The impairment of lung function caused by environmental exposure to pollutants and toxicants is a rising health problem, particularly in highly industrialized parts of the world. The problem is urgently calling for the development of new methodologies to assess both the level of elemental exposure and the effects for quality of health and longevity. This volume provides state-of-the-art information about the recent advances in occupational and non-occupational pollutant-related disorders of the respiratory tract, and the assessment of a threat they pose for the health-span. Heavy traffic-related air pollution, unnoticeable but salient health detriment, is dealt with at length.

This book contains the refereed contributions from the 43rd annual meeting of ISOTT. The annual meetings of ISOTT bring together scientists from various fields (medicine, physiology, mathematics, biology, chemistry, physics, engineering, etc.) in a unique international forum. ISOTT conferences are a place where an atmosphere of interaction is created, where many questions are asked after each presentation and lively discussions occur at a high scientific level. This vivid interaction is the main motivation for members to participate and gain new ideas and knowledge in the broad field of oxygen transport to tissue. The proceedings include sessions covered various research topics including Multi-Modal Imaging/Spectroscopy & Instrumentation; Cancer Metabolism; Cellular Hypoxia and Mitochondrial Function; Brain Oxygenation and Function; Other Organ Function and Metabolism; Oxygen Transport in Sports, Diseases and Clinical Care; Acupuncture, Meridians, and Primo Vascular System; EPR, MRS and MRI.

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.

This volume details our current understanding of the architecture and signaling capabilities of known canonical and non-canonical inflammasome complexes and highlights their action, in particular in response to infection with important bacterial model organisms and the corresponding disease pathologies. The first chapters review new insights into the assembly and structures of inflammasome components and emphasize general strategies of up- and downstream signaling events. In addition, the authors specifically discuss the composition and activity of inflammasomes during infection with various gut pathogens (Salmonella, Shigella, Yersinia, Listeria and Helicobacter), respiratory pathogens (Mycobacterium, Legionella, Burkholderia and Streptococcus) as well as skin and soft tissue pathogens (Francisella and Staphylococcus). The discoveries presented provide a better understanding of the cellular and molecular biology of inflammasomes, which will pinpoint important new therapeutic targets for the treatment and prevention of multiple infectious diseases in the future. It is a valuable resource for students, scientists and clinicians, providing up-to-date information on this emerging research topic.

This book is an informal autobiography by John West MD PhD. He obtained his medical degree in Adelaide, Australia and then spent 15 years mainly at the Royal Postgraduate Medical School, Hammersmith Hospital in London where he, with others, used radioactive oxygen-15 to make the first description of the uneven regional distribution of blood flow in the lung. In 1960-1961, he was a member of the Himalayan Scientific and Mountaineering Expedition led by Sir Edmund Hillary who had made the first ascent of Mt Everest 7 years before. During the expedition about 6 scientists spent up to three months at an altitude of 5800 m studying the effects of this very high altitude on human physiology. Because of his interests in the effects of gravity on the lung, Dr. West spent a year at the NASA Ames Research Center in Mountain View, California in 1967-1968. While there he submitted a proposal to NASA to measure pulmonary function of astronauts in space, and this was funded. Later, in 1981 he organized the American Medical Research Expedition to Everest during which the first measurements of human physiology on the summit, altitude 8848 m, were obtained. In the 1990's, Dr. West's team made the first comprehensive measurements of pulmonary function of astronauts in space using SpaceLab which was taken up in the Shuttle.

This issue of Clinics in Chest Medicine focuses on Advances in Mechanical Ventilation. Articles include: Mechanical Ventilation Design Features; Assessing Respiratory System Mechanical Function; Ventilator Induced Lung Injury; Managing Acute Lung Injury; Patient-Ventilator Interactions; Extracorporeal Gas Exchange; Preventing Ventilator Associated Infections; Ventilator Discontinuation Process; Ventilator Management of the Non-injured Lung; Non-invasive Ventilation; and more!

The second edition of the comprehensive two volume set brings respiratory medicine specialists fully up to date with the latest advances and information in their field. Beginning with an introduction to lung development and physiology of the respiratory system, the next chapters discuss pharmacology, symptoms, and respiratory diagnosis. Each of the following sections is dedicated to a specific type of respiratory disease or infection, further divided to provide in depth detail on every aspect of the topic. The text also explains how each respiratory disorder may be associated with other medical specialities such as critical care, cardiology, sleep medicine, and infectious diseases. This two volume set features numerous pulmonary radiographs including CT, nuclear images, bronchoscopy, and thoracoscopy, as well as tables and diagrams to enhance learning. Key Points Fully updated, new edition of two volume set providing latest advances in pulmonary and critical care medicine Covers numerous respiratory diseases and infections and their comorbidity with other medical specialties Highly illustrated with radiographic images, tables and diagrams Previous edition (9789350250730) published in 2011

This comprehensive volume provides a balanced and easily readable account of the rise of modern sleep medicine, its history and developmental milestones. Authored by an international group of experts, the remarkable progress and fascinating evolution from rudimentary concepts of the ancient prehistoric and early classical periods to our contemporary knowledge are covered in detail. These examples and their relationship to modern therapies offer neurologists, psychiatrists, respiratory specialists, clinicians, researchers and those interested in sleep medicine an important perspective to the origins of current practice.

Smoking and Lung Inflammation is the first book directly related to chronic lung inflammation of its kind in several respects. First, the it focuses on both basic and clinical research on COPD, and the inflammatory mechanisms that function in these diseases. Second, it is unique with respect to scope of the discussion of the unusual characteristics of the immune response which occurs in these patients. Third, it includes knowledge being gained from translational research conducted through clinical trials at several Medical Schools in the United States. Not only is this research providing information about novel drugs and therapies, but it is also advancing our understanding of the genetics of these diseases. This work will illuminate the molecular basis for these diseases, and hopefully will permit us to individualize the therapies for these diseases.

This book comprehensively describes the physiological changes and consequences that occur in humans during spaceflight. It specifically presents the adaptations of the cardiovascular and the respiratory system. Specific changes occurring after 10, 20 or more days in space are depicted. Furthermore, the book explains various effective countermeasures that are required upon return of the astronauts to Earth. The book is a must-have for all biomedical and clinical researchers in the field of cardiovascular biology and respiration, and a fascinating reading for all interested laymen, who wish to understand a bit more about spaceflight research and technology.

Lung cancer and autoimmune diseases are complex entities in that they involve gene disturbance, gene polymorphism, and impaired gene repair mechanisms. The volume focuses on altered gene expression in tumor processes and in chronic autoimmune disorders. The chapters discuss the biological rationale for novel disease protein markers, present relevant clinical results, and give some diagnostic and therapeutic tips.

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.

The mechanistic basis of chronic inflammation remains unclear. The research sheds new light on the immune cells expressing the activation markers HLA-DR and regulatory T cells (Tregs) and the cells expressing Siglec receptors as being key players in the immune system responsiveness to antigens and thus in lung tissue damage of chronic inflammation. The results help understand the mechanisms of action of common drugs used in COPD, such as formoterol, tiotropium, or corticosteroids, and point to novel drug targets. The chapters also deal with brain damaging effects, by far unrecognized, of inhaled corticosteroid therapy, a time-proven management of chronic inflammatory airway conditions; asthma being a case in point. Novel methods, likely less producing side effects, of macrolide antibiotics administration by inhalation are discussed, emphasizing not only bacteriostatic but also anti-inflammatory action.

In a simplified form, epigenetics refers to heritable changes in phenotype that are not due to changes in the underlying DNA sequence. In this book, epigenetic mechanisms of regulation and dysregulation in health and disease are explored in great depth. Detailed chapters on epigenetic processes including DNA methylation and chromatin post-translational modifications including potential interventions with DNA methyltransferase inhibitors and histone deacetylase inhibitors are explored in initial chapters. These provide a detailed overview and important background to the entire field. The book is then focussed on epigenetic mechanisms involved in various diseases including anti-inflammatory and autoimmune conditions. Important accounts relating to the effects of epigenetics in metabolic syndrome, cardiovascular disease and asthma are the focus of subsequent chapters. The role of epigenetic dysregulation in malignancy is a current topic of interest and represents an intense field of research. A large component of this book is dedicated to the analysis of aberrant epigenetic processes in carcinogenesis and cancer progression. Further, chapters are focused on emerging cancer prevention using nutritional components and anti-cancer therapies particularly with histone deacetylase inhibitors, which have already been approved for the treatment of cutaneous T-cell lymphoma. The emerging role of nanoparticle preparations, especially in the context of delivering potential epigenetic therapies to target cells in various diseases, is also explored in this book. Overall, this book encompasses a wide range of topics related to epigenetic mechanisms in health and disease and would appeal to anyone with an interest in epigenetics, chromatin biology and emerging epigenetic interventions and therapies.

This two-volume work covers the molecular and cell biology, genetics and evolution of influenza viruses, the pathogenesis of infection, resultant host innate and adaptive immune response, prevention of infection through vaccination and approaches to the therapeutic control of infection.. Experts at the forefront of these areas provide critical assessments with regard to influenza virology, immunology, cell and molecular biology, and pathogenesis. Volume I provides overviews of the latest findings on molecular determinants of viral pathogenicity, virus entry and cell tropism, pandemic risk assessment, transmission and pathogenesis in animal species, viral evolution, ecology and antigenic variation, while Volume II focuses on the role of innate and adaptive immunity in pathogenesis, development of vaccines and antivirals. 

This volume covers data describing the role of free radicals and antioxidants in respiratory disorders, including the data that deal with clinical and pre-clinical trials. Chapters describe the relationship of oxidative stress to a number of respiratory and pulmonary conditions from a basic science and clinical perspective, including chronic obstructive pulmonary disease, asthma, acute lung injury, pulmonary hypertension, toxicity and fibrosis, cancer and asbestosis. The book also discusses the use of conventional biomarkers of oxidative stress and breath condensates as adjuncts to classical laboratory testing, the effect of antioxidants on cellular protection, as well as the development of novel antioxidant modalities.

The past few decades have seen major impacts of different pandemics and mass casualty events on health resource use in terms of rising healthcare costs and increased mortality. In this context, the development of acute respiratory failure in patients requires the use of mechanical ventilation, either invasive or noninvasive. Recently, noninvasive ventilation (NIV) has proved to be a valuable strategy to reduce mortality rates in patients. This is the first book to describe the clinical indications of NIV in patients who have been hospitalized with high-risk infections as well as in the prehospital management of mass casualty incidents, including chemical or biological disasters and pandemics. Compiled by internationally respected experts, it offers comprehensive coverage of all aspects of noninvasive mechanical ventilation in public health emergencies, such as equipment needs and guidelines for health organizations. Considering recent events (SARS, H1N1 influenza pandemic), the book concludes with a critical review of current studies and future prospects for the use of NIV, offering a valuable resource for all practitioners managing mass casualty incidents and disasters.

Although respiratory syncytial virus (RSV) has been a high priority for vaccine development for over 50 years now, still no vaccine is available and none has yet demonstrated sufficient promise to move to licensure. The success of RSV immune prophylaxis and the availability of ever more powerful tools to study the immune response and pathogenesis of disease, combined with the ability to construct a wide variety of vaccines using different vaccine platforms, give us grounds to believe that an RSV vaccine is within reach. This book brings together in one source what is currently known about the virus: its clinical and epidemiologic features; the host response and pathogenesis of the disease; vaccines, vaccine platforms, and treatment; and animal and tissue culture models of RSV infection. It is designed to organize the critical information relevant to RSV vaccine development, facilitate the assimilation of data, and speed progress toward producing a safe and effective vaccine.

This book is unique in approaching multiple organ dysfunction syndrome (MODS) from the perspective of its pathophysiological mechanism, and addressing aspects that are overlooked in most of the available literature. Eminent experts in the field from Europe and beyond offer new insights into risk stratification, severity assessment, and management of critically ill patients with sepsis. The principal focus is on recently developed concepts in infection management and in antibiotic use, bearing in mind that in these patients the pharmacokinetics of antibiotics are altered, affecting renal clearance and requiring dosage adjustments. The significance of the PIRO (predisposing factors, infection, response, organ dysfunction) model in the development of effective treatment strategies is emphasized. This book will be of interest and value to all who are involved in the treatment of, or research into, sepsis and MODS.

This multidisciplinary book covers all aspects of oxygen delivery to tissue, including blood flow and its regulation as well as oxygen metabolism as discussed at the 33rd Annual Meeting of the International Society on Oxygen Transport to Tissue (ISOTT) held in Australia in 2005. Special attention is paid to methods of oxygen measurement in living tissue and the application of these technologies to understanding the physiological and biochemical basis for pathology related to tissue oxygenation.

Idiopathic Pulmonary Fibrosis: A Comprehensive Clinical Guide delivers a concise review of our current understanding of disease pathogenesis and provides current evidence in the medical literature regarding its diagnosis and management. Each chapter includes key points and a summary aiming to update clinicians about various issues concerning the diagnosis and management of IPF. In addition to outlining the current state of knowledge, each chapter also provides a summary of ongoing research and identifies the needs for future research in the field. Idiopathic Pulmonary Fibrosis: A Comprehensive Clinical Guide is an important new text that provides its readers with a better understanding of the pathobiology and natural history of IPF as it continues to evolve.

The spectrum of systemic rheumatologic disease (often termed connective tissue disease) is characterized by autoimmune-mediated organ dysfunction, and the lungs are a frequent target. There are numerous pulmonary manifestations associated with connective tissue diseases, and all patients with rheumatologic disease are at risk of developing associated lung disease. Pulmonary Manifestations of Rheumatic Disease covers the comprehensive management of rheumatologic lung disease, which requires a multi-disciplinary approach and is optimized by active engagement by rheumatologists working closely with pulmonologists and other specialists. The book offers a practical reference using a case-based approach for practicing clinicians in the ongoing assessment and understanding of rheumatologic lung disease, and presents the science and pathophysiology underlying rheumatologic lung diseases. The first text of its kind specifically dedicated to describe diverse, commonplace, and challenging aspects of rheumatologic lung diseases, Pulmonary Manifestations of Rheumatic Disease serves as an invaluable tool for the practicing clinician.

Over the last decade the science and medicine of high altitude and hypoxia adaptation has seen great advances. High Altitude: Human Adaptation to Hypoxia addresses the challenges in dealing with the changes in human physiology and the particular medical conditions that arise from exposure to high altitude. In-depth and comprehensive chapters cover both the basic science and the clinical consequences of exposure to high altitude. Genetic, cellular, organ and whole body system responses to high altitudes are covered and chapters discuss these effects on a wide range of diseases. Expert authors provide insight into the care of patients with pre-existing medical conditions that fail in some cases to adapt as well as offer insights into how high altitude research can help critically ill patients. High Altitude: Human Adaptation to Hypoxia is an important new volume that offers a window into greater understanding and more successful treatment of hypoxic human diseases.

Asthma is a chronic relapsing airways disease that represents a major public health problem worldwide. Intermittent exacerbations are provoked by airway mucosal exposure to pro-inflammatory stimuli, with RNA viral infections or inhaled allergens representing the two most common precipitants. In this setting, inducible signaling pathways the airway mucosa play a central role in the initiation of airway inflammation through production of antimicrobial peptides (defensins), cytokines, chemokines and arachidonic acid metabolites that coordinate the complex processes of vascular permeability, cellular recruitment, mucous hyper-secretion, bronchial constriction and tissue remodeling. These signals also are responsible for leukocytic infiltration into the submucosa, T helper-lymphocyte skewing, and allergic sensitization. Currently, it is well appreciated that asthma is a heterogeneous in terms of onset, exacerbants, severity, and treatment response. Current asthma classification methods are largely descriptive and focus on a single aspect or dimension of the disease. An active area of investigation on how to collect, use and visualize multidimensional profiling in asthma. This book will overview multidimensional profiling strategies and visualization approaches for phenotyping asthma. As an outcome, this work will facilitate the understanding of disease etiology, prognosis and/or therapeutic intervention.