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Clifford B. Saper, Chair of Neurology at Harvard Medical School, and Nicholas D. Schiff of Weill Medical College in NY join the original authors to thoroughly update this seminal text with over 90% new material. the goal of the new edition is to provide a clinically slanted volume that will help the reader understand and diagnose severe brain dysfunction both as it exists and as it evolves in the seriously ill. the book remains a treatise on pathophysiology because recent imaging, electrophysiologic, and biochemical technologies (discussed in the book) are by themselves insufficient substitute
"The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness."--BOOK JACKET.
Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition provides a comprehensive overview of the theory behind regulation of consciousness in humans, the mechanisms of loss of consciousness clinically, and the examination and diagnosis of the cause of loss of consciousness in patients. New sections provide the latest information on the treatment of comatose patients, brain death, recovery from structural coma, and the ethics of dealing with comatose patients.
Poetry. Winner of the 2012 Elixir Press Antivenom Poetry Award. David Ray Vance's STUPOR is unwaveringly contemporary. In this linguistically intriguing and imaginative engagement with Western life, Vance explores adaptation and desensitization, venturing to differentiate between what truly heals and what merely numbs. Provocative and summative, the title suggests both the depression and torpor characteristic of many folks' lives as society's passive drones. It also documents and evokes a defensive stance--the body knows best--triggered by the onslaught of stimuli: media and representation, violence, extremity, and decadence; the dizzying parade of prescriptions and their side effects; and the 'reality' of a technologically advanced world--a world in which everything is hyper and frighteningly infused with trauma. STUPOR, with its often-shocking images, asks a most difficult and unsettling question: what humanity will emerge from our bald contemporaneity, searching amidst the consequences of its cures. And it demands that we meet its questioning with our own, diligent and discerning, reaching beyond slumber toward an awareness as bloody and chaotic as all we desire to leave behind.--Duriel E. Harris, contest judge
Reproduction of the original: Benign Stupors by August Hoch
Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.
Delirium, stupor and coma are common clinical states that confront clinicians in almost every medical specialty. With appropriate diagnosis and treatment, coma can often be treated successfully. Conversely, delay in diagnosis and treatment may be lethal. This monograph provides an update on the clinical approach that was laid out in the previous 3 editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosis of brain death and the clinical physiology of the vegetative state and minimally conscious state, as well as the ethics of dealing with such patients and their families. The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness.
The care of stroke patients has changed dramatically. As well as improvements in the emergency care of the condition, there have been marked advances in our understanding, management and rehabilitation of residual deficits. This book is about the care of stroke patients, focusing on behavioural and cognitive problems. It provides a comprehensive review of the field covering the diagnostic value of these conditions, in the acute and later phases, their requirements in terms of treatment and management and the likelihood and significance of long-term disability. This book will appeal to all clinicians involved in the care of stroke patients, as well as to neuropsychologists, other rehabilitation therapists and research scientists investigating the underlying neuroscience.
This book reviews the range of psychoses that complicate the reproductive process, describing a range of interventions and preventive strategies.
NATIONAL BESTSELLER • A book in the best tradition of popular history—the untold story of Ireland's role in maintaining Western culture while the Dark Ages settled on Europe. • The perfect St. Patrick's Day gift! Every year millions of Americans celebrate St. Patrick's Day, but they may not be aware of how great an influence St. Patrick was on the subsequent history of civilization. Not only did he bring Christianity to Ireland, he instilled a sense of literacy and learning that would create the conditions that allowed Ireland to become "the isle of saints and scholars"—and thus preserve Western culture while Europe was being overrun by barbarians. In this entertaining and compelling narrative, Thomas Cahill tells the story of how Europe evolved from the classical age of Rome to the medieval era. Without Ireland, the transition could not have taken place. Not only did Irish monks and scribes maintain the very record of Western civilization -- copying manuscripts of Greek and Latin writers, both pagan and Christian, while libraries and learning on the continent were forever lost—they brought their uniquely Irish world-view to the task. As Cahill delightfully illustrates, so much of the liveliness we associate with medieval culture has its roots in Ireland. When the seeds of culture were replanted on the European continent, it was from Ireland that they were germinated. In the tradition of Barbara Tuchman's A Distant Mirror, How The Irish Saved Civilization reconstructs an era that few know about but which is central to understanding our past and our cultural heritage. But it conveys its knowledge with a winking wit that aptly captures the sensibility of the unsung Irish who relaunched civilization.