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This book serves as a clinical guide for the growing number of Advanced Practice Clinicians (APC) who care for stroke patients. It covers the entire spectrum of stroke care: acute, inpatient, and outpatient, as well as fundamental topics like neuroanatomy and radiology. Each chapter succinctly reviews crucial topics designed to guide APCs of any experience level with clinical decision-making. To further enrich the text, we incorporated guidelines, relevant trial data written in plain language, decision-making algorithms, clinical pearls, and case vignettes. Since this is a book for APCs, each chapter is written in a clear, clinically focused manner by an experienced APC with a collaborating physician. We hope this is a helpful resource not only for APCs in neurology but also for those practicing in other specialties, primary care, and students learning about stroke care.

This is the ultimate revision guide for candidates who are preparing to take the European Diploma in Anaesthesiology and Intensive Care (EDAIC) Part I and Part II examinations. This resource provides 303 practice questions and model answers for a complete guide to both parts of the examination. For Part I: Paper A, there are 135 example questions and model answers on physiology, pharmacology, anatomy, physics, and statistics. For Part I: Paper B, another 127 example questions and model answers cover general anaesthesia, regional anaesthesia, special anaesthesia, intensive care, internal medicine, and emergency medicine. To help candidates prepare for the Part II: the Oral part of the exam, there are five SOE-type questions and detailed worked answers addressing applied physiology, applied pharmacology, applied anatomy, clinical measurement, general anaesthesia, critical incidents, intensive care, and image interpretation for a total of 41 practice questions. Written by top quality authors who are or were previously experienced examiners within the European Society of Anesthesiology and Intensive Care (ESAIC), this is an authoritative guide to the EDAIC exam.

This book provides an overview of the etiology of coronary artery disease and focuses on the main therapies and drug interventions currently available. It highlights drug pharmacology and therapeutic challenges, with a special emphasis on the underlying principles of available therapeutics and the on-going development of drugs for coronary artery disease.The book is divided into eight chapters, the first of which describes the classical mechanism of coronary artery disease and its clinical presentations. Chapter 2 lists the principles of and related evidence on the prevention and treatment of coronary artery disease. This includes diet and lifestyle management, and guidelines for the treatment of acute coronary syndrome and stable coronary artery disease. In turn, Chapter 3 describes revascularization treatments, covering percutaneous coronary interventions, coronary artery bypass grafts and thrombolysis. This chapter also addresses the main therapeutic challenges.The following chapters provide an overview of three major categories of coronary artery disease drugs, which target thrombosis (Chapter 4), lipid metabolism (Chapter 5), and hypertension (Chapter 6). Heart failure constitutes the major health burden in the late stage of coronary artery disease; accordingly, current heart failure therapeutics and related drug pharmacology are described in Chapter 7. In closing, Chapter 8 provides a summary of on-going clinical trials for coronary artery disease drug development and discusses a number of promising areas in which intensive research into new therapeutics is being pursued.Given its scope, the book will be of interest to clinicians, medical students and research scientists, as well as to pharmaceutical professionals who are seeking new therapies and drugs for coronary artery disease and related disorders.

In this concise but authoritative book, the authors take the reader through the epidemiology, risk factors and the basic mechanism of coronary artery disease. In addition, they explain how coronary microvascular dysfunction can lead to angina, even after successful angioplasty following a heart attack. The methods for diagnosis and the options for treatment are explained, ending with a discussion of the evolution of coronary angioplasty from balloon catheters to novel, fully resorbable polymeric drug eluting stents. Enclosed is a list of currently available commercial devices, as well as a listing of experimental products under research and development, so that readers can appreciate the serious nature of this disease and have an understanding of how the medical device sector is attempting to address this major healthcare problem. Globally in 2010, ischemic heart disease was the cause of 13.3% of all deaths. In the US alone, the direct medical costs from coronary artery disease andstroke are currently estimated to be $126 billion per year, and are expected to rise to $309 billion by 2035.

The book is a useful guide to the management of the most-debated hot topics of practical interest in anesthesia and intensive care. It reviews the state of the art of issues related to both intensive care medicine and anesthesia, such as assisted ventilation, ultrasound assessment of renal function, sedation during non-invasive ventilation, subarachnoid hemorrhage, coagulation disorders in septic shock, difficult airways management and hemodynamic monitoring during anesthesia.Written by leading experts and including updated references, it provides a comprehensive, easy-to-understand update on anesthesia and intensive care. The book clearly explains complex topics offering practicing clinicians insights into the latest recommendations and evidence in the field while, at the same time, making it a valuable resource for students new to the study of anesthesia and intensive care.

Cardiovascular Thrombus: From Pathology and Clinical Presentations to Imaging, Pharmacotherapy and Interventions provides a comprehensive, up-to-date presentation of the research and clinical practices as related to the contemporary aspects of the diagnosis and management of cardiovascular thrombosis. The formation, identification and management of cardiovascular thrombus is of paramount importance for researchers and practicing physicians, yet it remains one of the most challenging diagnostic and clinical scenarios. This important reference connects between research, up-to-date clinical knowledge, and the technological tools available for diagnosis and management of thrombus in cardiovascular medicine. The book includes comprehensive descriptions and review of pathology, clinical presentations, diagnosis, pharmacotherapy, interventions and future trends. It is the perfect reference for basic science students and researchers in general and interventional cardiology, general and interventional radiology, vascular medicine specialists, and vascular, general and cardiac surgeons. Provides comprehensive presentation of the pathophysiology, clinical presentations and diagnosis of cardiovascular thrombosis Includes the most up-to-date information on the practical management of patients with thrombus related conditions Written by the leading experts in the field Describes the current and upcoming pharmacotherapy and technology available for thrombus research and treatment

This book demonstrates that a pandemic of coronary heart disease occurred in North America, western and northern Europe, and Australia and New Zealand from the 1930s to about 2000. At its peak it caused more deaths than any other disease. The book examines and compares trends in coronary heart disease mortality rates for individual countries. The most detailed analyses are for the United States, where mortality rates are examined for race, sex, and age groups and for geographic regions. Popular explanations for the rise and fall of coronary heart disease mortality rates are examined.

This book reviews current science and applications in fields including thrombosis and hemostasis, signal transduction, and non-thrombotic conditions such as inflammation, allergy and tumor metastasis. It is a detailed, up-to-date, highly referenced text for clinical scientists and physicians, including recent developments in this rapidly expanding field. More than a scientific resource, this is also an authoritative reference and guide to the diagnosis.

Vascular surgery has seen a remarkable evolution. A discipline focused on the natural history and treatment of vascular disease by open operation is now primarily a minimally invasive specialty. Mastery of the basic pathophysiology has been retained while the transformation by improved imaging and endovascular intervention has been integrated into practice.This fourth edition of Vascular Surgery: Principles and Practice has incorporated these advances building on the specialty's past assets. Knowledge of natural history and open surgery will always have an essential role in optimal care of patients with vascular diseases. The authors'exposition of the old and the new will make this edition a valuable resource for vascular surgeons and all others dedicated to the care of vascular patients.

Present research on the relationship between thrombosis and circulation is collected in this volume. Basic and clinical studies of thrombosis, fibrinolysis and platelets are reported. In particular, new proteins found in leeches or snakes which might be used to treat or prevent thrombosis are discussed.

Vascular pathology is essentially based on a transverse, the main basic lesions, this book provides precise multi-organ approach to pathology. It has been the descriptions in all of the main areas : atherosclerotic, subject of only a few reference works as it tends to be inflammatory, dysplastic, and traumatic diseases, etc. ignored by organ specialists. However, the vascular Throughout this book, the lesions are precisely system is widely distributed in all tissues ; it is modelled described with identification of the various recognized very early during organogenesis by haemodynamic syndromes and discussion of the main established factors, it possesses a remarkable reactivity and pathophysiological interpretations, together with a plasticity, and it is involved in a large number of complete bibliography. pathological processes. General pathologists are often poorly equipped to interpret morphological features We hope this book, based on the authors'medical and encountered during histological examination and to scientific knowledge, has the success it deserves. We integrate these findings into a rational approach. would like to thank them for giving us a very well documented book, which will be useful to both This book by Doctor Phat N. VUONG and Professor students and experienced pathologists.

Deep venous thrombosis (DVT) is the third most common cardiovascular disease. Two-thirds of patients with DVT are first episodes, and the remainders are recurrences. Pulmonary embolism is the most common complication of DVT. And now, DVT and pulmonary are considered two spectra of the same disease, namely venous thromboembolism (VTE). This book provides a comprehensive review of current diagnosis and treatment of DVT. This book includes chapters on clinical approaches in DVT, VTE and cancer, prevention of DVT in neurological surgery, combination of pretest clinical probability score and different D-dimer cutoff value for exclusion of VTE, ambulatory therapy for DVT, management of DVT with oral anticoagulant, surgical intervention for acute DVT, and recent multicenter survey of DVT from Japan. In this book, the mechanisms of VTE, diagnostic strategy of DVT, various treatment options for DVT, and prevention of VTE are discussed.

To give an update in the field of haemostasis scientists and clinicians fromoverseas and European countries met to dis- cuss the new trends in pathophysiology and clinical impli- cations. This book is devoted to the interactions of endo- thelial functions, tissue factors, coagulation inhibitors and haemostasis as well as detection and prophylaxis of thromboembolism. Data are presented of significant new re- search work on molecular and clinical approaches to diseases in haemostasis.

Editing a book of this nature was a simultaneously exhilarating and frightening experience. It was exhilarating to draw from cell biologists, biochemists, and molecular biologists, as well as those dermatologists, pathologists, and pul­ monologists who are cell biologists at heart, to author chapters. At the same time, it was frightening to ask such busy investigators to devote their precious time to writing chapters that summarize not just their own endeavors but their entire area of expertise. However, the authors assuaged our fears by enthusi­ astically accepting the proposal to write on specific topics despite the time burden, and to update and willingly accept our editorial comments. In the editors'view, the authors have captured the important scientific data in their respective fields, have organized the data into an understandable outline, and have applied the information to elucidating wound repair processes. The explosion of new, important discoveries in the field of wound repair and related areas as our book was developing has been very unsettling. This observation predicts obsolescence. In response to this possibility, the authors and the editors have attempted to build fundamental concepts upon existing data. Hopefully, these concepts will help provoke further experimentation to unravel the complex, interwoven processes of wound repair. The book has been organized into three parts: Inflammation, Granulation Tissue Formation, and Extracellular Matrix Production and Remodeling.

This symposium is devoted to Biotechnology in Blood Transfusion; there are 22 experts discussing the state of the art in the application of monoclonal anti­ bodies, recombinant DNA technologies and heterologous expression systems to the improvement and sometimes replacement of blood products, charac­ terization of blood constituents, and the effect of these developments on blood transfusion procedures. Ten and maybe five years ago the title of a symposium such as this would have been Biosciences in blood transfusion, informing what basic developments in molecular biology, biochemistry and human physiology might pertain to blood transfusion in the distant future. That future is getting closer, and not only one is interested in basic developments in immunology, recognition and identification of viral and bacterial components and products, tissue and blood bloodgroup blood group typing, typing, but also in the potential application of these developments and their economic perspectives. That is what biotechnology is all alI about: basic science telIs tells us where and how we might look for new technologies, and the development of such tech­ nologies is only possible if there is a perspective for improvement in quality, safety, acceptance or performance to cost ratio.

The participation of endothelial cells in various physiologic and pathologic processes has been hypothesized since before the turn of the century. However, until recently, direct evidence for endothelial involvement in these processes has been extremely difficult to obtain due to the inability to study endothelial cell function in vitro. Though the possibility of using cultured endothelial cells to study endothelial cell function in vitro was recognized many years ago, the inability to culture unambiguously identifiable endothelial cells limited investigators in their studies of endothelial function. As a result, the field of endothelial cell biology lay relatively fallow for many years. The development in the early 1970's of routine and easily implemented methods for culturing human endothelial cells and the demonstration that cultured endothelial cells synthesized a physiologically relevant protein, Factor VIII/von Willebrand Factor, quickly changed this state of affairs. Over the following decade the scope of endothelial cell research rapidly widened, spreading in a number of directions. First, methods were developed to culture endothelial cells from a variety of species. Second, methods were developed to culture endothelial cells from different organs and types of blood vessels (arteries, veins, and capillaries) within a single species. Third, and most important, investigators began using cultured endothelial cells as tools to study the potential involvement of endothelial cells in a wide assortment of biologically interesting processes. The net result has been a tremendous increase in our understanding of endothelial cell function.

This volume represents a part of the scientific proceedings of the Sixth Annual Meeting of the American Section of the International Society for Heart Research that was held in Oklahoma City from September 13-15, 1984. The chapters have been grouped according to the content of invited symposia on cardiovascular topics ranging from electrophysiology, autonomic control of the circulation, aging of the myocardium, mechanisms of cardiovascular injury, cultured heart cell studies, etc. Abstracts of all the papers presented at this meeting are included in Volume 16 (Supp. 1) of the Journal of Molecular and Cellular Cardiology. Since our understanding of the pathobiology of cardiovascular injury requires integrating knowledge from both basic and clinical sciences, the information presented in this volume extends from fundamental biochemical processes to pharmacological agents required to treat complex cardiac arrhythmias. At the molecular level, the structural lipids of the sarcolemma may be altered during myocardial ischemia; the role of free radicals in this process is one emerging area of active study. At the subcellular level, plasma membranes provide the anatomical basis for maintenance of optimal potentials of excitable cells; the anatomy and physiology of the sarcolemma ultimately determines the response to drugs and metabolic perturbants. At the cellular level, much progress has been made in our understanding of cultured and adult myocytes during ischemia and hypoxia; in particular, the electrophysiology of these model systems is well understood and several chapters address this approach.

Varicose veins are a very common problem. The precise aetiology of primary varicose veins remains unclear. It seems likely from the available evidence that inherited structural weakness combined with haemodynamic or microcirculatory abnormalities eventually lead to reduced vein wall elasticity, dilatation and the formation of varicosities. Increasing age, female gender, parity and occupation may all promote the development of varicose veins in susceptible individuals. Further clinical and experimental studies are necessary if the relative contribution of each of these factors is to be fully elucidated. References 1. Editorial. The treatment of varicose veins. Lancet 1975;ii:311. 2. Prerovsky I. Diseases of the veins. World Health Organisation, internal communication, MHO-PA 10964. 3. Weddell JM. Varicose veins: pilot study. Br J Surg 1969;23:179-186. 4. Hobsley M. Pathways in surgical management. 2nd ed. London: Edward Arnold, 1986. 5. Browse NL, Burnand KG, Lea Thomas M. Diseases of the veins. London: Edward Arnold, 1988. 6. Logan WPD, Brooke EM. The survey of sickness. Studies on medical and population subjects no. 12. London: General Register Office, 1957. 7. The committee on the Danish national morbidity survey. The sickness survey of Denmark. Copenhagen, 1960. 8. US Department of Health. Education and welfare: national health survey 1935-1936. Washington, DC, 1938. 9. The Department of National Health and Welfare and the Dominion Bureau of Statistics. Illness and health care in Canada. Canadian Sickness Survey 1950-1951. Ottawa, 1960.

Ventricular fibrillation is a cause of cardiac arrest and sudden cardiac death. The ventricular muscle twitches randomly, rather than contracting in a coordinated fashion (from the apex of the heart to the outflow of the ventricles), and so the ventricles fail to pump blood into the arteries and into systemic circulation. Ventricular fibrillation is a sudden lethal arrhythmia responsible for many deaths mostly brought on by ischaemic heart disease. Acute coronary syndrome (ACS) is a set of signs and symptoms related to the heart. ACS is compatible with a diagnosis of acute myocardial ischemia. This book presents current research from across the globe in the study of ventricular fibrillation and acute coronary syndrome, including clopidogrel response in acute coronary syndrome; primary ventricular fibrillation in'tako-tsubo'syndrome; and ECG predictors of fibrillatory events

Management of Acute Pulmonary Embolism highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts, who have each made noteworthy contributions in this exciting field. 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. The authors critically review and interpret available data, and provide clear recommendations for diagnosis and therapeutic concerns in clinical management of PE patients. Management of Acute Pulmonary Embolism is organized in three precise sections - diagnosis, treatment, and special topics. Each section is up-to-date and detailed, and provides clear recommendations for diagnostic and therapeutic approaches to patients with PE in clinical practice. This practical volume is an essential starting point for future study for both medical students and established investigators.

Transoesophageal Echocardiography (TOE) has a major impact on patient management during the perioperative period. It is an evolving tool in diagnosis of cardiovascular disease and haemodynamic assessment. The knowledge required for the examination and the practice of TOE is enormous and is continuously evolving. Consequently there is a clear need for a new comprehensive text written by experts involved in the perioperative care, not (only) by the cardiologists or full time echocardiographers.

TThis volume contains expert articles on the physiology and function of the microvascular and microlymphatic systems, the physiology of microvascular fluid filtration and reabsorption, interactions between blood cells and the microvascular endothelium, and molecular mechanisms of leukocyte activation. The therapeutic goals in chronic venous insufficiency include reduction of postischemic leukocyte-endothelial cell interaction, repair of microvascular barrier and improvement of microlymphatic drainage. In addition to measures to counteract inflammatory reactions elicited by local ischemia, surgical procedures such as transplantation of lymph vessels and subfascial division of perforating veins by an endoscopic approach are reviewed. Written by leading experts in the field, this book provides the first synopsis of the role of microcirculatory disturbances in chronic venous insufficiency. It will be of particular interest to phlebologists, angiologists, dermatologists, gerontologists, vascular, plastic and reconstructive surgeons, and general physicians.

Teleologically, the hemostatic mechanism is among The of Coronary Thrombosis and the most fundamental yet complex physiologic pro- in essence, represents a heartfelt gift of cesses in humans. Early scientists and physicians were knowledge from a dedicated group of scientists and fascinated by the blood's ability to remain in a liquid clinicians, who collectively have set out on a mission state only to clot in response to vascular injury. The to minimize the societal impact of'hemostasis in the cellular and noncellular components of normal wrong place.'The book is divided into four distinct hemostasis took centuries to discover, and the intrica- sections: Part 1, Scientific Principles, lays down the cies of their delicate interactions are still being unrav- supporting foundation; Part 2, Clinical Application eled today. As is so often the case, an in-depth of Scientific Principles, places the knowledge base in appreciation of physiologic hemostasis, representing a a working perspective, directly applying science to basic life-sustaining sequence of events, paved the patient care; Part 3, New Dimensions, provides a way for understanding abnormal hemostasis or glimpse of tomorrow. Steering the field clear of se- pathologic thrombosis. Aristotle, Malpighi, and proclaimed victory and the dangers of complacency as Osier, representing but a few of the founding fathers we move into the 21st century, Part 4, Evolution of in the field, would undoubtedly be honored to see Thrombocardiology, focuses on laboratory standards, their observations form the template for lifesaving clinical trials, and drugs in development.