bluuebunny/crossref_metadata_2025 huggingface dataset:
Limbform: a functional ontology-based database of limb regeneration experiments
Authors: Lobo Daniel , Feldman Erica B. , Shah Michelle , Malone Taylor J. , Levin Michael
Published: August 2014

Summary: The ability of certain organisms to completely regenerate lost limbs is a fascinating process, far from solved. Despite the extraordinary published efforts during the past centuries of scientists performing amputations, transplantations and molecular experiments, no mechanistic model exists yet that can completely explain patterning during the limb regeneration process. The lack of a centralized repository to enable the efficient mining of this huge dataset is hindering the discovery of comprehensive models of limb regeneration. Here, we introduce Limbform (Limb formalization), a centralized database of published limb regeneration experiments. In contrast to natural language or text-based ontologies, Limbform is based on a functional ontology using mathematical graphs to represent unambiguously limb phenotypes and manipulation procedures. The centralized database currently contains >800 published limb regeneration experiments comprising many model organisms, including salamanders, frogs, insects, crustaceans and arachnids. The database represents an extraordinary resource for mining the existing knowledge of functional data in this field; furthermore, its mathematical nature based on a functional ontology will pave the way for artificial intelligence tools applied to the discovery of the sought-after comprehensive limb regeneration models.

Availability and implementaion: The Limbform database is freely available at http://limbform.daniel-lobo.com .

Contact:  michael.levin@tufts.edu
Fish populations forming transient spawning aggregations: should
spawners always be the targets of spatial protection efforts?
Authors: Grüss Arnaud , Robinson Jan
Published: August 2014

Many coral reef fish form transient spawning aggregations at sites located a few to hundreds of kilometres from their normal residence areas. Reef fish spawning aggregations (“FSAs”) are often heavily exploited, which make them targets for management with marine reserves. We used a per-recruit model to compare the long-term conservation (impacts on female spawning-stock biomass-per-recruit (SSBR) and female : male sex ratio, SR) and fisheries effects (impacts on yield-per-recruit, YPR) of spawning reserves vs. normal residence reserves for two data-poor populations from Seychelles with contrasting life history traits and sexual modes: the Siganus sutor population of the main granitic islands, which has a fast life history and is gonochoristic and the Epinephelus fuscoguttatus population of Farquhar Atoll, which has a slow life history and is protogynous. Overall, our results suggest that normal residence reserves are more effective at improving both the SSBR and YPR of S. sutor. In contrast, the protection of a substantial fraction of spawning sites is preferable for E. fuscoguttatus to ensure the reproductive output of this protogynous population through normalization of SR and maintenance of high SSBR. Neither spawning reserves nor normal residence reserves improved the YPR of E. fuscoguttatus. However, yields of E. fuscoguttatus may increase on the long term via recruitment subsidy if a substantial fraction of spawning sites is protected. This may occur only if the population was recruitment limited in the absence of reserves and increases in SSBR compensate for lost opportunities caused by the area closures. Sensitivity analyses revealed that the relative effects of spawning reserves and normal residence reserves relate more to the change in catchability occurring with FSA formation than to life history traits. Thus, normal residence reserves should be preferred over spawning reserves for S. sutor essentially because its catchability at spawning sites is low relative to many other aggregation-forming populations. S. sutor therefore suffers higher fishing mortality in normal residence areas than at FSA sites. Our study demonstrates that spawning reserves are not always the most effective tool for balancing conservation and exploitation objectives for FSA-forming populations, and that this measure should ideally be weighed against other management options.
Oxford Handbook of Respiratory Medicine
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Revised and updated for its third edition, the Oxford Handbook of Respiratory Medicine is concise, practical, and designed for rapid access to essential information. It covers the latest clinical guidelines and developments in the field and features unique sections on practical procedures as well as 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 the ability to 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 also covered.
Chest pain
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The two main types of pain occurring in the thoracic region are described, principally pleuritic pain and chronic persistent, well-localized chest pain. The mechanism anatomically for the different types of pain, according to the site of pathology, is described. Diagnosis of the underlying causes often relies on pattern recognition of a constellation of symptoms, with confirmatory investigations. These are documented. The many causes of the different chest pain types are discussed, including: pneumococcal pneumonia, acute pulmonary embolism, pericarditis, costochondritis (Tietze’s syndrome), malignant disease, autoimmune disease, and benign asbestos pleural disease.
Diffuse alveolar haemorrhage
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The causes of this condition are listed, including, most commonly, Goodpasture’s disease, granulomatosis with polyangiitis (GPA), and systemic lupus erythematosus (SLE). The classical triad of diffuse alveolar infiltrates, haemoptysis, and fall in haemoglobin or haematocrit is discussed, along with other presentations, including cough, dyspnoea, low-grade fever, weight loss, myalgia, and arthralgia. Examination and investigations are highlighted, including the role of CT, bronchoscopy, blood tests, and biopsy. The emergency management of alveolar haemorrhage is dealt with, in terms of the need to make the underlying diagnosis, if possible, and supportive therapy, including oxygen, CPAP, plasma exchange, steroids, and cyclophosphamide.
Pregnancy and breathlessness
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

There are normal physiological changes which occur during pregnancy and may cause a sense of increased breathlessness. These are discussed in detail, including elevated serum progesterone levels and increased cardiac output. Other pathological causes of breathlessness are highlighted, which may represent a new diagnosis or a worsening of a pre-existing condition. A table is provided, which conveniently divides the causes into pulmonary, pleural, vascular, pulmonary oedema (cardiac and non-cardiac), and other rarer causes. The importance of investigating alongside the obstetricians is stressed, with possible involvement from anaesthetists and paediatricians, if delivery date is near. Appropriate investigations to help identify the significance of dyspnoea and possible pathological causes are outlined.
Preoperative assessment
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The respiratory physician may be asked to review a patient prior to emergency or elective surgery. This will usually be in the context of the patient with known respiratory disease, often COPD. This chapter gives suggestion for the approach to this assessment and options for management. These principally include strategies to optimize the underlying respiratory disease such as inhaler therapy, pulmonary rehabilitation, chest physiotherapy, CPAP, smoking cessation. Risk factors for perioperative complications are listed.
Asbestos and the lung
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Respiratory complications of asbestos exposure continue to increase and represent a significant workload for respiratory physicians. This chapter covers asbestosis, mesothelioma, benign asbestos pleural disease (pleural plaques, benign pleural effusion, diffuse pleural thickening, and rounded atelectasis), and their complications. There have been several recent developments in the management, allowing improved care of these patients, particularly the use of thoracoscopy for diagnosis and pleurodesis and indwelling pleural catheters. The recent NICE approval of pemetrexed has offered new management pathways for mesothelioma. Aspects of compensation for patients with asbestos-related diseases are discussed.
Bronchiolitis
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This condition was poorly recognized until recent times, when the similarity to Japanese pan-bronchiolitis led to the newly defined diffuse pan-bronchiolitis. This chapter discusses all the conditions leading to bronchiolitis, especially following lung transplant, bone marrow transplant, and when associated with connective tissue diseases, especially rheumatoid arthritis. The importance of making a proper diagnosis is discussed, particularly given the excellent therapeutic response brought about by macrolides, particularly in diffuse pan-bronchiolitis.
Connective tissue disease and the lung
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter explores the complex area of the various lung diseases seen in many autoimmune disorders. The diseases covered include: rheumatoid arthritis, systemic lupus erythematosus, polymyositis and dermatomyositis, systemic sclerosis, Sjögren’s syndrome, ankylosing spondylitis, and Behçet’s syndrome. The confusing area of autoantibody markers is usefully clarified. The use of various immunosuppressive agents and their side effects receive particular attention.
Hypersensitivity pneumonitis
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Hypersensitivity pneumonitis (previously called extrinsic allergic alveolitis) is caused by exposure to many inhalable antigens, from the common (such as from birds and mouldy hay) to the exotic (such as from shellfish and silkworm processing). The particular presentation, investigations, histological findings, and management of the different syndromes recognized are fully covered, including differential diagnosis. The use of steroids for these conditions is discussed.
Hyperventilation syndrome
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Hyperventilation syndrome, or dysfunctional breathing, is often part of the wider spectrum of somatization or functional disorders. It is defined and its pathophysiology discussed. Management can be difficult, and the process of making this diagnosis, largely through the exclusion of other disorders and recognizing its specific features, is covered. The use of the Nijmegen hyperventilation score to help in its diagnosis and management is included.
Lung transplantation
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Since the 1980s, lung transplantation, as management for end-stage lung disease, has increased considerably, limited almost exclusively by the supply of suitable donor organs. The pre- and post-operative management of patients has become a medical specialty in its own right. This chapter covers the referral criteria, initial investigations, and timing of referral to a transplant centre, contraindications, actual patient selection, and the underlying conditions for which transplantation may be appropriate. The surgical techniques are described, along with the immediate post-operative management, immunosuppression, and long-term follow-up. The many potential complications, such as early graft dysfunction, infection, drug side effects, acute and chronic rejection, malignancy (particularly lymphoma), as well as long-term prognosis, are fully covered.
Pleural effusion
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Recent research into the causes and management of pleural effusion has altered clinical practice. This chapter describes the usual causes (lung cancer, breast cancer, lymphoma, mesothelioma), clinical features, imaging, and management of malignant pleural effusions, parapneumonic effusions, empyema, tuberculous effusions, as well as rarer causes. There is an increasing role for CT and MRI pleural imaging, and particularly pleural ultrasound, to help diagnose and guide biopsy taking, which are all described in this chapter. The role of repeated aspiration, pleurodesis, and chronic indwelling catheters is covered, as well as the problem of trapped lung.
Pulmonary thromboembolic disease
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter discusses the current investigation and management of pulmonary thromboembolic disease, including the role of the Wells’ score for predicting likelihood of deep venous thrombosis and pulmonary embolism. Questions about the value of D-dimers and inferior vena caval filters, how long to continue anticoagulation, and how to predict risk from PE to determine who can be managed early as an outpatient (the PESI score) are answered. The acute management of massive pulmonary embolism is highlighted, including the role of thrombolysis and surgery. Thromboembolic disease in pregnancy is discussed, along with issues relating to the oral contraceptive pill and flight prophylaxis. Air, fat, amniotic fluid, and rarer sources of emboli are also covered.
Sleep apnoea and hypoventilation
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This comprehensive chapter on an increasingly recognized problem covers the more familiar obstructive sleep apnoea (OSA), with a discussion of clinical features, sleep studies, therapies, including CPAP and jaw advancement devices, driving advice to patients, paediatric OSA, and future developments. Important differences between European and American approaches to diagnosis and management are discussed. The many causes of central sleep apnoea (such as heart failure, altitude, and some cases of reduced ventilatory drive) and nocturnal hypoventilation (such as due to neuromuscular disorders) are discussed, along with current approaches to management. The rapidly increasing problem of obesity-related respiratory complications is also discussed.
Toxic agents
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The lung is exposed to a multitude of toxic agents delivered via the air and from the blood. With the ever increasing use of powerful drugs, the number of toxic reactions is increasing. This chapter begins with a clinical perspective describing the usual ways that patients present. The bulk of the text looks at individual drugs that cause problems sufficiently frequently to be in the differential of many different types of lung and pleural disease. Acute lung injury from a variety of inhaled toxic agents is also covered, as are paraquat and carbon monoxide poisoning.
Immunosuppressive drugs
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Many different immunosuppressive drugs are used in respiratory medicine. Each has their place and their particular, often dangerous, side effects. This means that a clear understanding of how they are used and monitored is required. This chapter covers the four most commonly used: corticosteroids, azathioprine, methotrexate, and cyclophosphamide.
Inhalers and nebulizers
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The multiplicity of inhaler devices on the market is often bewildering, as companies vie to increase their market share. The different devices have a role for those unable to use conventional inhalers. This chapter details the different devices, both their advantages and disadvantages. It is nearly impossible to remember the specific usage instructions for each type of inhaler, and this chapter contains a useful table for quick reference when helping patients to use their particular device. The place of nebulizers is also discussed.
Palliative care
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Unfortunately, palliative care is part of respiratory practice. This chapter discusses the various palliative strategies available in both malignant and non-malignant conditions to improve quality of life in terminal or severely ill patients. Both lung cancer and mesothelioma present challenging problems, and patients deserve the best care available which will involve different services. The use of different pain relief strategies to be used in different situations is discussed; controlling dyspnoea, cough, poor appetite, and anxiety is also covered, as is the problem of symptomatic pleural effusions. The chronic conditions of COPD and cystic fibrosis also present their own particular problems which are also covered in this chapter.
Smoking cessation
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Since smoking cessation is the only real treatment to influence the long-term outcome of patients with smoking-induced COPD (and prevent its occurrence in the first place), quite rightly, great emphasis should be placed on introducing and running smoking cessation programmes. Although these should run in the community, hospital attendance is an opportunity to influence patients’ smoking. This chapter describes the smoking cessation strategies available, particularly the use of the different types of nicotine replacement therapies. In addition, the place of the newer non-nicotine replacement therapies, such as bupropion, varenicline, and others currently under investigation, is covered. The controversial electronic cigarettes are also discussed, as is the future potential for nicotine vaccines.
Airway management
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Control of a compromised airway is part of basic care of patients with ventilatory requirements. The emergency management of such situations requires knowledge of simple (Guedel-type) airways, nasopharyngeal tubes, endotracheal intubation, and laryngeal mask airways. Practical aspects of these three approaches are covered in this chapter.
Pneumothorax aspiration
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This short chapter describes the indications for, and how to carry out, simple pleural aspiration using a large-bore (16G) cannula, as opposed to full drain insertion, for the management of pneumothorax. A separate chapter covers the management of pneumothorax itself.
Thoracic ultrasound
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This comprehensive chapter, new for the 3rd edition of this book, reflects recent rapid changes in the management of pleural problems. Training in ultrasound is now part of the formal training of respiratory specialist registrars and will soon become as ubiquitous as uterine ultrasound in obstetrics. New indications and uses for ultrasound examination of the chest are still appearing, and all chest physicians will need to be adept at this technique in the future. This chapter describes in detail the uses and background to ultrasound examination. It covers the training requirements to become competent, actually how to perform a good examination, and how to avoid complications. There are ultrasound images to help a newcomer understand what is being observed. The uses of ultrasound to guide, in real time, various interventional procedures are also covered.
Tracheostomy
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Both temporary and permanent tracheostomy may be required, as part of the management of a respiratory patient. The indications and main alternatives available for insertion are discussed in this chapter. Advice on converting from endotracheal intubation to a tracheostomy is offered, as well as the debate on when and how to remove one (decannulation). Complications of tracheostomy are also discussed, as are the various ‘add-ons’ available during tracheostomy breathing.
Schizophrenia and Other Psychotic Disorders
Authors: Erlich Matthew D. , Smith Thomas E. , Horwath Ewald , Cournos Francine
Published: August 2014

Patients with schizophrenia experience three categories of symptoms: positive (delusions and hallucinations); negative (blunting of affective expression, loss of volition, and apathy); and disorganized (as reflected by a formal thought disorder). A diagnosis of schizophrenia requires that continuous signs of illness, which may include prodromal and residual symptoms, be present for at least 6 months. Research indicates that schizophrenia is likely a neurodevelopmental illness with clear heritable risk factors. Patients with schizophrenia tend to have an illness onset by young adulthood and a generally debilitating and long-term course, but the degree of disability and functional impairment is widely variable. Other illnesses characterized by prominent psychotic symptoms include schizoaffective disorder and delusional disorder. Treatment for psychotic illnesses includes antipsychotic medication and recovery-oriented psychosocial interventions aimed at “psychiatric rehabilitation” wherein patients can learn or relearn skills necessary to live independently and work competitively.
Substance-Related and Addictive Disorders
Authors: Bryan Benjamin R. , Levin Frances R.
Published: August 2014

Alcohol use disorder tends to have a progressive course with varying outcomes. The rate of onset of a drug’s effects and the rate at which the effects diminish or are lost affect the evolution of a drug use pattern into a substance use disorder. Depression, psychosis, anxiety, and delirium are all common symptoms associated with drug use. Many patients underestimate the amount of alcohol or drugs they use when asked by a physician. Patients with addictive behaviors demonstrate varying degrees of denial. Evidence-based psychotherapeutic interventions for the treatment of substance use disorders include motivational interviewing and cognitive-behavioral therapy. A number of medications are available for treatment of substance use disorders: acamprosate, buprenorphine, bupropion, disulfiram, methadone, naloxone, naltrexone, and varenicline.
Feeding and Eating Disorders
Authors: Devlin Michael J. , Steinglass Joanna E.
Published: August 2014

This chapter discusses feeding and eating disorders, which are characterized by disturbed eating behavior and excessive concern about body weight and shape. There is substantial comorbidity of anorexia nervosa and bulimia nervosa. Many patients with bulimia nervosa have other mental health problems related to impulse control as well, such as substance use disorders. Patients with binge-eating disorder experience periods of consumption of objectively large amounts of food accompanied by a feeling of loss of control. Anorexia nervosa is one of the most lethal psychiatric illnesses, as it is associated with mortality rates as high as 5% per decade of illness.
Pharmacotherapy, ECT, and TMS
Authors: Stewart Jessica Ann , Russakoff L. Mark , Stewart Jonathan W.
Published: August 2014

Physicians’ attention to patients’ concerns and attitudes about taking medication will engender adherence, as will close monitoring of potentially disconcerting side effects. The primary indication for antipsychotic medications is the treatment of psychotic disorders and mania, even in the absence of psychosis. The more troublesome side effects of antipsychotic medications include increased appetite and weight gain; extrapyramidal side effects, tardive dyskinesia, and neuroleptic malignant syndrome. Antidepressants are effective for treating depressive illness, including major depression, persistent depressive disorder (dysthymia) and premenstrual dysphoric disorder. They are also often used effectively in the treatment of anxiety disorders, obsessive-compulsive disorder, bulimia nervosa, and somatic symptom disorders. Selective serotonin reuptake inhibitors (SSRIs) are generally well tolerated. Other important categories of medications include mood stabilizers and anxiolytics.
Psychotherapy
Authors: Olds David D. , Busch Fredric N.
Published: August 2014

The psychoanalytic psychotherapies, which include brief psychodynamic psychotherapy, psychoanalysis, long-term psychoanalytic psychotherapy, transference focused psychotherapy, mentalization based treatment, and panic focused psychodynamic psychotherapy, are based on the underlying theory that symptoms stem from unconscious traumatic memories or conflicts about sexual and aggressive wishes as well as maladaptive or self-destructive behavior patterns that are unconsciously repeated. The cognitive-behavioral psychotherapies, which include cognitive-behavioral therapy and dialectical behavior therapy, are based on the assumption that symptoms arise from maladaptive patterns of cognition and behavior that are learned via behavioral conditioning. Interpersonal psychotherapy, family therapy, and group therapy can be regarded as multiple-person therapies that view symptoms as arising from problems in relations between and among people. Crisis intervention and other supportive psychotherapies provide patients with advice and education to enhance coping skills and ego functions.
Informed Consent
Authors: Davis Gregory
Published: August 2014

Chapter 2 deals specifically with the topic of informed consent, an essential legal requirement for the general practice of medicine. Some of the cases are specific to mental health treatment, but most are critical to defining the standards of informed consent and are related to more purely medical conditions. Cases described here include Natanson v. Kline, Canterbury v. Spence, Kaimowitz v. Michigan Department of Mental Health, Truman v. Thomas, Clites v. Iowa, and Zinermon v. Burch.
Expert Testimony
Authors: Soloway Scott , Shelby Bryan C.
Published: August 2014

Chapter 4 reviews the major cases related to the admissibility and presentation of expert witness testimony in the courtroom. The majority of the cases involve general standards for medical and scientific evidence (Frye v. U.S., Daubert v. Merrell Dow Pharmaceutical, General Electric v. Joiner, Kumho Tire Co. v. Carmichael) that can be applied to psychiatry. The remaining cases (State v. Hurd, People v. Shirley, Rock v. Arkansas) relate to the admissibility—or not—of hypnotically refreshed testimony and hypnosis as a scientific practice.
Right to Treatment
Authors: Subedi Bipin
Published: August 2014

Chapter 8 focuses on cases that involve the rights of individuals to receive adequate mental health treatment while involuntarily hospitalized through either civil commitment or insanity defense proceedings. These cases set the stage, many years ago, for environmental and clinical expectations of appropriate care. The cases in this chapter are Rouse v. Cameron, Wyatt v. Stickney, and Youngberg v. Romeo. Cases involving a right to treatment for prisoners are included in chapter 26.
Right to Refuse Treatment
Authors: Lewis Rebecca
Published: August 2014

Chapter 9 describes cases related to one of the most important autonomy issues involved in the involuntary hospitalization of individuals with mental illness—the right to refuse treatment. These cases highlight the different judicial opinions about how to manage patients who refuse treatment as exemplified by the contrast between a treatment-driven approach in Rennie v. Klein, to a rights-driven approach in Rogers v. Commissioner. Other cases included in this chapter are Application of the President and Directors of Georgetown, Superintendent of Belchertown State School v. Joseph Saikowitz, and In the Matter of the Guardianship of Richard Roe, III.
Child Abuse Reporting
Authors: Sidhu Shawn S. , Bath Eraka
Published: August 2014

Chapter 11 covers three cases involving child abuse: Landeros v. Flood, People v. Stritzinger, and DeShaney v. Winnebago. Although it is now common practice for individuals who care for, educate, or treat children to be required to report child abuse, these cases highlight the evolution of that responsibility. Other themes include confidentiality of the reporting and the limits of state power in preventing child abuse.
ADA/Disability
Authors: Forman Howard
Published: August 2014

Chapter 16 includes a group of cases that relate to the Americans with Disabilities Act (ADA) of 1990. Most of the cases involve Title II of the act, specifically that no individual with a disability can be denied services by public entities. The disabilities claimed in the cases vary broadly, from HIV to carpal tunnel syndrome to schizophrenia, but they are all critical in defining accommodations for individuals with disabilities. Olmstead v. Zimring is particularly relevant to psychiatry because it addressed the concern about institutional warehousing of mentally disabled individuals. Other cases in this section include Carter v. General Motors, Bragdon v. Abbott, Pennsylvania v. Yeskey, Toyota v. Williams, Hargrave v. Vermont, and U.S. v. Georgia.
Prescribing
Authors: Raine Tim , Dawson James , Sanders Stephan , Eccles Simon
Published: August 2014

Prescribing – general
considerations

How to prescribe – best
practice

Drug interactions

Reporting adverse drug
reactions

Special considerations

Controlled drugs

Enzyme inducers and
inhibitors

Endocarditis
prophylaxis

Night sedation

Steroid therapy

Topical
corticosteroids

Empirical antibiotic
treatment

Clostridium difficile
(C. diff)

Prescribing medicines is rarely taught well in
medical school, yet it is one of the first tasks you’ll be asked to do on day one.
Even the most experienced of doctors will only know by heart the dose and frequency of
a maximum of 30–40 drugs, so do not worry if you cannot even remember the dose of
paracetamol; for adults it’s 1g/4–6h PO max 4g/24h in divided doses (...
Pharmacopoeia
Authors: Raine Tim , Dawson James , Sanders Stephan , Eccles Simon
Published: August 2014

Pharmacopoeia

Users are advised to always check local prescribing guidelines and formularies and
to consult the BNF when prescribing drugs.

Dose see Table 5.1, and see
Table 5.2 on how to commence a patient on an ACEi
Indications heart failure, hypertension, diabetic nephropathy,
prophylaxis of cardiovascular events ...
Skin and eyes
Authors: Raine Tim , Dawson James , Sanders Stephan , Eccles Simon
Published: August 2014

Rash emergency

Rash

Bacterial infections
causing a rash

Viral infections
causing a rash

Fungal infections
causing a rash

Chronic inflammatory
rashes

Other causes of
rash

Skin lumps

Skin cancers

Breast lumps

Leg ulcers

Acute red eye
emergency

Sudden visual
loss

Gradual visual
loss

Other visual
disturbances...
Interpreting results
Authors: Raine Tim , Dawson James , Sanders Stephan , Eccles Simon
Published: August 2014

Blood tests

Full blood count
(FBC)

Clotting

Cardiac markers

Inflammatory response

Urea and electrolytes
(U+E)

Liver function tests (LFT)
and amylase

Calcium and phosphate

Endocrine tests

Cardiology

Electrocardiogram
(ECG)

Respiratory

Chest X-ray (CXR)

Arterial blood gases
(ABGs)

Respiratory function
tests

Gastrointestinal

Abdomen X-ray (AXR)

Urine tests...
Delirium in Palliative Care
Authors: Breitbart William S.
Published: August 2014

Delirium is the most common and serious neuropsychiatric complication in palliative care settings. Delirium is often under-recognized or misdiagnosed in terminally ill patients. Delirium is highly prevalent and is a source of morbidity in patients, family members, and staff. Delirium is often a harbinger of impending death and can significantly interfere with pain and symptom control among terminally ill. This chapter provides an overview of the prevalence, assessment, and management of delirium among advanced cancer patients reviewing the most recent evidence-based data on the use of psychopharmacological agents in treatment and prevention of delirium in this patient population.
Management of Fatigue in Palliative Care Settings
Authors: Breitbart William S.
Published: August 2014

Fatigue is highly prevalent in palliative care settings. Studies suggest that as many as 60% to 90% of advanced cancer patients experience fatigue. Fatigue is frequently under-recognized and undertreated in the terminally ill. This chapter provides a comprehensive overview of the prevalence of fatigue in palliative care settings, instruments used in screening and assessment of fatigue, common contributing factors of fatigue in advanced cancer patients, and the most recent evidence on the strategies for management of fatigue in palliative care settings.
Hypersensitivity Pneumonitis
Authors: Bernstein David I.
Published: August 2014

Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis, is an allergic inflammatory parenchymal lung disease usually caused by inhalational exposure to organic antigens from microbial bioaerosols or animal sources encountered in the work or home environment. Patients with HP can present with wheezing and obstructive abnormalities leading to an incorrect asthma diagnosis. The presence of a gas exchange abnormality, bronchoalveolar lavage lymphocytosis, and characteristic infiltrative changes on high-resolution computed tomography of the chest can be used to distinguish HP from asthma. The early diagnosis of HP and cessation of exposure to causative antigens result in remission of the disease and no residual impairment.
Allergic Bronchopulmonary Aspergillosis
Authors: Greenberger Paul A.
Published: August 2014

Allergic bronchopulmonary aspergillosis (ABPA), a disease that complicates asthma and cystic fibrosis, is in the differential diagnosis of pulmonary infiltrates, peripheral blood or sputum eosinophilia, elevated total serum immunoglobulin E concentration, and bronchiectasis, any or all of which may occur in patients with established asthma. ABPA is one of the most important comorbid, coexisting subtypes of asthma because it results in irreversible lung destruction and may convert intermittent or persistent mild asthma into persistent severe asthma. The fact that the treatment of choice to clear pulmonary infiltrates and sputum eosinophilia is an oral steroid but not antifungal therapy remains true after 50 years of attempts to improve our understanding and treatment of ABPA. It remains to be established whether monoclonal antibodies will contribute to meaningful improvement in management of patients, or what combination therapy will be optimum instead of relying on oral glucocorticoids. Certainly, innovative, safe, and effective approaches to treatment are needed to decrease the harmful impact that untreated or inadequately treated ABPA can have on patients with asthma.
Chronic Obstructive Pulmonary Disease and Irreversible Airflow Obstruction
Authors: Peters Stephen P.
Published: August 2014

Patients with fixed airflow obstruction, whether from asthma or chronic obstructive pulmonary disease (COPD), or an overlap phenotype, represent an especially difficult group of patients to both categorize and manage. Many of the current research activities in both asthma and COPD are designed to subclassify patients with asthma and COPD into different endotypes and phenotypes, with the hope that the results will have implications for both the natural history of disease and the response to different therapies. Data outlined in this review, particularly the genetic findings, help strengthen the “Dutch hypothesis” Orie put forth more than 50 years ago about the commonalities of obstructive airways diseases operating under a variety of environmental influences. The identification of targets distinct from inflammation in both asthma and COPD, through different mechanisms—atopy, important in asthma, and smoking, important COPD–could lead to novel treatments for both of these diseases with fixed airflow obstruction. In the meantime, the use of bronchodilators, antiinflammatory agents, and environmental control and intervention, including smoking cessation, weight loss and control, and exercise and pulmonary rehabilitation, remain the foundation of the therapeutic approach for these diseases, regardless of their origin.
Infectious Comorbidities of Asthma in the Upper Airway
Authors: Bachert Claus , Vandeplas Griet
Published: August 2014

The link between the upper and lower airways is no longer a matter of debate. Acute or chronic disease of the upper airways and colonization by microorganisms such as Staphylococcus aureus leads to worsening of asthma symptoms. Asthmatic patients also are known to be more prone to developing chronic rhinosinusitis. Proper treatment of upper airway pathology, both medically and surgically, results in objective and subjective improvement of asthma. Understanding upper airway disease and its impact on asthma will provide new insights, not only in the pathogenesis of asthma, but also its treatment.
Exercise-Induced Bronchoconstriction and Asthma
Authors: Bonini Matteo , Moreira André , Bonini Sergio
Published: August 2014

Exercise-induced bronchoconstriction (EIB) is defined as “the transient narrowing of the airway with increasing airway resistance after exercise.” This chapter, in line with the objective of the book, discusses the relationship between EIB and asthma, with special reference to clinical features, pathophysiologic mechanisms, diagnostic criteria, and treatment preventive options.
Deep Fungal Diseases
Authors: Meunier Yann A.
Published: August 2014

Presentation of the Geographic Distribution, Main Symptoms, Treatment and Preventive Measures of fungal diseases: Basidiobolomycosis, Blastomycosis (North American or Gilchrist disease or Chicago disease), Blastomycosis (South American or Lutz-Splendore-Almeida disease), Chromomycosis, Coccidioidomycosis (or Posada, Wernicke and Rixford disease), Conidiobolomycosis, Histoplasmosis (African), Histoplasmosis (American or Darling disease), Lobomycosis (or Jorge Lobo disease) Mycetoma (or Madura foot), Pythiosis, Rhinosporidiosis, Scytalidiosis.
Viral Diseases
Authors: Meunier Yann A.
Published: August 2014

Presentation of the Geographic Distribution, Main Symptoms, Treatment and Preventive Measures of viral diseases: (1) Common Diseases: Hepatitis, Herpes simplex (or cold or fever sore), HIV/AIDS, Influenza (flu and (2) Rare Diseases: Arboviral disease, Arenaviruses diseases (including Tacaribe complex and Lassa fever diseases, Bunyaviral diseases (including Rift Valley fever -RVF-), Filoviral diseases (including Ebola and Marburg virus diseases, Flaviviral diseases, Hantaviral diseases (including Hantan virosis, Reoviral and rhabdoviral diseases (including Mossuril virus and Lyssavirus diseases), S.A.R.S., Togaviral diseases (including Chikungunya virus disease)
Tropical Health Hazards
Authors: Meunier Yann A.
Published: August 2014

Presentation of the Geographic Distribution, Main Symptoms, Treatment and Preventive Measures of diseases induced by the following animals: Bees and Hymenoptera, Butterflies, Cats, Centipedes, Dogs, Fish, Fleas, Jelly fish/Anemones/Physaliae, Leeches, Lice, Ticks, Mollusks, Muraenae (or moray eels), Rats, Scorpions, Snakes, Spiders, Trombiculidae
Probing strange stars with advanced gravitational wave detectors
Authors: Moraes Pedro H. R. S. , Miranda Oswaldo D.
Published: August 2014

When a neutron star is squeezed to huge densities, it can be converted to a strange star. Using the event/year rate of a neutron star–strange star binary system, we show that the operational phase of advanced gravitational wave detectors might show some evidence that such strange stars do exist. Moreover, we argue that such a system could be a plausible progenitor to GRB 051103 and GRB 070201. In the last run of the Laser Interferometer Gravitational-Wave Observatory (LIGO), no gravitational wave signal was found for these gamma-ray bursts, and a conclusive explanation for this needs to be found.
Detection of a QPO in five XMM–Newton observations of RE J1034+396
Authors: Alston W. N. , Markevičiūtė J. , Kara E. , Fabian A. C. , Middleton M.
Published: August 2014

The X-ray quasi-periodic oscillation (QPO) at ∼2.6 × 10−4 Hz in RE J1034+396 has been robustly observed in the 0.2–10 keV band of one ∼90 ks XMM–Newton observation, but was not detected in subsequent observations. Here, we investigate the power spectral density (PSD) of eight archival XMM–Newton observations of RE J1034+396, and search for the presence of QPOs in three energy bands: soft (0.3–0.8 keV); hard (1.0–4.0 keV) and total (0.2–10.0 keV). We find a significant detection of a QPO feature in the hard-band PSD of five low-flux/spectrally harder observations. The QPO frequency has remained persistent at ∼2.6 × 10−4 Hz over ∼4 yr of observations, though it is no longer detected in the soft band, except in the original observation. This result increases the duration where the QPO is present by a factor of 3 (now ∼250 ks), allowing for a better understanding of the QPO phenomenon observed in both active galactic nuclei and black hole X-ray Binaries.
Phosphorylated Akt Expression as a Favorable Prognostic Factor for Patients Undergoing Curative Resection and Adjuvant Chemoradiotherapy for Proximal Extrahepatic Bile Duct Cancer
Authors: Kim Byoung Hyuck , Kim Kyubo , Min Hye Sook , Chie Eui Kyu , Jang Jin-Young , Kim Sun Whe , Han Sae-Won , Oh Do-Youn , Im Seock-Ah , Kim Tae-You , Bang Yung-Jue , Jang Ja-June , Ha Sung W.
Published: August 2014

Objectives:

To evaluate the prognostic significance of phosphorylated Akt (p-Akt), phosphorylated mammalian target of rapamycin (p-mTOR), and total phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expressions in patients undergoing adjuvant chemoradiotherapy (CRT) for proximal extrahepatic bile duct (EHBD) cancer.

Methods:

Sixty-three patients with proximal EHBD cancer who underwent curative resection followed by adjuvant CRT were enrolled into this study. Postoperative radiotherapy was delivered to tumor bed and regional lymph nodes up to a median of 40 Gy (range, 40 to 54 Gy). Fifty-nine patients also received fluoropyrimidine chemotherapy as a radiosensitizer. p-Akt, p-mTOR, and PTEN expression were assessed with immunohistochemical staining on the tissue microarray.

Results:

p-Akt, p-mTOR, and PTEN were expressed in 23 (36.5%), 17 (27.0%), and 24 patients (38.1%), respectively. p-Akt expression was associated with distant metastasis and overall survival (OS), but not with locoregional recurrence. The 5-year distant metastasis-free and OS rates were 25.8% versus 58.2% (P=0.007), and 27.5% versus 50.2% (P=0.0167) in patients with negative and positive expression, respectively. On multivariate analysis, nodal involvement was the only significant prognosticator predicting inferior distant metastasis-free survival (P=0.0105), whereas p-Akt expression had a borderline significance (P=0.0541). As for OS, p-Akt expression was a marginally significant prognosticator (P=0.0635), whereas other risk factors lost the statistical significance.

Conclusion:

p-Akt expression tended to be associated with a favorable prognosis in patients undergoing curative resection followed by adjuvant CRT for proximal EHBD cancer.
Pedobacter pituitosus sp. nov., isolated from a waterfall
Authors: Chun Jeesun , Kang Ji Young , Jahng Kwang Yeop
Published: August 2014

A taxonomic study was carried out on a novel bacterial strain, designated MIC2002T, which was isolated from Wibong falls in Korea. Cells were Gram-stain-negative, aerobic, non-motile and rods, 0.3–0.5 µm wide and 4.0–5.0 µm long. The optimum temperature and pH range for growth were 25 °C and pH 6.5–7.0, respectively. Catalase and oxidase activities were positive. Flexirubin pigments were not produced. Comparison of the 16S rRNA gene sequences indicated that the isolate belonged to the genusPedobacter, withPedobacter daechungensisas its closest relative, with a similarity of 94.4 %. It contained iso-C15 : 0, anteiso-C15 : 0, C16 : 0, summed feature 3 (C16 : 1ω6cand/or C16 : 1ω7c) and iso-C17 : 03-OH as the major fatty acids and menaquinone MK-7 as isoprenoid quinone. The polar lipid profile of strain MIC2002Trevealed the presence of phosphatidylethanolamine and an unknown lipid. The DNA G+C content of the strain was 34.7 mol%. On the basis of the evidences presented, it was concluded that strain MIC2002Trepresents a novel species of the genusPedobacterwithin the familySphingobacteriaceae, for which the namePedobacterpituitosussp. nov. is proposed. The type strain is MIC2002T( = KACC 17064T = JCM 18729T).
Prolonged clonal spreading and dynamic changes in antimicrobial resistance of Escherichia coli ST68 among patients who stayed in a respiratory care ward
Authors: Chen Chih-Ming , Ke Se-Chin , Li Chia-Ru , Chiou Chien-Shun , Chang Chao-Chin
Published: August 2014

From 2007 to 2009, we collected a total of 83 bacteraemic isolates of Escherichia coli with reduced susceptibility or resistance to third-generation cephalosporins (TGCs). Isolates were genotyped by PFGE and multilocus sequence typing (MLST). The PFGE patterns revealed two highly correlated clusters (cluster E: nine isolates; cluster G: 22 isolates) associated with this prolonged clonal spreading. Compared with cluster E isolates, cluster G isolates were significantly more likely to harbour aac(6')-Ib-cr (P<0.05), and most of these isolates were isolated during a later year than cluster E isolates (P<0.05). By MLST analysis, 94 % of cluster E and G isolates (29/31) were ST68. Although no time or space clustering could be identified by the conventional hospital-acquired infection monitoring system, E. coli cases caused by cluster E and G isolates were significantly associated with having stayed in our hospital’s respiratory care ward (P<0.05). Isolates obtained from patients who had stayed in the respiratory care ward had a significantly higher rate of aac(6')-Ib-cr and bla
CTX-M-14 positivity, and were more likely to belong to ST68/S68-like (all P<0.05). To our knowledge, this is the first report of prolonged clonal spreading caused by E. coli ST68 associated with a stay in a long-term care facility. Using epidemiological investigations and PFGE and MLST analyses, we have identified long-term clonal spreading caused by E. coli ST68, with extra antimicrobial-resistance genes possibly acquired during the prolonged spreading period.