Currently, available information on pediatric and adolescent diabetes is limited to chapters in larger books covering the broader topic of pediatric endocrinology, and these do not have the space to delve into specific topics. This concise, timely book contains everything that a practicing provider needs to know in order to provide comprehensive, up-to-date care for children and adolescents with diabetes, from the latest methods for diagnosing various types of diabetes to integrating cutting-edge technology in the care of this patient population. Initial management, the use of insulin pumps, continuous glucose monitoring, and automated insulin delivery are discussed in detail, as are nutrition therapy, exercise, psychosocial challenges, acute and long-term complications, and future directions for treatment and research. Further, this book provides clinicians with guidelines for the implementation of best practices as outlined by leading associations such as the American Diabetes Association (ADA) and International Society of Pediatric and Adolescent Diabetes (ISPAD).
The Yale Children's Diabetes Program has been ranked among the best in the United States, including clinicians and researchers who are world-renowned for their efforts in improving the care of children with diabetes. This wealth of knowledge and experience positions the author team well as experts in this field.
This volume examines the role of mitochondria in different types of cell death, including apoptotic and necrotic cell deaths. Topics discussed include mitochondrial outer membrane permeabilization (MOMP) and the permeability transition pore; core processes such as calcium handling, fission and fusion, reactive oxygen species generation, and maintenance of mitochondrial DNA fidelity and protein folding homeostasis; and retrograde signaling between mitochondria and other cellular components, including the important role of mitochondria in antiviral immunity. The expertly authored chapters are drawn from multidisciplinary international perspectives, lending a nuanced and comprehensive approach to the material. Mitochondria and Cell Death, part of the Cell Death in Biology and Diseases series, is invaluable reading for graduate students, researchers, and clinicians in the fields of neuroscience, oncology, gastroenterology, and hepatology, as well as those interested in the study of mitochondria and cell biology.
This comprehensive volume presents an approach based on cutting edge clinical science to the integration of healthy behaviors in clinical practice, using three major categories; healthy eating, active living, and mindfulness. Chapters are authored and edited by a select group of national and international experts in their respective fields who have developed these concepts for application in routine practice. All chapters are formatted to provide key learning points and summarized conclusions for easy reference. Topics include the DASH diet, plant based nutrition, the Mediterranean diet, beneficial herbs and spices, fitness, spirituality, meditation, healthy sleep, and disease prevention.
Nutrition, Fitness, and Mindfulness will be a useful guide for all clinicians and healthcare professionals encouraging patients to make more thoughtful and healthy lifestyle choices.
This book on urologic ultrasound has proven to be beneficial to urologists in training and currently in practice, and is structured by organ system for the practice of urology in the outpatient/office setting. The second edition expands on current techniques and procedures, includes ultrasound images, and gives new information on the use of ultrasound for the diagnosis and management of male reproductive conditions. The updated edition also discusses ultrasound in the intraoperative setting, chapters on male reproduction, ultrasound protocols, and standards for urologic practices performing ultrasound.
Bolstered with detailed illustrations and contributions from experts in the field, Practical Urologic Ultrasound, Second Edition is an authoritative and practical reference for all urologists worldwide in their mission to provide excellence in patient care.
This book comprehensively covers chronic lung disease and cardiovascular disease and their influence on one another including the epidemiology, physiology, risk factors, pathophysiology, clinical features, diagnostic issues including laboratory and imaging tests, and therapeutic considerations. How the diseases specifically overlap is explored in detail, covering presentation, symptoms, clinical examination findings, diagnostic test results, as well as a number of important medication interactions. The cardiovascular considerations in this book will include left ventricular systolic and diastolic dysfunction, pulmonary hypertension and right ventricular disease, as well as cardiac arrhythmias. The book also addresses extra-cardiac cardiovascular comorbidities such as cerebrovascular disease and peripheral arterial disease. Each chapter includes detailed illustrations as well as useful pearls and best practices, making this an ideal reference for pulmonologists, cardiologists, and residents caring for patients with increased risk for these comorbidities.
This book is a comprehensive guide to the diagnosis and management of all stages of pulmonary embolism, starting with acute and ending with chronic thromboembolic pulmonary hypertension. Acute pulmonary embolism (PE) is responsible for 150-250,000 hospitalizations and 60-100,000 deaths each year in the United States, making it the third most common cause of cardiovascular death. Acute PE spans a wide spectrum of clinical outcomes mainly based on the right ventricle's (RV) capacity to tolerate strain. There have been many recent advances in the field of PE, including guidelines on classification and risk stratification, anticoagulation, as well as evolving areas in treatment options and follow up.The text begins with a review of the epidemiology and risk factors for PE. Chapters then delve into reviewing the decision pathways based on PE severity and treatment options, including the use of oral anticoagulation, systemic and catheter-directed thrombolysis, mechanical and surgical thrombectomy, and hemodynamic support with extracorporeal membrane oxygenation. The text then focuses on post-PE complications such as post-PE syndrome, chronic thromboembolic disease, and chronic thromboembolic pulmonary hypertension (CTEPH).This is an ideal guide for providers of lung health, including pulmonary and critical care physicians, cardiologists, thoracic and cardiovascular surgeons. Physician-trainees, physician assistants, nurses and respiratory therapists with interest in pulmonary disorders, cardiovascular disease, pulmonary embolism, critical care or pulmonary hypertension will also find great value in this comprehensive guide.
This book serves as the primary reference for precision medicine in the fields of pulmonary, critical care and sleep medicine by documenting principles written by experts in several aspects of precision medicine. It combines fundamental concepts of the field with state-of-the-art studies and how they translate into individual preventive, diagnostic and therapeutic plans. Precision medicine is focused on the integration of individual variability with disease prevention and treatment principles derived from population studies. This concept has risen to prominence in recent years in parallel with advances in genetics, molecular diagnostics and novel target-specific therapies. This fundamental shift in the approach to treatment has broad implications in how we prevent, diagnose and treat disease. Describing key concepts of precision medicine and relating these to pulmonary, critical care and sleep disorders is essential to educate relevant stakeholders and increase the impact of pulmonary precision medicine. The book is organized into seven sections: introduction; genetics; biomarkers; precise phenotyping; mobile health, wearables and telemedicine; precision therapeutics; and enabling widespread adoption of precision medicine. The chapters are organized with an introduction to the specific theme, followed by its basic concepts. They then delve into how these basic concepts relate to the larger theme of precision medicine, new precision medicine approaches to dealing with these problems, and key takeaway points. Liberally illustrated with images, figures, and tables, the text is thorough and intuitive for clinicians and researchers to learn the processes and applications of precision medicine. This is an ideal guide for clinicians to learn new precision medicine concepts in the fields of genetics, genomics, mobile health, and how they apply to their practice and their patients, as well as researchers seeking a basic understanding of precision medicine to assist in designing future research studies.
This book provides a comprehensive overview of the multisystem disease, cystic fibrosis, for both pediatric and adult patients. Written by experts in the field, the text outlines the progressive nature of CF as well as the impact of this autosomal recessive disease on the respiratory, gastrointestinal, endocrine, rheumatologic, and renal systems, as well as the patient's mental health. The book begins with a chapter describing the history of cystic fibrosis and how the face of this life-shortening disease has changed over the past several decades. The following chapters elucidate the pathophysiology of how cystic fibrosis impacts each organ system. Current management and therapeutics are detailed with step-by-step guidelines for clinicians. This book is unique in that it highlights the entire person, not just the respiratory system, with detailed inclusion of the patient perspectives throughout, informing practice standards and considerations. This is an ideal guide for pediatric and adult physicians who care for patients with cystic fibrosis, as well as respiratory therapists, physical therapists, nurses, nutritionists, and pharmacists who care for these patients.
Part I. Introduction
Cardiac Safety of Noncardiac Drugs: Historical Recollections
Raymond John Lipicky
Part II. Preclinical and Pharmacogenomic Cardiac Safety Evaluations
Molecular Physiology of Ion Channels That Control Cardiac Repolarization
Jeanne M. Nerbonne and Robert S. Kass
Cellular, Molecular, and Pharmacologic Mechanisms Underlying Drug-Induced Cardiac Arrhythmogenesis
hERG Assay, QT Liability, and Sudden Cardiac Death
Arthur M. Brown
Pharmacogenomics in Drug Development: When and How to Apply
Richard Judson and Arthur J. Moss
Part III. Clinical Methodologies and Technical Aspects of Assessing Cardiac Safety of Investigational Drugs: Focus on Cardiac Repolarization
/> Assessment of Ventricular Repolarization From Body-Surface ECGs in Humans
Jean-Philippe Couderc and Wojciech Zareba
ECG Acquisition and Signal Processing: 12-Lead ECG Acquisition
Justin L. Mortara
Digital 12-Lead Holter vs Standard Resting Supine Electrocardiogram for the Assessment of Drug-Induced QTc Prolongation: Assessment by Different Recording and Measurement Methods
Holter Monitoring for QT: The RR Bin Method in Depth
Fabio Badilini and Pierre Maison-Blanche
Part IV. Application of Electrocardiology in Clinical Research
Fundamentals of ECG Interpretation in Clinical Research and Cardiac Safety Assessment
Ihor Gussak, Robert Kleiman, and Jeffrey S. Litwin
Design and Conduct of the Thorough Phase I ECG Trial for New Bioactive Drugs
Use of ECGs in Support of Cardiac Safety in Phase II and III Clinical Trials
Martin P. Bedigian
Cardiac Arrhythmia Assessment in Phase IV Clinical Studies
Gerald A. Faich and Annette Stemhagen
Statistical Analysis Plans for ECG Data: Controlling the Intrinsic and Extrinsic Variability in QT Data
Alan S. Hollister and Timothy H Montague
Interpretation of Clinical ECG Data: Understanding the Risk From Non-Antiarrhythmic Drugs
Rashmi R. Shah
Part V. Regulatory Considerations
The FDA's Digital ECG Initiative and Its Impact on Clinical Trials
Barry D. Brown
Quality Control and Quality Assurance for Core ECG Laboratories
Amy M. Annand-Furlong
ECG Digital Communities and Electronic Reporting of Cardiac Safety Data: New Technologies for Reporting Digital ECG Data in Clinical Research Settings
Scott Grisanti and Robert Brown
With the growth of combined clinical neurophysiology fellowship training programs and their corresponding "pan-physiology" board examinations, there has been an increased need for educational materials that span the range of clinical neurophysiology topics. The Clinical Neurophysiology Primer aims to meet this need by providing a broad and intentionally basic treatment of the most central topics within clinical neurophysiology. The Clinical Neurophysiology Primer initially took shape within the clinical neurophysiology sections at Beth Israel Deaconess Medical Center and Rhode Island Hospital, as an outgrowth of their fellowships' didactic lecture series. Faculty and trainees at these and affiliated teaching hospitals participate in a series of lectures over the course of the academic year designed to acquaint trainees with the elements of clinical neurophysiology, supplementing their clinical experiences. We hope that this primer will prove valuable to others as a companion book intended for clinical neurophysiology fellows and neurology residents, to be used in conjunction with such a program of lectures.
This fully updated and revised new edition provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in prostate cancer. The book reviews new data about molecular characteristics of the disease, profiles the new grading system for prostate cancer introduced in 2015, and provides new perspectives about imaging of prostate cancer, as well as the role of targeted biopsies. The text summarizes the role of biomarkers and MRI in patient selection and management and details the world wide results of active surveillance. Specific chapters address communication and ethical issues, QOL outcomes, economic aspects, and psycho-social aspects of surveillance. The role of focal therapy for low risk disease is summarized, and the data supporting preventive interventions during surveillance reviewed. This text will serve as a very useful resource for physicians and researchers dealing with, and interested in this common malignancy, as it provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.
This book is designed to provide a comprehensive and state-of-the-art resource for clinicians who care for patients with sepsis and research scientist alike, . Patients with severe sepsis requiring ICU admission have very high rates of ICU and overall hospital mortality, with estimates ranging from 18 to 50%. Risk factors for death from sepsis include underlying illness, increased age, and multi-system organ failure. This is compounded by the significant variation in the management of early severe sepsis. Care of these patients and clinical conditions can be quite complex, and materials are collected from the most current, evidence-based resources. Book sections have been structured to review the overall definitions and epidemiology of sepsis as well as current insights into the pathophysiology of sepsis. This review summarizes the evidence for the international consensus guidelines for the identification and management of sepsis. The latter part of this book reviews emerging concepts and approaches in the diagnosis and management of sepsis that may significantly reduce mortality in the future. Sepsis: Pathophysiology, Definitions and the Challenge of Bedside Management represents a collaboration between authors drawn from a variety of disciplines and contributions from basic scientists and highly recognized clinical opinion leaders with expertise in clinical trials.?
Acute Respiratory Distress Syndrome (ARDS) remains an important cause of morbidity and mortality worldwide, and the incidence is predicted to increase with the aging population Several clinical disorders can initiate ARDS, including pneumonia, sepsis, gastric aspiration and trauma but despite intense research over the past 40 years, we still have an incomplete understanding of the pathophysiology of the disease and treatment remains largely supportive. This book provides an overview of acute lung injury and repair, describes current animal models to study lung injury and reviews current methodologies to study and measure lung injury and repair. Special emphasis is given to state of the art techniques and methods and relevance to human disease. Acute Lung Injury and Repair: Scientific Fundamentals and Methods is a useful resource for physicians and scientists who are interested in experimental model systems for insight into ARDS pathogenesis and treatment strategies. ?
This book offers a comprehensive overview of alpha-1 antitrypsin deficiency, an inherited condition that leads to lung disease in adults and liver disease in adults and children and is associated with chronic obstructive lung disease in adults. While it is a rare condition, the mechanisms underlying the clinical manifestations of this deficiency have been largely clarified. Treatment, however, is available only for the lung disease that arises from the condition, thus necessitating continued research into new and alternative therapeutic solutions. The book discusses the biology of alpha-1 antitrypsin, protein misfolding and polymerization, and diagnosis and treatment of alpha-1 antitrypsin deficiency and its associated diseases. It concludes with a discussion of rare disorders linked to alpha-1 antitrypsin deficiency and the role of healthcare organizations in the treatment of these diseases. Written for pulmonary clinicians and scientists, Alpha-1 Antitrypsin: Role in Health and Disease is a valuable resource that sheds light on this rare disease.
This thoroughly updated edition covers all clinical aspects of neuroinflammation. The latest developments in pathogenesis and advances in treatment are provided, along with an understanding of the immune system's role and interactions between the activated immune cells, cerebral endothelial cells, and other main components of the immune cascade. Cutting-edge and authoritative, this volume offers practitioners a valuable resource for research and clinical practice.
This book provides a comprehensive framework for treatment and management of bronchopulmonary dysplasia. In recent years great strides have been made toward understanding the pathogenesis and clinical aspects of BPD, which is the most common chronic lung disease affecting infants. This one-stop resource is written by leading scientists and clinicians in the field, and chapters discuss the most recent developments in the basic scientific, translational, and clinical characteristics of the disease. Topics such as hyperoxia, pre- and post-natal inflammation, and genetics and biomarkers of BPD are included, as well as non-invasive ventilation techniques, nutrition, and radiology applications from pre-term birth to adulthood. The book closes with an in-depth look at emerging therapeutic options for prevention of BPD. Bronchopulmonary Dysplasia is an essential volume for all neonatologists, pediatric pulmonologists, and scientists interested in developmental disorders of the lung.
This book presents pulmonary outcomes of prematurity, from their emergence in infancy through to their consequences in adulthood. With an increasing number of preterm births and more infants surviving, there is now a larger population of adults with lung disease originating in infancy requiring specialized care. Looking at the whole group of preterm infants, not just those with bronchopulmonary dysplasia, this text covers a wide spectrum of pulmonary outcomes, including: pulmonary hypertension, wheezing, and alterations in sleep. The chapter authors focus on critically appraising what is and is not known about each outcome and suggest key questions that still need to be answered. Respiratory Outcomes in Preterm Infants: Sequelae from Infancy through Adulthood is an ideal reference for the multidisciplinary group that cares for these preterm infants and the adults they become, including: neonatologists, pediatric pulmonologists, pediatricians, adult pulmonologists, primary care physicians, nurses, and fellows.
Ultrasound in the Intensive Care Unit explores the current state of evidence supporting use of bedside ultrasound for procedural guidance and for the critical care-focused assessment of a variety of organ systems. This text covers standard practice areas, such as ultrasound guidance for vascular access in the ICU, as well as novel, less well-known applications such as the use of ultrasound for assessment of diaphragm function in patients with respiratory failure. As current ultrasound education is often dependent on widely varying local expertise, this book serves as a standard reference in what is at present a fragmented and challenging field of study for busy clinicians. By providing a comprehensive overview of the current state of critical care ultrasonography, with content contributed by experts in the field, this text will serve as a valuable resource that will allow education in critical care ultrasound to keep pace with the rapid technological growth that has driven this vital area of critical care medicine. Ultrasound in the Intensive Care Unit is essential reading for pulmonologists, practitioners in internal, hospitalist, and critical care medicine; educators and instructors in critical care ultrasound; and medical students, residents, and critical care trainees.
?Newly revised and updated, this book provides geriatricians and orthopedic surgeons with the most vital tools to treat elderly patients who sustain a variety of fractures. The text uniquely encompass the etiologies of fracture in the elderly, perioperative management, the surgical treatment of common fractures in the elderly, as well as rehabilitation and prevention in the older patient. It focuses on the most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Unlike any other text, experts in both orthopedics and geriatrics review the content of each chapter for readability and appeal to his/her respective discipline, making this the physician's ultimate guide to treating elderly patients with injuries. Fractures in the Elderly, Second Edition is a valuable resource for geriatricians, orthopedic surgeons, physiologists, and rehabilitation specialists.
Cancer cell biology research in general, and anti-cancer drug development specifically, still relies on standard cell culture techniques that place the cells in an unnatural environment. As a consequence, growing tumor cells in plastic dishes places a selective pressure that substantially alters their original molecular and phenotypic properties.The emerging field of regenerative medicine has developed bioengineered tissue platforms that can better mimic the structure and cellular heterogeneity of in vivo tissue, and are suitable for tumor bioengineering research. Microengineering technologies have resulted in advanced methods for creating and culturing 3-D human tissue. By encapsulating the respective cell type or combining several cell types to form tissues, these model organs can be viable for longer periods of time and are cultured to develop functional properties similar to native tissues. This approach recapitulates the dynamic role of cell-cell, cell-ECM, and mechanical interactions inside the tumor. Further incorporation of cells representative of the tumor stroma, such as endothelial cells (EC) and tumor fibroblasts, can mimic the in vivo tumor microenvironment. Collectively, bioengineered tumors create an important resource for the in vitro study of tumor growth in 3D including tumor biomechanics and the effects of anti-cancer drugs on 3D tumor tissue. These technologies have the potential to overcome current limitations to genetic and histological tumor classification and development of personalized therapies.
This book discusses normal sex-related differences in lung structure and function and the role these differences play in lung disease. New research on the effects of sex hormone signaling on specific cell types of the lung has begun to reveal how these hormones may drive or prevent lung disease. Expertly written chapters examine the effects of sex hormones on normal pulmonary structure and function, hormone signaling in lung health, and specific diseases such as chronic obstructive pulmonary disease, asthma, pulmonary hypertension, and lung cancer. Gender, Sex Hormones, and Respiratory Disease: A Comprehensive Guide focuses on our current understanding and the gaps in research, with suggestions for future directions and implications for therapy. This book is a useful reference for pulmonologists and researchers and will prompt further inquiry aimed at improving overall lung health.
This book provides an overview of pulmonary hypertensive diseases, the current understanding of their pathobiology, and a contemporary approach to diagnosis and treatment. It discusses the definition and classification of these disorders and the epidemiology of pulmonary arterial hypertension (PAH); explores the approach to diagnosis and evaluation via methods such as echocardiography, right heart catheterization, and cardiopulmonary exercise testing; describes the major drug classes used to treat PAH and the cell signaling pathways that they target as well as adjunct and investigative therapies; and highlights special situations that are particularly challenging in the management of PAH. Written by experts in their respective fields, Diagnosis and Management of Pulmonary Hypertension is a valuable resource for pulmonologists, cardiologists, and practitioners in internal medicine and critical care.
This book provides a unique frame work for examining acute lung syndromes that arise from hematologic disorders or is defined by a hematologic abnormality as a key feature. Acute lung processes arising from hematologic disorders can present as life-threatening conditions, and as such, the pulmonary physician or critical care physician are often directly involved in care or called upon to provide expertise. Chapters are organized into three sections, each with an emphasis on pathogenesis and current understanding of mechanisms. The text begins with the central theme of the lungs as the direct interface between the external environment and blood, description of individual components of the hematopoietic system, their function and relevance to the lungs. The second section outlines both benign and malignant primary hematologic disorders that can lead to acute pulmonary manifestations. The final section focuses on acute lung syndromes stemming from complications of transfusion and treatment. Chapters are presented in an easy-to-access format, providing information on diagnosis, management, and outcomes. This is a valuable resource for pulmonary fellows in training, pulmonologists, critical care physicians, and physicians involved in caring for patients in the ICU.
This book is an important new resource for clinicians caring for ventilator dependent children, who often have complex health care needs, are supported by advanced technology and are at high-risk of serious complications. Despite the complicated health care needs of children who rely on chronic respiratory support, there are few guidelines and little evidence available to guide the clinicians who care for these patients. This book covers the many aspects involved in the care of these complex children, with input from experts in the fields of pediatric pulmonology, intensive care, ethics, respiratory therapy, and nursing. In depth chapters provide an introduction to the use of chronic invasive and non-invasive ventilation in children and describe and review what is known about methods of delivering ventilator support, care of the chronically ventilated patient in the community , use of chronic ventilator support in patients with disorders commonly leading to respiratory failure and outcomes for patients and their caregivers. This book is intended to be useful not only for pediatric pulmonologists, but also for intensivists, cardiologists, physical medicine/rehabilitation specialists, nurses, respiratory therapists and the primary care physicians involved in the complexities of managing care for this unique group of special needs children.