bluuebunny/crossref_metadata_2025_split huggingface dataset:
Papillomaviruses and polyomaviruses
Authors: Viscidi Raphael P. , Tan Chen Sabrina , Fakhry Carole 
Published: February 2020

Abstract
There are nearly 200 human papillomavirus types that infect epithelia of skin and mucous membranes. They infect only humans, and cause conditions including the following:
skin warts and verrucas, which are caused by types 1 and 2; infection initiated when, after minor skin abrasions, for example, the basal cells of the epithelium come in contact with infectious virus;
anogenital warts, which are caused by types 6 and 11; transmitted by direct sexual contact, these are the most common sexually transmitted infection; present clinically as multiple exophytic lesions or as subclinical flat lesions. They can be treated topically with podophyllin or imiquimod, or by ablative surgical methods. Recurrences are common. A highly efficacious prophylactic vaccine is available.
Molluscum contagiosum
Authors: Warrell David A. , Conlon Christopher P. 
Published: February 2020

Abstract
Molluscum contagiosum is caused by a Molluscipox DNA virus which infects keratinocytes of the epidermal stratum spinosum, producing distinctive small umbilicated papules on the skin. Its genome encodes a variety of proteins that suppress the host’s immune response. In children it is spread by skin contact, producing few or many lesions, while in sexually active adults it causes anogenital lesions. Molluscum is self-limiting within a few years in the immunocompetent, but those with pre-existing atopic eczema and immunosuppression, notably AIDS, commonly develop persistent diffuse eruptions with larger papules. Lesions can be removed mechanically or chemically. More severe infections can be treated with imiquimod or cidofovir.
Pseudomonas aeruginosa
Authors: Koh G.C.K.W. , Peacock Sharon J. 
Published: February 2020

Abstract
Pseudomonas aeruginosa is a highly versatile environmental Gram-negative bacterium that can be isolated from a wide range of habitats, including soil, marshes, and the ocean, as well as from plant and animal tissues. It is resistant to many disinfectants and antibiotics, giving it a selective advantage in hospitals. It rarely causes infection in the healthy host but is a major opportunistic pathogen. Diagnosis is usually straightforward when the organism is cultured from samples collected from normally sterile sites, but is often challenging when infection is suspected in non-sterile sites such as a catheterized urinary tract, burns, or skin ulcers, because P. aeruginosa may be either a pathogen or an innocent bystander. Treatment can be challenging as P. aeruginosa is intrinsically resistant to a broad range of antimicrobials.
Intracellular klebsiella infections (donovanosis and rhinoscleroma)
Authors: Richens John , Stoesser Nicole 
Published: February 2020

Abstract
Two rare intracellular species of Klebsiella, a Gram-negative bacillus, cause granulomatous disease in humans that is found in small endemic foci in warm climates, linked to poverty and poor hygiene. Donovanosis is caused by Klebsiella granulomatis (previously named Calymmatobacterium granulomatis) and is presumed to be sexually transmitted. Presenting with genital ulcers or growths, often accompanied by an inguinal ‘pseudobubo’ (granuloma inguinale), it is diagnosed by demonstrating Donovan bodies (vacuoles containing capsulated coccoid bacteria) lying within histiocytes in material taken from a typical lesion. Treatment is with azithromycin; surgery may be needed for complications. Rhinoscleroma, caused by Klebsiella rhinoscleromatis, is believed to transfer from person to person; following a period of rhinitis it most typically manifests with bulky growths in the upper respiratory tract. It is diagnosed by demonstrating intracellular organisms in typical lesions, combined with culture. Treatment is with ciprofloxacin; surgical debulking of lesions and/or reconstruction may be required.
Cystoisosporiasis
Authors: Weiss Louis M. 
Published: February 2020

Abstract
Cystoisospora belli is a coccidian protozoan that colonizes epithelial cells of the small intestine. Infection occurs by ingestion of parasite oocysts in water or food. Clinical features of infection include watery diarrhoea, dehydration, fever, and weight loss in both immune competent and immune deficient patients. Cystoisospora belli forms tissue cysts that allow for relapses of this infection. Cystoisosporiasis presenting as chronic diarrhoea is an opportunistic infection associated with HIV infection. Diagnosis is by microscopic examination of faecal specimens for C. belli oocysts, which show blue autofluorescence under ultraviolet light. Cystoisospora belli infection, even in patients with AIDS, responds rapidly to treatment with co-trimoxazole.
Blastocystis infection
Authors: Knight Richard 
Published: February 2020

Abstract
Blastocystis is an anaerobic unicellular non-invasive colonic parasite of animals and humans. It is transmitted faeco-orally, with human infection associated with travel, institutions, animal handlers, and immunodeficiency. Case reports strongly suggest that it causes a self-limited diarrhoeal illness. Diagnosis is by microscopic examination of faecal smears or concentrates. A trial of treatment with metronidazole is justified in patients who are immunocompromised, also when symptoms are prolonged. Molecular and ribosomal RNA studies now indicate that Blastocystis is a Stramenopile (a synonym for kingdom Chromista), currently only one species is recognized. Blastocystis has no flagellae, unlike other stramenopiles, which include slime nets, water moulds, and brown algae.
Chagas disease
Authors: Miles Michael A. 
Published: February 2020

Abstract
Trypanosoma cruzi, the protozoan parasite that causes Chagas disease, is a zoonotic infection with many mammal host and vector species. It is transmitted to humans by contamination of mucous membranes or abraded skin with infected faeces of bloodsucking triatomine bugs, also by blood transfusion, organ transplantation, transplacentally, and orally by food contaminated with infective forms. It multiplies intracellularly (pseudocysts) as amastigotes in mammalian cells, particularly heart and smooth muscle, from which flagellated trypomastigotes emerge to reinvade cells or circulate in blood. Around 10 million people are infected in Latin America; imported cases and congenital cases may occur elsewhere. Proven methods of controlling domestic triatomine bugs include insecticide spraying (with pyrethroids), health education, community support, and house improvement. Serological surveillance of children detects residual endemic foci or congenital transmission and is vital for monitoring the success of control programmes. There is no vaccine.
Trichomoniasis
Authors: Schwebke Jane 
Published: February 2020

Abstract
Trichomonas vaginalis is a sexually transmitted protozoan pathogen that may cause more than one-half of all curable sexually transmitted genital infections worldwide. Women with trichomoniasis are often asymptomatic, but they may develop vaginal malodour, discharge, erythema, or itching, and their male or female sexual partners may also be infected, although urethritis in men is less likely to cause symptoms. Women with trichomoniasis have an increased risk of HIV acquisition, HIV shedding, pelvic inflammatory disease, and preterm birth. For diagnosis, rapid antigen detection, culture, and polymerase chain reaction methods have advantages over conventional microscopy, but are more expensive. Oral metronidazole is usually an effective treatment, with both sexual partners needing to be treated to prevent reinfection.
Gut and tissue nematode infections acquired by ingestion
Authors: Chiodini Peter L. 
Published: February 2020

Abstract
Ascaris lumbricoides (the human roundworm) is widespread in the tropics and subtropics where sanitation is poor and the soil is contaminated with its eggs. Ascaris suum (the pig roundworm) is also capable of infecting humans. Some authorities consider them to be the same species, making A. suum a synonym of A. lumbricoides. Ingested eggs hatch in the small bowel, the larvae released migrate via the bloodstream and lungs, then return to the small bowel and develop into adult worms 15–30 cm long. Most infections are asymptomatic, but there may be pulmonary infiltrates with eosinophilia, abdominal discomfort and—in children with heavy infections—intestinal obstruction. Infection is diagnosed by finding eggs in the faeces. Treatment is with mebendazole, albendazole, or pyrantel pamoate.
Cystic hydatid disease (Echinococcus granulosus)
Authors: Moro Pedro L. , Garcia Hector H. , Gonzalez Armando E. 
Published: February 2020

Abstract
Cystic hydatid disease, caused by Echinococcus granulosus, is a zoonotic disease principally transmitted between dogs and domestic livestock, particularly sheep. Humans are infected when they ingest tapeworm eggs, with disease occurring in most parts of the world where sheep are raised and dogs are used to herd livestock. The most common clinical manifestations are cysts in the liver (typically presenting with hepatomegaly) and/or lung (presenting with cough, haemoptysis, and dyspnoea). Diagnosis is usually made on the basis of serological tests in combination with imaging techniques. Treatment options include surgery, chemotherapy with anthelminthic agents, or—for liver cysts—PAIR (puncture–aspiration–injection–reaspiration). Echinococcosis is a major public health problem in several countries. Control programmes have been aimed at educating dog owners to prevent their animals from having access to infected offal. Vaccines against sheep hydatidosis and the dog tapeworm stage are promising alternatives.
Sexual history and examination
Authors: Brook Gary , Sherrard Jackie , Luzzi Graz A. 
Published: February 2020

Abstract
Sexually transmitted infections (STIs) are common, especially in young people, and it is important that doctors recognize both the need to obtain a sexual history and when to perform genital examination. STIs can present with generalized or extragenital symptoms, the significance of which might be missed. Examples include secondary syphilis, primary HIV infection, disseminated gonococcal infection, and herpes simplex meningitis. Failure to consider a sexually acquired infection in a differential diagnosis might delay diagnosis and treatment. This chapter gives advice on how to take a sexual history and perform genital examination in both sexes. It also summarizes the common symptoms and syndromes associated with STIs and their causative pathogens, cross-referring to other chapters in the textbook.
Occupational safety
Authors: Waterman Lawrence 
Published: February 2020

Abstract
Any approach to occupational health must acknowledge that accidents in the workplace result in many injuries. Construction, agriculture, and primary extraction are the main causes of fatalities and serious injuries, but many more minor injuries result from all types of work. Health and safety law has developed with an emphasis on accident prevention that is based on designing and managing the working environment. Establishing this approach to safety management begins with an organization committing itself to a policy influenced by legal obligations and current good practice. While this chapter draws heavily on the UK situation, where there has been considerable experience and development of approaches to health and safety, it is incumbent on any physician to consider the work environment and whether changes to the workplace might improve not only the lot of their patients, but others potentially at risk in the workplace.
Noise
Authors: Koh David , Aw Tar-Ching 
Published: February 2020

Abstract
Noise can affect hearing in the occupational setting but can have other effects where exposures are non-occupational. For clinical purposes, noise is measured in decibels weighted according to the sensitivity of the human ear (dB(A)). Regardless of source, the effects of overexposure to noise are similar. Initially there is a temporary threshold shift, where reversibility of hearing loss is possible with removal away from further noise. Noise-induced hearing loss occurs following prolonged or intense exposure, with poor prospects for improvement of hearing. The classical audiogram for noise-induced hearing loss shows a 4 kHz dip. Non-auditory effects of prolonged noise exposure include annoyance, sleep disturbance, hypertension, and cardiovascular disease, stress, and impaired cognitive performance. Prevention of noise-induced hearing loss is by reducing exposure to noise at source minimizing exposure time, using hearing protection, and participating in surveillance.
Vibration
Authors: Aw Tar-Ching 
Published: February 2020

Abstract
Various occupations can lead to exposure to vibration, which can be transmitted to the whole body or localized to the hands. The main clinical effect of whole-body vibration exposure is low back pain. Effects from hand-transmitted vibration can be (1) vascular, with manifestations of secondary Raynaud’s phenomenon; (2) neurological, often presenting as paraesthesia and reduced sensory perception; and (3) musculoskeletal, including reduced grip strength and loss of manual dexterity. In tropical countries, as opposed to temperate climates, the clinical manifestations are predominantly neurological and musculoskeletal, instead of vascular. Management requires exclusion of differential diagnoses, and the identification and reduction of exposure to vibration at source. Diagnosis of an index case should prompt further investigation and where possible, modification of the system of work to prevent other cases from occurring.
Lightning and electrical injuries
Authors: Andrews Chris 
Published: February 2020

Abstract
Lightning strikes are rare accidents but carry a 10% case fatality, killing 0.1–0.3 per million population each year. During thunderstorms, the risk is increased by sheltering under trees or by being on open water, on tractors, or in open fields or in outdoor activity.
Lightning is considered to cause instant asystole. Immediate cardiopulmonary resuscitation is mandatory. Survivors might develop complications including pain syndromes and psychological sequelae. Burns are generally of minor consequence, unlike electrical injury. The most disabling consequences of the injury is generally the psychological sequelae. Meanwhile, electrocution is the fifth most common cause of workplace death, mainly affecting utilities, mining, and construction labourers. Domestic electrical accidents are common, where contact with overhead power lines, faulty power tools, and particularly using extension cords, are the most common causes, with metal ladders and antennae being particularly dangerous.
Poisoning by drugs and chemicals
Authors: Vale John A. , Bradberry Sally M. , Bateman D. Nicholas 
Published: February 2020

Abstract
Poisoning is usually an acute, short-lived event which necessitates immediate care, though complications such as rhabdomyolysis may persist for a few days. Less commonly, symptoms may arise only after prolonged exposure, as occurs with many heavy metals. Rarely, sequelae may not occur until many years after exposure (e.g. with vinyl chloride). It must be stressed that exposure does not necessarily equate with poisoning as uptake of the agent involved is required but, even if this occurs, poisoning does not necessarily result as the amount absorbed may be too small.
Poisoning may be accidental or deliberate; it is usually accidental in small children, but in adults it is almost invariably deliberate. Less commonly, it may be iatrogenic. Occupational poisoning is frequent in developing countries.
Diseases of affluent societies and the need for dietary change
Authors: Mann J.I. , Truswell A.S. 
Published: February 2020

Abstract
Nutritional problems of a country depend more upon the stage of technical and economic development than geographical location. People in affluent societies have ready access to food all year round. The diet is typically energy-dense, high in fat and often also in sugar. There are multiple sources of nutritional advice, not all based on sound science. Obesity is the most obvious and important nutritional disease in affluent societies, with comorbidities including type 2 diabetes, coronary heart disease, hypertension, some cancers, gallstones, osteoarthritis, and obstructive sleep apnoea. Obese people may also be disadvantaged by social, economic, and psychological effects. Particular dietary constituents promote or protect against coronary heart disease by their effect on cardiovascular risk factors, and some promote or protect against various cancers.
Medical management of normal pregnancy
Authors: Williams David J. 
Published: February 2020

Abstract
This chapter looks at the medical management of normal pregnancy, and how the global maternal mortality ratio fell by almost 50% between 1990 and 2015 and the reasons for this decline. In resource-poor nations, provision of basic antenatal facilities with community healthcare workers, improved transport, communications, and education are largely responsible. Yet despite this progress maternal deaths are still common, particularly in sub-Saharan Africa, usually from readily preventable causes that would not occur in the presence of a skilled birth attendant. In wealthy nations, new challenges to maternal health include obesity, older age, and a growing number of pregnancies in women with chronic diseases through in vitro fertilization. Pregnancy can be accurately diagnosed within a day of missing a menstrual bleed by identifying a rise in urinary human chorionic gonadotropin concentration.
Heart disease in pregnancy
Authors: Head Catherine E.G. 
Published: February 2020

Abstract
Pregnancy is a vasodilator state in which plasma volume and cardiac output increase such that many symptoms and signs of cardiac disease can occur physiologically. Disproportionate symptoms or abnormal signs such as a diastolic murmur require investigation as usual; necessary radiological investigations should not be withheld as the risks to the fetus are generally low. This chapter looks at the various aspects of pre-pregnancy risk assessment and delivery of the baby; heart conditions arising in pregnancy (e.g. peripartum cardiomyopathy, myocardial infarction); and managing heart conditions in pregnant women, such as valve diseases and cardiomyopathies, hypertrophic cardiomyopathy, congenital cardiac lesions, and anticoagulation.
Liver and gastrointestinal diseases of pregnancy
Authors: Heneghan Michael , Williamson Catherine 
Published: February 2020

Abstract
This chapter first looks at pregnancy-specific disorders that cause de novo abnormal serum liver tests in pregnancy. These include: hypertension-related liver diseases; acute fatty liver of pregnancy; intrahepatic cholestasis of pregnancy; hyperemesis gravidarum; and viral hepatitis, probably the most commonly recognized cause of jaundice occurring during pregnancy worldwide. The chapter also describes the influence of pregnancy on pre-existing diseases, the effect of these diseases on pregnancy outcome, the impact of specific drugs used to treat women with liver and gastrointestinal disorders on the fetus.
Autoimmune rheumatic disorders and vasculitis in pregnancy
Authors: Soh May Ching , Nelson-Piercy Catherine 
Published: February 2020

Abstract
Autoimmune diseases affect 5–7% of people, are more common in women of childbearing age, and are frequently encountered in pregnancy. They may remit or improve during pregnancy, but can flare or present in pregnancy. Many women with autoimmune rheumatic diseases have been advised against pregnancy in the past, but this is no longer appropriate with a new generation of pregnancy-friendly disease-modifying antirheumatic drugs and biological agents that afford excellent disease control without compromising fertility. Nevertheless, many women with autoimmune rheumatic diseases are older and have more comorbidities (i.e. hypertension, obesity, diabetes, cardiovascular disease, and so on) when they do attempt pregnancy. This chapter looks at the importance of planned pregnancies with good preconception advice from clinicians knowledgeable in both the disease process and its effects on pregnancy (and lactation), and vice versa.
Malignant disease in pregnancy
Authors: Crawford Robin A.F. 
Published: February 2020

Abstract
Cancer in pregnancy is rare, affecting less than 1 in 1,000 live births. It may be specific to pregnancy (gestational trophoblastic disease) or incidental to it, the less infrequent conditions being melanoma, lymphoma, and cervical malignancy. Tumours of the uterine cervix, ovary, breast, or thyroid can metastasize to the placenta, but not to the fetus. Gestational trophoblastic disease arises from fetal chorion and is a malignant transformation of the placenta. Melanoma and haematological tumours, which also can invade the placenta, may cross into the fetal circulation. Pregnancy may cause enlargement of a pituitary tumour and a previously silent tumour may present with symptoms in pregnancy. Rare cases of colonic and neurological cancers developing in pregnancy have also been reported.
Prescribing in pregnancy
Authors: MacKillop Lucy , Frise Charlotte 
Published: February 2020

Abstract
Many clinicians feel uncertain about prescribing for pregnant women. Despite well-known examples of drugs that have caused serious adverse effects to the developing fetus, most medications can be used safely and effectively in this setting, provided some simple principles are followed. The first of these is that the health of the mother is the most important factor in determining the health of the fetus. Inappropriate cessation of existing medication, or failure to initiate new agents when clearly indicated, can be more harmful than the judicious use of selected medication to maintain maternal health. A medication should be prescribed in pregnancy if the benefit to the mother, and therefore indirectly to the fetus, outweighs the potential risk of fetal exposure.
Symptoms of gastrointestinal disease
Authors: Woodward Jeremy 
Published: February 2020

Abstract
The skilful analysis of symptoms indicating disorders of the digestive system is an integral part of the practice of internal medicine. Many patients with abdominal symptoms do not have easily defined organic conditions. The traditional skills of taking a careful history and examining the patient thoroughly are invaluable in managing patients who have functional disorders such as ‘irritable bowel’, nonulcer dyspepsia, nonspecific diarrhoea, recurrent abdominal pain, and somatization disorder. The enormous advances in endoscopy, scanning, and other investigative techniques have not made clinical diagnosis less important. Most gastrointestinal disorders are minor self-limited conditions of uncertain cause or are functional in nature, thereby often eluding definition even if extensive diagnostic procedures are (unnecessarily) employed. At the other extreme, the early suspicion of life-threatening disease and prompt referral of patients for investigation depends on clinical judgement.