bluuebunny/crossref_metadata_2025_split huggingface dataset:
A young person’s experience of chronic disease
Authors: Anonymous  
Published: February 2020

Abstract
This chapter is an anonymous account of one young person’s experience of receiving lifelong treatment for chronic disease. A trip to the hospital or to see the doctor for a single issue doesn’t require an advanced level of trust. A chronic condition requires the patient to develop a bond of trust with their care provider to make decisions that will maintain or, ideally, improve the condition. Vice versa, the care provider, be it doctor or nurse, needs to be able trust the patient to take on board their advice and be sure any medical plan will be followed, whether it is a set of exercises or a rigid treatment regime. This is a process that occurs over time and, with a chronic condition, time is something that can be afforded.
Bioinformatics
Authors: Chaudhry Afzal 
Published: February 2020

Abstract
Bioinformatics may be defined as ‘conceptualizing biology in terms of molecules and applying “informatics techniques” (e.g. applied mathematics, computer science and statistics) to understand and organize the information associated with these molecules, on a large scale’. Clinical bioinformatics may be defined as ‘the clinical application of bioinformatics-associated sciences and technologies to understand molecular mechanisms and potential therapies for human diseases’. If clinical bioinformatics is to deliver the integration of molecular and clinical data and thereby translate research knowledge into effective ‘personalized’ medicine, then two broad constituencies need to be supported. Clinicians at the point of care need to understand and integrate, perhaps via decision support mechanisms, entities such as genotype/phenotype correlations, biomarker discovery, and pharmacogenomics; while researchers require accurate, structured, and (ideally) coded clinical data, as well as biological reference data sets.
Humanitarian medicine
Authors: Kravitz Amy S. 
Published: February 2020

Abstract
Humanitarian medicine addresses the human consequence of crises such as conflict, disaster, or displacement, and serves to assist those whose lives and health are impacted by such events. It is practised in challenging settings where resources are limited and environments unstable, and requires a clinical skillset which is both near limitlessly broad and context specific. The humanitarian sector has expanded significantly during the last two decades as a result of climate-related crises and increasing complex humanitarian emergencies due to protracted and multifaceted conflicts. The picture today is evolving rapidly to address expanding humanitarian demands and a changing global sociopolitical reality.
Complementary and alternative medicine
Authors: Ernst Edzard 
Published: February 2020

Abstract
Complementary and alternative medicine can be defined as diagnosis, treatment, and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy, or by diversifying the conceptual frameworks of medicine. It is popular; hence doctors should know about it. The term covers a vast array of treatments and diagnostic techniques which have little in common except that they are not part of mainstream medicine. The most important modalities are acupuncture, phytotherapy, homeopathy, and spinal manipulation. In industrialized countries, typical users of complementary and alternative medicine are middle-aged, female, well-educated members of a high socioeconomic class. Indications range from chronic benign conditions where mainstream medicine does not offer a cure (e.g. back pain) to life-threatening diseases like cancer and AIDS.
The genomic basis of medicine
Authors: Stankiewicz Paweł , Lupski James R. 
Published: February 2020

Abstract
The first phase of the studies on genetic variation in humans has been focused on single nucleotide polymorphisms and common variation. The large number of single nucleotide polymorphisms identified has enabled successful genome-wide association studies for disease susceptibility risk of complex traits (e.g. diabetes and cancer), but for the most part has had limited practical applications in clinical medicine. This chapter examines the recent technological developments which have enabled a higher-resolution analysis of the human genome and its extensive submicroscopic structural variation, including copy-number variants. Copy-number variants involving dosage-sensitive genes result in several diseases and contribute to human diversity and evolution. An emerging group of genetic diseases have been described that result from DNA rearrangements (e.g. copy-number variants and other structural variations including copy-number neutral inversions and translocations), rather than from single nucleotide changes.
Ion channels and disease
Authors: Ashcroft Frances , Tammaro Paolo 
Published: February 2020

Abstract
Ion channels are membrane proteins that act as gated pathways for the movement of ions across cell membranes. They are found in both surface and intracellular membranes and play essential roles in the physiology of all cell types. An ever-increasing number of human diseases are now known to be caused by defects in ion channel function. To understand how ion channel defects give rise to disease, it is helpful to understand how the ion channel proteins work. This chapter therefore considers what is known of ion channel structure, explains the properties of the single ion channel, and shows how single-channel currents give rise to action potentials and synaptic potentials.
Allergy
Authors: Ewan Pamela 
Published: February 2020

Abstract
Allergy is common and becoming commoner: it now affects about one-third of the UK population. This is being driven by environmental changes, which are also leading to an increase in both the complexity and severity of the condition. In addition to the traditional allergic disorders—asthma, rhinitis, and eczema—multisystem allergic disease and reactivity to several allergens are now common; new allergies have appeared, including those due to foods, drugs, and diagnostic agents; and anaphylaxis is increasing. In contrast, new cases of latex allergy have become uncommon. Where possible, patients with significant allergy should be referred to an allergy specialist who can provide expertise not offered by—and complementary to—that of other specialties. Identifying and managing allergic causes of disease leads to reduction or resolution of its manifestations.
Epidemiology of cancer
Authors: Swerdlow Anthony , Peto Richard 
Published: February 2020

Abstract
The epidemiology of cancer is the investigation of the incidence and causes of the disease in people under different conditions of life. Such investigations have generally been the way in which reliable evidence about causal agents for cancer, and the magnitude of the risks from these agents, have been found. They have shown that any type of cancer that is common in one population is rare in some other, and that the differences between populations are mostly not genetic, but rather the consequences of behaviours and circumstances of life. In principle, cancers are largely preventable. The range of incidence rates between geographical and ethnic groups is more than 10-fold for each of the common cancers, and for some cancers is more than 100-fold. Large changes in rates of many tumours can occur in migrants compared with rates in their homeland and within populations over time, indicating the scope for prevention.
Systemic treatment and radiotherapy
Authors: Jena Rajesh , Harper Peter 
Published: February 2020

Abstract
Cancer therapy is underpinned by a detailed understanding of cancer biology and the complex interaction of tumour and host. Systemic therapies and radiation therapy are being used in many early stage cancers, with a ‘risk adaptive’ approach to maximize the likelihood of uncomplicated tumour cure, both as primary treatment and in the postoperative setting. Targeted therapies have changed the course of many common cancers. Patients with early stage disease benefit through enhanced cure rates, while rational treatment approaches to metastatic disease improve outlook for many patients. Where cancer therapies are given with curative intent, care must be taken to consider long-term toxicities. Systemic therapies may be associated with organ-specific late effects such as dose-dependent cardiac toxicity from anthracycline chemotherapy, lung fibrosis from bleomycin, and sensorineural hearing loss from vincristine. Radiation therapy also carries a risk of tissue damage, dependent on the dose and volume of tissue that is irradiated.
Ageing and clinical medicine
Authors: Steves Claire , Pendleton Neil 
Published: February 2020

Abstract
In 2017 there were, for the first time, more people older than 65 years than children under the age of 5 years. Despite the recent exponential increase in human lifespan, health-span has not kept pace, and variability between countries in healthy lifespan exceeds that of life expectancy. The increase in morbidity as people age is largely explained by loss of physiological reserve capacity in multiple systems simultaneously, which is termed frailty. Recent evidence suggests that different heritable (intrinsic factors) factors drive the ageing of different organ systems, but diverse systems share environmental (or extrinsic) drivers. Ageing is associated with macromolecular changes (molecular damage); changes in nutrient sensing, metabolism, and metabolic signalling; senescence in stem cells; altered intercellular communication, in particular changes associated with inflammaging; and changes in circadian rhythms and the hypothalamo-pituitary-adrenal axis.
Optimizing well-being into old age
Authors: Firth  
Published: February 2020

Abstract
Healthy ageing, well-being in later life, quality of life, and disability-free life are ideas that drive policy and practice in our ageing society. Their meanings overlap in sometimes confusing ways, but there is consensus that the postponement or containment of disability is a necessary but insufficient precondition of healthy ageing and the optimization of well-being in later life. Psychological factors like self-efficacy and sense of coherence also seem necessary for healthy ageing, but may be difficult to work with for many clinicians trained in a more medical model of healthy ageing. Primary promotion of healthy ageing through the avoidance of disability has had some success, especially through its impact on cardiovascular disease, but we have much to learn about influencing diet and physical activity across the life course for well-being in later life.
Supporting older peoples’ care in surgical and oncological services
Authors: Dhesi Jugdeep , Partridge Judith 
Published: February 2020

Abstract
The clinical profile of patients presenting for elective and emergency surgery and for oncological treatment is changing. Patients are now older and more complex with coexisting multimorbidity and geriatric syndromes. There is increasing recognition of the need to improve the effectiveness, efficiency, and the experience of patients in this vulnerable group. Achieving the best outcomes requires attention to asessment, quantification of risk, and proactive and responsive management among other aspects. Such wide-ranging interventions cannot be delivered by single specialties, but require collaboration across disciplines and specialties to ensure delivery of patient-centred services, relevant education, and training, and a research programme that aims to inform routine clinical practice.
Neurodegenerative disorders in older people
Authors: Hindle John 
Published: February 2020

Abstract
Neurodegenerative disorders are associated with a progressive loss of structure and function of neurones that leads to neuronal death. Their aetiology combines ageing, genetic susceptibility, and risk factors including environmental exposure, balanced against protective factors. They present with varying combinations of progressive cognitive, emotional, motor, autonomic and peripheral symptoms, and clinical signs. Neurodegenerative conditions are all likely to have a preclinical prodromal period, followed by slow initial decline during which there is clinical presentation, followed by a further steady decline and an eventual accelerated decline. The rate of progression of these disorders varies greatly, but they are all inevitably progressive, currently have no cure, and require symptomatic treatment.
Promotion of dignity in the life and death of older patients
Authors: Burns Eileen , Scampion Claire 
Published: February 2020

Abstract
Respect for the dignity of patients is a traditional part of medical codes. Dignified care is key to a holistic person-centred approach, with participation of the individual, communication, and respect. Nurses and doctors recognize lack of dignity in depersonalized care, treating the person as an object, humiliation, abuse, and invisibility.
Older people regard dignity as critically important in their care. This relates to issues around privacy, courteousness, respect for the individual, and consideration about choices related to care, and to respect for cultural or religious needs. Assuring dignity requires the sensitive addressing of basic needs and the promotion of inclusivity and participation, with recognition that even in the presence of some impairment of cognition, the wishes and views of the patient remain central to decision-making.
Pain management
Authors: Fallon Marie 
Published: February 2020

Abstract
Pain occurs in more than 50% of patients with advanced disease, interferes with daily functioning and quality of life, and is very often undertreated. Patients can find it difficult to articulate the character of their pains, but it is important to determine whether it is somatic, neuropathic, or visceral since this has important implications for management. For most patients with cancer pain, a three-step approach combining simple or opioid analgesia (depending on severity) along with an adjuvant analgesic (depending on cause) will result in good pain relief, but the challenge is to achieve good pain relief without unacceptable adverse effects.
Biology of pathogenic microorganisms
Authors: Maskell Duncan J. , Wood James L.N. 
Published: February 2020

Abstract
Microorganisms are present at most imaginable sites on the planet, and have evolved to occupy these ecological niches successfully. A host animal is simply another ecological niche to be occupied. This chapter describes how the ability to cause disease may in some cases be an accidental bystander event, or it may be the result of evolutionary processes that have led to specific mechanisms allowing the pathogen to exploit the rich source of nutrients present in the host, and then be transmitted to another fresh host. Pathogenicity often relies on a series of steps, with specific and often distinct mechanisms operating at each of them. Some types of pathogen must adapt to the host environment by altering gene expression, and most must retain the ability to be transmitted readily between hosts.
Infection in the immunocompromised host
Authors: Cohen Jon , Khatamzas Elham 
Published: February 2020

Abstract
The term ‘immunocompromised host’ embraces a group of overlapping conditions in which the ability to respond normally to an infective challenge is in some way impaired. This includes patients with underlying conditions such as protein–calorie malnutrition and diabetes, as well as organ transplant recipients, those with haematological malignancies and others receiving therapeutic immunosuppression, and patients with HIV infection. Many patients have multiple risk factors that increase the risk of opportunistic infection. A high level of awareness is essential for the management of patients who are immunocompromised; infections can progress very quickly, the early physical signs are often muted, and the microbiology can be confusing.
Arenaviruses
Authors: ter Meulen Jan H. 
Published: February 2020

Abstract
Arenaviruses are zoonotic RNA viruses that are distributed worldwide and are adapted to various rodent genera. Some are highly pathogenic and cause haemorrhagic fevers that are endemic in restricted regions of a few countries. Humans are thought to become infected mainly through inhalation of aerosolized rodent urine or dust particles to which infectious urine has dried, or by ingestion of contaminated foodstuff: prevention therefore depends on rodent control and avoidance of contact with rodents, their excreta, and nesting materials. Because arenaviruses cause diseases that start insidiously and therapy is life-saving, they should be considered in all patients with fever of unknown origin and a history of possible exposure in the well-known endemic areas.
Filoviruses
Authors: ter Meulen Jan H. 
Published: February 2020

Abstract
Filoviruses are large RNA viruses, of which Ebola virus and Marburg virus cause the most severe forms of viral haemorrhagic fever and have been best-studied because of fear of their misuse as bioterrorism agents. These are zoonotic viruses with reservoirs, most likely fruit-eating bats, in the rainforests of tropical Africa, where they cause sporadic infections and outbreaks among great apes and humans. The primary mode of transmission of Ebola virus to humans often involves contact of hunters with dead animals that serve as amplifying hosts, especially gorillas, chimpanzees, and forest antelopes, whose meat is consumed as ‘bush meat’. Contact with bats has been implicated for both Marburg and Ebola virus. However, the viruses are highly infectious and are transmitted from the index case and subsequently from person to person by all body fluids, including sweat, respiratory droplets, and semen. The viruses can persist in convalescent patients for many months.
HTLV-1, HTLV-2, and associated diseases
Authors: Verdonck Kristien , Gotuzzo Eduardo 
Published: February 2020

Abstract
Human T-cell leukaemia virus (HTLV)-1 and HTLV-2 belong to the genus Deltaretrovirus of the family Retroviridae. They only infect humans, produce a lifelong infection, and can be transmitted from mother to child, through sexual intercourse, and via cellular blood components and organ transplantation. Both viruses are present in all continents and have a heterogeneous distribution. HTLV-1-endemic foci (general population prevalence &gt;1%) are found in Japan, the Caribbean, South America, Africa, and Australo-Melanesia. There are endemic foci of HTLV-2 among native Amerindians and Central African populations. HTLV-1 and 2 also occur among people who inject drugs. It is unclear why some infected people develop associated diseases while others remain asymptomatic.
Pneumococcal infections
Authors: Scott Anthony 
Published: February 2020

Abstract
Streptococcus pneumoniae is an encapsulated Gram-positive bacterium that lives almost exclusively in the human nasopharynx. Each pneumococcus expresses one of more than 90 immunologically distinguishable capsular polysaccharides that are the principal target of systemic human immunity and define its serotype. Pneumococci are transmitted through contact with infected nasal secretions or by airborne dissemination, and most preschool children carry them in their nasopharynx. The risk of acquisition is increased by contact with other children, crowded environments, and cold weather. The incidence of pneumococcal disease is highest in young children and elderly people, and also increased in males, certain indigenous populations, smokers, alcoholics, and patients with chronic medical illnesses or immune susceptibility, including HIV infection, sickle cell disease, and splenectomy.
Haemophilus influenzae
Authors: Robinson Esther 
Published: February 2020

Abstract
Haemophilus influenzae is a Gram-negative bacillus that is an exclusively human pathogen and commensal. There are six capsular serotypes (a–f), of which type b (Hib) is a major cause of childhood infectious disease. Transmission occurs by close bodily contact, the main source being other children. Carriage of the organism may be followed by disease in susceptible individuals. In infants, Hib causes symptoms ranging from a mild non-specific febrile illness (occult bacteraemia) to fully blown sepsis with meningitis, epiglottitis, pneumonia, septic arthritis, or cellulitis. Non-typeable H. influenzae are common nasopharyngeal commensals and cause otitis media and conjunctivitis in children. In adults, non-typeable H. influenzae cause exacerbations of chronic bronchitis, sinusitis, and pneumonia. Other Haemophilus species, including H. parainfluenzae, are common commensals and rare causes of infective endocarditis and other sepsis.
Melioidosis and glanders
Authors: Peacock Sharon J. 
Published: February 2020

Abstract
Melioidosis is a serious infection caused by the soil-dwelling Gram-negative bacillus Burkholderia pseudomallei. It is most commonly reported in north-east Thailand and northern Australia, but is increasingly recognized around the world. Infection is predominantly acquired through bacterial inoculation, often related to occupation, and mostly affects adults between the fourth and sixth decade who have risk factors such as diabetes mellitus and renal impairment. Clinical features are very varied, ranging from a septicaemic illness (the most common presentation), often associated with concomitant pneumonia (50%) and other features including hepatic and splenic abscesses, to a chronic illness characterized by fever, weight loss, and wasting. Aside from supportive care and drainage of collections of pus, treatment requires prolonged antimicrobial therapy, with a parenteral phase of 10 to 14 days (ceftazidime or a carbapenem) followed by oral therapy for 12 to 20 weeks (trimethoprim-sulfamethoxazole).
Francisella tularensis infection
Authors: Oyston Petra C.F. 
Published: February 2020

Abstract
Fransicella tularensis is a small Gram-negative coccobacillus that circulates in small rodents, rabbits, and hares, most frequently in Scandinavia, northern North America, Japan, and Russia. Clinical presentation depends on the route of infection. Most commonly this follows the bite of an infected arthropod vector, resulting in ulceroglandular tularaemia. The most acute and life-threatening disease, respiratory or pneumonic tularaemia, arises following inhalation of infectious aerosols or dusts. The organism is highly fastidious, requiring rich media for isolation and specialized reagents for positive identification; most cases are diagnosed serologically. Treatment is with supportive care and antibiotics (usually ciprofloxacin, doxycycline, or gentamicin). There is no vaccine.
Tetanus
Authors: Thwaites C. Louise , Yen Lam Minh 
Published: February 2020

Abstract
Clostridium tetani is a Gram-positive spore-forming anaerobic bacillus able to infect and cause disease in both humans and animals. The bacterium is highly sensitive to oxygen but can survive in the environment as an extremely resistant metabolically inactive spore. Under suitable anaerobic conditions the spore germinates and the bacteria multiply, releasing a highly potent neurotoxin, tetanus toxin, which is responsible for the clinical features of tetanus. Tetanus is a disease characterized by muscle spasms caused by a toxin produced by Clostridium tetani. Without treatment mortality is high due to muscle spasms which prevent respiration or due cardiovascular system instability secondary to autonomic nervous system dysfunction. Tetanus is prevented by good wound hygiene and/or vaccination and, although rare in developed countries, the disease remains a significant problem in many countries where facilities for treatment are often poor and mortality remains high.