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1

Central Council for Research in Ayurveda and Siddha (India). Select research papers on Ksharasutra (a minimal invasive ayurvedic para-surgical measure). New Delhi: Central Council for Research in Ayurveda and Siddha, Department of AYUSH, Ministry of Health and Family Welfare, Government of India, 2009.

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2

Thüroff, Stefan, and Christian G. Chaussy. Focal Therapy of Prostate Cancer: An Emerging Strategy for Minimally Invasive, Staged Treatment. Springer, 2015.

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3

Thüroff, Stefan, and Christian G. Chaussy. Focal Therapy of Prostate Cancer: An Emerging Strategy for Minimally Invasive, Staged Treatment. Springer, 2016.

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4

Ahmed, Hashim Uddin, Louise Dickinson, and Mark Emberton. Focal therapy for prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0065.

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Minimally-invasive therapies in localized prostate cancer offer the potential to reduce side effects and the healthcare burden/costs associated with radical modalities such as surgery or radiotherapy. As radical treatments carry significant perioperative morbidity (wound infection, haemorrhage, hospital stay), potentially life-long side effects (such as incontinence, erectile dysfunction, rectal toxicity), and fail to cure many men, ablative therapies that reduce treatment burden while retaining acceptable cancer control have increasingly become areas of evaluation. This chapter reviews the role of these approaches and the therapeutic dilemma that men with localized low volume prostate cancer currently face as in the context of novel therapies which aim to find a middle ground—tissue-preserving focal therapy—that follows the paradigm of almost all other solid organ cancers.
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Brown, Jim, and Neal Navani. Non-surgical management of early-stage lung cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0004.

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As low-dose computed tomography screening of ‘high-risk’ smokers is occurring with increasing frequency, the incidental discovery of solitary pulmonary nodules is becoming more frequent, and lung cancer multidisciplinary teams are now often faced with balancing risk and benefit when making decisions regarding the radical treatment of patients with a clinical diagnosis of early lung cancer but borderline fitness. Surgery offers the best prospect of cure but is associated with significant mortality and morbidity; the elderly and frail experience more toxicity and a greater impact on the quality of life. This chapter reviews the criteria for assessing surgical fitness and examines the evidence for minimally invasive and ablative techniques for the treatment of early peripheral lung cancer in the medically inoperable patient.
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6

Pagano, Francesco, and Pierfrancesco Bassi. Invasive Bladder Cancer. Springer, 2016.

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7

(Editor), PierFrancesco Bassi, and Francesco Pagano (Editor), eds. Invasive Bladder Cancer. Springer, 2007.

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8

(Editor), James G. Geraghty, Howard L. Young (Editor), Jonathan M. Sackier (Editor), H. Stephen Stoldt (Editor), and Riccardo A. Audisio (Editor), eds. Minimal Access Surgery in Oncology. Greenwich Medical Media, 1998.

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9

Zehnder, Pascal, and George N. Thalmann. Muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0078.

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In the United Kingdom, >4,000 people die of bladder cancer every year. This reflects around one-third of affected patients and occurs in those with primary metastatic disease, with invasion at presentation, and in persons whose tumour progresses to invasion from non-invasive disease. The outcome from invasive cancers has not dramatically altered over the last 30 years, due to a lack of screening programmes, a lack of advances in treatment, and the fact that many patients present with tumours at an advanced stage. Around 50% of patients with invasive disease die from bladder cancer despite radical treatment, suggesting the disease is metastatic at presentation. Cure is rarely possible in patients with locally advanced tumours and lymph node metastases. Therapeutic options include systemic chemotherapy and salvage radical treatment for responders or palliation. Following radical cystectomy for cancer, patients require lifelong follow-up for both oncologic and functional reasons.
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10

Mario, Dicato, Mathé Georges, and Reizenstein Peter 1928-, eds. Management of minimal residual malignancy in man. Oxford: Pergamon, 1988.

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11

Verma, Mukesh, Debmalya Barh, Angelo Carpi, and Mehmet Gunduz. Cancer Biomarkers: Minimal and Noninvasive Early Diagnosis and Prognosis. Taylor & Francis Group, 2017.

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12

Reizenstein, P., and G. Mathe. Managing Minimal Residual Malignancy in Man (Medical Oncology and Tumor Pharmacotherapy). Elsevier Science Publishing Company, 1989.

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13

Kubli, F. Breast Diseases: Breast-Conserving Therapy Non-Invasive Lesions, Mastopathy. Springer-Verlag, 1990.

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14

Breast diseases: Breast-conserving therapy, non-invasive lesions, mastopathy. Berlin: Springer-Verlag, 1989.

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15

Bonadonna, Gianni, and Georges Mathé. Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease II: Adjuvant Therapies of the Various Primary Tumors. Brand: Springer, 2012.

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16

Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease II: Adjuvant Therapies of the Various Primary Tumors. Springer, 2011.

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17

Wijnand, Splinter Theodorus Ary, and Scher Howard I, eds. Neoadjuvant chemotherapy in invasive bladder cancer: Proceedings of an international workshop held in San Francisco, May 19-20, 1989. New York: Wiley-Liss, 1990.

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18

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Amen Sibtain. Colorectal cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0015_update_001.

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Breast cancer reviews the epidemiology and aetiology of this malignancy, with particular attention to the genetics underlying familial breast cancer, its pathology along with its receptors, oestrogen receptor (ER), the growth factor receptor HER2, and epidermal growth factor receptor (EGFR), and the bearing these have on treatment and prognosis. The benefits of breast cancer screening in the population and families at higher risk are discussed. Presenting symptoms and signs are followed by investigation including examination, bilateral mammography, and core biopsy of suspicious lesions. Management of non-invasive in situ disease is considered. Invasive breast cancer is staged according to TNM guidelines. Early breast cancer is defined, managed frequently by breast conserving surgery and sentinel node biopsy from the axilla. A positive sentinel node biopsy requires clearance of the axilla. Larger lesions may require mastectomy. Breast radiotherapy is indicated after breast conserving surgery. Following surgery, the risk of systemic micrometastatic disease is estimated from the primary size, lymph node spread, and tumour grade. Adjuvant chemotherapy improves treatment outcome in all but very good prognosis premenopausal breast cancer, and intermediate or poor prognosis postmenopausal breast cancer. This is combined with trastuzumab in HER2 positive disease. Adjuvant endocrine therapy is recommended for all ER positive breast cancer, tamoxifen in premenopausal, aromatase inhibitors in postmenopausal women. Neoadjuvant chemotherapy may be used in large operable breast cancers to facilitate breast conserving surgery. Locally advanced breast cancer is defined, its high risk of metastatic disease requiring full staging before treatment. Systemic therapy is often best first treatment, according to receptor profile. Metastatic breast cancer although incurable can be controlled for years using endocrine therapy, chemotherapy, trastuzumab, palliative radiotherapy, and bisphosphonates as appropriate. Male breast cancer is uncommon, but management similar.
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19

Sarwer, David B., and Canice E. Crerand. Evaluation of Body Dysmorphic Disorder in Patients Seeking Cosmetic Surgery and Minimally Invasive Treatments. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0031.

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This chapter details the recommended elements of the mental health assessment of individuals seeking cosmetic surgery or minimally invasive cosmetic treatments. Recommendations are provided for both mental health clinicians and aesthetic medical providers (e.g., surgeons, dermatologists). The standard elements of a comprehensive, initial mental health evaluation provide the foundation for assessment. In addition to assessing patients’ current psychosocial functioning and mental health history, providers should more specifically evaluate patients’ body image concerns. This includes a detailed assessment of body dysmorphic disorder (BDD) symptoms. Mental health providers, as well as clinicians from whom cosmetic procedures are being requested, should also assess patients’ motivations and expectations for cosmetic treatment. These and other more specific areas of assessment will allow the consulting mental health professional to provide a comprehensive report to the medical professional providing the cosmetic treatment. It will also help surgeons, dermatologists, and other providers of cosmetic treatment to determine whether cosmetic treatment is appropriate for individuals with minimal appearance flaws who request cosmetic procedures.
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20

Marvasti, Farshad Fani. The Role of Complementary and Alternative Medicine in Integrative Preventive Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190241254.003.0009.

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Integrative preventive medicine (IPM) identifies complementary and alternative medicine (CAM) as a key contributor to the goal of extending disease-free high-quality life; CAM provides therapeutic approaches that are amenable to self-care, are cost-effective, are minimally invasive, and have minimal potential for side effects. Using CAM in IPM results in a shift away from passive screenings and treatment-centered approaches to prevention-focused care. Integrative preventive medicine redefines and expands the levels of prevention to include evidence-based CAM at each level of prevention alongside conventional approaches. And CAM reemphasizes the value of primary prevention as an underused level of prevention in our current approach to healthcare. Integrative preventive medicine affirms the value of evidence-based CAM in treating the major risk factors for morbidity and mortality and encourages physicians to actively discuss the diverse array of CAM therapies with their patients and to incorporate evidence-based CAM into their treatment plans.
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21

Lee, Olivia T., Jennifer N. Wu, Frederick J. Meyers, and Christopher P. Evans. Genitourinary aspects of palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0084.

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Genitourinary tract diseases in the palliative care setting most commonly involve urinary tract obstruction, intractable bleeding, fistulae, and bladder-associated pain. Sources of obstruction in the lower urinary tract include benign prostatic hyperplasia, invasive prostate or bladder cancer, urethral stricture, or bladder neck contracture. Upper tract obstruction includes intraluminal or extraluminal blockage of the renal collecting system and ureters, such as transitional cell carcinoma, fibroepithelial polyps, stricture, stones, pelvic or retroperitoneal malignancy, fibrosis, or prior radiation. Untreated, obstructive uropathy leads to elevated bladder, ureter, and kidney pressures, bladder dysfunction, urolithiasis, renal failure, pyelonephritis, or urosepsis. Intractable haematuria can cause problematic anaemia, frequent transfusions, clot retention, haemorrhagic shock, and death. In addition, urinary tract fistulae such as vesicovaginal and vesicoenteric fistulae are common in patients who have had prior pelvic surgery or radiation especially in the setting of immunocompromise, poor nutrition, and infection. Untreated, these symptoms lead to rash, skin breakdown, ulcers, chronic infection, and sepsis. Lastly, pelvic and bladder pain, depending on aetiology can be treated with oral medications, intravesical therapies, or surgical therapies such as palliative resection or urinary diversion. Selection of tests and treatment modalities in the palliative care setting should be based on using the least invasive means to achieve the most relief in suffering. Some genitourinary conditions are potentially fatal, and in the acute or subacute setting, require re-evaluation of the end-of-life goals and wishes of the patient and family.
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22

Chan, Kin-Sang, Doris M. W. Tse, and Michael M. K. Sham. Dyspnoea and other respiratory symptoms in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0082.

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Dyspnoea is prevalent among palliative care patients with increased severity over time. There are two patterns of dyspnoea-breakthrough dyspnoea and constant dyspnoea-and three separate qualities of dyspnoea-air hunger, work or effort, and tightness. The measurement of dyspnoea includes three domains: sensory-perceptual experience, affective distress, and symptom impact. The management of dyspnoea includes specific disease management, non-pharmacological intervention, pharmacological treatment, and palliative non-invasive ventilation. Cough is prevalent and disturbing in patients with cancer and chronic lung diseases, and is often associated with airway hypersecretion and impaired mucociliary clearance. Management includes specific treatments for underlying non-cancer and cancer-related causes, symptomatic treatment by antitussives, mucoactive agents, and airway clearance techniques for expectoration and reduction in mucus production. Anticholinergics may be indicated for death rattles to facilitate a peaceful death. Haemoptysis occurs in 30-60% of lung cancer patients and initial management of haemoptysis includes airway protection and volume resuscitation. Localization of the site and source of bleeding may determine the choice of treatment. If a life-threatening haemoptysis occurs, sedation should be given as soon as possible. Support should be given to the family, and debriefing provided to team members.
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23

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Madhumita Bhattacharyya. Gynaecological cancers. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0020_update_001.

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Genitourinary cancers examines the malignancies arising in the kidney, ureter, bladder, prostate, testis, and penis. Renal cancer has high propensity for systemic spread, largely mediated by overexpression of vascular endothelial growth factor (VEGF). Treatments include surgery, immunotherapy, and targeted therapy. Wilms tumour, a childhood malignancy of the kidney, warrants specialist paediatric oncology management to provide expertise in its unique pathology, staging, and treatment, often with surgery and chemotherapy. Cancer of the bladder and ureters, another tobacco related cancer, may present as either superficial or invasive disease. The former is managed by transurethral resection and intravesical therapy. The latter may require radical surgery, preoperative chemotherapy, or radiotherapy. Prostate cancer, the commonest male cancer, is an androgen dependent malignancy. It has attracted controversy with regards to PSA screening, and potential over treatment with radical prostatectomy. Division into low, intermediate, and high risk disease according to tumour grade, stage, and PSA helps in deciding best treatment, antiandrogen therapy for metastatic disease, radiotherapy and adjuvant hormone therapy for locally advanced disease, either surgery or radiotherapy for early intermediate risk disease, and active monitoring for low risk cases. Testicular cancer divides according to pathology into seminoma, nonseminomatous germ cell tumours (NSGCT), and mixed tumours, the latter two frequently producing tumour markers, alpha-fetoprotein (AFP) and/or human chorionic gonadotrophin (HCG). Stage I disease is managed by inguinal orchidectomy and surveillance or adjuvant chemotherapy. More advanced disease is managed by chemotherapy, with high probability of cure in the majority. Penile cancer, often HPV related, can be excised when it presents early, but delay in presentation may lead to regional and systemic spread with poor prognosis.
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24

Smith, Robert M. Other bacterial diseasesErysipeloid. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0025.

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Erysipeloid is an acute bacterial infection usually causing acute localised cellulitis as a secondary infection of traumatised skin. It is caused by Erysipelothrix rhusiopathiae (insidiosa), a non-sporulating Gram-positive rod-shaped bacterium, ubiquitous in the environment. It is the cause of swine erysipelas and also a pathogen or commensal in a variety of wild and domestic birds, animal and marine species. Human infection primarily associated with occupational exposure to infected or contaminated animals or handling animal products and therefore is commoner in farmers, butchers and abattoir workers and fisherman.Risk factors for the rare human invasive E. rhusiopathiae infection include conditions that affect the host immune response, such as alcoholism, cancer and diabetes. Treatment is with penicillin.Erysipelas can affect animals of all ages but is recognised more frequently in juveniles. Swine exhibit similar stages to the disease in man. Clinical manifestations in swine vary from the classical rhomboid urticaria (diamond skin), the condition of greatest prevalence and economic importance, to sepsis, polyarthritis, pneumonia and death.Prevention is largely a matter of good hygiene, herd management and by raising awareness in those at risk (especially butchers, farmers and fishermen); ensuring that clinicians are aware of E. rhusiopathiae as a possible cause of occupational skin lesions and bacterial endocarditis is important.
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