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Percutaneous cardiac and endovascular procedures are performed by a variety of interventional physicians and continue to evolve and expand. One of the most important steps in performing these procedures is vascular access and their Achilles heel is vascular access site complications. This volume is intended to help the clinician by providing a practical overview of the techniques and technologies used in top catheterization laboratories to access the arterial and venous beds. 

Dr. Mazen Abu-Fadel and his contributors, part of the renowned cardiovascular team at the University of Oklahoma Health Sciences Center, carefully walk the reader through the various techniques used to obtain vascular access into most arterial and venous sites. They thoroughly describe current data, techniques, advantages, risks, and benefits of each vascular access site. Covering everything from anatomic landmarks to closures devices, Arterial and Venous Access in the Cardiac Catheterization Lab offers a complete overview of each procedure. In addition, it provides an up-to-date guide to the best medical technologies and equipment used when performing these procedures.

Arterial and Venous Access in the Cardiac Catheterization Lab is an invaluable resource for a wide range of clinical personnel, from attending physicians and trainees to nursing staff and vascular technicians. Written by experienced leaders in the field, it demonstrates how to perform complex, risky procedures while providing patients with expert care.

The healthcare arena has seen a shift in recent years, with more healthcare provisions being delivered or managed via electronic means. Healthcare providers can now provide patients with diagnosis, treatment, monitoring, or a prescription without ever sharing the same physical space. With so much more patient data now stored and accessed electronically, the security of this information is ever more critical to the delivery of effective and efficient healthcare services. As blockchains are resistant to modification of their data, blockchain technology therefore provides traceable and reliable security to e-Healthcare systems and services.

Advocates for adaptable, person-centered healthcare, offering theoretical insights and practical examples from a diverse global perspective.

Generalism is a key approach to healthcare organization and delivery that enables person-centered, dynamic, and cost-effective patient care. With its emphasis on adaptability, generalism requires expansive, nurturing, and personalized approaches to clinical education in which a generalist attends to and explores patient priorities.

Generalism in Clinical Practice and Education outlines a generalist philosophy of practice, which is brought to life through interleaved examples. Written by a range of international clinicians, patients, and academics this book does not prescribe a single way to do generalism properly. Rather, it seeks to inspire readers’ future engagement with generalism in practice and education through sharing underpinning concepts, values, and principles. This ‘big picture’ attention to generalism across public health, social determinants of health, and clinical care is at the heart of sustainable and efficient use of resources to prioritize those in need. The book explores four key principles that aim to achieve creative, inclusive, and agile approaches to clinical care. Its goal is to support generalism in clinical practice and education and to produce clinical practitioners and learners who enjoy, embrace, and enhance future clinical care.
 

Intuition is central to discussions about the nature of scientific and philosophical reasoning and what it means to be human. In this bold and timely book, Hillel D. Braude marshals his dual training as a physician and philosopher to examine the place of intuition in medicine.

How the politics of “medical necessity” complicates American health care

The definition of medical necessity has morphed over the years, from a singular physician’s determination to a complex and dynamic political contest involving patients, medical companies, insurance companies, and government agencies. In this book, Daniel Skinner constructs a comprehensive understanding of the politics of defining this concept, arguing that sustained political engagement with medical necessity is essential to developing a health care system that meets basic public health objectives.

From medical marijuana to mental health to reproductive politics, the concept of medical necessity underscores many of the most divisive and contentious debates in American health care. Skinner’s close reading of medical necessity’s production illuminates the divides between perceptions of medical need as well as how the gatekeeper concept of medical necessity tends to frame medical objectives. He questions the wisdom of continuing to use medical necessity when thinking critically about vexing health care challenges, exploring the possibility that contracts, rights, and technology may resolve the contentious politics of medical necessity.

Skinner ultimately contends that a major shift is needed, one in which health care administrators, doctors, and patients admit that medical necessity is, at its base, a contestable political concept.

Precision medicine is rapidly becoming the standard-of-care for the treatment of cancer patients. This is made possible, in part, by the ready availability and reasonable costs of comprehensive DNA and RNA sequencing assays. However, precision medicine is complex and incorporates entirely new types of data and treatment paradigms that are outside of the training of most oncologists in practice today.

Precision Medicine Oncology: A Primer is a concise review of the fundamental principles and applications of precision medicine, intended for clinicians, particularly those working in oncology. It provides an accessible introduction to the technological advances in DNA and RNA sequencing, gives a detailed overview of approaches to the interpretation of molecular test results and their point-of-care implementation for individual patients, and describes innovative clinical trial designs in oncology as well as characteristics of the computational infrastructures through which massive quantities of data are collected, stored, and used in precision medicine oncology.
 

In this primer for patients, their families, and their doctors, a leading physician and scientist explains why the standard treatment for hypothyroidism fails many—and offers an empowering call for change.
 
Hypothyroidism, also commonly referred to as Hashimoto’s disease, affects millions in the United States alone. It occurs when the thyroid—the butterfly-shaped gland that sits in your neck right above the front of your shirt collar—malfunctions or after thyroid surgery, causing thyroid hormone levels in circulation to drop below normal. Thus, treatment is aimed at bringing these hormone levels back to normal. This is done with daily tablets of thyroxine or T4. Because hypothyroidism is so common, we likely know someone who is on this type of medication. While most patients respond well to this standard treatment, about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing these symptoms to be unrelated to the thyroid disease. In Rethinking Hypothyroidism, Dr. Antonio C. Bianco, a physician and a scientist who has studied hypothyroidism and thyroid hormones for decades, offers an accessible overview of the disease’s treatment and the role of big pharma in shaping it, making the case that the current approach is failing many patients. But more than this, Bianco calls for alternatives to improve lives, and he equips patients and their families with the tools to advocate for other treatments.

This is an auto-narrated audiobook edition of this book.

In this primer for patients, their families, and their doctors, a leading physician and scientist explains why the standard treatment for hypothyroidism fails many—and offers an empowering call for change.
 
Hypothyroidism, also commonly referred to as Hashimoto’s disease, affects millions in the United States alone. It occurs when the thyroid—the butterfly-shaped gland that sits in your neck right above the front of your shirt collar—malfunctions or after thyroid surgery, causing thyroid hormone levels in circulation to drop below normal. Thus, treatment is aimed at bringing these hormone levels back to normal. This is done with daily tablets of thyroxine or T4. Because hypothyroidism is so common, we likely know someone who is on this type of medication. While most patients respond well to this standard treatment, about ten to twenty percent (some two to three million individuals in the United States) are far from living a typical life. They exhibit “foggy brain”—low energy, confusion, and poor memory. Many doctors have shrugged off their complaints, believing these symptoms to be unrelated to the thyroid disease. In Rethinking Hypothyroidism, Dr. Antonio C. Bianco, a physician and a scientist who has studied hypothyroidism and thyroid hormones for decades, offers an accessible overview of the disease’s treatment and the role of big pharma in shaping it, making the case that the current approach is failing many patients. But more than this, Bianco calls for alternatives to improve lives, and he equips patients and their families with the tools to advocate for other treatments.

For years after graduating from medical school, Dr. Clifton K. Meador assumed that symptoms of the body, when obviously not imaginary, indicate a disease of the body—something to be treated with drugs, surgery, or other traditional means. But, over several decades, as he saw patients with clear symptoms but no discernable disease, he concluded that his own assumptions were too narrow and, indeed, that the underlying basis for much of clinical medicine was severely limited.

Recounting a series of fascinating case studies, Meador shows in this book how he came to reject a strict adherence to the prevailing biomolecular model of disease and its separation of mind and body. He studied other theories and approaches—George Engel's biopsychosocial model of disease, Michael Balint's study of physicians as pharmacological agents—and adjusted his practice accordingly to treat what he called "nondisease." He had to retool, learn new and more in-depth interviewing and listening techniques, and undergo what Balint termed a "slight but significant change in personality."

In chapters like "The Woman Who Believed She Was a Man" and "The Diarrhea of Agnes," Meador reveals both the considerable harm that can result from wrong diagnoses of nonexistent diseases and the methods he developed to help patients with chronic symptoms not defined by a medical disease. Throughout the book, he recommends subsequent studies to test his observations, and he urges full application of the scientific method to the doctor-patient relationship, pointing out that few objective studies of these all-important interactions have ever been done.

How healthy control subjects in clinical research transformed the practice and labor of science, as told by the Normals themselves.

In the 1950s, the National Institutes of Health were in search of a large, replenishing stream of healthy people to participate in clinical studies. To establish legal sources of test subjects, the NIH signed unprecedented contracts with American colleges, church organizations, and other government agencies, and in the process gave rise to a new type of test subject: the “normal patient.” Thousands of them eventually moved into the NIH Clinical Center to live in hospital rooms, eat food prepared in a metabolic kitchen, and follow—or flout—the rules.

The Normals is a groundbreaking account of the NIH Normal Volunteer Patient Program, which has lasted into the twenty-first century. This program harnessed outside organizations in all areas of postwar American life—colleges and universities, labor unions, civic groups, federal prisons, and churches—to recruit research subjects for human experiments. Drawing on thousands of pages of unearthed government documents, oral histories, and personal materials shared by the patients themselves (collected in a new archive), Laura Stark follows five experiments and the people involved, delving into their biographies, their time at the Clinical Center, and the thorny problem of determining who counts as “normal.” The “Normals” were not passive objects of study, Stark shows, but active research participants who collaborated with scientists, maintained the laboratories where they served, informed official ethics policies, and bargained to meet their needs.

By taking seriously the pillow fights and the first kisses, the bible clubs and the movie nights that animated the Clinical Center as much as the medical experiments, The Normals brings to life a surprising true story of the origins of our present-day system of human experiment, one that at once explores what it means to work, to serve, to volunteer.