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Brain Hypoxia and Ischemia explores the various aspects of cell death and survival that are crucial for understanding the basic mechanisms underlying brain hypoxia and ischemia. Chapters focus on a panorama of issues including the role of ion channels/transporters, mitochondria and apoptotic mechanisms, the roles of glutamate/NMDA, mechanisms in penumbral cells and the importance of intermittent hypoxia and gene regulation under these stressful conditions. The volume explores findings from both mammalian and invertebrate model systems and their applicability to human systems and diseases. Careful consideration is also given to differences in hypoxia and ischemia across development. This volume aims to increase the understanding of these mechanisms and to stimulate research on better diagnosis and treatment of diseases that afflict the brain and potentially other organs when O2 levels are dysregulated. Brain Hypoxia and Ischemia is designed for neuroscientists, clinicians and medical/graduate students for use in both basic research and clinical practice.
Over the past decade, the hospitalist model has become a dominant system for the delivery of inpatient care. Forces such as national mandates to improve safety and quality, and intense pressure to safely reduce length of hospital stays, are now exerting pressure on neurologists. To meet these challenges, a new neurohospitalist model is emerging. This is the first authoritative text to detail the advances and strategies for treating neurologic disease in a hospital setting. It includes chapters on specific acute neurologic diseases including stroke, epilepsy, neuromuscular disease and traumatic brain injury and also addresses common reasons for neurologic consultation in the hospital including encephalopathy, electrolyte disturbances and neurologic complications of pregnancy. Ethical and structural issues commonly encountered in neurologic inpatients are also addressed. This will be a key resource for any clinician or trainee caring for neurologic patients in the hospital including practising neurologists, internists and trainees across multiple subspecialities.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
Hypoxia remains a constant threat throughout life. It is for this reason that the International Hypoxia Society strives to maintain a near quarter century tradition of presenting a stimulating blend of clinical and basic science discussions. International experts from many fields have focused on the state-of-the-art discoveries in normal and pathophysiological responses to hypoxia. Topics in this volume include gene-environment interactions, a theme developed in both a clinical context regarding exercise and hypoxia, as well as in native populations living in high altitudes. Furthermore, experts in the field have combined topics such as skeletal muscle angiogenesis and hypoxia, high altitude pulmonary edema, new insights into the biology of the erythropoietin receptor, and the latest advances in cardiorespiratory control in hypoxia. This volume explores the fields of anatomy, cardiology, biological transport, and biomedical engineering among many others.
This volume contains the most recent works on intracranial pressure and neuromonitoring in brain injury selected from 300 abstracts submitted to the 10th International Symposium on Intracranial Pressure. It includes state of the art monitoring of the brain injured patient in intensive care as well as the current state of knowledge in neurochemical and oxygen monitoring of the injured brain. Recent advances in molecular mechanisms of injury and the pathophysiology of ischemia and trauma are also included. "... this publication presents a comprehensive survey of the present state of art in the field and thus gives directions for further research to those engaged in ICP measurement and neuromonitoring”. Intensive Care Med
Intensive care in childhood is a relatively new field of medicine. Due to major differences in physiology, many disciplines are involved in the care of the critically ill child. Apart from specific disease patterns, morbidity in direct relation to the stay in the ICU or the underlying disease mainly determine long term morbidity. Today we understand that the treatment of the critically ill child can have a great impact on the quality of life in adulthood. This book covers the whole spectrum of intensive care in childhood. It is based on the experience of leading specialists from the various fields involved in the treatment of these children.
Provides current insights into critical abnormalities of the heart and lungs. The 3rd Edition includes chapters on microcirculation, regional distribution of blood flow, methods of increasing oxygen delivery, septic shock, environmental lung injury, and the effects of high pressure environments. Much more focused toward the critical care aspects of cardiopulmonary disorders.
Development of the brain and the emergence of the mind constitute some of the most important concerns of contemporary biology. Disturbances during fetal life may have profound implications for a child's future neurological and psychological development, which can in turn impact society. The new edition of this highly respected work presents a comprehensive review of the basic mechanisms of brain development and the pathophysiology of disorders of the infant brain, written by a team of distinguished neuroscientists, neonatologists, and neuropediatricians. The book follows the main milestones of brain development, from formation of the neural tube and wiring of the neurons in the brain. Neurotrophic factors, neurotransmitters, glial cell biology, cerebral circulation development of sensory functions are all described in detail. Furthermore, there are more philosophical chapters on the evolution of the brain and the emergence of consciousness. Clinical considerations are highlighted where relevant.
A panel of international ICU and epilepsy physicians and researchers detail the epileptic phenomena that occur in the complex environment of the ICU. Focusing on the central nervous system, the authors systematically examine the most up-to-date evidenced-based data regarding ICU seizures, including their most frequent causes, their pathophysiology, their clinical presentation, and the diagnostic evaluation needed to confirm their presence. They also discuss the challenges and specifics of the management of ICU seizures, reviewing the new antiepileptics and their interaction with other ICU medications, drugs with epileptogenic properties used in the ICU, and the role of the new enterally available antiepileptics in treating seizures. Numerous tables summarize drug interactions, neuroimages reveal common ICU seizure etiologies, and multiple electroencephalographic recordings demonstrate clinical or subclinical seizures in ICU patients.
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme