Kardiologi

The main goal of the second edition of this book is to update the content on the rapidly growing field of lymphoscintigraphy, a radionuclide-based imaging procedure that provides information on the functional status of the lymphatic system. Although the technique was originally introduced to identify the cause of peripheral edema (i.e., blockage of the venous or lymphatic circulation), more recent and widespread applications include radioguided biopsy of the sentinel lymph node in patients with solid cancers. This procedure is crucial for the adequate planning of oncologic surgery in a growing number of cancers, most notably breast cancer, cutaneous melanoma, head and neck cancers, penile cancer, and cervical cancer.The book focuses on the latest advances in lymphoscintigraphy techniques, including both novel tracers recently approved for clinical use (especially in the field of sentinel lymph node mapping) and the expanding role of hybrid imaging with SPECT/CT - and in sentinel node detection using hybrid tracers (radiolabeled and fluorescent) for dual-signature guidance. Each chapter addresses the clinical application of lymphoscintigraphy in different anatomic areas or disease conditions. After an introductory section concerning the pathophysiology of the specific site/disease, the clinical relevance and impact of lymphoscintigraphy is demonstrated by a collection of richly illustrated teaching cases describing the lymphoscintigraphic patterns most commonly observed, as well as anatomic variants and technical pitfalls. Emphasis is placed on tomographic multimodality imaging. The book gathers contributions by experts in nuclear oncology, who have revised their chapters by updating the didactic material and adding clinical cases. Regarding sentinel lymph node biopsy in particular, a major distinction of this text is the incorporation of the staging guidelines of the American Joint Committee on Cancer (8th edition) into the didactic material.

In this issue of Critical Care Nursing Clinics, guest editor and Heart Failure and Valve Coordinator Nicole Jones, APRN, CNS, brings her considerable expertise to the topic of Heart Failure and Transcatheter Aortic Valve Replacement. Critical care nurses are vital to improving patient outcomes and the delivery of quality care in patients with heart failure, including recent emphases on the in-patient admission, faster diagnosis of acute or decompensated heart failure, in-patient management in an appropriate care environment, and planned discharge. In this issue, top experts in the field provide current updates in both the clinical care of the heart failure patient as well as nursing interventions to improve outcomes. Contains 12 relevant, practice-oriented topics including patient symptom perceptions and lay consultations prior to hospitalization with HF and how clinicians can improve care; barriers to heart failure treatment optimization; the role of telemedicine in improving GDMT for heart failure patients during a pandemic; nurse-led anesthesia for TAVR or other TAVR patient care improvements; TAVR efficiency/screening and care pathways for improving efficiency while maintaining outcomes; and more.  Provides in-depth clinical reviews on heart failure and transcatheter aortic valve replacement, offering actionable insights for clinical practice.  Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This text is an introduction to electrophysiology, following a quantitative approach. The first chapter summarizes much of the mathematics required in the following chapters. The second chapter presents a very concise overview of the general principles of electrical fields and current flow, mostly es- tablished in physical science and engineering, but also applicable to biolog- ical environments. The following five chapters are the core material of this text. They include descriptions of how voltages come to exist across membranes and how these are described using the Nernst and Goldman equations (Chapter 3), an examination of the time course of changes in membrane voltages that produce action potentials (Chapter 4), propagation of action potentials down fibers (Chapter 5), the response of fibers to artificial stimuli such as those used in pacemakers (Chapter 6), and the voltages and currents produced by these active processes in the surrounding extracellular space (Chapter 7). The subsequent chapters present more detailed material about the application of these principles to the study of cardiac and neural electrophysiology, and include a chapter on recent developments in mem- brane biophysics. The study of electrophysiology has progressed rapidly because of the precise, delicate, and ingenious experimental studies of many investigators. The field has also made great strides by unifying the numerous experimental observations through the development of increasingly accurate theoretical concepts and mathematical descriptions. The application of these funda- mental principles has in turn formed a basis for the solution of many different electrophysiological problems.

Non-Invasive Imaging of Atherosclerosis is a primer, reference and review of some of the key features of current activities in the field of atherosclerosis. The Editors' goal is to provide material and stimulating ideas to basic scientists and clinical researchers in order to extend the application of vascular imaging and to further develop methods suitable for investigation of the arterial wall. The first section presents current knowledge about pathology, vascular mechanics and compensatory mechanisms active during atherogenesis. It explores the early lesion, complications of plaques and early detection of plaques. Section II reviews several key methodological issues of B-mode ultrasound imaging and some of the most current data. Quantitative B-mode ultrasound is an established non-invasive tool widely used in large epidemiologic studies and interventional clinical trials of atherosclerosis. The last section addresses the most promising areas of development in vascular imaging. This involves new techniques to evaluate the atherosclerotic bed, to follow atheroma progression/regression and to evaluate vascular mechanics in atherosclerotic arteries. The last chapter places the application of non-invasive imaging in perspective.

This volume represents the proceedings ofthe invited lectures ofthe first International Symposium on "e;Serotonin from Cell Biology to Pharmacology and Therapeutics"e; which was held in Florence on March 29 -Aprill, 1989. This meeting, held under the co-sponsorship of the Serotonin Club and the Fondazione Giovanni Lorenzini, represents the first attempt to bring together scientists fascinated by the complexity of the action of 5-hydroxytryptamine throughout the body and in various species. Hence this volume provides the reader with the unique overview of the sources, effects, receptors, physiological actions and pathological role of Serotonin. As such it will be of interest not only to the person devoting herorhis research efforts to the study of 5-hydroxytryptamine but also to all scholars and even clinicians wanting to know how the powerful monoamine can modulate cellular functions. To accelerate the publication of these proceedings the Editors and the publishers have selected the camera ready format and have avoided a lengthy refereeing process. Hence the scientific content of, and the opinions expressed in the chapters are the sole responsibility of the authors. The Editors Milan and Houston The Editors want to thank Mrs. H. Liepman and her staff at Kluwer for the prompt and efficient handling of the manuscripts.

It has been known or suspected for centuries that there is an association between mind and emotions and the occurrence of heart disease apd sudden death. During the past fifty years this relationship has become identified with the concept of Stress, a notion developed and popularized by Hans Selye. In recent years there has been an upward surge of interest in stress by scientists in several disciplines and by the general public. Although, books, journal articles, seminars and media programs devoted to stress now abound, the definition, manifestations, mechanisms, and management of stress remain uncertain and controversial. In an attempt to clarify the situation an International Symposium on Stress and Heart Disease was held in Winnipeg, Canada, June 26-29, 1984, and the proceedings form the basis of this book and its companion volume "e;Patho- genesis of Stress-Induced Heart Disease"e;. Although most species which have ever existed are now extinct through countless millenia, the human species has successfully adapted to changing conditions ("e;stressors"e;) such as ice ages, predators and parasites, wars, famine and plague, and now it is coping with rapidly changing social, economic and political circumstances. Such adaptation occurs at all levels of life- at the molecular level within the cell, at the level of the whole cell, in the groups of cells as organs, in the entire organism or individual, and in some cases, in the society in which the individual lives.

Some 25 years ago, the coronary care unit concentrated high technology and the acutely ill patients who might benefit from it in a single, recognizable space. Since then, that space and its technical equipment have changed, as has part of its population. Acute ischemia, silent and manifest, occurs within and outside of the coronary care unit as pain, arrhythmia, or pump failure. Its detection and treatment require the utilization of many diagnostic techniques and skills, not the least of which is two-dimensional Doppler echocardio- graphy, which is gaining importance. Future developments, in tandem with computer technology, may add to this importance by enabling tissue identification, spatial representation, and Doppler flow mapping. This book describes the state of the art for the practicing clinician using Doppler echocardi?graphy at the bedside of patients with acute ischemic manifestations of coronary heart disease. The first requirement is to move from the echo laboratory to the coronary care unit, emergency department, operating room, or catheterization laboratory, using equipment suited for that purpose. The second, more trying imperative is to secure good cooper- Ition between those treating the acutely ill patient and the investigator who interferes with his probes. If successful ceeding in both, rewarding results can be obtained, since echocardiography is a very sensitive and specific tool for recognizing and quantifying early ischemia.

Heart Hypertrophy and Failure brings together leading basic scientists and clinicians, presenting improved knowledge of the pathophysiology and treatment of the condition. The result is a synthesis of state-of-the-art information on molecular biology, cellular physiology and structure-function relationships in the cardiovascular system in health and disease. The papers presented describe fundamental mechanisms underlying changes in the cellular machinery during the development of cardiac hypertrophy and heart failure. Audience: Students, scientists, clinical and experimental cardiologists who seek to understand and manage the perplexing problems of hypertrophy and heart failure.

Cardiac Cellular Electrophysiology is intended for the clinical cardiologist who wishes to refresh or deepen his understanding of the cellular basis of cardiac electrophysiology, for researchers interested in the basis of the electrical activity of the heart, such as clinical investigators, physiologists or pharmacologists, for teachers in physiology, pharmacology and other biomedical studies, and for medical students from graduate to postgraduate level. Cardiac Cellular Electrophysiology starts with a primer of basic electrophysiology, the cardiac action potential and the physiological basis of the electrocardiogram. Our second aim after having introduced the basic concepts was to continue with giving an overview of the properties of the most important ionic currents in the heart, and to treat their modulation, in order to deal with the mechanisms underlying cardiac ischaemia, arrhythmias and remodelling. Edward Carmeliet and Johan Vereecke, Katholieke University Leuven, Belgium, have collaborated for over 30 years in cardiac electrophysiology research. Their studies include the genesis of the normal action potential, its changes in ischaemia, the effect of drugs, and the mechanism of arrhythmias, using techniques from the classic potential registration with intracellular microelectrodes to whole cell clamp and single channel measurements.

Most of the progress in cardiac energetics in recent years has been spurred by the pressure-volume area concept, the natural extension into energetics of earlier pioneering work delineating the time-varying elastance framework for ventricular contraction. The book draws together a broad spectrum of researchers - basic, applied and clinical - having a shared interest in the energetics of cardiac muscle and ventricle, providing an overview of the current state of the art.

The most salient feature of the infor- last four chapters of the book evaluate the mation provided by nuclear medicine is its information from an analytical and pathophysiological and functional charac- statistical point of view. This approach is ter. For adequate experimental or clinical required for correct decision-making. interpretation, such information should This book is therefore the result of necessarily be interpreted alongside the accumulated experience in nuclear cardiology views of the clinical cardiologist, who is with the invaluable cooperation of medical able to apply it to the individual patient. statisticians. It is directed to physicians This approach, which is routine in every- with an interest in nuclear cardiology, to day clinical practice, reaches its plenitude nuclear medicine specialists wishing to when the whole process is completed and learn the uses and limitations of these an intimate cooperation is established procedures in everyday clinical cardiology, between the nuclear medicine specialist and to cardiologists who feel the need to and the clinical cardiologist. In such understand the rationale and methodology instances, each one of these professionals of the studies which benefit their patients. understands the needs, limits and possi- We understand that the ultimate reason bilities of the other. for any scientific book is the transmission The present book is the fruit of such of knowledge, and we are fully conscious cooperation. In our hospital, an efficient of the enthusiasm of the authors of the nuclear cardiology team has been made up present text to achieve that aim.