Top level clinical and laboratory scientists present their most recent clinical and experimental findings and concepts. The well balanced contributions illustrate the enormous significance of the dialogue between both laboratory and clinic, ultimately for the benefit of the patients, and contribute to a better understanding of secondary brain damage from trauma and ischemia as basis to develop more effective treatment including drugs.

The publication of the Vth International Symposium 1995 on "Mechanisms of Secondary Brain Damage" in Mauls/ltaly is a collection of focused reviews reaching from novel molecular- and cell biological findings to aspects of clinical management in head injury and cerebral ischemia. A specific purpose of these series of meetings introduced in 1984 is for an exchange on problems of mutual interest by international high ranking experts from the basic sciences and related clinical disciplines, such as intensive care medicine, neurology, or neurosurgery. The present volume covers three major areas: (a) Molecular and cell biological mechanisms including inflammation (b) Novel findings on mechanisms and treatment in cerebral ischemia (c) Secondary processes in head injury, regeneration and treatment Molecular-and cell biology is currently attracting attention towards activation of genomic processes associated with the demise of cells referred to as "programmed cell death" and "apoptosis" which, actually, might be distinguished from each other. Thus, the phenomenon of delayed neuronal death in selectively vulnerable brain areas following brief interruption of blood flow is scrutinized as to the contribution of the activation of suicide genes. The physiological role of such a response, among others, is removal of surplus neurons during ontogenesis of the brain. Yet, evidence is accumulating that similar mechanisms playa role in cerebral ischemia, probably also trauma, where nerve-and other cells demonstrate features of apoptosis. Observations on protection of neurons by administration of protein synthesis inhibitors in cerebral ischemia provide more direct support.

A distinction between primary and secondary brain damage of vari ous origin, particularly in acute lesions, such as head injury and ische mia is not entirely new. The concept is of practical significance, be cause it is the foremost intention of all clinical efforts to prevent, or at least attenuate the development of secondary sequelae. Primary dam age to nervous elements usually cannot be influenced by treatment. Its prevention is the objective of prophylactic measures. The current volume gathered prominent scientists and clinicians from various fields to pro vide a competent introduction and survey of the various aspects involved in secondary brain damage. It was attempted to provide criteria for the distinction between the primary and secondary phenomena on a morpho logical and functional level, on the basis of the kinetics involved and, most importantly, regarding the different specific manifestations, such as disturbances of microcirculation, aspects of the blood-brain barrier, and of cellular structure and function at a molecular level. Although it was not expected that a grand unifying hypothesis will be reached recon cilable with the many, occasionally opposing views on such a complex subject, nevertheless, the present volume attains an appropriate result. It can best be described as a mosaic of many different pieces which only as an ensemble reflect the current state of the art.

Information is provided from the basic and clinical sciences on the mechanisms damaging the brain from trauma or ischemia. New aspects involve the endoplasmic reticulum, mitochondrial failure, pathobiology of axonal injury, molecular signals activating glial elements, or the emerging therapeutical role of neurotrophins. Experimental issues involve a better analysis of the ischemic penumbra, the salvagable tissue. Therapeutic contributions reach from the environmental influence to gene expression, including neuroprotection, such as hibernation – mother nature’s experiment – or hypothermia which is reported to induce cell swelling. Treatment issues deal also with thrombolysis and combination therapies, or with the clearance of adverse blood components – LDL/fibrinogen – by a novel procedure using heparin. Other highlights are discussing the specificities of pediatric vs. adult brain trauma, or the evolving role of the Apolipoprotein-E e4 gene in severe head injury. An update is also provided on an online assessment of the patient management during the pre- and early hospital phase in Southern Bavaria. The empirical observation of neuroworsening is analyzed in further details, whether this is a specificity autonomously driving the posttraumatic course. Finally, the unsolved question why drug trials in severe head injury have failed so far in view of the promising evidence from the laboratory is subjected to an expert analysis.

Textbook of Critical Care, by Drs. Jean-Louis Vincent, Edward Abraham, Frederick A. Moore, Patrick Kochanek, and Mitchell P. Fink, remains your best source on effective management of critically ill patients. This trusted reference - acclaimed for its success in bridging the gap between medical and surgical critical care - now features an even stronger focus on patient outcomes, equipping you with the proven, evidence-based guidance you need to successfully overcome a full range of practice challenges. Inside, you’ll find totally updated coverage of vital topics, such as coagulation and apoptosis in certain critical care illnesses, such as acute lung injury and adult respiratory distress syndrome; sepsis and other serious infectious diseases; specific organ dysfunction and failure; and many other vital topics. At www.expertconsult.com you can access the complete contents of the book online, rapidly searchable, with regular updates plus new videos that demonstrate how to perform key critical care procedures. The result is an even more indispensable reference for every ICU. Access the complete contents of the book online at www.expertconsult.com, rapidly searchable, and stay current for years to come with regular online updates. Practice with confidence by consulting with a "who’s who" of global experts on every facet of critical care medicine. Implement today’s most promising, evidence-based care strategies with an enhanced focus on patient outcomes. Effectively apply the latest techniques and approaches with totally updated coverage of the importance of coagulation and apoptosis in certain critical care illnesses, such as acute lung injury and adult respiratory distress syndrome; sepsis and other serious infectious diseases; specific organ dysfunction and failure; and many other vital topics. See how to perform key critical care procedures by watching a wealth of new videos online. Focus on the practical guidance you need with the aid of a new, more templated format in which basic science content has been integrated within clinical chapters, and all procedural content has been streamlined for online presentation and paired with videos.

Using the unique cycles of trauma framework, the 4th edition of this classic and highly acclaimed resource is thoroughly updated to bring you comprehensive coverage of cutting-edge research findings and current issues, trends, and controversies in trauma nursing. Detailed information guides you through all phases of care – from preventive care and the time of injury to the resuscitative, operative, critical, intermediate, and rehabilitative stages. Timely discussions on emerging topics such as mass casualty and rural trauma/telemedicine keep you up to date with the latest developments in the field. This practical, evidence-based reference is the most complete resource available for both novice and experienced trauma nurses working in a variety of care settings. - Comprehensive coverage includes practical, clinically relevant trauma information for nurses at all levels of knowledge and experience working in a variety of settings. - Evidence-based content ensures that you are using the latest and most reliable information available to provide state-of-the-art care for trauma patients. - A user-friendly format, logical organization, and helpful tables and illustrations help you find information quickly and clarify key concepts and procedures. - Detailed information guides you through all phases of care – from preventive care and the time of injury to the resuscitative, operative, critical, intermediate, and rehabilitative stages. - Special populations coverage prepares you to meet the unique needs of pregnant, pediatric, and elderly patients, as well as bariatric patients, burn victims, patients with substance abuse issues, and organ and tissue donors. - A section on Clinical Management Concepts gives you a solid understanding of key issues affecting all patients regardless of their injury, including mechanism of injury, traumatic shock, patient/family psychosocial responses to trauma, pain management, wound healing, and nutrition. - A new Mass Casualty chapter prepares you to act quickly and confidently in the event of a disaster, with guidelines for initial response and sustained response, lessons learned from recent disasters, government involvement, and hazmat, bioterrorism, and nuclear-radiological preparedness. - A new chapter on Rural Trauma/Telemedicine focuses on the unique nature of rural trauma care and offers strategies to help you improve healthcare delivery in this challenging environment. - A new Trauma in the Bariatric Patient chapter provides the specialized information you need to meet the challenges and needs of this growing patient population.

Jasper's Basic Mechanisms, Fourth Edition, is the newest most ambitious and now clinically relevant publishing project to build on the four-decade legacy of the Jasper's series. In keeping with the original goal of searching for "a better understanding of the epilepsies and rational methods of prevention and treatment.", the book represents an encyclopedic compendium neurobiological mechanisms of seizures, epileptogenesis, epilepsy genetics and comordid conditions. Of practical importance to the clinician, and new to this edition are disease mechanisms of genetic epilepsies and therapeutic approaches, ranging from novel antiepileptic drug targets to cell and gene therapies.

- NEW! Global Health Care boxes inform you about global healthcare concerns such as HIV/AIDS, Ebola, Tropical Diseases and more. Includes prevalence, mechanism of disease and transmission. - NEW! Over 1,000 illustrations help clarify complex pathophysiological concepts and make the book visually appealing - NEW! Thorough chapter updates include the latest information on new treatment advances, 100 new figures for improved clarity, and much more throughout the text.

**Selected for Doody's Core Titles® 2024 in Anesthesiology & Pain Medicine**Balancing must-know scientific knowledge with clinical applications, Cottrell and Patel's Neuroanesthesia, 7th Edition, reflects the latest developments in neurosurgical anesthesia, providing a comprehensive, authoritative overview of this challenging field. Clinically oriented chapters offer key clinical points, case presentations, and discussions, delivering the complete and authoritative guidance you need to ensure optimal perioperative care and safety for neurosurgical patients. Broad, clearly organized coverage of all important aspects of neuroanesthesia enables you to find reliable answers to any clinical question. - Integrates current scientific principles with the newest clinical applications, including current clinical management guidelines for neurosurgical patients. - Provides expert guidance on what to do under a variety of circumstances, the logic behind why it should be done, and tips for avoiding complications. - Includes clear, conceptual illustrations throughout, along with neuroimaging, clinical photos, charts and graphs, and clinical algorithms, making complex concepts easier to understand at a glance. - Covers the latest advancements in the field including cerebrospinal fluid hemodynamics and physiology, minimally invasive techniques, brain tissue oxygenation oximetry, microdialysis, neuroimaging and neurointerventional radiology, traumatic brain injury, pediatric neuroanesthesia, and acute treatment of depression. - Any additional digital ancillary content may publish up to 6 weeks following the publication date.