Pediatric Respiratory Medicine, 2e

Book Preface

From its inception, Pediatric Respiratory Medicine was to be an international textbook. This second edition broadens that international perspective. The tremendous advances in communication, the expansion of professional societies globally, and the interactions among clinicians and scientists on different continents make it essential that medical textbooks be international in scope, summarizing different geographic and social approaches to advance the understanding of health and disease.

A number of major infl uences contributed to the evolution of pediatric pulmonology as a distinct pediatric subspecialty.

These included the following:
● Growing interest by pediatricians in childhood respiratory problems, especially asthma and pneumonia
● Growth of adult pulmonology, which provided training for pediatricians and spawned an expanded interest in the research, clinical, and educational aspects of pediatric pulmonary disorders
● The establishment of cystic fi brosis centers
● Increasing interest by pathologists in the growth and development of the lung
● Increasing technologic and epidemiologic research in respiratory disease
● Increased interest in childhood tuberculosis in the 1950s and dramatic changes in the worldwide patterns of this disease, particularly with the presence of HIV infection
● Development of neonatology as a discipline and heightened interest in respiratory problems of the newborn and subsequent chronic lung disease
● Growth of academic departments of pediatrics and the desire and need for research and teaching in the pediatric subspecialties
● Establishment of pediatric intensive care units
● Increasing publication of books and journals focusing on various respiratory illnesses of infants and children As the discipline grew, there was progressive recognition by funding and certifying agencies. This culminated in the establishment of certifi cation examinations in a number of countries, enhanced funding of research programs for pediatric respiratory disorders by governmental agencies, increased focus on pediatric respiratory problems by academic societies, and proliferation of training programs.

The breadth and depth of clinical and research interests encompassed in this discipline have increased markedly over the past fi ve decades. However, major challenges still face our children. The global burden of disease falls disproportionately on children, especially those living in developing countries. Environmental conditions play a major role in disease initiation and severity in children, not just in the traditional infectious diseases but in the so-called “lifestyle” diseases such as asthma, obesity, and type 2 diabetes. These chronic diseases are posing threats to children’s health in developing countries as well as those in high-income developed countries. Emerging issues such as the impact of climate change on children’s health are going to become important.

Although no book can cover all issues of current and future interest, this book attempts to meet these varied concerns. The chapters have been written to provide more epidemiologic, anatomic, biochemical, pharmacologic, physiologic, cellular, and molecular information for those interested in these areas while also increasing discussion of the clinical aspects of both common and rarer presentations and diseases for the clinicians caring for the millions of children who suffer from respiratory disorders. Thus we trust that the book will be of benefi t to students at all levels of training as well as experienced pediatric respiratory and primary care physicians. The major purpose of this textbook is to provide a relatively quick and concise overview of a topic, thereby allowing the reader to have a better foundation as he or she reads current articles that focus on more specifi c aspects of the subject. This edition is published in a new format for greater ease of use of content and graphics, with recommended selected readings, and access to an extensive collection of references on the accompanying web site, www.pedrespmedtext.com.

Many thanks are in order. First, to our publisher, Elsevier, and especially to Dolores Meloni, Karen Carter, Anne Snyder, and Michael Goldberg, for advice, patience, persistence, guidance, and encouragement. Second, to all of our contributing authors, some the same as for the last edition and some new, for their enormous contribution of time and effort. We also acknowledge the great support of our wives and families.

Finally, to the children with respiratory illnesses and their families, who have helped us to better understand and manage these conditions and shown us courage in the face of adversity.