Mechanisms Of Hypoxic Brain Injury In The Newborn And Potential Strategies For Neuroprotection

It is with great pleasure that I present to you this book. At the present time, physicians and scientists are working feverishly to find novel strategies for neuroprotection in human preterm and term hypoxic newborns. Cerebral hypoxia-ischemia and asphyxia present a great challenge to all of us concerned with the deleterious consequences that manifest as cerebral dysfunction, mental retardation, and cerebral palsy. This book entitled Mechanisms of Hypoxic Brain Injury in the Newborn and Potential Strategies for Neuroprotection will be of great interest to physicians, clinician-scientists, and researchers in a number of disciplines including Pediatrics, Neonatal-Perinatal Medicine, Developmental Biology, Neurology, Pediatric Neurology, Obstetrics and Gynecology, Neuroscience, Developmental Neuroscience, Developmental Neurochemistry, and to everyone interested in the developing brain . The information presented in this book will be appropriate to residents, clinical fellows, pre- and post-doctoral fellows, faculty of basic science departments, faculty of clinical departments, and to the most advanced researchers in the field of hypoxic ischemic brain injury in the fetus and the newborn. I would like to thank sincerely my colleagues and contributors to this book for their excellent efforts and extremely valuable time. Each contributor to this book is a pioneer in his or her field: the contributions are superb. As a reader, you will find that the authors of this book are from different parts of the world and that this book presents the forefront of cutting-edge global research and developments in the field of hypoxic brain injury in newborns. Finally, I would like to thank my wife Ira Mishra, whose constant support and patience have been invaluable in helping to produce not just this book but thirty years of my research investigations on the mechanisms of hypoxic injury in the developing brain.

Now in its third edition, this is a comprehensive survey of fetal and neonatal brain injury arising from hypoxia, ischemia or other causes. The volume spans a broad range of areas from epidemiology and pathogenesis, through to clinical manifestations and obstetric care, and then on to diagnosis, long-term outcomes, and medico-legal aspects. An important theme running throughout is to highlight scientific and clinical advances that have a role to play in minimising risk, improving clinical care and outcomes.

Despite compelling preclinical evidence from laboratory models of brain hypoxia suggesting potential neuroprotective strategies, only scattered data are available from clinical studies. A few candidate neuroprotectants have been studied regarding antioxidant, antiapoptotic, anti-excitotoxic, immunomodulatory, and neurotrophic effects. In parallel with clinical innovations, preclinical research initiatives are also identifying new animal models more closely resembling the clinical course and pathology of neurodegenerative diseases. Clarifying the specific mission of the brain cells involved in the damage/repair system in the examined animal models is important to define new therapeutic targets. Following hypoxic damage, detrimental events intermingle with the repairing events in both time- and cellular-dependent fashion. Identifying reliable post-hypoxia brain markers is mandatory to develop potential therapeutic interventions, improving translational research from the experimental observations to the clinical application. A deeper understanding of the precise participation of neurons, glia, and endothelial cells is expected to offer more clues for designing new therapeutic strategies to reduce the current gap among the experimental and the clinical data. One of the main issues should be to study the epigenetic mechanism of neuroprotective agents and their action on the genetic modification induced by hypoxia. Achieving this goal is presumed critical to obtain more conclusive results in patients that by now do not receive appropriate therapy for mitigating the several diseases generated by brain hypoxia. Although a few ongoing studies are evaluating interesting approaches, future research is necessary to come to a novel mechanism of neuroprotection. This book encompasses different chapters conveying the goals and aims of the pertaining research.

Development of the brain and the emergence of the mind constitute some of the most important concerns of contemporary biology. Disturbances during fetal life may have profound implications for a child's future neurological and psychological development, which can in turn impact society. The new edition of this highly respected work presents a comprehensive review of the basic mechanisms of brain development and the pathophysiology of disorders of the infant brain, written by a team of distinguished neuroscientists, neonatologists, and neuropediatricians. The book follows the main milestones of brain development, from formation of the neural tube and wiring of the neurons in the brain. Neurotrophic factors, neurotransmitters, glial cell biology, cerebral circulation development of sensory functions are all described in detail. Furthermore, there are more philosophical chapters on the evolution of the brain and the emergence of consciousness. Clinical considerations are highlighted where relevant.

This text presents a state-of-the-art review of asphyxial brain injury to the foetus and new born, a leading source of both neonatal mortality and long-term neurologic disability. Beginning with an historical overview of birth-related injury, followed by an epidemiologic review of the relationship of birth injury to later neuromotor disability, it provides a detailed analysis and exhaustive review of each aspect. The contributors are among the most knowledgeable international authorities in the field; they have synthesized a uniformity of medical and scientific quality, clarity of style, and thoroughness of scope. Continual emphasis is placed on the material's relevance and usefulness to clinicians; equally important is the emphasis on communication between clinicians and basic neuroscientists. The task of paediatricians and neonatologists in coming years will be to better understand the mechanism of brain damage, the prediction of disability, and the introduction of efficacious neuroprotective strategies. To that end, this volume deserves wide recognition by physicians in all disciplines related to neonatal care, including paediatricians, neonatologists, neurologists, obstetricians, family practitioners, nurses and legal counsel.

This landmark book, a reference work now in its second edition, provides healthcare practitioners in neonatology with an up-to-date, comprehensive source of readily accessible practical advice that will assist in the expert management of patients and their diverse illnesses. Leading experts in their fields discuss the underlying causes and mechanisms and all aspects of the treatment of the full range of neonatal diseases and abnormalities, citing the evidence base whenever appropriate. In addition, detailed information is provided on epidemiology and fetal medicine; therapeutic issues such as the organization of care, transport services, and home care after discharge; legal issues; nutrition; and the consequences of medication use during pregnancy, maternal drug abuse and smoking, and maternal diabetes. The inclusion of summaries, tables, and carefully selected guidelines and recommendations will supply practitioners with quick references and instant solutions during daily practice. The book will be a superb resource for all involved in the care of newborn babies, including neonatologists, pediatricians, pediatric surgeons, anesthesiologists, midwives, and nursing staff. It is published within the SpringerReference program, which delivers access to living editions constantly updated through a dynamic peer-review publishing process.

Explores the spectrum of topics important to the treatment of critically ill patients with cardiac and respiratory failure, including in-depth discussions on pathophysiologic principles, approaches to therapy and individual disorders. Ethical and legal aspects are also considered.

Endogenous neuoprotection is a phenomenon where a brief episode of ischemia renders the brain resistant against a subsequent longer-asting ischemia event. Experimentally, the author was able to model hypoxic preconditioning in animal model. Increasing knowledge of this endogenous neuroprotectin by ischemic tolerance may help to minimize neuronal damage following ischemic stroke and hypoxic encephalopathy. This book is, therefore, the first overview of this important topic and will certainly influence further investigations in clinical and neuroscience research.