who secondarily become ill after contact with an asymptomatic carrier. An infection is not synonymous with an infectious disease, as some infections do not cause illness in a host. Infectious pathogens include some viruses, bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are the cause of disease epidemics, in the sense that without the pathogen, no infectious epidemic occurs. The term infectivity describes the ability of an organism to enter, survive and multiply in the host, while the infectiousness of a disease indicates the comparative ease with which the disease is transmitted to other hosts.[2] Transmission of pathogen can occur in various ways including physical contact, contaminated food, body fluids, objects, airborne inhalation, or through vector organisms. Infectious diseases are sometimes called "contagious" when they are easily transmitted by contact with an ill person or their secretions (e.g., influenza). Thus, a contagious disease is a subset of infectious disease that is especially infective or easily transmitted. Other types of infectious/transmissible/communicable diseases with more specialized routes of infection, such as vector transmission or sexual transmission, are usually not regarded as "contagious," and often do not require medical isolation (sometimes loosely called quarantine) of victims. However, this specialized connotation of the word "contagious" and "contagious disease" (easy transmissibility) is not always respected in popular use. (wikipedia)

Tuesday, March 19, 2013

ECG For The Emergency Phyician PDF Eook

An ECG is a way to measure and diagnose abnormal rhythms of the heart, particularly abnormal rhythms caused by damage to the conductive tissue that carries electrical signals, or abnormal rhythms caused by electrolyte imbalances. In a myocardial infarction (MI), the ECG can identify if the heart muscle has been damaged in specific areas, though not all areas of the heart are covered. The ECG cannot reliably measure the pumping ability of the heart, for which ultrasound-based (echocardiography) or nuclear medicine tests are used. It is possible for a human or other animal to be in cardiac arrest, but still have a normal ECG signal (a condition known as pulseless electrical activity). The ECG device detects and amplifies the tiny electrical changes on the skin that are caused when the heart muscle depolarizes during each heartbeat. At rest, each heart muscle cell has a negative charge, called the membrane potential, across its cell membrane. Decreasing this negative charge towards zero, via the influx of the positive cations, Na+ and Ca++, is called depolarization, which activates the mechanisms in the cell that cause it to contract. During each heartbeat, a healthy heart will have an orderly progression of a wave of depolarisation that is triggered by the cells in the sinoatrial node, spreads out through the atrium, passes through the atrioventricular node and then spreads all over the ventricles. This is detected as tiny rises and falls in the voltage between two electrodes placed either side of the heart which is displayed as a wavy line either on a screen or on paper. This display indicates the overall rhythm of the heart and weaknesses in different parts of the heart muscle. Usually, more than two electrodes are used, and they can be combined into a number of pairs (For example: left arm (LA), right arm (RA) and left leg (LL) electrodes form the three pairs LA+RA, LA+LL, and RA+LL). The output from each pair is known as a lead. Each lead looks at the heart from a different angle. Different types of ECGs can be referred to by the number of leads that are recorded, for example 3-lead, 5-lead or 12-lead ECGs (sometimes simply "a 12-lead"). A 12-lead ECG is one in which 12 different electrical signals are recorded at approximately the same time and will often be used as a one-off recording of an ECG, traditionally printed out as a paper copy. Three- and 5-lead ECGs tend to be monitored continuously and viewed only on the screen of an appropriate monitoring device, for example during an operation or whilst being transported in an ambulance. There may or may not be any permanent record of a 3- or 5-lead ECG, depending on the equipment used. (wikipedia)

Tuesday, February 12, 2013

The Allergy and Asthma Cure PDF EBOOK

Asthma (from the Greek ἅσθμα, ásthma, "panting") is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath.Asthma is thought to be caused by a combination of genetic and environmental factors. Its diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry. It is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic) where atopy refers to a predisposition toward developing type 1 hypersensitivity reactions. Treatment of acute symptoms is usually with an inhaled short-acting beta-2 agonist (such as salbutamol) and oral corticosteroids. In very severe cases intravenous corticosteroids, magnesium sulfate and hospitalization maybe required. Symptoms can be prevented by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids. Long-acting beta agonists (LABA) or leukotriene antagonists may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled. The prevalence of asthma has increased significantly since the 1970s. As of 2011, 235–300 million people were affected globally, including about 250,000 deaths. Asthma is characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. Sputum may be produced from the lung by coughing but is often hard to bring up. During recovery from an attack it may appear pus like due to high levels of white blood cells called eosinophils. Symptoms are usually worse at night and in the early morning or in response to exercise or cold air. Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may have marked and persistent symptoms. A number of other health conditions occur more frequently in those with asthma including: gastro-esophageal reflux disease (GERD), rhinosinusitis, and obstructive sleep apnea. Psychological disorders are also more common with anxiety disorders occurring in between 16–52% and mood disorders in 14–41%. It however is not known if asthma causes psychological problems or if psychological problems lead to asthma. Asthma is caused by a combination of complex and incompletely understood environmental and genetic interactions. These factors influence both its severity and its responsiveness to treatment. It is believed that the recent increased rates of asthma are due to changing epigenetics (heritable factors other than those related to the DNA sequence) and a changing living environment. Many environmental factors have been associated with asthma's development and exacerbation including: allergens, air pollution, and other environmental chemicals. Smoking during pregnancy and after delivery is associated with a greater risk of asthma-like symptoms. Low air quality, from traffic pollution or high ozone levels, has been associated with both asthma development and increased asthma severity. Exposure to indoor volatile organic compounds may be a trigger for asthma; formaldehyde exposure, for example, has a positive association. Also, phthalates in PVC are associated with asthma in children and adults as are high levels of endotoxin exposure.Asthma is associated with exposure to indoor allergens.Common indoor allergens include: dust mites, cockroaches, animal dander, and mold. Efforts to decrease dust mites have been found to be ineffective. Certain viral respiratory infections may increase the risk of developing asthma when acquired as young children such as: respiratory syncytial virus and rhinovirus. Certain other infections however may decrease the risk. (wikipedia)

Monday, February 11, 2013

The Obesity Myth PDF EBOOK

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30 kg/m2.Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. Anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.(wikipedia)

Monday, February 4, 2013

ABC of Breast Desease Third Edition Ebook Pdf

The aim of the third edition of the ABC of Breast Diseases is to provide an up to date, concise, well illustrated, and evidence based text that will meet the dual challenges of mana ging the increasing numbers of women who attend breast clinics and the increasing numbers of women who are diagnosed with breast cancer. This edition contains many new illustrations and diagrams. The chapters on screening, adjuvant therapy, clinical trials, and prognostic factors have been completely rewritten, and all other chapters have
been extensively revised. The topics of adjuvant therapy and metastatic breast cancer have been extended to cover the explosion of results gained from the many multinational breast cancer trials which have reported since the last edition of this ABC was published.

New authors have added their work to that of those who have already contributed to the success of the book. Thanks to Jan Mauritzen my PA who has coordinated the many revisions, to Eleanor Lines. Commissioning Editor, ABC series, to Sally Carter, Development Editor, BMJ editorial and Nick Morgan, Senior Development Editor at Blackwell Publishing who converted the authors’ words and pictures into the book that is before you. Such a comprehensive review has been time consuming. I continue to be grateful for the support of my colleagues in the Edinburgh Breast Unit, and to my family Pam, Oliver, and Jonathan. I also thank the many patients who agreed to be photographed for this book, but more importantly, for the inspiration they provide in how they cope, not only with their disease but with all that we do to them.

The care provided for patients with breast cancer is better coordinated and more truly multidisciplinary than that for any other cancer. This is a testimony to those multidisciplinary teams that treat breast cancer, and to the many groups and individual women who have demanded access to good quality care for all. As a clinician I hope that the knowledge and understanding gained through research will continue to result in improved treatments. Many challenges remain in the field of breast diseases, and there is much we do not know. This book is our effort to inform you of everything that we think we know and understand about breast diseases and its management.

Thursday, January 31, 2013

ABC of Health Informatic Free Ebook Pdf

Health informatics (also called Health Information Systemshealth care informatics,healthcare informaticsmedical informaticsnursing informaticsclinical informatics, or biomedical informatics) is a discipline at the intersection of information sciencecomputer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. It is applied to the areas of nursingclinical caredentistrypharmacypublic health,occupational therapy, and (bio)medical research.
  • The international standards on the subject are covered by ICS 35.240.80 in which ISO 27799:2008 is one of the core components.
  • Molecular bioinformatics and clinical informatics have converged into the field of translational bioinformatics.
World wide use of computer technology in medicine began in the early 1950s with the rise of the computers.[3] In 1949, Gustav Wagner established the first professional organization for informatics in Germany.[4] The prehistory, history, and future of medical information and health information technology are discussed in reference.[5] Specialized university departments and Informatics training programs began during the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units began to appear during the 1970s in Poland and in the U.S.[4] Since then the development of high-quality health informatics research, education and infrastructure has been a goal of the U.S. and the European Union.[4]
Early names for health informatics included medical computing, biomedical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science,medical software engineering, and medical computer technology.[citation needed]
The health informatics community is still growing, it is by no means a mature profession, but work in the UK by the voluntary registration body, the UK Council of Health Informatics Professions has suggested eight key constituencies within the domain - information management, knowledge management, portfolio/programme/project management, ICT, education and research, clinical informatics, health records(service and business-related), health informatics service management. These constituencies accommodate professionals in and for the NHS, in academia and commercial service and solution providers.
Since the 1970s the most prominent international coordinating body has been the International Medical Informatics Association(IMIA).[6]
Even though the idea of using computers in medicine emerged as technology advanced in the early 20th century, it was not until the 1950s that informatics began to make a significant impact in the United States.[3]
The earliest use of electronic digital computers for medicine was for dental projects in the 1950s at the United States National Bureau of Standards by Robert Ledley.[7] During the mid-1950s, the United States Air Force (USAF) carried out several medical projects on its computers while also encouraging civilian agencies such as the National Academy of Sciences - National Research Council (NAS-NRC) and the National Institutes of Health (NIH) to sponsor such work.[8] In 1959, Ledley and Lee B. Lusted published “Reasoning Foundations of Medical Diagnosis,” a widely-read article in Science, which introduced computing (especially operations research) techniques to medical workers. Ledley and Lusted’s article has remained influential for decades, especially within the field of medical decision making.[9]
Guided by Ledley's late 1950s survey of computer use in biology and medicine (carried out for the NAS-NRC), and by his and Lusted's articles, the NIH undertook the first major effort to introduce computers to biology and medicine. This effort, carried out initially by the NIH's Advisory Committee on Computers in Research (ACCR), chaired by Lusted, spent over $40 million between 1960 and 1964 in order to establish dozens of large and small biomedical research centers in the US.[8]
One early (1960, non-ACCR) use of computers was to help quantify normal human movement, as a precursor to scientifically measuring deviations from normal, and design of prostheses.[10] The use of computers (IBM 650, 1620, and 7040) allowed analysis of a large sample size, and of more measurements and subgroups than had been previously practical with mechanical calculators, thus allowing an objective understanding of how human locomotion varies by age and body characteristics. A study co-author was Dean of the Marquette University College of Engineering; this work led to discrete Biomedical Engineering departments there and elsewhere.
The next steps, in the mid-1960s, were the development (sponsored largely by the NIH) of expert systems such as MYCIN andInternist-I. In 1965, the National Library of Medicine started to use MEDLINE and MEDLARS. Around this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett's Laboratory of Computer Science [11] at Massachusetts General Hospital in Boston, another center of biomedical computing that received significant support from the NIH.[12] In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system was used to support MUMPS language specifications. As of 2004, a descendent of this system is being used in the United States Veterans Affairs hospital system. The VA has the largest enterprise-wide health information system that includes an electronic medical record, known as the Veterans Health Information Systems and Technology Architecture (VistA). A graphical user interface known as the Computerized Patient Record System (CPRS) allows health care providers to review and update a patient’s electronic medical record at any of the VA's over 1,000 health care facilities.
During the 1960s, Morris Collen, a physician working for Kaiser Permanente's Division of Research, developed computerized systems to automate many aspects of multiphasic health checkups. These system became the basis the larger medical databases Kaiser Permanente developed during the 1970s and 1980s.[13] The American College of Medical Informatics (ACMI) has since 1993 annually bestowed the Morris F. Collen, MD Medal for Outstanding Contributions to the Field of Medical Informatics.[14]
In the 1970s a growing number of commercial vendors began to market practice management and electronic medical records systems. Although many products exist, only a small number of health practitioners use fully featured electronic health care records systems.
Homer R. Warner, one of the fathers of medical informatics,[15] founded the Department of Medical Informatics at the University of Utahin 1968. The American Medical Informatics Association (AMIA) has an award named after him on application of informatics to medicine.
Like other IT training specialties, there are Informatics certifications available to help informatics professionals stand out and be recognized. In Radiology Informatics, the CIIP (Certified Imaging Informatics Professional) certification was created by ABII (The American Board of Imaging Informatics) which is sponsored by SIIM (the Society for Imaging Informatics in Medicine) in 2005. The CIIP certification requires documented experience working in Imaging Informatics, formal testing and is a limited time credential requiring renewal every five years. The exam tests for a combination of IT technical knowledge, clinical understanding, and project management experience thought to represent the typical workload of a PACS administrator or other radiology IT clinical support role. Certifications from PARCA (PACS Administrators Registry and Certifications Association) are also recognized. The five PARCA certifications are tiered from entry level to architect level. (wikipedia)


Tuesday, January 29, 2013

ABC Patient Safety Free EBOOK PDF

Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. The frequency and magnitude of avoidable adverse patient events was not well known until the 1990s, when multiple countries reported staggering numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization calls patient safety an endemic concern.Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety.The resulting patient safety knowledge continually informs improvement efforts such as: applying lessons learned from business and industry, adopting innovative technologies, educating providers and consumers, enhancing error reporting systems, and developing new economic incentives. Millennia ago, Hippocrates recognized the potential for injuries that arise from the well intentioned actions of healers. Greek healers in the 4th Century B.C., drafted the Hippocratic Oath and pledged to "prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone."Since then, the directive primum non nocere (“first do no harm) has become a central tenet for contemporary medicine. However, despite an increasing emphasis on the scientific basis of medical practice in Europe and the United States in the late 19th Century, data on adverse outcomes were hard to come by and the various studies commissioned collected mostly anecdotal events. In the United States, the public and the medical specialty of anesthesia were shocked in April 1982 by the ABC television program 20/20 entitled The Deep Sleep. Presenting accounts of anesthetic accidents, the producers stated that, every year, 6,000 Americans die or suffer brain damage related to these mishaps.In 1983, the British Royal Society of Medicine and the Harvard Medical School jointly sponsored a symposium on anesthesia deaths and injuries, resulting in an agreement to share statistics and to conduct studies.By 1984 the American Society of Anesthesiologists (ASA) had established the Anesthesia Patient Safety Foundation (APSF). The APSF marked the first use of the term "patient safety" in the name of professional reviewing organization.Although anesthesiologists comprise only about 5% of physicians in the United States, anesthesiology became the leading medical specialty addressing issues of patient safety.Likewise in Australia, the Australian Patient Safety Foundation was founded in 1989 for anesthesia error monitoring. Both organizations were soon expanded as the magnitude of the medical error crisis became known. (wikipedia)

Monday, January 21, 2013


Antenatal care has evolved from a philanthropic service for mothers and their unborn babies to a multiphasic screening programme. Much has been added in the past few years but a lack of scientific scrutiny has meant that little has been taken away. Healthy mothers and fetuses need little high technological care but some screening is desirable to allocate them with confidence to the healthy group of pregnant women. Women and fetuses at high risk need all the scientific help available to ensure the safest environment for delivery and aftercare. The detection and successful management of women and fetuses at high risk is the science
of antenatal care; the care of other mothers at lower risk is the art of the subject and probably can proceed without much technology.

Midwives are practitioners of normal obstetrics and are taking over much of the care of normal or low-risk pregnancies, backed up by general practitioner obstetricians in the community and by consultant led obstetric teams in hospitals. This book has evolved from over 40 years of practice, reading, and research. We have tried to unwind the tangled skeins of aetiology and cause and the rational from traditional management, but naturally what remains is an opinion. To broaden this, the authorship has been widened; Dr Margery Morgan, a consultant obstetrician and gynaecologist at Singleton Hospital, has joined Professor Chamberlain as a co-author, bringing with her the new skills used in antenatal care.


Tuesday, January 15, 2013

Wound Care Essentials Practice Principles Third Edition EBOOK PDF

This is an exciting and challenging time for wound care clinicians as a new understanding of the biology of  healing wounds has given rise to many new wound care treatments and therapies. Although we are gaining new knowledge as to the biology of wound healing, “we can no longer care only for the wound itself; we must step back and look at the entire human being who happens to have a wound that needs healing.

”1 Being able to differentiate among the various treatment options, when and how to apply them, in what combinations, and when to change them has indeed become both an art and a science. “With the emergence of more complex products, we will be increasingly required to use these products ppropriately to maximize their impact. As a better understanding of the wound environment becomes available, our ability to tailor our approach and better treat the patient as a whole increases.”

Providing quality care for your wound patients starts with an analysis of the patient’s individualized wound assessment and continues with developing a plan of care, selecting the proper product, and reevaluating the plan of care as appropriate. Wound dressings can present a challenging decision for clinicians. Moist wound healing, moisture-balanced dressings, and certainly the principles of optimal wound interventions are key concepts needed to support the healing process. As clinicians try to heal wounds faster, the marketplace continues to provide many more treatment choices.

Currently there are reported to be more than 500 different types of dressings available to manage patients with wounds.3 Keeping abreast of wound dressing choices and various application techniques, as well as which product to use and when, is an ambitious task for all clinicians Wound healing in the 21st century has certainly changed. There have been more advances in wound care over the past four decades than during the previous 2,000 years.