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The endothelium, a monolayer of endothelial cells, constitutes the inner cellular lining of the blood vessels (arteries, veins and capillaries) and the lymphatic system, and therefore is in direct contact with the blood/lymph and the circulating cells. The endothelium is a major player in the control of blood fluidity, platelet aggregation and vascular tone, a major actor in the regulation of immunology, inflammation and angiogenesis, and an important metabolizing and an endocrine organ. Endothelial cells controls vascular tone, and thereby blood flow, by synthesizing and releasing relaxing and contracting factors such as nitric oxide, metabolites of arachidonic acid via the cyclooxygenases, lipoxygenases and cytochrome P450 pathways, various peptides (endothelin, urotensin, CNP, adrenomedullin, etc.), adenosine, purines, reactive oxygen species and so on. Additionally, endothelial ectoenzymes are required steps in the generation of vasoactive hormones such as angiotensin II. An endothelial dysfunction linked to an imbalance in the synthesis and/or the release of these various endothelial factors may explain the initiation of cardiovascular pathologies (from hypertension to atherosclerosis) or their development and perpetuation. Table of Contents: Introduction / Multiple Functions of the Endothelial Cells / Calcium Signaling in Vascular Cells and Cell-to-Cell Communications / Endothelium-Dependent Regulation of Vascular Tone / Conclusion / References
Guest edited by Dr. Michell Levy, articles for this edition of Critical Care Clinics include: Specificity and sensitivity; How to use biomarkers;Physiologic Parameters as biomarkers: What can we learn from physiologic variables and variation?;Multi-marker Panels;Coagulation biomarkers;Biomarkers in neurosurgery;Biomarkers in Trauma; and Cardiac Biomarkers
Among the non-communicable diseases, cardiovascular disorders are the leading cause of morbidity and mortality in both the developed and the developing countries. The spectrum of risk factors is wide and their understanding is imperative to prevent the first and recurrent episodes of myocardial infarction, stroke or peripheral vascular disease which may prove fatal or disabling. This book has tried to present an update on risk factors incorporating new research which has thrown more light on the existing knowledge. It has also tried to highlight regional diversity addressing such issues. It will hopefully be resourceful to the cardiologists, general practitioners, family physicians, researchers, graduate students committed to cardiovascular risk prevention.
Heart failure is a serious condition caused by the heart failing to pump enough blood around the body at the right pressure. It usually occurs because the heart muscle has become too weak or stiff to work properly, most commonly caused by heart attack, high blood pressure or cardiomyopathy (heart disease). This textbook is a comprehensive guide to the latest advances in the diagnosis and management of heart failure. Comprising nearly 1000 pages, the book features 15 sections, beginning with discussion on clinical issues of heart failure, followed by imaging techniques. Each of the following sections covers a different disorder or disease that subsequently may lead to heart failure. Topics include coronary artery disease, stroke, arrhythmia, hypertension, nutritional aspects, cardio-oncology, and much more. The book concludes with rehabilitation, legal aspects, and future directions. Authored by internationally recognised experts in the field, the text is further enhanced by clinical photographs, diagrams and tables. Key points Comprehensive guide to latest advances in diagnosis and management of heart failure Extensive text comprising nearly 1000 pages covering numerous associated disorders and diseases Internationally recognised editor and author team Highly illustrated with clinical photographs, diagrams and tables
This edition of Bouncebacks! Emergency Medicine books examines the bounceback visit, putting the reader in the footsteps of the clinician as the patient deteriorates. The story pauses at important decision points as possible management strategies are reviewed in a literature-based fashion, followed by a revelation of the path chosen by the actual provider. As the patient’s course progresses, we reach additional decision points and address further clinical questions. In addition to our chapter authors, many with expertise in critical care emergency medicine, we have an all-star lineup of expert-whisperers: first an EM/critical care section editor (below) and second, EMCRIT.org’s double-boarded critical care guru, Scott Weingart. Their comments are inserted in grey boxes and are intended to give tips and tricks borne of experience and to provide context to the literature, "as if" they are standing over our shoulder and advising during a resuscitation. Additionally, there are three chapters where we address the medical-legal aspects of care. Enter Greg Henry MD, past president of The American College of Emergency Physicians (ACEP) and one of the most experienced physician medical-legal experts in the country. He opines on the approach that both the defense and plaintiff would likely pursue and, by extension, how we can make patients safer through our evaluation and documentation before there is an adverse outcome. Whereas, these chapters contain the actual documentation from the ED chart, a very few chapters have slight modifications to the final aspects of the return visit at decision point 3, to allow for exploration of different critical care scenarios. There is still plenty of commentary on the documentation, missed red-flags, and what could have been done to improve care at the initial visit. Our goal is to make each chapter challenging, dynamic, and realistic… to move us from “standard of care” to “excellence in care.” Book Review: "It's back, it's Bouncebacks! One of the mostly widely read and highly regarded education series in all of Emergency Medicine. Clinicians fear the medical malpractice landscape, but Mike Weinstock and the team give you all the tools you need to protect yourselves. Documentation people, documentation. Now with a critical care version. Read this book, sleep better at night, as simple as that! Love, love this series!" -- Mel Herbert, MD, MBBS, BMedSci, FACEP, FAAEMProfessor of Emergency Medicine at the Keck School of Medicine LAC + USC Medical Center, Owner and Editor of EM: RAP
This issue of Critical Care Clinics, Guest Edited by Dr. Rinaldo Bellomo, focuses on Modern Critical Care Endocrinology. Article topics include: Diabetes insipidus and SIADH in the ICU; Estrogen therapy in ICU patients; The angiotensin family, ACE and ACE 2; Angiotensin II in vasodilatory shock; Vasopressin in vasodilatory shock; Hydrocortisone in vasodilatory shock; Erythropoietin in trauma and critical illness; HbA1c and permissive hyperglycemia in diabetic ICU patients; Osteoporosis and the critically ill patient; New oral agents for the treatment of diabetes; Melatonin in critical care; The incretins in ICU patients; Hepcidin; Thyroid hormone therapy in the ICU; and Hormonal therapy in organ donors.
Pediatric intensivists, cardiologists, cardiac surgeons, and anesthesiologists from the leading centers around the world present the collaborative perspectives, concepts, and state-of-the-art knowledge required to care for children with congenital and acquired heart disease in the ICU. Their multidisciplinary approach encompasses every aspect of the relevant basic scientific principles, medical and pharmacologic treatments, and surgical techniques and equipment. From the extracardiac Fontan procedure, and the Ross procedure through new pharmacologic agents and the treatment of pulmonary hypertension to mechanical assist devices, heart and lung transplantation, and interventional cardiac catheterization—all of the developments that are affecting this rapidly advancing field are covered in depth. Employs well-documented tables, text boxes, and algorithms to make clinical information easy to access. Features chapters each written and reviewed by intensivists, surgeons, and cardiologists. Integrates the authors' extensive experiences with state-of-the-art knowledge from the literature. Offers four completely new chapters: Cardiac Trauma, Congenital Heart Disease in the Adult, Congenitally Corrected Transposition of the Great Arteries, and Outcome Evaluation. Describes the basic pharmacology and clinical applications of all of the new pharmacologic agents. Details important refinements and developments in surgical techniques, including the Ross pulmonary autograft replacement of the aortic valve, video-assisted fluoroscopy, and the extracardiac Fontan connection, and discusses their indications and potential complications. Explores the latest advances in the treatment of pulmonary hypertension, new developments in mechanical assist devices, heart and lung transplantation, and interventional cardiac catheterization. Examines issues affecting adults with congenital heart disease.