Severe asthma is a form of asthma that responds poorly to currently available medication, and its patients represent those with greatest unmet needs. In the last 10 years, substantial progress has been made in terms of understanding some of the mechanisms that drive severe asthma; there have also been concomitant advances in the recognition of specific molecular phenotypes. This ERS Monograph covers all aspects of severe asthma – epidemiology, diagnosis, mechanisms, treatment and management – but has a particular focus on recent understanding of mechanistic heterogeneity based on an analytic approach using various ‘omics platforms applied to clinically well-defined asthma cohorts. How these advances have led to improved management targets is also emphasised. This book brings together the clinical and scientific expertise of those from around the world who are collaborating to solve the problem of severe asthma.

This book provides readers with a comprehensive review of severe asthma in children and adolescents, covering epidemiology, genetics, risk factors, co-morbidities, clinical presentation, diagnosis and treatment. Written by leaders in the field, chapter discussions draw on the mechanisms driving the disease, genetics, multidisciplinary approaches, immunomodulators, and other important aspects in the management of the disease. Severe Asthma in Children and Adolescents: Mechanisms and Management is designed to be a practical guide, opening with an introduction on the epidemiology of severe childhood asthma, as well as a discussion of special considerations of the disease unique to the preschool-aged patient. The distinctions between the diagnosis and management of asthma in young children of various ages, and specific approaches for the adolescent with severe asthma, including the transition into adult care are then addressed. Finally, the book closes with a discussion on the current state and future avenues for severe asthma research. Severe Asthma in Children and Adolescents is an indispensable reference for the healthcare professional, for basic and translational researchers, as well as for students, residents and fellows.

COPD is one of the most common diseases worldwide and is projected to be the third leading cause of death by 2020. But that does not mean it is easy to understand or manage. In everyday practice, pulmonologists face areas of controversy in COPD, for which evidence-based medicine is often unavailable. This ERS Monograph considers where the current controversies in COPD lie, discussing areas such as screening, premature birth, asthma–COPD overlap syndrome, treatment, rehabilitation and palliative care. This book will be of great interest to both clinicians and scientists, and aims to stimulate further discussion about this diverse and fascinating disease. "...contains a vast amount of information on the disease, its prevalence, signs and symptoms, diagnositc tests and treatment options. The book's format makes it quick and simple to find out what you need to know, and its size would make it easy to take to work for use in practice [...] invaluable for anyone working with patients with the disease." Emma Vincent, Nursing Standard

This book provides a practical, stepwise, evidence-based approach to effective management of patients with difficult to treat asthma. The impact of asthma on morbidity and healthcare utilization increases exponentially with severity. Severe refractory asthma accounts for less than 5% of all asthma. Its prevalence, however, is often overestimated as there are several other confounding factors that make asthma ‘difficult to treat’. Many novel (albeit expensive) therapies are now available and providers caring for patients with severe asthma are charged with selecting the best evidence treatment. This calls for complex and nuanced decision-making. Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also multiple patient and healthcare provider behaviors. Therefore, now more than ever, it has become increasingly important to differentiate “difficult” from “severe refractory” asthma to allow identification of patients most likely to benefit from these therapies. This volume delves into the current understanding of mechanisms and increasingly recognized heterogeneity of this complex disease. It discusses a structured approach to identification and optimization of factors contributing to poor asthma control, including nonadherence, comorbidities and occupational/environmental triggers. The book includes ‘state of the art’ reviews on recent advances in traditional and targeted asthma therapies, as well as a glimpse into what the future may hold. Highlights include a comprehensive guide to management of severe asthma in children and pregnancy, as well as practical considerations to management of asthma based on different clinical phenotypes. Each chapter is authored by leading experts in the field who share their own clinical approach. This is an ideal guide for clinical pulmonologists and allergist/immunologists, as well as primary care providers, physician extenders in specialty practice, physicians in pulmonary/allergy training, and even industry partners.

This reference collects the latest studies on the development, diagnosis, and treatment of childhood asthma and offers current perspectives on new technologies that will shape the management of pediatric asthma in the forthcoming decade-illustrating how advances in pulmonary function measurement, inflammatory markers, imaging, and pharmacogenetics

Advanced Perioperative Crisis Management is a high-yield, clinically-relevant resource for understanding the epidemiology, pathophysiology, assessment, and management of a wide variety of perioperative emergencies. Three introductory chapters review a critical thinking approach to the unstable or pulseless patient, crisis resource management principles to improve team performance and the importance of cognitive aids in adhering to guidelines during perioperative crises. The remaining sections cover six major areas of patient instability: cardiac, pulmonary, neurologic, metabolic/endocrine, and toxin-related disorders, and shock states, as well as specific emergencies for obstetrical and pediatric patients. Each chapter opens with a clinical case, followed by a discussion of the relevant evidence. Case-based learning discussion questions, which can be used for self-assessment or in the classroom, round out each chapter. Advanced Perioperative Crisis Management is an ideal resource for trainees, clinicians, and nurses who work in the perioperative arena, from the operating room to the postoperative surgical ward.

The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.

Asthma is a disease of many faces and is frequently seen in children. This Monograph covers all aspects of paediatric asthma, across all ages, from birth through to the start of adulthood. It considers diagnostic problems in relation to the many phenotypes of asthma, covers the treatment of both mild-to-moderate and severe asthma, and discusses asthma exacerbations as well as exercise-induced asthma. The issue also provides an update on the pathophysiology of asthma, the role of bacterial and viral infections, and the impact of environmental factors, allergy, genetics and epigenetics. Finally,

Revised and updated for its third edition, the Oxford Handbook of Respiratory Medicine is the must-have resource for junior doctors and students, and all clinicians caring for patients with respiratory problems. Concise, practical, and designed for rapid access to essential information, this handbook will ensure you have everything you need for the ward, clinic, or exams. This handbook covers the latest clinical guidelines and developments in the field. It features unique sections on practical procedures and a symptoms section to aid in differential diagnosis and clinical management. Practical advice on management is integrated throughout and a dedicated section on respiratory emergencies ensures you can cope with any eventuality. New sections such as thoracic ultrasound, indwelling pleural catheters, safe sedation, and cardiopulmonary exercise testing have been added, and all major respiratory diseases and symptoms are covered in practical, succinct chapters. This third edition will ensure you have all the information you need at your fingertips.

Asthma is a chronic airway disease affecting over 300 million people worldwide with an expected increase of an additional 100 million by 2025. Past decade has observed a notable increase in asthma prevalence on both national and global levels with highest rates observed in western countries (about 30%). Over the past 40 years, a drastic increase in global prevalence, morbidity, mortality, and economic burden have been observed due to asthma especially in children. The rising numbers of hospital admissions for asthma, especially young children, reflect an increase in severe asthma, poverty and lack of proper disease management. Worldwide, approximately 180,000 deaths annually are caused due to this condition. The financial burden on a single asthma patient per year in different western countries ranges from US$300–1,300. Asthma is an intricate respiratory disorder with differences in its severity, natural history and hence treatment response. These differences in intensities of various presentations such as bronchial hyper-responsiveness, airway inflammation, mucus production, airflow obstruction make asthma a heterogeneous disease. The mainstay of current therapies for asthma includes inhaled corticosteroids, phosphodiesterase inhibitors, leukotriene modifiers and β2-adrenoceptor agonists. Some of the currently available drugs are efficient in one or more aspects. However the associated side effects or heterogeneity of the disease limit their usefulness and efficacy, thereby putting a demand on development of new drugs and therapies. On the other hand, asthma has also been treated/managed via herbal medications. These approaches have been described in Unani, Ayurvedic or Chinese system of medicine since antiquity. In fact, several anti-asthmatic drugs were developed from herbs commonly utilized in the non-Western system of medicine. This book focuses on the pathophysiology of asthma, its medication (both herbal and modern), limitations and their future prospects.