Metabolic Encephalopathy

Metabolic Encephalopathy is meant to combine and correlate animal and human studies. It is hoped that increased awareness of the importance of early diagnosis and treatment of these disorders may result in a lowering of the incidence of structural changes and morbidity. These disorders hold a special fascination for both basic scientists and clinical investigators because they are accessible, treatable and there exists good animal models for study. Therefore, this book will pull together basic and clinical neuroscience issue in the treatment of specific metabolic encephalopathies.

The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.

Brain dysfunction is a major clinical problem in intensive care, with potentially debilitating long-term consequences for post-ICU patients of any age. The resulting extended length of stay in the ICU and post-discharge cognitive dysfunction are now recognized as major healthcare burdens. This comprehensive clinical text provides intensivists and neurologists with a practical review of the pathophysiology of brain dysfunction and a thorough account of the diagnostic and therapeutic options available. Initial sections review the epidemiology, outcomes, relevant behavioral neurology and biological mechanisms of brain dysfunction. Subsequent sections evaluate the available diagnostic options and preventative and therapeutic interventions, with a final section on clinical encephalopathy syndromes encountered in the ICU. Each chapter is rich in illustrations, with an executive summary and a helpful glossary of terms. Brain Disorders in Critical Illness is a seminal reference for all physicians and neuroscientists interested in the care and outcome of severely ill patients.

In recent years, there has been rapid growth in knowledge pertaining to the nervous system. This has, in some measure, been due to the development and application of a number of techniques such as the 2-deoxyglucose method and microchemical methods for measuring metabolites and regional cerebral blood flow. Data from the application of these techniques are just beginning to be collected, and the next few years promise to bring many new and exciting findings. The study of energy metabolism in brain is particularly interesting due to the fact that although the brain has scant energy reserves (as compared with the liver), it has one of the highest metabolic rates in the body. Recent studies from several laboratories have shown a surprising divergence of re sponses to metabolic insult in different areas of brain. In this regard, the cer ebellum, for example, may have metabolic features which are uniqve from those of any other region. The high-energy phosphate compounds ATP and phos phocreatine, supplied by the oxidative metabolism of glucose, are necessary for normal cerebral functions such as the maintenance of membrane potentials, transmission of impulses, and synthetic processes. Interruption of substrate or "poisoning" of the system by a variety of means lead to a rapid change in cellular energetics, and ultimately cell death. From the clinical standpoint, an interesting feature of metabolic encephalopathy is that in many cases, early diagnosis and treatment may result in a rapid reversal of symptoms.

This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care.

Encephalopathy and Nitrogen Metabolism in Liver Failure contains research reports and state-of-the-art reviews that were presented at the 11th International Symposium on Hepatic Encephalopathy and Nitrogen Metabolism in relation to liver disease, that was held in Amsterdam, The Netherlands from 30 May to 1 June, 2002. Themes covered include the metabolism of ammonia and amino acids in relation to liver disease, the assessment of hepatic encephalopathy (HE), minimal HE, animal models of HE, neuropsychiatric dysfunction in patients with chronic liver disease, the pathogenesis of HE, the astrocyte in liver disease, acute liver failure and cerebral edema, treatment of HE and artificial liver support systems. This volume provides an indispensable source of important new research findings and ideas for clinicians and biomedical scientists working in the field of HE and nitrogen metabolism in relation to liver disease.

Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the first edition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describing clinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeutic procedures. The final chapter addresses paraneoplastic syndromes. The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understanding oncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.

Basic Neurochemistry: Molecular, Cellular and Medical Aspects, a comprehensive text on neurochemistry, is now updated and revised in its Seventh Edition. This well-established text has been recognized worldwide as a resource for postgraduate trainees and teachers in neurology, psychiatry, and basic neuroscience, as well as for graduate and postgraduate students and instructors in the neurosciences. It is an excellent source of information on basic biochemical processes in brain function and disease for qualifying examinations and continuing medical education. Completely updated with 60% new authors and material, and entirely new chapters Over 400 fully revised figures in splendid color