bluuebunny/crossref_metadata_2025_split huggingface dataset:
Right ventricular outflow tract stenting in the management of tetralogy of Fallot with pulmonary artery hypoplasia and major aortopulmonary collaterals
Authors: Penford Gemma , Stumper Oliver 
Published: August 2020

AbstractFallot’s tetralogy is the most common cyanotic congenital heart lesion. It is a term that encompasses a spectrum of morphologies, all emerging from the fundamental feature of anterior deviation of the outlet septum and associated abnormalities of pulmonary blood flow. This case follows the journey of a patient with severe Fallot’s tetralogy and multifocal pulmonary blood flow from the neonatal period through to his post-operative period. The case explores key points in the assessment of these patients, addressing the medical, interventional, and surgical options for neonatal cyanosis, and then goes on to discuss common issues and pitfalls surrounding peri-operative care.
Neonatal enteroviral myocarditis: a potentially devastating disease
Authors: Donne Grazia Delle , Daubeney Piers 
Published: August 2020

Abstract
Myocarditis is the most common cause of dilated cardiomyopathy. Diagnosis can be challenging—the presentation can vary from mild heart failure to cardiogenic shock and is often preceded by respiratory or gastrointestinal symptoms. The aetiology is predominantly viral in childhood. The electrocardiogram, echocardiogram, and cardiac biomarkers all assist in making the diagnosis. There is an emerging role for cardiac magnetic resonance imaging as a diagnostic tool. Endocardial biopsy is the gold standard for the diagnosis, but the risk of the procedure often precludes its use in childhood. Treatment of myocarditis comprises standard heart failure management and, in the most severe cases, mechanical support and transplant. Overall, myocarditis has a better outcome than other causes of dilated cardiomyopathy. Surviving the initial episode is not assured but does lead to excellent long-term outcomes, both in terms of survival and recovery of left ventricular function.
Fetal management of hypoplastic left heart syndrome
Authors: Harris Michael , Sharland Gurleen 
Published: August 2020

Abstract
Hypoplastic left heart syndrome (HLHS) is a major form of congenital heart disease, with universal mortality if left untreated. Even with treatment, survival to eventual palliative univentricular Fontan circulation is in the order of 65% at the age of 5 years. The condition also carries with it a significant load in terms of comorbidities, recurrent interventions, and reduced quality of life. Fetal diagnosis of HLHS is important for accurately counselling the prospective parents on the available options during and after the pregnancy. It is crucial for the adequate planning of, and preparation for, delivery, with evidence emerging that babies delivered with such preparation are in better preoperative condition. Risk stratification is possible with the assessment of restrictive flow at the interatrial septum and the use of magnetic resonance imaging to assess the status of the fetal lungs in this situation. Fetal intervention in cases of a restrictive atrial septum is an emerging and challenging area, with limited evidence for efficacy currently. Due to the high-risk nature of this condition, it is difficult to prove that fetal diagnosis makes any significant impact on mortality.
The preterm patent ductus arteriosus: the controversy of closure
Authors: Abumehdi Mohammad Ryan , Hunter Lindsey 
Published: August 2020

Abstract
Management of preterm patent ductus arteriosus (PDA) has, and currently is, an issue of much contention. Management strategies have varied between conservative medical management to pragmatic PDA surgical ligation. However, despite the association between the haemodynamically significant ductus arteriosus and many of the morbidities of the preterm neonate, there remains no clear benefit in morbidity and mortality to closure. This case demonstrates the challenges faced by both the neonatal and the cardiology teams and the common trajectory for the preterm infant with the haemodynamically significant patent ductus arteriosus. The case highlights up-to-date developing techniques, clinical tips, and important learning points to aid the management of this common, but controversial, pathology.
Arrhythmias in congenital heart disease
Authors: Bruaene Alexander Van De , Haldar Shouvik , Nair Krishnakumar 
Published: August 2020

Abstract
Patients with congenital heart disease are prone to the entire spectrum of atrial and ventricular arrhythmias. The arrhythmia can be related to the malformation itself (e.g. Wolff–Parkinson–White in Ebstein anomaly), structural remodelling due to ageing/longer life expectancy (e.g. atrial fibrillation), mode of repair (e.g. intra-atrial re-entry tachycardia after right atrial incision or monomorphic ventricular tachycardia after tetralogy of Fallot repair), and severe ventricular dysfunction in those with end-stage heart failure. Therefore, adequate knowledge of the congenital heart defect, its current haemodynamics and arrhythmogenic substrate, precise assessment, and risk stratification will lead to appropriate arrhythmia management. This chapter discusses the diagnosis, assessment, and management of arrhythmia in two adult patients with congenital heart disease. The aim is to offer practical advice for managing these patients, supported by scientific data.
Common arterial trunk
Authors: Tretter Justin T , Alsaied Tarek , Redington Andrew N 
Published: August 2020

Abstract
Common arterial trunk, or truncus arteriosus, is a rare form of congenital heart disease defined by the presence of an arterial trunk which arises from the ventricular mass through a common ventriculo-arterial junction and gives rise to the systemic, pulmonary, and coronary circulations. The anatomical variation and associated cardiac anomalies dictate the clinical presentation and specific surgical repair strategy. This chapter reviews a common presentation of a newborn with common arterial trunk, serving as the basis for discussion of the anatomical variation, physiology, resulting clinical presentation and preoperative management, surgical repair strategy, and outcomes.
Dyslipidaemia
Authors: Drexel Heinz 
Published: August 2020

Abstract
Lipid metabolism has gained cardiological interest only after statins were demonstrated to reduce cardiovascular disease in secondary and primary prevention. Therefore, this chapter first introduces the physiological and atherogenic properties of lipoproteins, before focusing on interventions. Both the efficacy and safety of statins have been proven in numerous randomized clinical trials. Because there is a considerable residual risk in statin-treated patients, additional approaches have been investigated. The focus is now on further reductions in low-density lipoprotein (LDL) cholesterol levels. First, high-intensity statin regimens were shown to reduce residual risk. Subsequently, ezetimibe was demonstrated, for the first time, to have a beneficial effect as a non-statin lipid intervention. More recently, inhibitors of the enzyme PCSK9 have demonstrated a very high efficacy in reducing LDL cholesterol levels. Although the causality of LDL for atherosclerotic cardiovascular disease has been proven in epidemiological studies, including Mendelian randomization studies, as well as interventional trials, adherence to statins and other therapies is far from optimal. In contrast, interventions to increase high-density lipoprotein (HDL) cholesterol levels could not proven to have further benefits when combined with statins.
Thrombosis
Authors: Verheugt Freek 
Published: August 2020

Abstract
Blood coagulation plays a role in the pathogenesis of acute and chronic vascular disease. Acute myocardial infarction is generally associated with partial or complete thrombotic occlusion of one of the coronary arteries, whereas embolic stroke usually is associated with clot formation in the left atrium, left ventricle, or carotid arteries. Arteries in the lower extremities may get occluded by thrombosis, leading to ischaemia or amputation. Finally, venous thromboembolism is mainly caused by thrombus formation in the veins of the pelvis and/or the legs. This chapter deals with the effectiveness and safety of antiplatelet and anticoagulant drugs in primary and secondary prevention of cardiovascular disease.
Heart failure
Authors: Zannad Faiez , Ferreira João Pedro , McDonagh Theresa 
Published: August 2020

Abstract
Heart failure (HF) is a global pandemic affecting nearly 30 million people worldwide and is increasing in prevalence. Chronic heart failure with reduced left ventricular ejection fraction (HFrEF) results from impaired systolic dysfunction and represents about half of HF cases. The commonest aetiology is myocardial ischaemia. Chronic heart failure with preserved left ventricular ejection fraction (HFpEF) is symptoms and/or signs of heart failure, with left ventricular ejection fraction in the normal range. Acute HF is characterized by a rapid onset of signs and symptoms of HF, requiring urgent treatment. Acute HF may present as a first occurrence (de novo) or, more frequently, as a consequence of acute decompensation of chronic HF and may be caused by primary cardiac dysfunction or precipitated by extrinsic factors, often in patients with chronic HF. The diagnostic, workup, and treatment options for these conditions will be summarized in the chapter.
Supraventricular (narrow complex) tachycardias
Authors: Martí-Almor Julio 
Published: August 2020

Abstract
Supraventricular tachycardia (SVT) includes all tachycardia rhythms (more than 100 bpm), of which the mechanism involves the His Bundle or tissues above it. Usually, these tachyarrhythmias present a narrow QRS complex (except in the presence of a bundle branch block or a manifest accessory pathway which conducts anterogradely to cause a ventricular pre-excitation pattern on the electrocardiogram). This chapter only focuses on narrow QRS complex SVT involving the atrial tissue, the atrioventricular node, and accessory pathways. Atrial fibrillation and atrial flutter are excluded because they are specifically covered in other chapters. The role of antiarrhythmic drugs in SVTs is mainly restricted to acute situations because ablative therapy has surrogate pharmacotherapy and ablation is considered the best long-term treatment for most cases. Nevertheless, it is very important to know how to deal with antiarrhythmic drugs in emergency situations.
Bradyarrhythmias
Authors: Burri Haran 
Published: August 2020

Abstract
This chapter overviews the types of bradycardia and their acute management, including the use of rate-accelerating drugs, and overviews the indications for pacemaker therapy. Focus is on pharmacotherapy with atropine, adrenaline, isoprenaline, isoproterenol, dobutamine, dopamine, theophylline, and aminophylline.
Syncope
Authors: Ruiz-Granell Ricardo 
Published: August 2020

Abstract
Syncope results from sudden, transient, global cerebral hypoperfusion. Neurally mediated syncope, orthostatic hypotension, arrhythmic and cardiac syncope, and steal syndromes are the main pathophysiological forms of syncope. This chapter focuses on the treatment of neurally mediated syncope and orthostatic syncope, since other forms of syncope are reviewed elsewhere. In neurally mediated and orthostatic syncope, patient education and non-pharmacological measures are the mainstay of treatment, although benefits of pharmacological treatment are not so evident.
Myocarditis and pericardial syndromes
Authors: Boffa Giovanni , Ceconi Claudio 
Published: August 2020

Abstract
Myocarditis is defined as inflammatory disease of the myocardium, diagnosed by established histological, immunological, and immunohistochemical criteria. Aetiology-targeted therapy is indicated when supported by evidence. However, in the vast majority of patients with myocarditis, the most important targets of treatment are heart failure and arrhythmias. Management of systolic left ventricular (LV) dysfunction should follow the recommendations of current European Society of Cardiology guidelines on heart failure. Immunosuppression is indicated only in giant cell myocarditis. In patients with severe LV dysfunction, inotropic support may be necessary and ventricular assist devices may represent a bridge to recovery or to heart transplantation There are no specific treatments of arrhythmias in myocarditis. Implantation of cardioverter–defibrillators must be deferred in the acute phase. In patients with severe ventricular arrhythmia, a wearable cardioverter–defibrillator can represent a bridge to recovery, implantation of cardioverter–defibrillators, or heart transplantation. Pericardial diseases may be either an isolated disease or part of a systemic disease. The main pericardial syndromes that are encountered in clinical practice include pericarditis (acute, subacute, chronic, and recurrent), pericardial effusion, cardiac tamponade, and constrictive pericarditis, and pericardial masses. Major advances have occurred in therapy with the first multicentre randomized clinical trials. Colchicine has been demonstrated as a first-line drug to be added to conventional anti-inflammatory therapies in patients with a first episode of pericarditis or recurrences, in order to improve response to therapy, increase remission rates, and reduce recurrences.
Kidney disease
Authors: Banerjee Debasish , Ramphul Robin , Goldsmith David 
Published: August 2020

Abstract
The cardiovascular disease profile in patients with chronic kidney disease, and liver disease and during pregnancy is different from that in the general population. Due to altered physiology in these conditions, drug handling is different. Hence, drug therapies in these conditions are described separately in this section. Cardiovascular disease is the commonest cause of morbidity and mortality in patients with chronic kidney disease. Yet drug therapy is often withheld or used in inappropriate doses. The kidneys have a major role in the pharmacokinetics of numerous drugs, and hence the renal function determines the dose and effect of these drugs. This chapter describes common cardiovascular events in chronic kidney disease patients and appropriate drug therapy. Evidence-based guidance is provided when appropriate, and the dose adjustments are as known, when available, in accordance to the current European Society of Cardiology guidelines.
Liver disease
Authors: Hojs Nina Vodošek , Ala Aftab , Banerjee Debasish 
Published: August 2020

Abstract
Cardiovascular disease in patients with liver disease, previously uncommon, is rising because of an increasing incidence of non-alcoholic fatty liver disease and better survival of patients with viral hepatitis, particularly hepatitis C. Liver dysfunction alters the pharmacokinetics and pharmacodynamics of many drugs, and hence careful use and dose adjustments are necessary. This chapter describes common cardiovascular conditions and the pharmacotherapy in patients with different liver diseases.
Major drug interactions
Authors: Poulsen Maja Hellfritzsch , Krogh Marlene Lunddal 
Published: August 2020

Abstract
Drug interactions are commonly present in our daily clinical work and have the ability to either enhance or reduce the effects of a drug, but also, just as importantly, decrease or increase the risk of side effects, thereby increasing the risk of toxicity. This chapter will focus on the clinically important drug–drug interactions with some of the most often used cardiovascular drugs and especially where there is a risk of causing harm to patients due to serious side effects. Both pharmacokinetic and pharmacodynamic interactions will be discussed, with focus on the most vulnerable patients. In some cases, drug combinations are contraindicated, whereas in other cases, the combinations can be used with, for example, close monitoring or dose reductions, but most importantly, the risk of interactions should be considered in order to take appropriate precautions upfront.
Tales of Kieran: The occupational physician’s odyssey 1—Solvents
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 1: Solvents J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Kieran’s involvement in a legal case about dry-cleaning solvents and dementia.
Tales of Kieran: The occupational physician’s odyssey 2—New job
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 2: New job J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Kieran’s attempt at filling his recently vacated post at Lincaster Health Authority when he got a new job.
Why I became an occupational physician …
Authors: Kearns Joseph L. 
Published: August 2020

Abstract
Why I became an occupational physician … briefly explores the reasons and influences behind Joseph L. Kearns’s decision to pursue a career in occupational medicine. It takes us through his field trips to industrial enterprises, National Service in the RAMC, and move from initial cover work to full-time position at J. Lyons and Company.
Coming to the end of the road in occupational health—lessons from cancer care
Authors: Brecker Naomi , Wren Barbara 
Published: August 2020

Abstract
In Coming to the end of the road in occupational health—lessons from cancer care Naomi Brecker and Barbara Wren briefly explore their experience of the pessimistic ‘no hope’ outlook of some of their patients in occupational health, and similar situations from oncology patients.
Fifty years ago: ‘The medical officer of health and the small workplace’
Authors: Robinson A.W.W. 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: ‘The medical officer of health and the small workplace’ A. W. W. Robinson briefly explores Britain’s lack of occupational health coverage compared to the rest of Europe and discusses the merits of a National Occupational Health Service.
Tales of Kieran: The occupational physician’s odyssey 3—The Birdman of Linbridge
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 3: The Birdman of Linbridge J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Kieran’s attempts at eradicating bird-induced psittacosis at Linbridge University using a gun, a cardboard cutout, and a PAL Sound Emitter.
Why I became an occupational physician …
Authors: Brill Monty 
Published: August 2020

Abstract
Why I became an occupational physician … briefly explores the reasons and influences behind Monty Brill’s decision to pursue a career in occupational medicine. It takes us through his undergraduate days at Glasgow in the early 1950s, move to become a GP in London, and how his later post at an engineering company sparked an interest in occupational health.
Are you ready for the EU Sharps Directive 2010/32/EU?
Authors: Wicker Sabine , Grime Paul 
Published: August 2020

Abstract
In Are you ready for the EU Sharps Directive 2010/32/EU? Sabine Wicker and Paul Grime briefly explore the ‘Sharps Directive’ legislation introduced to reduce workplace needlestick injuries in hospitals and the healthcare sector.
Fifty years ago: ‘A new portable hand operated external cardiac compressor’
Authors: Baker B.S. 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: A new portable hand operated external cardiac compressor B.S. Baker briefly explores the merits of the portable hand-operated external cardiac compressors that allowed the user to resuscitate patients in hazardous conditions such as mines or fires.
Fifty years ago: ‘Height, Weight and Obesity in an Industrial Population’
Authors: Howell R.W. 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: ‘Height, Weight and Obesity in an Industrial Population’ R.W. Howell briefly explores the relationship between obesity and sickness from work, looking at a sample from the UK Atomic Energy Authority’s establishment at Windscale and Calder, in Cumberland.
Tales of Kieran: The occupational physician’s odyssey 7—Aromatherapy
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 7 Aromatherapy J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Kieran’s job hunt to avoid becoming an aromatherapist.
Fifty years ago: ‘Emery Pneumoconiosis’
Authors: Bech A.O. , Kipling M.D. , Zundel W.E. 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: ‘Emery Pneumoconiosis’ A.O. Bech, M. D. Kipling, and W. E. Zundel briefly explore the uses of emery in industry, and the exposure to its dust faced by factory workers.
The artemis simulations: stellar haloes of Milky Way-mass galaxies
Authors: Font Andreea S , McCarthy Ian G , Poole-Mckenzie Robert , Stafford Sam G , Brown Shaun T , Schaye Joop , Crain Robert A , Theuns Tom , Schaller Matthieu 
Published: August 2020

ABSTRACT
We introduce the Assembly of high-ResoluTion Eagle-simulations of MIlky Way-type galaxieS (artemis) simulations, a new set of 42 zoomed-in, high-resolution (baryon particle mass of $\approx 2\times 10^4 \, {\rm M}_{\odot }\, h^{-1}$), hydrodynamical simulations of galaxies residing in haloes of Milky Way mass, simulated with the eagle galaxy formation code with re-calibrated stellar feedback. In this study, we analyse the structure of stellar haloes, specifically the mass density, surface brightness, metallicity, colour, and age radial profiles, finding generally very good agreement with recent observations of local galaxies. The stellar density profiles are well fitted by broken power laws, with inner slopes of ≈−3, outer slopes of ≈−4, and break radii that are typically ≈20–40 kpc. The break radii generally mark the transition between in situ formation and accretion-driven formation of the halo. The metallicity, colour, and age profiles show mild large-scale gradients, particularly when spherically averaged or viewed along the major axes. Along the minor axes, however, the profiles are nearly flat, in agreement with observations. Overall, the structural properties can be understood by two factors: that in situ stars dominate the inner regions and that they reside in a spatially flattened distribution that is aligned with the disc. Observations targeting both the major and minor axes of galaxies are thus required to obtain a complete picture of stellar haloes.