Building on the existing titles in the "Airways Smooth Muscle" sub-series, the sixth volume explores physiological and pharmacological processes in the lung in vivo. The various animal models available for studying the bronchospasm and inflammation associated with human asthma are thoroughly reviewed by internationally recognised scientists. Specific chapters focus on the problems of administering drugs to animal airways, the mechanics of assessing lung function in the models, and describe in detail the species used, from rodents to primates. The use of genetically altered animals, an area of particular interest to molecular biologists, is also considered in depth. This up-to-date and extensively referenced work will prove invaluable to pharmacologists, physiologists and other biological scientists at all levels in academia and in the pharmaceutical industry.

The purpose of this book is to clarify the use of antibiotics in the management of the eommon respiratory illnesses seen in general practiee. The underlying philosophy, whieh embraees the avoidanee of unneeessary use, is that proper use entails a full understanding of the nature of the illness. The eoneept of seleetive antibiotie use reeognizes that respiratory illnesses eommonly eomprise multiple illness features, and that some of these features have a viral cause and some a bacterial one. In assessing antibiotic need, eaeh feature or eomponent part of an illness may be evaluated individually, so enabling adecision for antibiotie use in the illness as a whole. The nature of eaeh individual illness feature with its antibiotic indication is diseussed in sueeessive ehapters, and this aecumulated knowledge is of value in managing the more eomplex PUO and flu-like illnesses whieh are diseussed at the end of the book. The first two ehapters eneompass the principles of antibiotic use and the relationship between antibiotie preseribing and various states of the patient, e.g. allergy, pregnaney ete. An attempt has been made to justify every reeommendation or decision, and non-antibiotic management is diseussed where relevant.

This book sets out to illustrate the key steps in some of the commoner procedures in pulmonary and oesophageal surgery. Each chapter deals with one operation. It was always our intention that the emphasis should be on detailed illustrations of the various stages of each operation. The text is of secondary importance, serving to provide continuity and to guide the reader through the illustrations. The techniques outlined are those which have evolved in our practice over the years and are therefore the result of varied influences and personal experience. Where an individual surgeon's name is attached to an operative technique we make no claim to describe the procedure exactly as that surgeon would have performed it, and it would perhaps have been more accurate to describe the technique as being "in the style of ...... ". We would wish to apologise in advance to any surgeon who feels that we have not accurately depicted his technique or have deviated from it in any important respect.

The increasing incidence and prevalence of allergic disease worldwide is one of the most remarkable phenomena of the past 50 years. One in three people in developed countries will experience an allergic condition at some point in their lives and advances in understanding the causes of this trend, and in allergy treatment and care, have captured the imagination of scientists, clinicians and the public. Landmark Papers in Allergy is a definitive collection of over 90 papers charting key discoveries and scientific advances in relation to allergy and the development of treatment and care for allergic disorders. Comprehensive in its coverage, the book includes the first clear descriptions of allergic diseases; the major advances in treatments, such as the discovery of antihistamines, cortisone, biological therapies and immunotherapy; the great immunological advances, such as the discovery of immunoglobulin E (IgE) and leukotrienes; the possible factors behind the increase in allergy, such as the house dust mite, changes in hygiene and diet; and the growing understanding of the social, psychological and quality-of-life consequences of allergy. Including authoritative commentaries from leading international experts providing reflections on the historical importance and current relevance of each landmark paper, Landmark papers in Allergy is essential reading for any clinician or academic with an interest in allergy.

The topics chosen for discussion represent the most common problems referred by family doctors to chest clinics. It was taken for granted that the reader will be familiar with the symptoms, signs, and natural history of respiratory diseases, so that the stress is on differential diagnosis and treatment. Tuberculosis once occupied nearly all the time of chest physicians. At present weeks go by without a single case presenting itself. There has been no comparable improvement in cancer of the lung, which remains one of the most intract able problems. Asthma was seldom referred to out-patient clinics when the disease was regarded as more unpleasant than dangerous. The hazards of severe attacks and the advan tages of liaison with a hospital department are now widely recognized. A similar change of attitude to the management of chronic bronchitis brought many new patients to the chest clinics in place of the vanishing tuberculous population. Some uncommon pulmonary diseases are included: allergic alveolitis, because of the importance of early diagnosis, and sarcoidosis in order to discourage unnecessary treatment. The book is intended to be a practical guide and is not a critical review. This might serve as an excuse for its didactic style and the exclusion of controversial subjects. Some statements are repeated at more than one place in order to help readers who wish to consult individual chapters bearing on some current problem. Source references are omitted and are replaced by a short list of books recommended for further reading."

Cardiopulmonary exercise testing is an important diagnostic test in pulmonary medicine and cardiology. Capable of providing significantly more information about an individual's exercise capacity than standard exercise treadmill or 6-minute walk tests, the test is used for a variety of purposes including evaluating patients with unexplained exercise limitation or dyspnea on exertion, monitoring disease progression or response to treatment, determining fitness to undergo various surgical procedures and monitoring the effects of training in highly fit athletes. Introduction to Cardiopulmonary Exercise Testing is a unique new text that is ideal for trainees. It is presented in a clear, concise and easy-to-follow manner and is capable of being read in a much shorter time than the available texts on this topic. Chapters describe the basic physiologic responses observed during sustained exercise and explain how to perform and interpret these studies. The utility of the resource is further enhanced by several sections of actual patient cases, which provide opportunities to begin developing test interpretation skills. Given the widespread use of cardiopulmonary exercise testing in clinical practice, trainees in pulmonary and critical care medicine, cardiology, sports medicine, exercise physiology, and occasionally internal medicine, will find Introduction to Cardiopulmonary Exercise Testing to be an essential and one of a kind reference.

Many books have been written about the pathology of the major organs of the body such as the lungs, heart, gastrointestinal tract etc. Included in these are descriptions - often with a minor emphasis - of pathological conditions which affect their serosal surfaces. In this book I have endeavoured to reverse the process and treat the mesothelium as an organ in its own right, rather than being the "no man's land" between various major structures. A number of pathological conditions are common to the coverings of the three major body cavities - the pleura, pericardium and peritoneum - while some abnormalities are exclusive to one or other sites. I hope that the contents of this book cover a broad enough spectrum of mesothelial diseases to be of help to service pathologists, who are ever increasingly being asked to make diagnoses, particularly on small biopsies of pleural and peritoneal tissues. It is also my hope that the various aspects of the subject have been dealt with in sufficient depth to be of use to pathol ogists engaged in teaching and research, and to those whose interests lie in the structure and function of the mesothelium. There is still much to be learned in understanding the way the mesothelium behaves in the realm of both inflammatory response and tumour formation. If this book provides a stimulus to furthering research in these fields I feel it will have achieved its objective.

DDDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analysis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was concerned more with diagnosis in the widest sense and this series deals more definitively with general care and specific treatment of symptoms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and assessment and investigations, but the emphasis is on what to do best for the patient. Family medical practitioners have particular difficulties and advantages in their work. Because they often work in professional isolation in the community and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and relatively untried methods compared with those that are 'old' and well proven. Their ad vantages are that because of long -term continuous care for their patients they have come to know them and their families well and are able to become familiar with the more common and less serious diseases of their communities.

Asthma is a very common chronic disease involving the respiratory system in which the airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers. In children, the most common triggers are viral illnesses, such as those that cause the common cold and identifiable allergies. This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. While measurement of airway function is possible for adults, most new cases are diagnosed in children who are unable to perform such tests. Diagnosis in children is based on a careful compilation and analysis of the patient's medical history and subsequent improvement with an inhaled bronchodilator medication. This 2nd edition will provide clinicians with an update on the management of asthma, and will include new sections covering paediatric asthma, new treatment strategies, and updated management guidelines (including new British Thoracic Society BTS] guidelines).

Inspite of considerable progress in prevention, diagnosis, and treatment, pulmonary embolism has remained a threat to the patient and a challenge for the physician both in conservative, as well as in operative disciplines. Pulmonary embolism is according to pathology observations still the most frequently overlooked clinical diagnosis. In 1-5 per 100 autopsies, clinically unexpected pulmonary emboli are found. In addition, the sequelae of recurrent pulmonary emboli, the syndrome of pulmonary hypertension with or without right heart failure, continues to present a therapeutic dilemma - and no progress is in sight. In intensive care medicine pulmonary embolism, either acute, massive, and/or recur- rent, continues to be both a therapeutic as well as a preventive challenge mobilizing pharmacotherapeutic, catheter-interventional, and operative resources. Diagnostic, therapeutic, and preventive strategies are currently in use. Their basis, however, seems surprisingly thin, as far as our knowledge on the natural course of this chameleon-like illness with and without fibrinolytic, anticoagulative, catheter or opera- tive treatment is concerned. A large European multicenter register has been initiated by Professors Kasper and Geibel with the help of Boehringer Ingelheim Pharmaceutics, in order to better describe the natural course of pulmonary embolism under current treat- ment modalities. Furthermore, recently the clinical significance of the valve patent foramen ovale as a source of paradoxical emboli is beginning to be better understood. Many concepts therefore require revision.

Chest Imaging Cases thoroughly encompasses the field of thoracic radiology through 137 cases covering common and challenging radiologic and clinical issues. The cases are divided into categories important for board examinations and clinical practice: diagnoses that should be made on radiography, trachea, esophagus, chest wall, thoracic outlet, congenital lesions, mediastinal lesions, pleura, diaphragm, pulmonary masses, diffuse lung disease, pulmonary vascular disease, thoracic trauma, and post-surgical complications. Using a problem and solution format, each case features high-quality images, practical differential diagnoses, approaches to daily practice, management pearls and suggested readings. Concise discussions keep cases brief and informative, allowing for efficient learning and interpretation. Chest Imaging Cases is the essential resource for honing diagnostic skills in thoracic radiology for students, physicians-in-training and practitioners. Features: * Features over 500 images and 137 cases covering common and challenging clinical issues. * Each case includes high-quality images, practical differential diagnoses, approaches to daily practice, and suggested readings. * Concise discussions keep cases brief and informative, allowing for efficient learning and interpretation.

Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the first part provides and update on general issues and introduces both interstitial lung disease and associated pulmonary hypertension. A detailed analysis of the pathology of the various interstitial lung diseases is also provided. The second part addresses specific categories of disease. Bronchiolitis, hypersensitivity pneumonitis, and other conditions are covered, and the use of inspiratory and expiratory high resolution CT scan is discussed as well. This important new text is an invaluable resource for the practicing physician who must be aware of the broad and troubling manifestations of interstitial lung disease.

Airway sensory nerve terminals are tailored to detect changes in the physical and chemical environment, thereby supplying local pulmonary information to the central nervous system. Since most intrapulmonary nerve terminals arise from fibres travelling in the vagal nerve, the classification of sensory airway receptors' is largely based on their action potential characteristics, electrophysiologically registered from the vagal nerve. However, the architecture of airways and lungs makes it nearly impossible to functionally locate the exact nerve terminals that are responsible for the transduction of a particular intrapulmonary stimulus. In this monograph we focus on three sensory receptor end organs in lungs that are currently morphologically well-characterised: smooth muscle-associated airway receptors (SMARs), neuroepithelial bodies (NEBs) and visceral pleura receptors (VPRs). Unravelling the main functional morphological and neurochemical characteristics of these sensory receptors using advanced immunohistochemistry and confocal microscopy has already allowed us to draw important conclusions about their potential function(s). The current development of ex vivo lung models for the selective identification of SMARs, NEBs and VPRs using vital staining will certainly facilitate direct physiological studies of these morphologically well-characterised airway receptors, since these models allow direct live studies of their functional properties.

This practical volume highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts. Important aspects of diagnosis, risk stratification, and differential treatment of patients with PE are presented in a concise, yet comprehensive manner. Emphasis is placed on specific issues related to PE, including pregnancy, cancer, thrombophilia, and air travel.

Leading investigators review the highlights of current fibrosis research and the experimental methodologies used uncover the mechanisms that drive it. In their discussion of research methodologies utilizing cultured cells to model various aspects of the fibrotic response in vitro, the authors describe the isolation, characterization, and propagation of mesenchymal cells, and highlight the similarities and differences between methods that are appropriate for different types of fibroblasts. Approaches for studying collagen gene regulation and TGF-b production are also discussed, along with experimental methodologies utilizing animal models to study the pathogenesis of fibrosis. The protocols follow the successful Methods in Molecular Medicine (TM) series format, each offering step-by-step laboratory instructions, an introduction outlining the principles behind the technique, lists of the necessary equipment and reagents, and tips on troubleshooting and avoiding known pitfalls.

EMPOWER YOURSELF! No one with lung cancer needs to be alone in their fight against this disease. Lung Cancer: Your Questions, Expert Answers, Fourth Edition guides patients and their families through diagnosis, treatment and survivorship. Providing both the doctor's and patient's point of view, this book is a complete guide to understanding treatment options, post-treatment quality of life, sources of support, and much more. Through Lung Cancer: Your Questions, Expert Answers, Fourth Edition, expert authors use their experiences with patients to provide support and hope to the tens of thousands of people coping with lung cancer.

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.

Rely on this best-selling laboratory manual to provide the hands-on practice you need to confidently perform the most common to complex respiratory procedures for class and clinical. Step-by-step instructions with detailed diagrams and illustrations seamlessly guide you through every procedure.

Completely revised and updated, the 3rd Edition reflects the latest technologies and standards of care, including the most current respiratory equipment. Plus, you'll enhance your skills with 10 new procedure videos--online at DavisPlus--demonstrating how to perform advanced respiratory procedures.

Asthma is a common chronic inflammatory condition affecting the airways and displays a varied phenotypic picture. It is becoming increasingly recognized by healthcare workers and epidemiological studies suggest that along with other atopic diseases, its prevalence is rising. The precise etiology of asthma remains uncertain, but genetic and environmental factors such as viruses, country of origin, allergen exposure, early use of antibiotics, and numbers of siblings have all been implicated in its inception and development. Pathologically it is characterized by inflammation, physiologically by airway hyper-responsiveness (or hyper-reactivity) resulting in reversible airflow obstruction, and clinically by wheeze, chest tightness, breathlessness and cough. It can present in early childhood as well as adulthood, and varies markedly in severity, clinical course, subsequent disability and response to treatment. Exacerbations and symptoms of asthma are the final manifestation of a complex interplay between an array of inflammatory cells and mediators, which cause airway smooth muscle to intermittently relax and contract.
Despite greater knowledge surrounding the immunopathological origins of asthma and considerable advances in its management, it remains one of the most important chronic diseases in young adults and poses a significant degree of morbidity throughout all age groups. A minority of patients experience difficulty in controlling asthma and pose significant therapeutic difficulties in specialist clinics. Exacerbations of asthma contribute to significant costs for healthcare systems and are implicated in adversely affecting the quality of life of individuals and their families. Moreover, although asthma deaths have decreased over the past few decades, an appreciable number of deaths still occur each year. Regular anti-inflammatory therapy with inhaled corticosteroids is required in all but the mildest of disease and attenuates underlying airway inflammation and hyper-responsiveness, while bronchodilators are designed to relax airway smooth muscle and prevent bronchoconstriction on exposure to bronchoconstrictor stimuli. Other forms of treatment are required in individuals with persistent symptoms and exacerbations. In recent years several potentially exciting treatments have emerged and are in varying degrees of development.
Part of the new Oxford American Respiratory Library, this concise, portable guide provides an essential reference on current, evidence-based medical approaches to diagnosing and managing asthma. This practical volume features chapters on the pathophysiology of the disease with information on the common symptoms and potential triggers. In addition, the text includes discussions of new and emerging pharmacotherapies and complementary treatment therapies, with guidelines for symptom prevention.

The Oxford American Handbook of Pulmonary Medicine is an essential quick reference guide to all the major respiratory symptoms and diseases. Each topic is covered in a consistent format including practical tips for both inpatient and outpatient care settings. The handbook features a section on practical procedures plus useful pages on lung and bronchial anatomy, CT anatomy, lung function, and blood gas nomograms. Edited and written by pulmonologists from the respected National Jewish Medical Center in Denver, Colorado, this book will be an invaluable resource for students and residents, as well as a useful reference for practitioners. The Oxford American Handbook of Pulmonary Medicine is the indispensable, evidence-based source on the subject.

Simplify, simplify! Henry David Thoreau For writers of technical books, there can be no better piece of advice. Around the time of writing the first edition - about a decade ago - there were very few monographs on this s- ject: today, there are possibly no less than 20. Based on critical inputs, this edition stands thoroughly revamped. New chapters on ventilator waveforms, airway humidification, and aerosol therapy in the ICU now find a place. Novel software-based modes of ventilation have been included. Ventilator-associated pneumonia has been se- rated into a new chapter. Many new diagrams and algorithms have been added. As in the previous edition, considerable energy has been spent in presenting the material in a reader-friendly, conv- sational style. And as before, the book remains firmly rooted in physiology. My thanks are due to Madhu Reddy, Director of Universities Press - formerly a professional associate and now a friend, P. Sudhir, my tireless Pulmonary Function Lab technician who found the time to type the bits and pieces of this manuscript in between patients, A. Sobha for superbly organizing my time, Grant Weston and Cate Rogers at Springer, London, Balasaraswathi Jayakumar at Spi, India for her tremendous support, and to Dr. C. Eshwar Prasad, who, for his words of advice, I should have thanked years ago. vii viii Preface to the Second Edition Above all, I thank my wife and daughters, for understanding.

Cystic Fibrosis: The Facts provides a much needed simple and understandable source book about this disease. It is aimed at those living with Cystic Fibrosis (CF), either themselves or members of their families or their friends.
The book explains clearly what is happening to the body in CF, what causes it and what treatment options are available for the different aspects of the disease. There are more detailed chapters for those wanting to find out about the genetics of the disease and specific aspects such as how it affects life choices and employment. It looks to the future in terms of potential new therapies for CF and provides useful information on organizations that can provide help and further information across those areas of the world where the disease is prevalent.

This concise primer shows clinical health psychologists how to assess and treat adults suffering from chronic respiratory disease. It provides basic medical information for practitioners, especially those performing in outpatient settings who may be unfamiliar with these conditions, and gives psychologists clear, practical answers to the following questions: What is this disease? What is its impact on this person's life? How, as a psychologist, should I assess and treat this person? In this book readers will learn to identify common symptoms of respiratory dysfunction, and the basic features of common pulmonary diseases including chronic obstructive pulmonary disease, asthma, fibrosis and pneumoconiosis, pulmonary arterial hypertension, sarcoidosis, cystic fibrosis, and sleep apnea. Common medical treatments are described, along with environmental and occupational exposures that can exacerbate symptoms, as well as the impacts of gender, racial, and environmental factors. Chapters examine psychological evaluation and treatment, with a particular focus on anxiety and depression, the two most common comorbid mental health conditions. Cognitive and behavior treatments, psychotropic medications, and anti-smoking interventions are discussed, as are the mental health effects of chronic pulmonary disease on family members and friends, end-of-life issues, ethical and professional issues.