Sleep Loss and Obesity: Intersecting Epidemics represents a major contribution to the field of sleep medicine. It is a comprehensive review of the neurobiology of sleep, circadian timing and obesity, the deleterious effects of sleep loss and obesity on health, and the worrisome associated social and medical costs in a range of patient populations and overall to society. The number of individuals who are obese has reached alarming levels. As a result, the incidence of Type 2 diabetes, cardiovascular disorders, heart disease, and kidney failure have also increased. The surgeon general estimates that the total annual cost of obesity in the US is about $117 billion. This cost is expected to escalate significantly because the number of overweight and obese children is increasing rapidly. Indeed, the new generation is expected to have a shorter life-span then their parents. In addition, sleep loss is emerging as an important contributing factor to obesity. People who sleep less or are sleep deprived tend to eat more, especially carbohydrates, and have a higher body mass index. Increased weight restricts the upper airway, causing obstructive sleep apnea and further sleep loss. In the end there is a vicious cycle of weight gain and sleep loss. In the past few years there has been a tremendous growth in our understanding of brain mechanisms controlling energy metabolism. Interestingly the neurons regulating waking also regulate feeding. There is also a mechanism that regulates the timing of feeding and sleep. In shift-workers this system is likely to be disturbed, and this has an adverse impact on both feeding and sleep. Sleep Loss and Obesity: Intersecting Epidemics is the first title to clearly examine how obesity and sleep loss are interacting epidemics. This fascinating title makes the link between energy metabolism, sleep and circadian timing; identifies poor sleep as a risk-factor for obesity in children and adults and offers treatment strategies for obstructive sleep apnea and obesity. This book will be a vital source of information for all physicians interested in sleep disorders and obesity. It will also be of value to neuroscientists, health system administrators, and policy makers.

Interstitial lung diseases comprise a significant part of any respiratory medicine practice. This timely second edition of Diffuse Lung Disease is a practical clinically-oriented resource, covering all the major advances in diagnostic techniques and therapies. Authored by world authorities in the field, this book provides clear and specific recommendations for the management of all forms of interstitial lung diseases. This book is divided into two sections. The first section addresses the general aspects of diagnosis and management, including clinical approach, radiographic approach, physiological changes, and classification. The second section details each individual form of interstitial lung disease. Organized in an easy to follow format, each disease specific chapter includes tables outlining diagnostic approach, differential diagnosis, disease monitoring, and treatment. Illustrative cases, replete with high quality HRCT images, bring an added dimension to this outstanding book.

Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach is an excellent resource for clinicians who care for individuals affected by alcohol use disorders in diverse settings. Although alcohol abuse alone does not cause acute lung injury, it renders the lung susceptible to dysfunction in response to the inflammatory stresses of sepsis, trauma, and other clinical conditions recognized to cause acute lung injury. In parallel, these same pathophysiological effects of alcohol abuse significantly increase the risk of a wide range of serious lung infections. Many clinicians involved in the primary treatment of alcohol use disorders, such as addiction psychiatrists, will find this text of interest as it will expand their understanding of the health consequences of alcohol use disorders. In parallel, clinicians who specialize in pulmonary and/or critical care medicine will have a unique resource that provides a comprehensive review of the pathophysiology of alcohol-related lung disorders and insights into evolving therapeutic options in these vulnerable individuals. Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach fills a gap in the literature and presents the evolving clinical research that may soon lead to novel therapies that can improve lung health in individuals with alcohol use disorders and co-existing conditions such as HIV infection.

Hailed by professional journals and esteemed by primary care physicians, Bronchial Asthma: A Guide for Practical Understanding and Treatment, Sixth Edition, has been fully updated to help physicians face the challenge of diagnosis and management in every variety of patient subpopulation.

Sleep Medicine is a field that attracts physicians from a variety of clinical backgrounds. As a result, the majority of sleep specialists who interpret sleep studies (PSG) do not have specialized training in neurophysiology and electroencephalography (EEG) interpretation. Given this and the fact that PSGs usually are run at a third of the speed of EEGs and that they usually have a limited array of electrodes, waveforms frequently appear different on the PSGs compared to the EEGs. This can lead to challenges interpreting certain unusual looking activity that may or may not be pathological. This Atlas of Electroencephalograpy in Sleep Medicine is extensively illustrated and provides an array of examples of normal waveforms commonly seen on PSG, in addition to normal variants, epileptiform and non-epileptiform abnormalities and common artifacts. This resource is divided into five main sections with a range of topics and chapters per section. The sections cover Normal Sleep Stages; Normal Variants; Epileptiform Abnormalities; Non-epileptiform Abnormalities; and Artifacts. Each example includes a brief description of each EEG together with its clinical significance, if any. Setting the book apart from others in the field is the following feature: Each EEG discussed consists of three views of the same page -- one at a full EEG montage with 30mm/sec paper speed, the same montage at 10mm/sec (PSG speed) and a third showing the same thing at 10 mm/sec, but with the abbreviated PSG montage. Unique and the first resource of its kind in sleep medicine, the Atlas of Electroencephalograpy in Sleep Medicine will greatly assist those physicians and sleep specialists who read PSGs to identify common and unusual waveforms on EEG as they may appear during a sleep study and serve as a reference for them in that capacity.

Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is a comprehensive, timely and up-to-date review of pediatric sleep disordered breathing (SDB) and offers a thorough focus on several key areas: namely, the normal development and maturation of the airway and breathing during sleep, the techniques that are in place for assessment of SDB in children, the clinical manifestations and characteristics of several pediatric populations at risk for SDB, the implications of SDB in various end-organ systems, and, finally, a critical review of the evidence on current therapeutic approaches. This unique and complete text is of welcome interest to all practicing physicians and healthcare professionals who evaluate children with sleep problems -- namely pulmonologists, pediatricians, sleep physicians, pediatric neurologists, pediatric otolaryngologists, and family practitioners, as well as clinical researchers, pediatric nurse practitioners and respiratory therapists. Written by a distinguished and international panel of authors who are renowned experts in their field and who offer an expanded view of the problems associated with SDB, Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is an indispensible resource for all physicians who evaluate children for sleep-disordered breathing.

The field of interventional bronchoscopy is rapidly expanding and has emerged as a new and exciting subspecialty in pulmonary medicine. To date, the impact of interventional bronchoscopy procedures has been felt in diagnosis, staging, and management of lung cancer, the most lethal cancer worldwide. Interventional Bronchoscopy: A Clinical Guide provides a state-of-the art description of interventional bronchoscopy procedures, addressing the scientific basis, indications, techniques, results, complications, and cost issues. Chapters address the current status, the advantages of new techniques and, most importantly, when to choose new techniques over the existing techniques. Each chapter will discuss the future of these procedures. Interventional Bronchoscopy: A Clinical Guide is an essential resource for a successful interventional pulmonology service and will be useful for the bronchoscopist, anesthesiologist, radiologist, thoracic surgeon and oncologist as well as practicing pulmonologists who do not perform these procedures but have to make decisions regarding appropriate referral of their patients to advanced airway centers.

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.

The successful prophylaxis and treatment of ubiquitous respiratory infections is essential for the enhancement of public health. The chapters provide new insights into the biology of causative pathogens, tackle the epidemiological aspects, and present an update on diagnostics, prevention and therapy of infections. The emerging new pathogens and antibiotic resistance of the old ones are discussed. Novel markers of the severity of community acquired pneumonia, which bears high morbidity and mortality, also are presented.

It is now 20 years since thoracoscopic surgery first entered everyday hospital practice, revolutionizing surgery and offering major benefits to patients. The intervening years have witnessed rapid progress, with the development of a variety of specialized techniques and equipment. This superbly illustrated book provides authoritative and comprehensive descriptions of the various minimally invasive techniques that are currently employed in thoracic and cardiac surgery. A wide range of thoracoscopic procedures are explained and discussed, and detailed attention is also paid to robotic and robot-assisted surgical techniques. Throughout, the emphasis is on clear description of procedures and identification of practical aspects of relevance in surgical practice. The authors are some of the world's most experienced thoracic and cardiac surgeons, and many of them have contributed greatly to the exploration and development of the field.

From epidemiology and pathogenesis to disease management, this book reviews our current understanding of and provides up-to-date information of Idiopathic Pulmonary Fibrosis (IPF). A subtype of Idiopathic Interstitial Pneumonias (IIP), IPF is one of the most elusive and intractable respiratory disease to date and its triggering factors remain unclear. However, new developments such as serum markers that are highly specific to IPF (i.e. KL-6, SP-A, and SP-D), the establishment of systematic diagnostic imaging (HRCT) and accumulated reports of treatment using an antifibrotic agent (pirfenidone) are slowly improving our understanding of the disease. Edited by an established authority in the field and written by experts, this book will be valuable to not only to beginning learners but also to physicians, instructors and researchers whose work involves IIPs. With each chapter exploring critical questions, with unresolved issues and future prospects, the book offers a valuable resource for understanding issues such as the newly proposed entity of interstitial pneumonia with emphysema (combined pulmonary fibrosis and emphysema: CPFE) and the mechanism of how so many IIP sufferers develop lung cancer.

An understanding of virus infection and the underlying role of the immune system in protection against these diseases is vital in today's medical climate. Previously, only symptoms could be treated, as there were no antiviral therapies. The increasing amounts of research and the huge number of discoveries of immunologic agents and pathways has led to the opportunity to look to the basic physiology of the various disease process as never before. This book is designed to provide the clinician with a thorough and yet approachable textbook describing the relationships between immunology, virology and the disease process.

This comprehensive resource brings together the most current theories, evidence and best practice parameters for the use of nocturnal non-invasive ventilation (nNIV). Chapters focus on the application of acute and chronic nNIV in patients with cardio-respiratory disorders over a range of major medical settings. Updates on past and recent research in this field are highlighted. Authored by leading clinicians and investigators, Nocturnal Non-Invasive Ventilation provides practical and cutting-edge knowledge to physicians, researchers and allied health professionals on the front lines of treating cardio-respiratory and sleep disorders.

Chapter 1. A Clinical Approach to Rare Lung Diseases Ralph Panos, M.D. Chapter 2. Clinical Trials for Rare Lung Diseases Jeffrey Krischer, Ph.D. Chapter 3. Idiopathic and Familial Pulmonary Arterial Hypertension Jean M. Elwing, M.D., Gail Deutsch, M.D., William C. Nichols, Ph.D., and Timothy LeCras, Ph.D., Chapter 4. Lymphangioleiomyomatosis Francis X. McCormack, M.D, and Elizabeth P. Henske, M.D., Ph.D. Chapter 5. Autoimmune Pulmonary Alveolar Proteinosis Bruce Trapnell, M.D., Koh Nakata, M.D., Ph.D., and Yoshikazu Inoue, M.D., Ph.D. Chapter 6. Mutations in Surfactant Protein C and Interstitial Lung Disease James P. Bridges, Ph. D. and Ralph Panos, M.D. Chapter 7. Hereditary Hemorrhagic Telangiectasia Claire Shovlin, M.D and S. Paul Oh, Ph.D. Chapter 8. Hermansky Pudlak Syndrome Lisa Young, M.D. and Bill Gahl, M.D., Ph.D. Chapter 9. Alpha One Antitrypsin Deficiency Charlie Strange, M.D. and Sabrina Janciauskiene, Ph.D. Chapter 10. The Marfan Syndrome Amaresh Nath, M.D and Enid Neptune, M.D. Chapter 11. Surfactant Deficiency Disorders SP-B and ABCA3 Larry Nogee, M.D. Chapter 12. Pulmonary Capillary Hemangiomatosis Edward D. Chan, M.D., Kathryn Chmura, B.A, and Andrew Sullivan, M.D. Chapter 13. Goodpasture's Syndrome Gangadar Taduri, M.D., D.M., Raghu Kalluri, Ph.D., and Ralph P. Panos, M.D. Chapter 14. Primary Ciliary Diskinesia Michael R. Knowles, M.D., Hilda Morillas, M.D., Margaret W. Leigh, M.D., Maimoona Zariwala, Ph.D. Chapter 15. Pulmonary Alveolar Microlithiasis Koichi Hagiwara, MD, Takeshi Jokoh, M.D., Teruo Tachibana, MD Chapter 16. Cystic Fibrosis Andre Cantin, M.D. Chapter 17. Pulmonary Langerhan's CellHistiocytosis Robert Vassallo, M.D. Chapter 18. Sarcoidosis Ralph Panos, M.D. and Andrew Fontenot, M.D. Chapter 19. Scleroderma Lung Disease Brent Kinder, M.D.

Endoscopic Therapy is emerging as the preferred therapy for early neoplasia in Barrett's Esophagus. This volume provides the key decision making factors in determining endoscopic therapy for an individual patient. All current techniques and complications of ET are provided including, photodynamic therapy (PDT), APC, multipolar electrocoagulation (MPEC), RF, ER, and cryotherapy. Each technique includes "how to highlights", high quality color endoscopic images, line drawings and diagrams. Endoscopic imaging modalities to detect dysplasia, decision making in the clinical arena and cost-effectiveness of ablation are some of the additional topics discussed in this highly practical volume. Written by experts in the field of endoscopic therapy, this text educates GI practitioners and researchers about this under-utilized approach to the treatment of Barrett's Esophagus.

Offers a comprehensive approach to modern imaging of environmental and occupational diseases of the chest Pays particular attention to the role of computed tomography in the detection of early subclinical abnormalities Considers new groups of workers at risk of exposure to agents that may cause pneumoconiosis Written by internationally acclaimed experts

Inadequate humidification of inspired gases can cause a variety of serious problems, and humidification has accordingly become an important aspect of modern intensive care medicine. This book is designed to serve as a practical guide for clinicians, providing information on the theoretical background of humidification, the equipment, and its optimal use. The book starts by examining the physiological basis of humidification. Current devices are then discussed, with careful attention to factors influencing their performance and methods to evaluate their effectiveness. The two scenarios of mechanical and non-mechanical ventilation are considered, and the issue of ventilator-associated pneumonia is addressed in detail. Further chapters focus on such topics as humidification following tracheostomy, humidification of the artificial airway during secretion management, measurement of inspired gas temperature in the ventilated neonate, and humidification in the home care setting.

Incidence of invasive fungal sinusitis has been increasing over the years. The understanding of its pathophysiology has improved with newer serological tests and diagnostic methods helping in earlier diagnosis and reducing patient morbidity. It was believed earlier that invasive fungal sinusitis is seen only in immune compromised patients but clinical reports suggest otherwise. More anti-fungal drugs are being added to improve incidence of patient survival. This book aims to compile all practical information about invasive fungal sinusitis into a single volume. Therefore, busy clinicians would not have to perform exhaustive literature studies to diagnose invasive fungal sinusitis. The book aims to provide an overview of diseases which could be mistaken for invasive fungal sinusitis and discuss how the management is different. Book sections consist of clinical, microbiological, serological, pathological, radiological and pharmacological features of the disease and its management. Each section is important in today's context as it dynamically alters the management of the patient. Early clinical suspicion and rapid microbiological, pathological and radiological diagnosis with aggressive treatment with surgical debridement and medical therapy leads to favorable outcomes.

In this book, a new approach for diagnosis and risk evaluation of ar-terial hypertension is introduced. The new approach was implement-ed as a hybrid intelligent system combining modular neural net-works and fuzzy systems. The different responses of the hybrid system are combined using fuzzy logic. Finally, two genetic algo-rithms are used to perform the optimization of the modular neural networks parameters and fuzzy inference system parameters. The experimental results obtained using the proposed method on real pa-tient data show that when the optimization is used, the results can be better than without optimization. This book is intended to be a refer-ence for scientists and physicians interested in applying soft compu-ting techniques, such as neural networks, fuzzy logic and genetic algorithms, in medical diagnosis, but also in general to classification and pattern recognition and similar problems.

Principles and Practice of Interventional Pulmonology provides a comprehensive text covering all aspects of Interventional Pulmonology. Providing both pathophysiologic background as well as illustrated and clear instruction on how procedures ought to be performed, this text will be of great value to interventional pulmonologists, thoracic surgeons, surgical oncologists, and interventional radiologists.

La crescita esponenziale dell'interesse per la ventilazione non invasiva (NIV) verificatasi negli ultimi 10-15 anni, non solo dal punto di vista clinico e applicativo, ma anche speculativo, ha pochi eguali nella recente storia della medicina.
In Italia e in Europa in generale tale metodica e applicata su larga scala, prevalentemente nei reparti di Pneumologia e nelle Unita di Cure Intermedie Respiratorie, mentre per quanto riguarda la sua applicazione nei reparti di Terapia Intensiva Generale (UTI) i dati emersi da uno studio multicentrico condotto nei paesi francofoni vedono la NIV impiegata in una quantita di casi che rappresenta fino al 50% dei pazienti che richiedono assistenza ventilatoria.
Il recente studio EUROVENT ha inoltre dimostrato come la NIV non si limiti alla sua applicazione "acuta," dal momento che circa 25.000 pazienti sono attualmente ventilati "in cronico" a domicilio. Inoltre, si calcola che milioni di cittadini europei soffrano attualmente di disturbi respiratori durante il sonno, e per molti di essi il trattamento medico di prima scelta e rappresentato dalla NIV. Questo libro si propone lo scopo di richiamare l'attenzione sulle piu recenti acquisizioni in questo campo, con la speranza di fornire uno strumento valido e maneggevole per la scelta e l'impostazione della migliore modalita di ventilazione.

The common cold is unlike any other human disease because of two f- tors: firstly, it is arguably the most common human disease and, secondly, it is one of the most complex diseases because of the number of viruses that cause the familiar syndrome of sneezing, sore throat, runny nose and nasal congestion. These two factors have made a 'cure' for the common cold one of the most difficult scientific and clinical endeavours (a topic often d- cussed in the popular media, where comparisons are made with the ease of putting a man on the moon). The present book brings together a wide range of experts from epidemiologists to virologists and pharmacologists to look at recent advances in our knowledge of the common cold. In some respects the book is unique, as it focuses on the common cold, a syndrome so familiar to the layperson but one that receives little attention from the scientist and clinician. The common cold can be viewed from many different aspects as illustrated in Figure 1. The core knowledge for understanding the common cold must first come from virology and this is discussed in several chapters of the book. There have been major advances in this field because of the use of new methods of detecting viruses such as polymerase chain reaction techniques that have greatly aided our understanding of the epidemiology of viruses associated with common cold.

Chronic obstructive pulmonary disease (COPD) affects millions of people across the world. COPD is not only a major burden to patients but is also costly and results in billions of dollars of direct and indirect costs annually. In recent years and with advancement of science, the understanding of COPD has improved significantly. Fortunately, current management guidelines consider COPD a preventable and treatable condition, and recent studies clearly indicate that available pharmacological and non-pharmacological interventions may improve various clinical outcomes. COPD: A Guide to Diagnosis and Clinical Management offers an exciting, evidence-based assessment of the field and will be of significant interest to clinicians who care for patients with COPD, including primary care providers and specialists. Comprehensive and state-of-the-art, this title is authored by experts who took the task of developing a resource that focuses on the essential issues in caring for patients with COPD. The first four chapters of the book cover major points about the systemic nature of COPD, the clinical and physiological assessments, and the outcome measures and prognostic markers. In the following section, various pharmacologic and non-pharmacological management strategies are reviewed based on the available evidence. The final sections outline the non-pulmonary effects of COPD and their management. COPD: A Guide to Diagnosis and Clinical Management is a vital, evidence-based text that will prove invaluable for all clinicians who care for patients with this debilitating disorder.

During the past decades, "Dynamics of the singing voice" has successfully been established as a reference text for teachers of singing, singers, choral conductors and organists, speech and voice therapists, laryngologists and other health professionals, psychologists and those in linguistics. It discusses the physiological, psychological, musical and emotional aspects of the voice, particularly as they relate to singing but also to speaking. The book provides a greater understanding of how the voice works and the many factors involved in singing as well as an objective discussion of singing without reference to specific techniques.

In this fifth edition, the author has now updated and rearranged the content. Furthermore she has added a new chapter on vocal pedagogic aspects in order to meet the requirements of the art of singing of the 21st century. Thus this new book provides the reader with the established concepts in combination with the latest knowledge about modern approaches to the singing voice.

The dynamics of body metabolism are changed in the disease process and interact with physical activity. The alteration of metabolism and its consequences raise the need for simple and reliable methods for assessment of body composition. The chapters aim to investigate various interacting components converging on metabolic changes in lung and muscle tissues taking into consideration the drug effects. The effects of exercise and nutritional status are dealt with at a great extent.