Some time ago, Schiano raised the question "To B or not to B", which means "To Biopsy or not to Biopsy" the liver for the evaluation of chronic hepatopathies. For a long period, liver biopsy (LB) was considered the "gold standard" for the evaluation of liver morphology. A major disadvantage of LB is its invasiveness: the risk of post-biopsy discomfort for patients and sometimes, for serious complications; also the lack of sensitivity to detect fibrosis, due to its heterogeneity; and the inability to obtain good quality fragments, adequate for pathological examination. In these conditions, the question is whether LB can be regarded as the "gold standard" for staging and grading chronic hepatitis in daily activity. But what alternative can we propose for the evaluation of liver fibrosis at this moment? The answer is: non-invasive methods and the ultrasound elastographic ones presented in this volume. Transient Elastography (FibroScan, Echosens) is a recognized method in many countries. Published papers and meta-analyses showed the value of this method for the diagnosis of liver cirrhosis (AUROC - 94%); for staging chronic HCV hepatitis (a cut-off value of 7.5 kPa differentiates F0–1 from F2–4 with 67% sensitivity, 87% specificity, 86% positive predictive value (PPV) and 68% negative predictive value (NPV), with a diagnostic accuracy of 76%; but also in HBV chronic infection, NASH, PBC, PBS). Acoustic Radiation Force Impulse (ARFI) Elastography (Siemens S2000) is another elastographic methods with promising results (a meta-analysis showed that the mean diagnostic accuracy of ARFI expressed as AUROC was 0.88 for the diagnosis of significant fibrosis (F≥2), 0.91 for the diagnosis of severe fibrosis (F≥3), and 0.93 for the diagnosis of liver cirrhosis. In the subgroup of patients who underwent both ARFI and TE, the diagnostic accuracy of ARFI was comparable to TE for the diagnosis of significant and severe fibrosis, with a trend to be inferior for the diagnosis of cirrhosis. The future of liver fibrosis evaluation points towards non-invasive methods, decreasing dramatically the number of liver biopsies. Studies have been published regarding the value of Real Time Elastography, performed for the first time with Hitachi systems (EUB-8500 and EUB-900), which uses an extended combined autocorrelation method to produce a real-time elasticity image by using a freehand approach to compress the tissues with the ultrasound transducer. The relative tissues’ elasticity is calculated and displayed as a color overlay on the conventional B-mode image. HiRT-E could be a promising method for the evaluation of liver fibrosis in chronic hepatopathies, but new methods of color code interpretation are needed to improve the accuracy, as well as a reference acquisition methodology. ShearWave™ Elastography, the new "kid on the block", produces an image where true local tissue elasticity is displayed in a color map in "real time". Elasticity is displayed using a color coded image superimposed on a B-mode image. Stiffer tissues are coded in red and softer tissues in blue, with an image resolution of approximately 1mm. The true elasticity is assessed based on Shear wave propagation speed into the tissue. It is a very new method and only small studies were presented at international meetings. Thus, having the alternative of noninvasive elastographic methods for the evaluation of liver fibrosis (maybe together with serum tests such as FibroMax) and knowing the low real life yield of liver biopsy (and the risk of complications), we can safely conclude that, for daily medical activity, liver biopsy can be avoided in the vast majority of cases. This ebook presents an interesting set of chapters on the subject and is of good value to hepatologists interested in non invasive diagnostic methods for liver diseases.

Liver biopsy (LB) is sometimes considered to be the "gold standard" for the evaluation of liver morphology in the diagnosis of chronic hepatopathies. A major disadvantage of LB is its invasiveness: the risk of post-biopsy discomfort for patients and sometimes, of serious complications; the lack of sensitivity to detect fibrosis, due to its heterogeneity and the difficulty to obtain adequate physical samples for pathological examination is also problematic. In these circumstances, the idea of LB as the "gold standard" for staging and grading chronic hepatitis in routine medical diagnoses is questionable. Non-invasive methods such as ultrasound elastography provide an effective alternative for liver evaluation without the risk of complications that arise from liver biopsies. There are a number of variants of elastographic techniques which include transient elastography (FibroScan, Echosens), Acoustic Radiation Force Impulse (ARFI) elastography (Siemens S2000) and other methods of shear wave elastography. This revised edition of Hepatic Elastography Using Ultrasound Waves presents an updated set of chapters on the related topic. Chapters cover several methods of hepatic elastography (transient, shear wave, real time strain, elastPQ etc.). This edition consolidates all methods of point shear wave elastography (including ARFI and ElastPQ methods) into a single chapter and presents information on 2D shear wave elastography in a separate chapter. In addition, this revised edition offers readers new information on the comparison of each elastographic technique and supplements readers with a set of general guidelines on liver elastography. This revised edition is an essential reference for hepatologists interested in non invasive diagnostic methods for liver diseases.

During the last two decades microsurgery has progressively taken the place of macrosurgery since it largely improves the experimental models in liver research. This is a concise but comprehensive book focusing on key issues in microsurgical techniques for liver research. The book has been written for medical, biological, veterinary and pharmaceutical researchers and advanced students who wish to develop experimental models of liver diseases by using microsurgery. The book is organized in twelve chapters in which the basic and applied aspects of experimental liver surgery are included. Many illustrations are given to reproduce each microtechnique which should particularly useful to the readers.

Non-alcoholic fatty liver disease (NAFLD) is a common cause of elevated liver enzymes and chronic liver disease in Western countries. NAFLD is characterized by elevated liver enzymes in the absence of alcohol consumption and secondary causes of liver disease. It is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and metabolic syndrome (hypertension, abdominal obesity, dyslipidemia, glucose intolerance). This book is a quick reference guide for medical students and professionals about NAFLD. Readers will find a summary of epidemiology, clinical features, diagnosis, imaging techniques, histopathology, and disease management. The book also presents information about NAFLD linked with hepatocellular carcinoma and guidelines for treating NAFLD in pediatric patients. Each chapter presents information in a simple, structured manner making this text an ideal handbook for supplementing hepatology modules in medical curricula.

This handbook explains the application of nanoparticles in medical diagnosis and treatment. It is a ready reference on the subject, starting with the introduction to nanoparticles and progressing to synthetic procedures for nanotherapeutics, human disease diagnosis and nanocarrier-based drug delivery. The book also covers information about specific nanoparticle conjugates, in which nanoparticles are combined with drugs or nucleic acid strands (DNA, siRNAs, shRNAs, miRNAs) as well as topics of relevant to this field such as immunotherapy and vaccination development strategies. Each chapter also provides references for further reading. </p> A Comprehensive Guide to Nanoparticles in Medicine is an ideal resource for scholars in medicine, pharmacology and technology who require an understanding to some basic facets of nanoparticles.

Advances in Modern Medicine introduces recent advanced medical practices performed at the Kure Medical Center and Chugoku Cancer Center (KMCCCC) - one of the leading hospitals in Japan - to those working in the field of medicine throughout the world, including physicians, surgeons, pharmacists, psychologists, medical engineers, medical technologists, nurses, and students. Readers will be updated on the general trends in modern medicine relevant to a variety of medical specialties performed at KMCCCC. The volume covers topics such as cancer management, acute phase reaction against a national-level disaster, depression management, emergency medicine, hepatobiliary and gastrointestinal diseases, orthopedics, organ transportation, infection control, blood disease, chronic kidney disease, palliative care, dermatology, ophthalmology, pathology, and nursing for cancer patients. Aspiring medical students can learn more about the latest developments in their field of interest, while patients can learn about treatment options available for different diseases.

This Ebook covers the emerging and most important theories underlying artificial intelligence applications in a variety of medical problems. It is written for physicians, researchers, engineers, statisticians and advanced students who wish to increase their familiarity with different topics of modern mathematics related to predictive medicine. Both theoretical and applied aspects are presented in this book. Many illustrative mathematical explanations and worked-out examples are given. This book features contributions by nine noted experts from leading medical centers worldwide, which should prove to be of considerable interest to the readers.

This anthology of articles on causal inference and scientific paradigms in epidemiology covers several important topics including the search for causal explanations, the strengths and limitations of causal criteria, quantitative approaches for assessing causal relationships that are relevant to epidemiology and emerging paradigms in epidemiologic research. In order to provide historical context, an overview of philosophical and historical developments relevant to causal inference in epidemiology and public health is also provided. Several theoretical and applied aspects of causal inference are dealt with. The aim of this Ebook is not only to summarize important developments in causal inference in epidemiology but also to identify possible ways to enhance the search for causal explanations for diseases and injuries. Examples are provided from such fields as chronic disease epidemiology, Veterans health, and environmental epidemiology. A particular goal of the Ebook is to provide ideas for strengthening causal inference in epidemiology in the context of refined research paradigms. These topics are important because the results of epidemiologic studies contribute to generalizable knowledge by clarifying the causes of diseases, by combining epidemiologic data with information from other disciplines (for example, psychology and industrial hygiene), by evaluating the consistency of epidemiologic data with etiological hypotheses about causation, and by providing the basis for evaluating procedures for health promotion and prevention and public health practices.

<p></p> Multidisciplinary Interventions for People with Diverse Needs is a book written from an interdisciplinary perspective with the objective of helping readers to understand the problems faced by people with special needs. <p></p> Key Features: <p></p> - provides an updated theoretical and contextual foundation of medical issues <p></p> - provides information about the meaning, evaluation and intervention of the problems related to a variety of debilitating diseases and disability conditions (dementia, language disorders, diabetes, alterations of consciousness, celiac disease and disability in general) <p></p> - contains an accessible, well written, didactic text which is useful to both students and working professionals <p></p> The book equips the reader with information about different approaches to medical and social issues that arise when dealing with persons who are experiencing some degree of disability. For teachers and working professionals, the handbook serves as a guide for teaching, for the development of the structure of training courses, for the design of evaluation models and intervention of the topics addressed in the book. <p></p> The combination of information about the professional and human aspects of special needs education makes this book a useful reference for pedagogues, psychologists, students, teachers and professionals involved in social science, healthcare, and sports medicine, among other fields. <p></p>

Precision medicine is a disruptive innovation with a fast-evolving pace in the healthcare ecosystem. Precision medicine enables precise diagnosis and targeted treatment by considering individual variability in the abnormalities of causative genes and molecular drivers behind biochemical mechanisms. A vast amount of data created by advanced omics technologies is a foundation of precision medicine’s success, and the implications of the findings from these technologies can potentially improve clinical outcomes. Recent Advances in Molecular and Translational Medicine: Updates in Precision Medicine presents essential information of molecular and translational research in precision medicine, with a specific focus on pediatrics. This book provides an accessible introduction to omics technologies, gives a detailed explanation of bioinformatics workflows to interpret high-throughput omics profiles for molecular diagnosis, and collects some of the cutting-edge research for precise therapeutics. Contributions to the book have been provided by experts in biomedical engineering and clinical practice, thus, bringing an informed perspective to the reader on each topic. The book is a valuable resource for postgraduate students, researchers, data scientists and clinicians interested in precision medicine, as well as researchers in the field of genetics and pediatrics who are interested in understanding the role of precision medicine in clinical practice.