bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Anaesthesia in Babies and Children
Authors: Peutrell J M , Mather S J 
Published: November 2023

Abstract
Regional anaesthesia is currently undergoing a renaissance in paediatric anaesthetic practice, particularly in day case surgery, for post-operative pain relief and in ex-premature babies. However, most practical textbooks of local anaesthetic technique are not written with small children, and particularly newborn infants, in mind. This practical manual has been designed to aid both those aiming to refresh their knowledge of the techniques of regional anaesthesia in babies and children, and those learning these methods for the first time. Whilst it is not intended as a substitute for direct trainig by experts, its clear and concise text and simple diagrams make it an ideal companion to 'hands on' training in the operating theatre. Both authors have extensive experience of teaching anaestheitc trainees. The two introductory chapters of this book describe the relevant pharmacological and biological differences between infants, children and adults, and the general practical aspects of regional anaesthesia. The book is then divided into sections describing the nerve blocks of the major anatomical regions of the body. The descriptions of the different blocks can be read independently and include the relevant anatomy, indications, specific contraindictions, equipment, drugs and dosages, Each description concludes with a step-by-step guide to the block illustrated with photographs and simple diagrams.
Vascular biology of coronary artery bypass grafts: pathophysiology of graft failure and strategies for its prevention
Authors: Angelini Alan J Bryan ,Gianni D 
Published: November 2023

Abstract
During the 25 years that have elapsed since the introduction of coronary artery bypass grafting (CABG) it has been clear that graft patency is one of the primary determinants of clinical outcome. In the early 1980s, the unsatisfactory late results with saphenous vein became obvious, with up to 50% of grafts occluded at 10 years, and a significant proportion of the remainder diseased. Subsequently, the superior clinical results reported using the left internal thoracic artery to graft the left anterior descending coronary artery (2) led to its routine use (3). These two observations have clearly shown that the biological characteristics and long-term behaviour of a particular conduit may profoundly influence late clinical outcome.
Talking to relatives
Authors: Faulkner Ann , Maguire Peter 
Published: November 2023

Abstract
In previous chapters, the emphasis has been on identifying the patients’ problems and encouraging them to generate possible solutions. It is too easy to forget that relatives may also have problems in coping with a loved one’s illness, and may need professional help, especially as they often feel that they are not entitled to disclose problems because the patient is seen to be the priority.
Conditions for the running of peer review groups
Authors: Grol Richard , Lawrence Martin 
Published: November 2023

Abstract
In order to start peer review successfully and to run it smoothly, it is not enough to have a good programme, acceptable guidelines, and feasible evaluation tools. Certain conditions should be fulfilled to make the peer review process into a fruitful and valuable experience for the participants. These conditions are concerned with Research has indicated that general practitioners and practices are on the one hand motivated and on the other hand hesitant to partake in peer review on several grounds (Grol 1987). On the whole, care providers in general practice work on their own and are accountable only partly to others. This was largely the case in British general practice until recently, although the recent emphasis on audit has made peer review within group practice much more common. Participation in peer review gives colleagues the opportunity to take a peep behind the curtains and to offer their criticism. It goes without saying, that this may evoke fear and resistance. Participants may be frightened of being made a fool of in front of others, frightened that weak points will be brought to light, or that they will be branded as bad GPs. Or they may be convinced that no forms of criticism can ever take place objectively and fairly. In some cases, there may be a certain reluctance when it comes to criticizing others.
Educational tasks
Authors: Havelock Peter , Hasler John , Flew Richard , Mcintyre Donald , Schofield Theo , Toby John 
Published: November 2023

Abstract
Vocational training for general practice is just one example of the process described in the previous chapter of adults learning a new profession. The aims of vocational training are to help trainees: This second aim requires the trainee to develop the self-awareness and attitudes that enable doctors to understand their personal involvement in practice, to overcome their limitations, and to maintain their integrity and motivation throughout a professional lifetime. These aims will be considered more fully in Chapter 4 on constructing a curriculum.
A developing relationship
Authors: Havelock Peter , Hasler John , Flew Richard , Mcintyre Donald , Schofield Theo , Toby John 
Published: November 2023

Abstract
The personal development of trainees is closely interconnected with their medical and professional development. We have already referred to the advantages of staging the trainee year (see Chapters 4 and 5) and the difficulties that adults may have in learning and doing at the same time (see Chapter 2). In this chapter we shall look at the personal growth of the trainee and at the trainer-trainee relationship, two closely interrelated subjects that can be sources of extreme joy and misery. These issues will be examined from the point of view of both trainer and trainee: we shall also examine the trainee’s relationship with the practice. The purpose of this chapter is to challenge ideas and offer insights to all those trainers who have, at one time or another, felt strong emotions of any sort about their trainees or about their training.
Pathogenesis of systemic vasculitis
Authors: Nachman Patrick , Jennelle J Charles , Falk Ronald J 
Published: November 2023

Abstract
Systemic vasculitides have a wide range of aetiologies and pathogenic mechanisms, and can be broadly divided into primary and secondary forms. Over the years, systemic vasculitides have been categorized according to a number of different classifications. In an effort to standardize the terminology of primary systemic vasculitides, an international consensus conference at Chapel Hill, North Carolina recently proposed a modified nomenclature. The Chapel Hill terminology is shown in Table 6.1, and the terms described therein will be used in this chapter (Jeanette et al. 1994). This nomenclature is based on histological characteristics of the inflammatory process and the size of the affected vessels. Each histological pattern of inflammation may result from a number of different pathogenic mechanisms. Other forms of vasculitides may be secondary to systemic autoimmune diseases, infectious agents, environmental toxins, or therapeutic agents (see also Fig. 6.1).
The skeletal system
Authors: Smith Francis W 
Published: November 2023

Abstract
Two different types of radionuclide investigation are available for examining the skeleton: the bone scan and the bone marrow scan. Over the years a number of boneseeking radiopharmaceuticals have been used to image the skeleton. Calcium analogues such ass7msr and 85Sr are no longer used because of their relatively high radiation dose to bone; 18F, an hydroxyl analogue, has a short half-life of 1.8 h, but because it is a positron emitter, finds limited clinical application in the study of bone. Phosphate analogues which can be labelled with 99mTc are now widely used for bone imaging and have good localization in bone and fairly rapid blood clearance from the soft tissues. The bone marrow is imaged using minute colloid particles, which are phagocytosed by the reticuloendotholial cells of the bone marrow.
Infection
Authors: Peters AM 
Published: November 2023

Abstract
The scintigraphic imaging of inflammation and infection has expanded considerably over the last few years, both in terms of clinical usage and scope of the agents that have been developed. The main agents, until recently, have been the radiolabelled white cells and 67Ga. Radiolabelled white cells target inflammatory processes in which the neutrophil is the predominating infiltrating cell. They, therefore, cannot distinguish between infective and non-infective inflammation. 67Ga is even less specific, since in addition to inflammatory pathology, it also targets several neoplasms. The most important agent more recently introduced is human polyclonal immunoglobulin (HIG), which is proving useful for imaging inflammation and apparently only targets tumours when they have an associated inflammatory response. There are many other agents that are being explored for imaging inflammation, discussed later, but they are largely experimental or not widely available.
Positron emission tomography
Authors: Sharp Peter F 
Published: November 2023

Abstract
While the advantages of PET imaging over conventional single photon nuclear medicine imaging are widely acknowledge (see Table 19.1), until recently the high cost of the equipment and operating expenses had limited it to relatively few centres. Recently this has begun to change. Manufacturers have started to develop a market in (relatively) cheap PET imagers. The major cost of the imager is the de.tector material; the ECATART uses a partial ring of detectors consisting of two opposing banks of detectors spanning an arc of 165° and rotates it at a speed of 30 rpm to compensate. Dualheaded gamma cameras are now common in the nuclear medicine departments.
The foot
Authors: Wardrope Jim. , English Bryan 
Published: November 2023

Abstract
The foot supports all the bodyweight and is essential for proper walking and running motion. It acts as a spring shock absorber through the arches of the foot. All the structures of the medial arch including all the joints of the big toe are essential for running and walking.Injuries to the metatarsal-tarsal joint are often severe but may be difficult to diagnose.Crush injury to the foot can give severe and prolonged symptoms, but X-ray appears normal. Compartment syndrome may affect the small muscles of the foot—suspect in cases of severe unremitting pain.Injury to the heel, such as a fall from a height, requires specific views of the calcaneum. Suspect more proximal injuries or even lumbar spine fractures in falls on to the feet from a height.Severe non-traumatic pain may be due to critical ischaemia. “ Stress fractures, acute gout, and hallux rigidus are common causes of non-traumatic foot pain.
Postoperative problems
Authors: Stonebridge Peter , Smith David , Duncan Lesley , Thompson Alastair 
Published: November 2023

Abstract
It is important for medical staff to always listen and respond to the concerns of the nursing staff. Surgical nurses have a wealth of experience that must never be dismissed. Delay in responding will rarely be in the patient’s interests.
The patient appears to have an unobstructed airway and is breathing normally but rapidly. The first action must be to safeguard the patient’s airways and breathing. In this case both are secure but ill patients need oxygen so high flow oxygen is given while resuscitation and assessment take place.
Introduction
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
In the early days of medicine, decisions about methods of diagnosis and treatment were based on authority. The opinion of the eminent practitioner, based on experience and the earlier authority of others, was the main source of information. As medicine became more scientific, experience became more formalized, in the form of controlled experiments and formal data collection. Now, doctors are encouraged to use scientific data as the source of their decisions about methods of diagnosis and treatment. We are now in the era of evidence-based medicine. This is a shift in the paradigm of medicine, from authority-based to evidence based practice. The same process is happening in every field of health-care, so that we now have evidence-based nursing, evidence-based physiotherapy, and so on.
The Normal distribution
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
When we have a continuous variable we represent the probability distribution using probability density, rather than probability. Probability is attached not to particular values of the variable but to sets of values, such as all the possible values between two numbers. It can be represented as the area under part of a probability density curve. Many statistical methods require that data follow a Normal distribution at least approximately. Graphical methods such as histograms and Normal plots can be used to check this assumption.
Significance tests
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
A P value is the result of a significance test. It measures the strength of the evidence concerning some proposition about the populations. The null hypothesis is stated, that there is no relationship or difference in the population from which the sample is drawn. A test statistic is found which would follow a known distribution if the null hypothesis were true. P is the probability of a test statistic as far from what would be expected as that observed, if the null hypothesis were true. If P is small, usually taken to be less than 0.05, we have evidence against the null hypothesis. The smaller P is, the stronger is the evidence. If the probability of a value as extreme as that observed is high we have weak evidence against the null hypothesis, the data are consistent with the null hypothesis and the relationship or difference is not significant. If the difference is not significant we have failed to show that there is a difference in the population, but one may still exist. The sample may not be large enough to detect it. We have not proved that there is no difference.
Comparing the means of small samples
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
The t distribution is used to find confidence interval and to do tests of significance for data which follow a Normal distribution. This can be done for small samples as well as large. The one-sample or paired t method is used when we have data from the same sample or from matched samples. The method uses the differences between the paired observations and makes inferences about the mean difference in the population. The method requires that the differences must follow a Normal distribution and that mean difference is constant and so unrelated to the magnitude of the measurement. The two-sample or unpaired t test is used if we have means from two independent samples. It is also called the two-sample or independent t method. The two samples must be from Normal distributions with the same variance.
Methods based on rank order
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
Methods based on rank order are non-parametric, meaning that we do not assume that the data come from a distribution, such as the Normal, the parameters of which must be estimated from the data. Non-parametric methods require fewer assumptions about the data than do methods which require the assumption that data come from a particular family of distributions, but are less powerful when the assumptions are met. To provide confidence intervals, most rank based methods require very strong assumptions about the data. Rank methods are primarily tests of significance.
Clinical measurement
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
Almost all rneaurements are made with some error. We can measure this in two ways: using the within-subject standard deviation and other statistics derived from this, such as the repeatability, and using the interclass correlation. The first helps us to interpret the individual observation, the second tells about the general properties of the measurement method. We can compare two different methods of pleasuring the same thing by the 95% limits of agreelnent, based on differences between measurements made on the same subject using the two11 methods.16
The clinical background to the Rett disorder
Authors: Kerr Alison M , Engerström lngegerd Witt 
Published: November 2023

Abstract
Doubtless the Rett disorder has been with the human race throughout its history and we suppose that cases were hidden within such heterogeneous diagnostic categories as ‘cerebral palsy’ and ‘autism’. Most of its features were recorded by Andreas Rett and published in German (Rett 1966). Other neurologists observed the same phenomena (Ishikawa et al. 1978) and Hagberg presented the first report in English (Hagberg et al. 1983). Early cooperation between Rett, Moser, Hagberg and Fukuyama and the family support organizations led by Mrs Kathy Hunter, founder of the International Rett Syndrome Association, encouraged the establishment of a series of international symposia attended by a wide range of clinical and laboratory based scientists and this greatly facilitated progress in research.
The morphological substrate for communication
Authors: Belichenko Pavel V 
Published: November 2023

Abstract
It is a consistent finding in the study of human language brain areas that 90-95% of right-handed people have a left dominant language hemisphere while the majority ofleft-handed people do not have a right dominant hemisphere (Milner 1974; Hecaen et al. 1981; Beaton 1997; Moffat et al. 1998; Tzourio et al. 1998). The neocortical areas, Broca’s motor speech areas 44, 45 and Wernicke’s sensory speech area 22 are known to play an important role in human language processing (for review see Mesulam 1990). There are a few major and several minor factors which influence speech dominance. Chief factors bearing on interhemispheric asymmetry include handedness, sex, age, use of language and cultural background (Galaburda and Sanides 1980; Bogolepova 1994, 1996; Glezer et al. 1994; Witelson et al. 1995; Moffat et al. 1998).
Pathology of lacunar infarction
Authors: Lammie G A 
Published: November 2023

Abstract
Autopsy is often expected to reveal the precise nature, extent, and underlying cause of a disease, resolving the diagnostic uncertainties so common during life. However, autopsy conclusions may be limited by, amongst other things, a lack of clinical information (e.g. a history of atrial fibrillation), the fleeting nature of some pathologies (such as lysed thromboemboli), the possibility of sampling errors (small lesions in large organs, as well as in inaccessible lesions such as small or intra-osseous vessels), even on occasion an embarrassment of pathological riches (multiple potential sources of emboli), and, importantly, the difficulty of inferring mechanism from morphology. A pathological diagnosis may be, therefore, as subjective and inferential as the clinical, and cause is often best couched in terms of probabilities.
Striatocapsular infarcts
Authors: Weiller C 
Published: November 2023

Abstract
Striatocapsular infarcts can be defined as large (&gt;20 mm) subcortical infarcts in the territory of the lenticulostriate arteries, sometimes extending into the territory of the adjacent deep perforators, for example Heubner’s recurring artery or the anterior choroidal artery. They do not usually present with a lacunar syndrome and are typically caused by a middle cerebral artery (MCA) mainstem lesion, and thus result from large vessel disease. Straitocapsular infarcts represent the prototype embolic brain infarction frequently are found in cases after successful thrombolysis. Collected evidence to support this hypothesis is reported in this chapter.
Subcortical haemorrhages
Authors: Kase C S 
Published: November 2023

Abstract
Haemorrhage in the subcortical grey nuclei occurs in the striatum (putamen and caudate) and in the thalamus, and these locations account for the majority of cases of intracerebral haemorrhage (ICH) in clinical series. Subcortical haemorrhages are most common in the putamen (19–53% of ICHs) and thalamus (4–26% of ICHs), while those in the head of the caudate nucleus account for only 1–5 per cent of ICHs (Table 26.1). Although these various sites of ICH share a number of features, such as mechanisms and management, their clinical and imaging aspects are unique to each location, and they will be addressed separately, following the discussion of the general features that apply to all.
Using statistics
Authors: Armstrong David , Grace John 
Published: November 2023

Abstract
The initial exploration of the data will produce ideas about interesting relationships, some very clear, others suggestive. The task now is to determine whether the relationships between variables are as significant in the statistical sense as they seem to be when they are ‘eyeballed’. In other words, those excess prescriptions given to adolescents may turn out to have no more importance than a chance variation, whilst the apparent small difference between prescribing rates to male and female elderly may turn out to be an important and ‘real’ finding.
Brainwashing
Authors: Taylor Kathleen 
Published: November 2023

Abstract
The term ‘brainwashing’ was first recorded in 1950, but it is an expression of a much older concept: the forcible and full-scale alteration of a person’s beliefs. Over the past 50 years the term has crept into popular culture, served as a topic for jokes, frightened the public in media headlines, and slandered innumerable people and institutions. It has also been the subject of learned discussion from many angles: history, sociology, psychology, psychotherapy, and marketing. Despite this variety, to date there has been one angle missing: any serious reference to real brains. Descriptions of how opinions can be changed, whether by persuasion, deceit, or force, have been almost entirely psychological. Brainwashing, Kathleen Taylor’s fascinating and informative voyage through the subject, combines the latest findings in social psychology and neuroscience to investigate the incredibly complicated workings of the human brain. In elegant and accessible prose, and with abundant use of anecdotes and case-studies, she looks at the history and myth, psychology, neuroscience, and politics of how we humans manipulate each others’ minds.
Hypothesis and imagination
Authors: Medawar Peter 
Published: November 2023

Abstract
If an educated layman were asked to set down his understanding of what goes on in the head when scientific discoveries are made and of what it is about a scientist that qualifies him to make them, his account of the matter might go something like this. A scientist is a man who has cultivated (if indeed he was not born with) the restless, analytical, problem-seeking, problem-solving temperament that marks his possession of a Scientific Mind. Science is an immensely prosperous and successful enterprise-as religion is not, nor economics (for example), nor philosophy itself-because it is the outcome of applying a certain sure and powerful method of discovery and proof to the investigation of natural phenomena: The Scientific Method. The scientific method is not deductive in character-it is a well-known fallacy to regard it as such-but it is rigorous nevertheless, and logically conclusive. Scientific laws are inductive in origin.