Surgical Endocrinology

Surgical Endocrinology

Author: John Lynn

Publisher: Butterworth-Heinemann

Published: 2013-10-22

Total Pages: 596

ISBN-13: 1483193829

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Surgical Endocrinology presents the fundamentals and practical application of the subject matter. It discusses the molecular background and physiology of the endocrine systems. It addresses the legal aspects of endocrine surgery such as duty of care, and breach of such duty. Some of the topics covered in the book are the principles of endocrine surgery; molecular structures of organisms; physiology of endocrine system; multiple endocrine neoplasia and molecular genetics; non-surgical management of pituitary tumors; assay formulations and automation technology; syndrome of ectopic hormone production; and anesthesia for pituitary surgery. The classifications of endocrine problems for pregnant women are fully covered. The definition and symptoms of thyrotoxicosis are discussed in detail. The text describes in depth the different histological imaging methods. The anatomy and surgery of anterior pituitary are completely presented. A chapter is devoted to the classification of pituitary adenomas and other tumours. The book can provide useful information to surgeons, doctors, students, and researchers.


Book Synopsis Surgical Endocrinology by : John Lynn

Download or read book Surgical Endocrinology written by John Lynn and published by Butterworth-Heinemann. This book was released on 2013-10-22 with total page 596 pages. Available in PDF, EPUB and Kindle. Book excerpt: Surgical Endocrinology presents the fundamentals and practical application of the subject matter. It discusses the molecular background and physiology of the endocrine systems. It addresses the legal aspects of endocrine surgery such as duty of care, and breach of such duty. Some of the topics covered in the book are the principles of endocrine surgery; molecular structures of organisms; physiology of endocrine system; multiple endocrine neoplasia and molecular genetics; non-surgical management of pituitary tumors; assay formulations and automation technology; syndrome of ectopic hormone production; and anesthesia for pituitary surgery. The classifications of endocrine problems for pregnant women are fully covered. The definition and symptoms of thyrotoxicosis are discussed in detail. The text describes in depth the different histological imaging methods. The anatomy and surgery of anterior pituitary are completely presented. A chapter is devoted to the classification of pituitary adenomas and other tumours. The book can provide useful information to surgeons, doctors, students, and researchers.


Advances in Treatment and Management in Surgical Endocrinology

Advances in Treatment and Management in Surgical Endocrinology

Author: Alexander L. Shifrin

Publisher: Elsevier Health Sciences

Published: 2019-06-11

Total Pages: 328

ISBN-13: 0323661947

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Up-to-date and evidence-based, Updates on Treatment and Management of Endocrinopathies [correct title?] provides an overview of recent developments regarding the most prevalent endocrine disorders. A concise, easy-to-read reference for endocrinologists and endocrine surgeons, this timely reference includes an overview of each disorder as well as diagnosis, management, treatment, prognosis, and a summary by a renowned expert who has contributed to the most current literature. Addresses endocrine diseases of the thyroid, parathyroid, and adrenal glands as well as familial endocrine syndromes: multiple endocrine neoplasia type 1 and 2 (MEN). Includes both surgical and nonsurgical treatments. Consolidates today's available information on this timely topic into one convenient resource.


Book Synopsis Advances in Treatment and Management in Surgical Endocrinology by : Alexander L. Shifrin

Download or read book Advances in Treatment and Management in Surgical Endocrinology written by Alexander L. Shifrin and published by Elsevier Health Sciences. This book was released on 2019-06-11 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Up-to-date and evidence-based, Updates on Treatment and Management of Endocrinopathies [correct title?] provides an overview of recent developments regarding the most prevalent endocrine disorders. A concise, easy-to-read reference for endocrinologists and endocrine surgeons, this timely reference includes an overview of each disorder as well as diagnosis, management, treatment, prognosis, and a summary by a renowned expert who has contributed to the most current literature. Addresses endocrine diseases of the thyroid, parathyroid, and adrenal glands as well as familial endocrine syndromes: multiple endocrine neoplasia type 1 and 2 (MEN). Includes both surgical and nonsurgical treatments. Consolidates today's available information on this timely topic into one convenient resource.


Endocrine Surgery

Endocrine Surgery

Author: Johnathan Hubbard

Publisher: Springer Science & Business Media

Published: 2009-10-14

Total Pages: 605

ISBN-13: 1846288819

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There has been a recent surge of interest within the world of endocrine surgery in the US and worldwide with resultant significant changes on the way surgery is performed. Where before a 5-7 year period was taken for a general surgeon, after which the medic would take a 1 year residency then a fellowship, now they are looking at 3 years core surgery and then going straight to specialise, opening up the discipline to more people. The book is a valuable tool for those revising for board examinations and Fellowship examinations. The text, compiled by expert authors from the USA, Europe and Asia, provides an international perspective on the basic knowledge and clinical management.


Book Synopsis Endocrine Surgery by : Johnathan Hubbard

Download or read book Endocrine Surgery written by Johnathan Hubbard and published by Springer Science & Business Media. This book was released on 2009-10-14 with total page 605 pages. Available in PDF, EPUB and Kindle. Book excerpt: There has been a recent surge of interest within the world of endocrine surgery in the US and worldwide with resultant significant changes on the way surgery is performed. Where before a 5-7 year period was taken for a general surgeon, after which the medic would take a 1 year residency then a fellowship, now they are looking at 3 years core surgery and then going straight to specialise, opening up the discipline to more people. The book is a valuable tool for those revising for board examinations and Fellowship examinations. The text, compiled by expert authors from the USA, Europe and Asia, provides an international perspective on the basic knowledge and clinical management.


Innovations in Modern Endocrine Surgery

Innovations in Modern Endocrine Surgery

Author: Michael C. Singer

Publisher: Springer Nature

Published: 2021-07-02

Total Pages: 298

ISBN-13: 3030739511

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This book is the first to focus on the range of innovations that have been critical to the emergence of modern endocrine surgery. It provides a state-of-the art review of these developments, providing surgeons a single resource to better understand them. The text is broken into five parts. The first two parts cover the diagnosis and preoperative work-up of thyroid disease and parathyroid disease. Part three and four cover surgical adjuncts and surgical techniques. Finally, part five covers post-operative management and reviews developments that have allowed for ambulatory management to become a standard aspect of endocrine surgery. The book is written by experts that have been the primary proponents of the individual innovations. Chapters discuss the challenges and issues that the innovation address, its current state or use, and potential short- and long-term future directions/advances. Equipped with the knowledge provided by this text, surgeons can assess their own practice and choose to integrate innovations that may improve their patients’ outcomes. Innovations in Modern Endocrine Surgery serves as a valuable resource for all physicians and trainees interested in the how and why of performing modern thyroid and parathyroid surgery. It also allows surgeons to measure the state of their current practice against the most progressive techniques and determine if opportunities exist to update their approach.


Book Synopsis Innovations in Modern Endocrine Surgery by : Michael C. Singer

Download or read book Innovations in Modern Endocrine Surgery written by Michael C. Singer and published by Springer Nature. This book was released on 2021-07-02 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is the first to focus on the range of innovations that have been critical to the emergence of modern endocrine surgery. It provides a state-of-the art review of these developments, providing surgeons a single resource to better understand them. The text is broken into five parts. The first two parts cover the diagnosis and preoperative work-up of thyroid disease and parathyroid disease. Part three and four cover surgical adjuncts and surgical techniques. Finally, part five covers post-operative management and reviews developments that have allowed for ambulatory management to become a standard aspect of endocrine surgery. The book is written by experts that have been the primary proponents of the individual innovations. Chapters discuss the challenges and issues that the innovation address, its current state or use, and potential short- and long-term future directions/advances. Equipped with the knowledge provided by this text, surgeons can assess their own practice and choose to integrate innovations that may improve their patients’ outcomes. Innovations in Modern Endocrine Surgery serves as a valuable resource for all physicians and trainees interested in the how and why of performing modern thyroid and parathyroid surgery. It also allows surgeons to measure the state of their current practice against the most progressive techniques and determine if opportunities exist to update their approach.


Endocrine Surgery

Endocrine Surgery

Author: Demetrius Pertsemlidis

Publisher: CRC Press

Published: 2017-06-01

Total Pages: 1532

ISBN-13: 1498715966

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The second edition of Endocrine Surgery is a comprehensive update of the previous edition published in 2003. Edited by three leading authorities in the field of surgical endocrinology, the book encompasses the clinical, imaging, nuclear, molecular, technological and evidence-based principles that are applied in the diagnosis and treatment of all categories of endocrine tumors. Authored by experts from across the globe, this textbook reflects the best international clinical practice and also provides an outstanding educational resource. With full color illustrations throughout, the new edition emphasizes contemporary approaches in successive stages including: pituitary endocrine tumors; pathology and pathophysiology of pulmonary neuroendocrine cells; surgery of endocrine tumors of the lungs and thymus; robotic endocrine surgery; molecular testing of thyroid nodules; pediatric surgery for neuroblastoma and ganglioneuroma; multiple endocrine neoplasia; retroperitoneoscopic adrenalectomy; radionuclide imaging of carcinoid tumors, pancreas and adrenals; serotonin-induced cardiac valvular disease and surgical treatment; multimodal management of primary and metastatic neuroendocrine tumors; pathophysiology and surgery of Type II diabetes; post-bariatric surgery hyperinsulinemic hypoglycemia; and surgical management of metabolic syndrome. Endocrine Surgery 2e provides the clinician with a definitive resource to reach curative outcomes in the treatment of patients with endocrine pituitary, thyroid, and parathyroid entities. Further coverage of broncho-pulmonary, adrenal, pancreatic, and intestinal neoplasia is also included, making this the definitive textbook on the subject. Demetrius Pertsemlidis, MD FACS The Bradley H. Jack Professor of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA William B. Inabnet III, MD FACS Professor of Surgery and Chief, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Icahn School of Medicine at Mount Sinai, New York, USA Michel Gagner, M.D. FRCSC, FACS, FASMBS Clinical Professor of surgery, Herbert Wertheim School of Medicine, Florida International University, Miami, FL and Senior consultant, Hôpital du Sacre Coeur, Montreal, Quebec, Canada Print Versions of this book also include access to the ebook version.


Book Synopsis Endocrine Surgery by : Demetrius Pertsemlidis

Download or read book Endocrine Surgery written by Demetrius Pertsemlidis and published by CRC Press. This book was released on 2017-06-01 with total page 1532 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of Endocrine Surgery is a comprehensive update of the previous edition published in 2003. Edited by three leading authorities in the field of surgical endocrinology, the book encompasses the clinical, imaging, nuclear, molecular, technological and evidence-based principles that are applied in the diagnosis and treatment of all categories of endocrine tumors. Authored by experts from across the globe, this textbook reflects the best international clinical practice and also provides an outstanding educational resource. With full color illustrations throughout, the new edition emphasizes contemporary approaches in successive stages including: pituitary endocrine tumors; pathology and pathophysiology of pulmonary neuroendocrine cells; surgery of endocrine tumors of the lungs and thymus; robotic endocrine surgery; molecular testing of thyroid nodules; pediatric surgery for neuroblastoma and ganglioneuroma; multiple endocrine neoplasia; retroperitoneoscopic adrenalectomy; radionuclide imaging of carcinoid tumors, pancreas and adrenals; serotonin-induced cardiac valvular disease and surgical treatment; multimodal management of primary and metastatic neuroendocrine tumors; pathophysiology and surgery of Type II diabetes; post-bariatric surgery hyperinsulinemic hypoglycemia; and surgical management of metabolic syndrome. Endocrine Surgery 2e provides the clinician with a definitive resource to reach curative outcomes in the treatment of patients with endocrine pituitary, thyroid, and parathyroid entities. Further coverage of broncho-pulmonary, adrenal, pancreatic, and intestinal neoplasia is also included, making this the definitive textbook on the subject. Demetrius Pertsemlidis, MD FACS The Bradley H. Jack Professor of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA William B. Inabnet III, MD FACS Professor of Surgery and Chief, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Icahn School of Medicine at Mount Sinai, New York, USA Michel Gagner, M.D. FRCSC, FACS, FASMBS Clinical Professor of surgery, Herbert Wertheim School of Medicine, Florida International University, Miami, FL and Senior consultant, Hôpital du Sacre Coeur, Montreal, Quebec, Canada Print Versions of this book also include access to the ebook version.


Endocrine Neoplasia

Endocrine Neoplasia

Author: Cord Sturgeon

Publisher: Springer Science & Business Media

Published: 2009-12-03

Total Pages: 347

ISBN-13: 1441908579

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Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management. The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.


Book Synopsis Endocrine Neoplasia by : Cord Sturgeon

Download or read book Endocrine Neoplasia written by Cord Sturgeon and published by Springer Science & Business Media. This book was released on 2009-12-03 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management. The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.


Surgical Endocrinopathies

Surgical Endocrinopathies

Author: Janice L. Pasieka

Publisher: Springer

Published: 2015-04-07

Total Pages: 380

ISBN-13: 3319136623

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This book covers clinical management including diagnosis, localization and physiology, for a number of clinical diseases treated by endocrinologists and surgeons. Following each chapter there is a 3-4 page biographical sketch of the person behind the clinical endocrinopathy, whose name is closely associated with the disease. The field of endocrine surgery is rich in history and this is the first text to bring together in one place the person behind the disease and the pioneers of the field. The text covers both the current management of endocrine surgical diseases, and also provides a historical background by highlighting the person in whom these discoveries were named after. Surgical Endocrinopathies is of great value to endocrine surgeons, ENT surgeons, endocrinologists, internal medicine and medical historians.


Book Synopsis Surgical Endocrinopathies by : Janice L. Pasieka

Download or read book Surgical Endocrinopathies written by Janice L. Pasieka and published by Springer. This book was released on 2015-04-07 with total page 380 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers clinical management including diagnosis, localization and physiology, for a number of clinical diseases treated by endocrinologists and surgeons. Following each chapter there is a 3-4 page biographical sketch of the person behind the clinical endocrinopathy, whose name is closely associated with the disease. The field of endocrine surgery is rich in history and this is the first text to bring together in one place the person behind the disease and the pioneers of the field. The text covers both the current management of endocrine surgical diseases, and also provides a historical background by highlighting the person in whom these discoveries were named after. Surgical Endocrinopathies is of great value to endocrine surgeons, ENT surgeons, endocrinologists, internal medicine and medical historians.


Endocrine Surgery

Endocrine Surgery

Author: Demetrius Pertsemlidis

Publisher: CRC Press

Published: 2020-06-30

Total Pages: 752

ISBN-13: 9780367573461

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The second edition of Endocrine Surgery is a comprehensive update of the previous edition published in 2003. Edited by three leading authorities in the field of surgical endocrinology, the book encompasses the clinical, imaging, nuclear, molecular, technological and evidence-based principles that are applied in the diagnosis and treatment of all categories of endocrine tumors. Authored by experts from across the globe, this textbook reflects the best international clinical practice and also provides an outstanding educational resource. With full color illustrations throughout, the new edition emphasizes contemporary approaches in successive stages including: pituitary endocrine tumors; pathology and pathophysiology of pulmonary neuroendocrine cells; surgery of endocrine tumors of the lungs and thymus; robotic endocrine surgery; molecular testing of thyroid nodules; pediatric surgery for neuroblastoma and ganglioneuroma; multiple endocrine neoplasia; retroperitoneoscopic adrenalectomy; radionuclide imaging of carcinoid tumors, pancreas and adrenals; serotonin-induced cardiac valvular disease and surgical treatment; multimodal management of primary and metastatic neuroendocrine tumors; pathophysiology and surgery of Type II diabetes; post-bariatric surgery hyperinsulinemic hypoglycemia; and surgical management of metabolic syndrome. Endocrine Surgery 2e provides the clinician with a definitive resource to reach curative outcomes in the treatment of patients with endocrine pituitary, thyroid, and parathyroid entities. Further coverage of broncho-pulmonary, adrenal, pancreatic, and intestinal neoplasia is also included, making this the definitive textbook on the subject. Demetrius Pertsemlidis, MD FACS The Bradley H. Jack Professor of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA William B. Inabnet III, MD FACS Professor of Surgery and Chief, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Icahn School of Medicine at Mount Sinai, New York, USA Michel Gagner, M.D. FRCSC, FACS, FASMBS Clinical Professor of surgery, Herbert Wertheim School of Medicine, Florida International University, Miami, FL and Senior consultant, Hôpital du Sacre Coeur, Montreal, Quebec, Canada Print Versions of this book also include access to the ebook version.


Book Synopsis Endocrine Surgery by : Demetrius Pertsemlidis

Download or read book Endocrine Surgery written by Demetrius Pertsemlidis and published by CRC Press. This book was released on 2020-06-30 with total page 752 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of Endocrine Surgery is a comprehensive update of the previous edition published in 2003. Edited by three leading authorities in the field of surgical endocrinology, the book encompasses the clinical, imaging, nuclear, molecular, technological and evidence-based principles that are applied in the diagnosis and treatment of all categories of endocrine tumors. Authored by experts from across the globe, this textbook reflects the best international clinical practice and also provides an outstanding educational resource. With full color illustrations throughout, the new edition emphasizes contemporary approaches in successive stages including: pituitary endocrine tumors; pathology and pathophysiology of pulmonary neuroendocrine cells; surgery of endocrine tumors of the lungs and thymus; robotic endocrine surgery; molecular testing of thyroid nodules; pediatric surgery for neuroblastoma and ganglioneuroma; multiple endocrine neoplasia; retroperitoneoscopic adrenalectomy; radionuclide imaging of carcinoid tumors, pancreas and adrenals; serotonin-induced cardiac valvular disease and surgical treatment; multimodal management of primary and metastatic neuroendocrine tumors; pathophysiology and surgery of Type II diabetes; post-bariatric surgery hyperinsulinemic hypoglycemia; and surgical management of metabolic syndrome. Endocrine Surgery 2e provides the clinician with a definitive resource to reach curative outcomes in the treatment of patients with endocrine pituitary, thyroid, and parathyroid entities. Further coverage of broncho-pulmonary, adrenal, pancreatic, and intestinal neoplasia is also included, making this the definitive textbook on the subject. Demetrius Pertsemlidis, MD FACS The Bradley H. Jack Professor of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA William B. Inabnet III, MD FACS Professor of Surgery and Chief, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Icahn School of Medicine at Mount Sinai, New York, USA Michel Gagner, M.D. FRCSC, FACS, FASMBS Clinical Professor of surgery, Herbert Wertheim School of Medicine, Florida International University, Miami, FL and Senior consultant, Hôpital du Sacre Coeur, Montreal, Quebec, Canada Print Versions of this book also include access to the ebook version.


Evidence-Based Endocrine Surgery

Evidence-Based Endocrine Surgery

Author: Rajeev Parameswaran

Publisher: Springer

Published: 2019-01-03

Total Pages: 0

ISBN-13: 9789811338182

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In this textbook, leading experts from highly acclaimed institutions describe evidence-based best practice in the management of a wide range of benign and malignant thyroid, parathyroid, adrenal, and neuroendocrine conditions. Detailed attention is devoted to the current role of surgery, including minimally invasive surgery and robotic surgery, in different endocrine disorders. The reader will also learn how best to respond to the problems that may be encountered during endocrine surgical practice. While much of the focus is on surgical aspects, the approach is multidisciplinary, with inclusion of information on recent advances in epidemiology, genetics, cytology, pathology, imaging modalities, and other treatment options. The clear text is complemented by instructive clinical cases as well as numerous high-quality illustrations and tables summarizing key points. This book will be of value for specialists in endocrine medicine and surgery as well as general surgeons with an interest in endocrine surgery.


Book Synopsis Evidence-Based Endocrine Surgery by : Rajeev Parameswaran

Download or read book Evidence-Based Endocrine Surgery written by Rajeev Parameswaran and published by Springer. This book was released on 2019-01-03 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this textbook, leading experts from highly acclaimed institutions describe evidence-based best practice in the management of a wide range of benign and malignant thyroid, parathyroid, adrenal, and neuroendocrine conditions. Detailed attention is devoted to the current role of surgery, including minimally invasive surgery and robotic surgery, in different endocrine disorders. The reader will also learn how best to respond to the problems that may be encountered during endocrine surgical practice. While much of the focus is on surgical aspects, the approach is multidisciplinary, with inclusion of information on recent advances in epidemiology, genetics, cytology, pathology, imaging modalities, and other treatment options. The clear text is complemented by instructive clinical cases as well as numerous high-quality illustrations and tables summarizing key points. This book will be of value for specialists in endocrine medicine and surgery as well as general surgeons with an interest in endocrine surgery.


Endocrine Neoplasia

Endocrine Neoplasia

Author: Cord Sturgeon

Publisher: Springer

Published: 2010-05-04

Total Pages: 348

ISBN-13: 9781441908582

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Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management. The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.


Book Synopsis Endocrine Neoplasia by : Cord Sturgeon

Download or read book Endocrine Neoplasia written by Cord Sturgeon and published by Springer. This book was released on 2010-05-04 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management. The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.