This volume presents the most recent developments in diagnosis and treatment of patients with gastroesophageal reflux disease (GERD) and those who continue to be refractory to conventional GERD therapies. The book delineates the role of newly developed endoscopic therapies in GERD and outlines the best candidates for surgical fundoplication. Topics as the risks associated with GERD, lifestyle modification in GERD and the role of H2RA and proton pump inhibitor therapy in treating reflux disease are also explored. Written by authorities in the field, Diagnosis and Treatment of Gastroesophageal Reflux Disease is a concise yet comprehensive resource that is useful for primary care providers, gastroenterologists, pulmonologists, surgeons and ENT specialists.

The field of neural control of breathing has advanced rapidly in the past two decades, with the emergence of many new and promising research directions of increasing sophistication. The complexity and diversity of the current methodologies signify its remarkable vivacity, albeit at the price of much confusion. Captured in this book are the broad and intricate nature of the field and its multifaceted frontiers, including aspects of genetics, cell and molecular biology, comparative biology, neurophysiology, neurochemistry, neuroanatomy, imaging, human physiology in health and disease, and influence of environmental factors. Major topics include chemosensitivity, respiratory sensation, respiratory neurons, rhythmogenesis, plasticity, development, chemoreflex and exercise, respiratory instability and variability with behavioral and sleep states, etc., which are systematically laid out in the book for easy referencing.

In recent years there have been various discoveries connecting inflammation and lung cancer and clearly there is growing interest in this area of cancer research. The link between unresolved inflammation and cancer has been well established with estimates that 15% of cancer deaths are inflammation-related. Evidence for this link includes the following: a) some inflammatory diseases are associated with increased risk of cancer development; b) inflammatory mediators are present surrounding and within most tumors; c) overexpression of inflammatory cytokines increases cancer development and progression in murine studies; d) inhibition of inflammatory mediators decreases cancer development and progression; and e) the use of non-steroidal anti-inflammatory drugs (NSAIDs) has been found to decrease cancer incidence and delay progression. The volume will present aspects of the inflammatory tumor microenvironment (TME), its many roles in tumor progression and metastasis, including creation of a hypoxic environment, increased angiogenesis and invasion, changes in expression of micro-RNAs (miRNAs) and an increase in a stem cell phenotype. The book will also cover the mechanisms of inflammatory mediators. Chronic overexpression of inflammatory mediators in the TME, as seen in smokers and patients with non-small cell lung cancer (NSCLC), can also lead to increased tumor initiation, progression, invasion and metastasis. The volume will provide a comprehensive perspective of the latest findings and summaries of progress made regarding inflammation and its connection to lung cancer.

Ventilator-associated pneumonia (VAP) continues to be one of the greatest challenges to critical care practitioners and one of the greatest threats to the survival of our patients. The choice of this topic for an issue of the PERSPECTIVES IN CRITICAL CARE INFECTIOUS DISEASES Series is therefore quite appropriate. Despite its importance, many areas of the management of ventilator-associated pneumonia remain controversial. We therefore are pleased to include contributions from experts and investigators offering different perspectives on some of these controversial areas.

Familiarity with nitric oxide is essential to a modern understanding of pathophysiologic mechanisms of infectious disease. Recent research has established nitric oxide and related reactive nitrogen intermediates to be important molecular mediators of diverse physiologic processes such as control of vascular tone, regulation of the immune system, and microbial and tumor cell growth. This book contains chapters by the leading researchers in the field and examines the biology and biochemistry of nitric oxide and its role in a variety of specific infections ranging from sepsis, tuberculosis and malaria to viral myocarditis, influenza, and AIDS.

The first edition of this book, published in 2009, was the only book of its kind dedicated exclusively to the diagnosis and management of pulmonary arterial hypertension (PAH) in patients with interstitial lung disease (ILD). Over the past few years, new diagnostic tests and treatments of pulmonary arterial hypertension have been developed and tested. Diagnostic testing has led to more frequent and specific diagnosis in PAH patients, leading to the more widespread use of effective treatment and improved quality of life and reduction of mortality for PAH patients. Pulmonary Hypertension and Interstitial Lung Disease: A Clinical Guide, Second Edition provides an updated and expanded state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. The first section of the book discusses general features and includes an overview of clinical features, diagnosis and pathology of ILD. The second part discusses specific disorders such as idiopathic pulmonary fibrosis, sarcoidosis, and hypersensitivity pneumonia. Pulmonary Hypertension and Interstitial Lung Disease, Second Edition is an invaluable resource for all physicians whose practice involves the care and treatment of patients with interstitial lung disease.

"Methods in Pulmonary Research" presents a comprehensive review of methods used to study physiology and the cell biology of the lung. The book covers the entire range of techniques from those that require cell cultures to those using in vivo experimental models. Up-to-date techniques such as intravital microscopy are presented. Yet standard methods such as classical short circuit techniques used to study tracheal transport are fully covered. This book will be extremely useful for all who work in pulmonary research, yet need a practical guide to incorporate other established methods into their research programs. Thus the book will prove to be a valuable resource for cell biologists who wish to use organs in their research programs as well biological scientists who are moving their research programs into more cell related phenomena.

Pulmonary Immunotoxicology is a comprehensive exploration of the effects of various inhaled materials upon the immune system of the respiratory tract. It will be useful to investigators in the field of pulmonary toxicology and immunotoxicology, and to those involved in administration and regulation of matters related to inhaled materials. It can also serve as a textbook for a course in pulmonary immunotoxicology at graduate or advanced undergraduate level. Pulmonary Immunotoxicology comprises four sections. The first provides basic background concepts essential for understanding pulmonary immunotoxicology, including discussions of the normal structure and function of the respiratory system, its basic immunology, and the manner by which inhaled particles and gases are removed from the air and deposited upon respiratory tract surfaces. The second section provides an overview of the major types of pathological consequences which can arise from immunomodulation within the respiratory tract, including hypersensitivity and asthma, inflammation and fibrosis, as well as immunosuppression and autoimmunity. The third section, which comprises the largest portion of the book, deals specifically with major classes of airborne agents that are known to alter the immune function of the respiratory tract. These are arranged into major classes: organic agents, metals, gases, particles, biologics, and complex mixtures. The fourth and final section of the book explores the area of risk assessment, including discussions of the basic concepts of risk assessment as they apply specifically to immunotoxicologic effects upon the lungs, and the use of biomarkers as indices of potential pulmonary immunotoxic responses to inhaled materials.

People age 65 and older are the fastest growing segment of the U.S. population. In the 2010 census 16% of the population, 50 million people, were age 65 and older. That number is projected to increase to 66 million by the year 2050. Life expectancy has also increased, with recent CDC reports indicating life expectancy at 77.9 years. Age-adjusted death rates have decreased significantly with the largest changes occurring in older patients. Despite these trends, the 10 leading causes of death include several pulmonary etiologies including lung cancer, chronic respiratory diseases, influenza and pneumonia. Aging and Lung Disease: A Clinical Guide is devoted to understanding the impact of respiratory diseases in older patients. It includes reviews of physiology of the aging lung, allergy and immunology of the aging, as well as sleep changes over the life cycle. There are also comprehensive reviews on specific disease topics including chronic obstructive lung disease, lung cancer, atypical mycobacteria, interstitial lung disease, pulmonary hypertension, pulmonary embolism, obstructive sleep apnea, and sleep disorders in older patients. Two chapters focus on unique issues in older patients; HIV and lung transplant. Included also are important chapters on assessing functional and cognitive status and end-of-life issues in older patients with lung disease. In addition to outlining the current state of knowledge, each chapter focuses on special considerations when caring for older patients. Of particular interest to pulmonologists, internists, and gerontologists, other readers, such as pulmonary and geriatric nurse practitioners, as well as clinical researchers interested in both pulmonary and aging issues, will find Aging and Lung Disease: A Clinical Guide to be a vital resource for improving their care of older patients with lung disorders.

This first volume of the comprehensive, two-volume work on oxidative stress in lung disease introduces the molecular mechanisms, and the role of oxidants in the progression of different lung diseases. The lungs of humans and animals are under constant threat from oxidants from either endogenous (e.g. in situ metabolic reactions) or exogenous sources (e.g. air pollutants). Further, oxidative stress causes the oxidation of proteins, DNA and lipids, which in turn generates secondary metabolic products. The book consists of sections, each focusing on different aspects of oxidant-mediated lung diseases. As such it is a unique reference resource for postgraduate students, biomedical researchers and also for the clinicians who are interested in studying and understanding oxidant-mediated lung diseases. The second volume will incorporate other aspects of oxidant-mediated lung diseases, including prevention and therapeutics.

Cardiorespiratory function is prominently affected by oxidative stress. Cigarette smoking is the archetype of oxidative and nitrative stress and free radical formation. New adverse effects of smoking keep on propping up in research. The chapters provide the comprehensive view of new developments in this area regarding cardiovascular and lung function and muscle catabolism. Alterations in inflammatory cytokines and proteins as well as degradation of muscle proteins due to smoking, by far unrecognized, caused by oxidative stress also are presented. Much less is known about the effect of cognitive stress on vagally-mediated cardiorespiratory function and surprisingly, on vagal immune pathway. The experimental studies also show that clinically important meconium aspiration syndrome contains an oxidative trait which is amenable to antioxidative treatment. This volume creates a source of information on the damaging role of oxidative stress in cardiorespiratory function that has by far not been available.

This volume contains a collection of papers from the research program Protective Artificial Respiration (PAR) . In 2005 the German Research Association DFG launched the research program PAR which is a joint initiative of medicine and fluid mechanics. The main long-term objective of this program is the development of a more protective artificial respiratory system to reduce the physical stress of patients undergoing artificial respiration. To satisfy this goal 11 projects have been defined. In each of these projects scientists from medicine and fluid mechanics do collaborate in several experimental and numerical investigations to improve the fundamental knowledge on respiration and to develop a more individual artificial breathing concept. "

Severe Community Acquired Pneumonia is a book in which chapters are authored and the same topics discussed by North American and European experts. This approach provides a unique opportunity to view the different perspectives and points of view on this subject. Severe CAP is a common clinical problem encountered in the ICU setting. This book reviews topics concerning the pathogenesis, diagnosis and management of SCAP. The discussions on the role of alcohol in severe CAP and adjunctive therapies are important topics that further our understanding of this severe respiratory infection.

Pulmonary embolism is a common but vexing illness. This book provides a contemporary overview of the most important issues from a Western and a Japanese perspective, providing the reader with state-of-the-art knowledge of the epidemiology and molecular biology of the disease. In the Diagnosis section, the relationship between venous thrombosis and pulmonary embolism is explored, and exciting new findings are presented in the fields of echocardiography and magnetic resonance imaging. The Management section focuses on surgical intervention with acute embolectomy as well as updating thromboendarterectomy for chronic pulmonary embolism. The importance of primary and secondary prevention is emphasized in chapters addressing low molecular weight heparin and the inferior vena cava filter. This cutting-edge book is a valuable resource for practicing physicians, researchers, and students in internal medicine, hematology, pulmonary critical care, and vascular medicine.

Eureka: Respiratory Medicine is an innovative book for medical students that fully integrates core science, clinical medicine and surgery. The book benefits from an engaging and authoritative text, written by specialists in the field, and has several key features to help you really understand the subject: Chapter starter questions - to get you thinking about the topic before you start reading Break out boxes which contain essential key knowledge Clinical cases to help you understand the material in a clinical context Unique graphic narratives which are especially useful for visual learners End of chapter answers to the starter questions A final self-assessment chapter of Single Best Answers to really help test and reinforce your knowledge The First Principles chapter clearly explains the key concepts, processes and structures of the respiratory system. The Clinical Essentials chapter provides an overview of the symptoms and signs of respiratory disease, relevant history and examination techniques, investigations and management options. A series of disease-based chapters give concise descriptions of all major disorders, e.g. asthma, COPD and lung cancer, each chapter introduced by engaging clinical cases that feature unique graphic narratives. The Emergencies chapter covers the principles of immediate care in situations such as massive pulmonary embolism. An Integrated Care chapter discusses strategies for the management of chronic conditions across primary and other care settings. Finally, the Self-Assessment chapter comprises 80 multiple choice questions in clinical Single Best Answer format, to thoroughly test your understanding of the subject. The Eureka series of books are designed to be a 'one stop shop': they contain all the key information you need to know to succeed in your studies and pass your exams.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Induced pluripotent stem cells in cardiovascular research.- TRPs in the brain.-The channel physiology of the skin."

Acute lung injury (ALI) impacts patient care in every ICU in the world. Our collective understanding of this condition has grown immensely over the past decade but morbidity and mortality remain unacceptably high. To enhance the understanding of clinicians and researchers, this book addresses the pathophysiology of acute lung injury from a molecular and cellular standpoint; includes animal models of acute lung injury and points to potential therapeutic advances based on scientific findings. It is a concise compendium of the multiple pathways, mechanisms and molecules involved in the pathophysiology of acute lung injury and is intended to help caregivers understand the process and thus care for patients more effectively.

Defining the Lung Cancer Problem 1 Lung cancer is the leading cause of cancer death in the world. It kills almost as many Americans as cancers of the breast, prostate, colon, rectum, pancreas, and 2 kidney combined, and accounts for 28.6% of all US cancer deaths. With an increase in the 5-year relative survival rate from 13% to only 16% in the more than 2 30 years from 1974 to the present, it will take us another 840 years to eradicate lung cancer deaths if we do not improve the current rate of progress. As discussed in this text, lung cancer prevention has received substantial att- tion. The decrease in smoking in recent decades has helped, but smoking is not the only problem. Lung cancer in people who have never smoked is currently the 5th 3 leading cause of cancer death in the United States. Several factors contribute to the lethality of lung cancer, including the rapidity of tumor growth, advanced stage at diagnosis (due to nonspecificity of early sy- toms and the uncertain efficacy of screening), early development of metastases, and resistance to therapy. Several chapters in this book discuss new molecular targets that may be potentially exploitable in the future, as well as discussing our track record to date in exploiting them.

On 15 November 1997, the first international symposium "Neural and Chemical Control of Breathing: Pharmacological and Clinical Aspects" was held at Leiden University Medical Center on the occasion of the retirement of one of the members of the Control of Breathing Research Group of the Departments of Physiology and Anesthesiology, Dr. Aad Berkenbosch. Among others, Dr. Berkenbosch, played an important role in this research group, which made a large and significant contribution to scientific research on the regulation of breathing. This book presents the proceedings of that meeting together with papers of several authors who have strong bonds with the Leiden Departments of Physiology and Anesthesiology. All studies represent state of the art work on the subject of respiratory control and cardiovascular medicine, with emphasis on the physiological, pharmacological and anesthesiological aspects of both fields. The book is divided in several sections: Oxygen Physiology. Prof. John Severinghaus presents among other things his ideas on oxygen sensing and high altitude related diseases. Prof. Honda gives results from studies in a unique set of subjects without carotid bodies. The findings of Honda's group support the idea that an intact hypoxic drive from the carotid bodies is necessary for the generation of central hypoxic depression. Dr. Hans van Beek discusses the effects of hypoxia and hypercapnia on cardiac contractility in animal models. Prof. Oeseburg demonstrates the feasibility of Near Infra Red Oximetry for monitoring tissue oxygenation in patients. Central Chemoreception.

CLINICAL APPLICATION OF MECHANCIAL VENTILATION, FOURTH EDITION integrates fundamental concepts of respiratory physiology with the day-to-day duties of a respiratory care professional. Utilizing the wide degree of topics covered, including airway management, understanding ventilator waveforms, and addressing critical care issues, readers have the best resource available for understanding mechanical ventilation and its clinical application. Enhancing the learning experience are valuable illustrations of concepts and equipment, highlighted key points, and self-assesment questions in NRBC format with answers. Whether preparing for the national exam or double-checking a respiratory care calculation, this book provides the fundamental principles of repsiratory care with the clinical guidance necessary for mechanical ventilation.

Pneumonia (along with influenza) is the sixth leading cause of death in adults. About 4 million adults develop pneumonia each year in the US, resulting in 64 million days of restricted activity, 39 million days of bed confinement, and 10 million days of lost work. Yet the admission rates to hospital, length of stay, investigations, antimicrobial therapy and prevention strategies vary greatly from one geographic area to the next, and the scientific basis for many of our management strategies for pneumonia is weak to nonexistent. There are over 100 microbial agents that can cause pneumonia and many of these, especially Streptococcus pneumoniae, Group A streptococcus, and Staphylococcus aureus, are in a state of flux in terms of changing antimicrobial resistance. This book is designed to provide new information about pneumonia and identify critical research questions that will come to the fore as we enter the 21st century.