Incidental Findings


Book Description

In Singular Intimacies, which the New England Journal of Medicine said captured the'essence of becoming and being a doctor,' Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, she's finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: She's had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the real'slight prick and pressure' of a long needle as well as the very real sense of invasion and panic that routinely visits her patients. These fifteen intertwined tales include 'Living Will,' where Dr. Ofri treats a man who has lost the will to live, and she too comes dangerously close to concluding that he has nothing to live for;'Common Ground,' in which a patient's difficult decision to have an abortion highlights the vulnerabilities of doctor and patient alike;'Acne,' where she is confronted by a patient whose physical and emotional abuse she can't possibly heal, so she must settle on treating the one thing she can, the least of her patient's problems; and finally a stunning concluding chapter,'Tools of the Trade,' where Dr. Ofri's touch is the last in a woman's long life.




Clinical Neuroradiology


Book Description

This superbly illustrated textbook, endorsed by the European Society of Neuroradiology, explains in detail the clinical importance of neuroradiology in complementing history taking and physical examination during the workup of patients suspected of having neurological, neurosurgical, or psychiatric disorders. The role of imaging of the brain and spinal cord is described across the full range of relevant conditions, including, for example, cerebrovascular diseases, trauma, CSF disorders, developmental malformations, autoimmune diseases, epilepsy, tumors and tumor-like conditions, neurodegenerative diseases, metabolic conditions, and bipolar and depressive disorders. The structured approach to imaging and image analysis will ensure that the book is an invaluable resource for neuroradiologists in training and clinicians alike. Starting from the clinical indication, suggestions for imaging protocols are provided and checklists of common findings and aspects key to interpretation are presented. The book is published within the SpringerReference program, which combines thorough coverage with access to living editions constantly updated via a dynamic peer-review process.







Singular Intimacies


Book Description

A “finely gifted writer” shares “fifteen brilliantly written episodes covering the years from studenthood to the end of medical residency” (Oliver Sacks, MD, author of The Man Who Mistook His Wife for a Hat) Singular Intimacies is the story of becoming a doctor by immersion at Bellevue Hospital, the oldest public hospital in the country—and perhaps the most legendary. It is both the classic inner-city hospital and a unique amalgam of history, insanity, beauty, and intellect. When Danielle Ofri enters these 250-year-old doors as a tentative medical student, she is immediately plunged into the teeming world of urban medicine: mysterious illnesses, life-and-death decisions, patients speaking any one of a dozen languages, and overworked interns devising creative strategies to cope with the feverish intensity of a big-city hospital. Yet the emphasis of Singular Intimacies is not so much on the arduous hours in medical training (which certainly exist here), but on the evolution of an instinct for healing. In a hospital without the luxury of private physicians, where patients lack resources both financial and societal, where poverty and social strife are as much a part of the pathology as any microbe, it is the medical students and interns who are thrust into the searing intimacy that is the doctor-patient relationship. In each memorable chapter, Ofri’s progress toward becoming an experienced healer introduces not just a patient in medical crisis, but a human being with an intricate and compelling history. Ofri learns to navigate the tangled vulnerabilities of doctor and patient—not to simply battle the disease.




Incidental Radiological Findings


Book Description

This book covers incidental radiological findings (IFs) from different perspectives, provides interesting ethical background information, highlights the differences between IFs in clinical routine and during research studies, explains the management of IFs with reference to practices in different countries. The prevalence of IFs is increasing due to the wider use of modern imaging modalities in routine clinical practice and large population-based cohort studies. The reporting of these findings may lead to further diagnostic investigations and treatment and must therefore be handled with knowledge and care. The management of IFs in clinical routine is regulated by the guidelines of the different academic societies, while management in the setting of research studies depends on a variety of factors. In general, IFs must be disclosed to the imaged subject if they are potentially clinically relevant, but subjects must also be protected from the consequences of false positive findings. This book, written by distinguished experts in their fields, discusses all these issues and will be of interest to radiologists, other clinicians, and radiographers/technicians.




Common Neuro-Ophthalmic Pitfalls


Book Description

A case-based teaching tool describing real-life cases of neuro-ophthalmic disorders. Bridges the gap between textbook information and everyday clinical practice.




CT of the Heart


Book Description

This book is a comprehensive and richly-illustrated guide to cardiac CT, its current state, applications, and future directions. While the first edition of this text focused on what was then a novel instrument looking for application, this edition comes at a time where a wealth of guideline-driven, robust, and beneficial clinical applications have evolved that are enabled by an enormous and ever growing field of technology. Accordingly, the focus of the text has shifted from a technology-centric to a more patient-centric appraisal. While the specifications and capabilities of the CT system itself remain front and center as the basis for diagnostic success, much of the benefit derived from cardiac CT today comes from avant-garde technologies enabling enhanced visualization, quantitative imaging, and functional assessment, along with exciting deep learning, and artificial intelligence applications. Cardiac CT is no longer a mere tool for non-invasive coronary artery stenosis detection in the chest pain diagnostic algorithms; cardiac CT has proven its value for uses as diverse as personalized cardiovascular risk stratification, prediction, and management, diagnosing lesion-specific ischemia, guiding minimally invasive structural heart disease therapy, and planning cardiovascular surgery, among many others. This second edition is an authoritative guide and reference for both novices and experts in the medical imaging sciences who have an interest in cardiac CT.




Cardiology Explained


Book Description

One of the most time-consuming tasks in clinical medicine is seeking the opinions of specialist colleagues. There is a pressure not only to make referrals appropriate but also to summarize the case in the language of the specialist. This book explains basic physiologic and pathophysiologic mechanisms of cardiovascular disease in a straightforward manner, gives guidelines as to when referral is appropriate, and, uniquely, explains what the specialist is likely to do. It is ideal for any hospital doctor, generalist, or even senior medical student who may need a cardiology opinion, or for that ma.




Secondary Findings in Genomic Research


Book Description

Secondary Findings in Genomic Research offers a single, highly accessible resource on interpreting, managing and disclosing secondary findings in genomic research. With chapters written by experts in the field, this book is the first to concisely explain the ethical and practical issues raised by secondary genomics findings for a multi and interdisciplinary audience of genomic researchers, translational scientists, clinicians, medical students, genetic counselors, ethicists, legal experts and law students, public policy specialists and regulators. Contributors from Europe, North America, and Asia effectively synthesize perspectives from a spectrum of different scientific, societal, and global contexts, and offer pragmatic approaches to a range of topics, including oversight, governance and policy surrounding secondary genomic results, criteria for identifying results for return, communication and consent, stakeholders' attitudes and perspectives, disclosing results, and clinical, patient-centered protocols.




Returning Individual Research Results to Participants


Book Description

When is it appropriate to return individual research results to participants? The immense interest in this question has been fostered by the growing movement toward greater transparency and participant engagement in the research enterprise. Yet, the risks of returning individual research resultsâ€"such as results with unknown validityâ€"and the associated burdens on the research enterprise are competing considerations. Returning Individual Research Results to Participants reviews the current evidence on the benefits, harms, and costs of returning individual research results, while also considering the ethical, social, operational, and regulatory aspects of the practice. This report includes 12 recommendations directed to various stakeholdersâ€"investigators, sponsors, research institutions, institutional review boards (IRBs), regulators, and participantsâ€"and are designed to help (1) support decision making regarding the return of results on a study-by-study basis, (2) promote high-quality individual research results, (3) foster participant understanding of individual research results, and (4) revise and harmonize current regulations.