bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antigens recognized by T lymphocytes on renal cell carcinoma
Authors: Eynde Benoît J Van den , Probst-Kepper Michael 
Published: November 2023

Abstract
The study of tumor antigens recognized by T cells was made possible about 15 years ago when cytolytic T lymphocytes (CTL) capable of killing the autologous tumor cells were isolated from the lymphocytes of cancer patients. Human melanoma cells can be grown relatively easily in vitro, and the first CTL were obtained from blood lymphocytes of melanoma patients. Melanoma there- fore has become the paradigmatic tumor for human tumor immunology (Boon et al. 1994). Anti-melanoma CTL have also been isolated from tumor-infiltrating lymphocytes (TIL), and in some cases homogeneous CTL clones were obtained by limiting dilution cloning of CTL lines. In a few cases it has been possible to test the recognition of some normal cells by the CTL clones, and thereby determine the specificity with which they are able to kill the tumor cells.
Monoclonal antibodies to renal cancer antigens
Authors: Divgi C , Oosterwijk E , Steffens, M , Bander N 
Published: November 2023

Abstract
Cancer immunologists continued to attempt to define recognized tumor antigens and discern the reasons why immune surveillance sometimes fails and allows cancer development. The occasional spontaneous regression in renal cancer (Everson and Cole 1966; Freed et al. 1977; Snow and Schellhammer 1982; Vogelzang et al. 1992) provides indirect evidence implying a role of the immune system in the natural history of renal cancer. Oliver et al. (1989) observed a series of 73 patients with metastatic renal cancer without therapy until disease progression. This study provided data on the natural history of metastatic renal cancer as well as a baseline for comparison to therapy trials. Oliver et al.
Therapeutic options for localized disease
Authors: Montie James E , Beduschi Ricardo 
Published: November 2023

Abstract
Renal cell carcinoma (RCC) is the most common malignancy of the kidney and constitutes approximately 85 per cent of all primary renal cancers and roughly 3 per cent of all adult malignancies. Radical nephrectomy, as described by Robson et al. (1969), has been the standard treatment for clinically localized RCC for the past 30 years. Nevertheless, management of clinically localized RCC has evolved considerably in the last few years. Radical nephrectomy is no longer regarded as the only curative therapy available, and surgical removal of the entire organ is no longer required in all cases of RCC. The widespread use of ultra- sound, computerized tomography (CT), and magnetic resonance imaging (MRI) as diagnostic tools in patients with symptoms unrelated to the urinary tract has permitted detection of solid renal tumors, many of which ultimately prove to be renal cancers.
Inferior vena caval tumors
Authors: Sorcini Andrea , Libertino John A 
Published: November 2023

Abstract
Renal cell carcinoma (RCC) has the propensity to infiltrate the surrounding parenchyma, to penetrate the capsule and extend into the perirenal adipose tissue and adjacent structures, and, in particular, to infiltrate the venous system and propagate into the inferior vena cava (IVC). Electron microscopy reveals renal tumor cells around thin-walled vessels and small fenestrations with the neoplastic process prolapsing into the lumen. These characteristics are consistent with RCC, but they have been described in con- junction with adrenocortical carcinomas and Wilms’ tumors.
Surveillance strategies following surgery for renal cell carcinoma
Authors: Uzzo Robert G , Novick Andrew C 
Published: November 2023

Abstract
Epithelial tumors of the kidney account for approximately 3 per cent of all solid neoplasms (Parker et al. 1997). Adenocarcinoma or renal cell carcinoma (RCC) represent nearly 85 per cent of newly diagnosed malignancies of the kidney occurring at an estimated rate of 4.4–11.1 per 100 000 person-years in the US (Chow et al. 2000). Recent data from the US Surveillance, Epidemiology, and End Results (SEER) program demonstrate a steady increase in RCC of 2.3–4.3 per cent annually between 1975 and 1995 (Chow et al. 2000). This rise can be attributed in part to early detection through the widespread use of non-invasive imaging techniques (Rodriguez et al. 1995), although this reason alone cannot fully explain the upward trend (Chow et al. 2000).
Adjuvant therapy for renal cell carcinoma
Authors: Baar Joseph , L.Trump Donald 
Published: November 2023

Abstract
It is estimated that there will be 31 200 new cases of renal cell carcinoma (RCC) diagnosed in the US in 2000, and 11 900 people will die from this disease (American Cancer Society). Approximately 70 per cent of patients present with localized or locally advanced disease (Golimbu et al. 1986) and are potentially curable by nephectomy alone. However, relapse rates are high in such patients, with 5-year survival rates of 56–100, 47–100, and 34–80 per cent in patients with stage I (that is, T1N0), stage II (that is, T2 N0), and stage III disease (that is, T1N1M0 to T3cN1M0), respectively.
Cell-based therapy in the treatment of renal cell carcinoma
Authors: Gitlitz Barbara J , Belldegrun, Arie S , Figlin Robert A 
Published: November 2023

Abstract
Over the last 50 years, considerable advances have been made in our knowledge of tumor immunology. This encompasses concepts such as antigen processing and presentation via the major histocompatability complex (MHC) (Bjorkman and Parham 1990; Bjorkman et al. 1987); regulation of the immune response by cytokines, the influence of secondary signals such as co-stimulatory molecules, any, most notably, the characterization of a variety of genes encoding tumor-associated antigens (TAA). For many tumor types, the DNA and amino acid sequences of TAA have been elucidated including MHC-restricted immunodominant peptide sequences. This basic research has formed the basis for the exploration of more targeted clinical immunotherapies.
Laparoscopic adrenalectomy by the posterior lumbar approach
Authors: Baba Shiro , Iwamura Masatsugu 
Published: November 2023

Abstract
Laparoscopy today is a procedure well past its learning curve and a standard part of the urologic armamentarium. Since laparoscopic adrenalectomy by transperitoneal anterior (Go 1993; Higashihara et al. 1993) and lateral approaches (Gagner et al. 1993) was reported in 1993, this procedure has gradually become the primary treatment option for benign adrenal diseases. Its success is due primarily to improvements in instrumentation and the rapid acquiring of laparoscopic anatomy by urologists. Operating in the retroperitoneum across the peritoneal cavity, however, necessitates considerable retraction of intraperitoneal organs.
Learning theory perspectives on early reactions to traumatic events
Authors: Perrin Sean 
Published: November 2023

Abstract
The term ‘learning theory’ as used in this chapter refers to classical and operant conditioning theo ries. Both approaches view reinforcement as the central process by which the environment acts upon the organism to produce complex behaviour patterns (Donahoe, 1998). The differences between the two theories are evident in the procedures used to demonstrate learning. In the classical conditioning procedure (Pavlov, 1927) a reflex-eliciting stimulus (e.g. food) is presented to the animal following an environmental event (e.g. a tone). In the operant procedure (Thorndike, 1911), the elic iting stimulus is presented following a particular behaviour (e.g. pressing a lever). In both cases, the eliciting stimulus acts as a reinforcer because it changes the way the environment guides behaviour.
Cognitive perspectives on early reactions to traumatic events
Authors: Pilgrim Hazel 
Published: November 2023

Abstract
Cognitive theory has inspired and informed a number of distinct forms of psychological inter ventions generically referred to as cognitive therapy. In recent years they have been subjected to systematic evaluation with encouraging results for clinically significant expressions of anxiety, phobias, depression and obsessive-compulsive disorders. It has also been demonstrated as a valid therapy for PTSD (Marks et al., 1998; Tarrier et al., 1999). Development of cognitive theories has often followed clinical observations in such a way that the theory, in tum, engenders suggestions as to which types of interventions may be useful in therapeutic practice. This being the case, cognitive therapies and theories are in a process of continuous evolution.
Systemic approaches to early interventions in a community affected by organized violence
Authors: Ajdukovic Dean , Ajdukovic Marina 
Published: November 2023

Abstract
Reviews of the literature on the effectiveness of early interventions with individuals and groups show the importance of the social context in which healing should progress. When describing the initial stage of psychological first aid Freeman et al. (2000) list activities that involve active, organized and supporting environments. This includes forms of practical help, provisions of food and shelter, protection from further threat, immediate care for physical needs, etc. Herman (1992) maintains that restoring connections with the environment, which emphasizes the importance of the social network of a victim, is among the critical points of trauma recovery.
Early intervention strategies applied following rape
Authors: Resnick Heidi , Acierno Ron , Stafford, Jane , Minhinnett Robin 
Published: November 2023

Abstract
In this chapter we provide a brief review of the literature related to development and implementation of early intervention strategies following completed rape of women by men. Most, if not all, of the principles in this chapter may be applicable to sexual assault more broadly defined including, but not limited to attempted sexual assault, contact sexual molestation, sexual assault of girls, boys and men, same-gender sexual assault and sexual harassment. However, the large majority of controlled studies of sexual assault have been conducted with women raped by men.
A brief early intervention service for accident and assault victims
Authors: Bisson Jonathan I 
Published: November 2023

Abstract
Psychological sequelae to accidents and assaults are common. Breslau et al. (1991) interviewed 1007 American adults aged between 21 and 30. Almost 40% had been exposed to a major traumatic event of which accidents and assaults were the most common. Kessler et al. (1995) in their large epidemiological survey in the USA found lifetime prevalence of PTSD following serious accident to be 20.7% in men and 23.6% in women. For physical attack the rates were 12.4% in men and 30.8% in women, and for rape 65% in men and 45.9% in women. In Breslau et al.’s (1991) study 11.6% of those who had suffered a sudden injury or serious accident and 22.6% of those physically assaulted developed PTSD compared to 80% of women who reported rape. The presence of high levels of psychological morbidity following accidents and assaults has major implications for hospital trauma services including orthopaedic surgery, general surgery, accident and emergency medicine, ophthalmology and maxillo-facial surgery in addition to primary care and mental health services.
Muscular Dystrophy and Related Myopathies
Authors: Maddocks Ian , Stern Leon 
Published: November 2023

Abstract
The management of muscular dystrophy and the various related myopathies presents particular challenges in the maintenance of effective professional oversight during the transition from adolescent to adult (which often entails a change in institutional and professional relationships) and in assisting caring family members face the inevitability of deterioration and death after long years of intense loving effort in the promotion of positive attitudes and optimal function. Some of the skills learnt in the more usual settings of palliative care can be appropriate to this situation, but sensitivity will be necessary if, in introducing them, they are regarded as appropriate only to the terminal phase. A broad coalition of professional skills will best meet the complex physical and emotional needs of patient and family as the terminal period draws on.
Quadriplegia and Paraplegia
Authors: Ceranski Walter A 
Published: November 2023

Abstract
Since palliative care in the individual with quadriplegia or paraplegia involves a person with a stable deficit and a nearly normal life expectancy, it requires an understanding of the relationship between a variety of factors (such as level and mechanism of injury) and preserved function. To this end, this chapter begins with a review of those relationships. This is followed by an overview of complications of quadriplegia and paraplegia (along with comments regarding their potential impact on quality of life and productivity). This knowledge can assist in making informed decisions on how (and how aggressively) to treat these complications. Finally, some suggestions are made for areas of research which could contribute to the effectiveness of treatment. The hope remains that advances in research will lead to such restoration of function that the need for palliative care in the person with quadriplegia or paraplegia will no longer exist.
Locked-in Syndrome
Authors: Grisold Heinz Lahrmann Wolfgang 
Published: November 2023

Abstract
In this chapter the neurologic symptoms, the neuroanatomical and pathophysiological background, and the palliative management of patients with locked-in syndrome (LIS) is presented. Most often LIS is caused by basilar artery thrombosis. The patient becomes completely paralysed with only vertical eye and upper lid movements spared. Consciousness, sensation, and hearing are most often intact. Emphasis is put on the explanation of the diagnosis and its implications to the patient, the relatives, and the caring team. Of major importance is to establish a sufficient mode of communication with the LIS patient. Different methods and technical solutions are presented. The ethical point of this condition, which belongs to the nightmares of human beings, is discussed.
Spasticity
Authors: Noth Johannes Gereon R , Fink Gereon R 
Published: November 2023

Abstract
Spasticity-an increased stretch resistance of the passive skeletal muscle with exaggerated tendon jerks-is a common neurologic symptom in palliative care and can result from any lesion (e.g. due to a stroke or a brain tumor) of the long corticospinal tract. The clinical variety of spastic syndromes results from the topology of the CNS lesion and the subsequent differential involvement of the descending pathways. The overall approach to the management of spasticity includes reversing any noxious stimulus, using physical interventions before adding pharmacotherapy, and reserving more invasive techniques (e.g. nerve blocks, orthopedic or neurosurgical procedures) to a few exceptional situations. The aim of the treatment is to prevent joint contractures, decubiti, and orthostatic hypotension. Current pharmacological treatment is based on substances that act as muscle relax-ants including baclofen, tizanidine, diazepam, and botolinum toxin.
Dysphagia
Authors: Borasio Mario Prosiege Edith Wagner-Sonntag Gian Domenico 
Published: November 2023

Abstract
Dysphagia is a major problem in neurological patients requiring palliative care. An accurate assessment of swallowing problems and of dysphagia-related symptoms based on clinical, videofluoroscopic, and videoendoscopic evaluation is a prerequisite for appropriate treatment. Management of dysphagia in palliative patients comprises many pharmacological and non-pharmacological interventions. It should be performed on a team basis and should include the patient and his/her relatives in all important decisions such as augmented feeding techniques.
Communication Impairment
Authors: Foulsum Amanda Scott Margaret 
Published: November 2023

Abstract
This chapter examines the nature of communication impairment frequently encountered in palliative care settings and the role of the speech and language therapist in the assessment and management of these problems. The specific components of communicationcognition, speech, language and pragmatics-are examined. The focus of intervention for this clinical population is one of informational counselling and the provision of compensatory management strategies. This intervention involves the patient and their key communication partners and should take into consideration changes in the patient’s functional and emotional states.
Epileptic Seizures and Myoclonus
Authors: Noachtar Sabine We l Soheyl 
Published: November 2023

Abstract
Epileptic seizures and myoclonus are bothersome for both patients and relatives. They occur in a variety of syndromes and different diseases. Myoclonus can be of epileptic origin, but there are a lot of other etiologies also involved. Non-epileptic myoclonus and epilepsy have to be distinguished because therapy and prognosis are different.
Pain
Authors: Daniela hord Eugenia , Portenoy Hord Russell K 
Published: November 2023

Abstract
Pain usually can be relieved through the systematic application of guidelines adapted from extensive experience in the population with cancer pain. These guidelines are predicated on a comprehensive assessment, which clarifies the nature of the pain, determines whether there is a primarily treatable cause, clarifies the most effective pain management strategies, and provides insight into the degree to which pain is accompanied by other problems that together undermine quality of life. Opioid pharmacotherapy is the mainstay analgesic approach and the most important principle of prescribing is individualization of the dose based on repeated dose titration. The high prevalence of pain in patients with neurologic illnesses warrants controlled trials to help better understand the clinical profile of these syndromes and find the best treatment options.
Fatigue
Authors: Doninger Lynne I Wagner David Cella Nicholas A 
Published: November 2023

Abstract
Fatigue is one of the most commonly reported symptoms among medically ill populations and adversely impacts quality of life. In clinical settings, fatigue is often not assessed and, consequently, inadequately treated. Causative factors are likely to be multifactorial in nature, and the underlying pathophysiology of fatigue is poorly understood. Principles for the clinical management of fatigue are similar across medically ill populations for whom fatigue is a prominent feature (e.g. multiple sclerosis, cancer, HIV/AIDS). Comprehensive assessment of fatigue should include an evaluation of fatigue characteristics to understand its functional impact and provide insight into potential etiologies. Treatment of fatigue should address causative factors that are commonly observed in medically ill populations and are easily detected and treated (e.g. anemia). Pharmacological and non-pharmacological interventions have been utilized for the management of fatigue; however, few randomized clinical trials have been conducted.
Urological Symptoms
Authors: Badlani Darshan K Shah Gopal H 
Published: November 2023

Abstract
In order to best manage a neurologically impaired patient, it is important to consider the patient’s age, sex, level of lesion, and degree of ambulation, manual dexterity, and independence. The concerns of the urologist are primarily the preservation of the upper urinary tract or renal function and avoidance of urinary tract infection. This translates to ensuring adequate bladder storage and emptying at low intravesical pressures. The patient’s concern, conversely, has to do with social mores such as preservation of continence. The patient needs a solution that is both socially acceptable and easily adopted.
Psychiatric Symptoms
Authors: Stiefel AlIexandre Berney Friedrich 
Published: November 2023

Abstract
This chapter focuses on the main diagnostic and treatment issues related to patients presenting with psychiatric symptoms in the palliative care setting. Specific pharmacological treatments and general aspects such as coping, defenses, and communication skills are discussed. A supportive attitude towards the patient’s own efforts to cope with a severe illness, as well as a proactive attitude, intended to integrate major biographical and contextual aspects in the patient’s treatment plan are proposed here.
Personal Identity and Palliative Care
Authors: Defanti Carlo A 
Published: November 2023

Abstract
This chapter explores the issue of personal identity and its possible alterations due to brain diseases. Impairment of cognition and other higher nervous functions can be severe enough to alter the personality of affected people to such a degree that the question of their personal identity is raised. Even though this philosophical problem may appear to be far removed from the reality of hospital wards, in fact it is relevant for the clinical decision-making process, especially during the advanced stages of dementia, in, for instance, challenging the authority of advance directives for health care. Moreover, personal identity and its preservation can and should be a therapeutic goal for palliative care of demented people.
Informed Consent
Authors: Bernat James L 
Published: November 2023

Abstract
All patients have the ethical right of informed consent and refusal that requires physicians, except in emergency treatment, to seek their permission before proceeding with medical care. This right is transferred to a legally authorized surrogate decision maker to exercise on their behalf when patients lose the capacity to make health-care decisions. Patients and surrogates require adequate information and the absence of coercion. Ideally, patients and physicians will practice shared decision making so the decision is patient-centered. Surrogates for incompetent patients should attempt to follow the explicit or implicit preferences of the patients they represent and decide in their best interest when they lack knowledge of their treatment preferences. Child patients should be included in the consent process to the extent they are capable of understanding. Consent is a process and not an event. It is a communication process that evolves over time. Consent for participation as a human research subject imposes even stricter standards of information exchange and lack of coercion than consent for treatment.
Physical separations of elements: compartments and zones in biology
Authors: Fraústo da Silva J J R , Williams R J P 
Published: November 2023

Abstract
In order to understand the observed binding of the chemical elements, metals and non-metals, to particular chemical sites in biological systems, we have discussed three factors: (1) the limitations on the concentration of chemical elements imposed by their abundance and availability in the environment; (2) the possibility of adjusting this availability in a cell by pumping an element or compound across a single membrane into or out of its inner aqueous phase; (3) the intrinsic stability, thermodynamic and kinetic, of the association of the chemical elements with particular ‘ligand’ frameworks which have ‘designed’ structures, either in solution or in a condensed phase.
Phosphate, Silica, and Chloride: Acid-base Non-metals
Authors: Fraústo da Silva J J R , Williams R J P 
Published: November 2023

Abstract
It is not warranted to give in this book anything but passing reference to the non-metal chemistry of H, C, N, and O since these four elements form the central part of organic biochemistry and there are excellent volumes dealing with this subject. At the same time, it is pertinent to give a summary table (Table 18.1) of the involvement of metal ions with virtually all the small molecules which are the available precursors of biological organic chemistry.