bluuebunny/crossref_metadata_2025_split huggingface dataset:
Other dementias
Authors: Pryse-Phillips William , Wahlund Lars-Olof 
Published: October 2023

Abstract
Cognition is the action or faculty of knowing—knowledge—implying consciousness. The complex faculty is taken to include orientation, attention, memory, language functions, gnosis, visual perception, comprehension, abstraction, reasoning, constructional praxis, judgement, and new learning. Definitions of dementia emphasize memory loss, the presence of other cognitive disturbances, a progressive course, and the presence of diffuse brain disease. Thus the DSM-IIIR criteria for probable Alzheimer’s disease require the presence of dementia; deficits in two or more areas of cognition; progression; normal consciousness; and the absence of other diagnosable pathologies. The diagnosis is supported by progressive deterioration of specific cognitive skills; impaired Activities of Daily Living and inappropriate behaviour; positive family history; normal cerebrospinal fluid; normal electro-encephalography (EEG) or non-specific changes only; and CT evidence of cerebral atrophy. But to require the absence of other pathologies begs the question as to the diagnosis and makes the diagnosis of Alzheimer’s disease one of exclusion. In this chapter, we will survey briefly those conditions which fulfil many of the criteria for Alzheimer’s disease but exhibit physical signs or other clinical features which disallow that diagnosis. As there are so many of them, those occurring less frequently are included in an appendix at the end of this chapter.
Therapeutic intervention in dementia
Authors: Forette Fran&lt;;oise , Rockwood Kenneth 
Published: October 2023

Abstract
We are on the threshold of a new era in the treatment of dementia, in that pharmacological therapy is becoming available for palliation of cognitive symptoms. Until now, only the depressive symptoms, often seen in the early stages of dementia, and behaviour problems, more characteristically seen in the later stages, have been amenable to pharmacological treatment. This chapter will review standard methods of treatment of such problems and will also outline the current possibilities for the treatment of cognitive symptoms. In addition, it will discuss prescription of such medications in the setting of a multidisciplinary memory disability team.
Management of common problems
Authors: O’Neill D , Carr D 
Published: October 2023

Abstract
In this chapter we will discuss class-specific management (i.e. for dementia of any cause), assuming that dementia-specific treatment (i.e. cholinesterase inhibitors for Alzheimer’s disease, or blood pressure control and smoking cessation for vascular dementia) will be initiated. The evidence-based literature in dementia is heavily biased towards i) the aetiopathology of the dementias, ii) their accurate diagnosis, and iii) pharmacological interventions, particularly those aimed at the cholinergic system. While these are issues of great importance, there is a relative lack of formal evaluation of the assessment and management of problems by dementia services as well as the efficacy and appropriateness of commonly used strategies for intervention. There are also differences between memory disorders teams as to the emphasis and structure of management strategies for those patients and caregivers who consult them. It is important that existing strategies should be evaluated and where shown to be effective should be incorporated into routine service provision. A lack of controlled studies should not prevent the use of common-sense strategies but should spur on research programmes on their efficacy, a need recognized by the European Union (O’Neill, in press) and the National Institute on Aging in the United States.
Amputations (replants)-total and subtotal
Authors: Wilson G R , Nee P A , Watson J S , Harrison R K 
Published: October 2023

Abstract
Treat Life-Threatening Injuries First. Avoid delay (‘toxins’ are released from anoxic muscle). Avoid damage to the amputation stump and the part. Refer all cases and let the transplant team discuss with the patient the feasibility/wisdom of replanting.
Swollen PIP joint (volar plate injury)
Authors: Wilson G R , Nee P A , Watson J S , Harrison R K 
Published: October 2023

Abstract
Irreversible volar plate contracture (bent finger) can develop late (up to 3 months). Follow up all these injuries at least once. Thereafter, tell the patient to return if the finger starts to bend and will not straighten completely. Then refer to hand surgeon or therapist.
What happens next?
Authors: Ismach Madeline 
Published: October 2023

Abstract
Professionals interact with children and their families in different ways according to the nature of their contact and responsibilities. The key to making a positive and informed contribution to the safety of children is to have an understanding of the child protection system and be clear about your professional role. There are many reasons why GPs may give the identification of child abuse or neglect rather less attention than other medical responsibilities. Nevertheless guidance to GPs from the Department of Health indicates that GPs are a vital part of the professional childcare network and that there is a clear expectation of cooperation with child protection procedures. (See also Chapter 6c.)
Complications of long-term dialysis: cellular immunity, infection, and neoplasia
Authors: Khan Izhar H , Catto Graeme R D 
Published: October 2023

Abstract
The treatment of end-stage renal disease (ESRD) with dialysis has evolved greatly since the pioneering days of Wilhelm Kolf’s experiments with the artificial kidney during the Second World War. Then, and in the early days of renal replacement therapy, dialysis was a novel treatment which sustained life in patients who would otherwise have succumbed to uremia. During the 1970s in the United States of America, and in the past two decades in the United Kingdom and Europe, improvements in the technological aspects of dialysis and the ability to offer this treatment to patients with a variety of renal diseases, irrespective of age or of the presence of comorbidity, have resulted in a great increase in the number of patients receiving dialysis therapy. In the USA 200 patients per million of the population start dialysis each year (USRDS Report, 1991). However, in the UK around 80 patients per million of the population commence dialysis each year (Feest et al., 1990), but this number is likely to rise as the incidence of ESRD is much higher than the number of patients treated (Khan et al., 1994). A greater proportion of patients now also receives a renal transplant and many patients currently receiving renal replacement therapy in Western countries have a functioning renal graft. Nevertheless, a significant proportion of patients with ESRD are kept alive with dialysis. Some patients are less likely to receive a renal transplant because of increased preformed antibodies as a result of previous unsuccessful grafts or transfusions. Furthermore, in some countries ethical and religious objections to cadaveric transplants have led to a much higher proportion of ESRD patients on dialysis. An increasing number of older patients now starting dialysis are also not considered for transplantation. There are many patients who are likely to remain on dialysis for years and be at risk of long-term complications.
Aluminum, silicon, and strontium accumulation/ intoxication as a complication of long-term dialysis
Authors: D’Haese Patrick C , Broe Marc E De 
Published: October 2023

Abstract
A number of considerations indicate that trace elements may accumulate in dialysis patients. This is due to:the patients’ uremic state;the dialysis treatment during which these constituents may be transferred to the patient;the diet; and the administration of pharmaceutical preparations which may contain high con¬ centrations of a number of trace metals (Alfrey, 1989; Salusky eta/., 1991; D’Haese eta/., 1990a).
Drugs used in cardiac anaesthesia
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
The drugs that are used during cardiac anaesthesia include premedicants, drugs for inducing and maintaining general anaesthesia, antibiotics, vasoactive and cardio-active drugs, drugs that affect the clotting system, drugs for cerebral and renal protection, and insulin for the control of blood sugar. As patients with heart disease undergoing cardiac surgery are very fearful and apprehensive, with inevitable cardiovascular sequelae, the purpose of premedication is to allay anxiety, to provide analgesia for painful events prior to induction, and to give some degree of amnesia. Either an oral benzodiazepine (diazepam, lorazepam, midazolam, or temazepam) or an intramuscular injection of an opiate (morphine or papavaretum) can be used to achieve sedation. Opiates have the additional benefit of providing preoperative analgesia. An anticholinergic agent (hyoscine bromide or atropine) or a tranquillizer (droperidol) is usually administered with the opiate as an antiemetic and amnesic agent. Premedicants are often administered parenterally to avoid uncertain uptake or first-pass metabolism when given orally (however, they still have to be absorbed from the intramuscular site).
Guidelines for coronary artery bypass grafting
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
Previously, only patients with three-vessel coronary artery disease were scheduled for coronary artery bypass grafting. Today, patients with left anterior descending artery stenosis alone can undergo a left internal mammary artery graft with or without the use of cardiopulmonary bypass. These patients may benefit from a degree of myocardial depression since they have a hyperdynamic response to surgical stimuli. Generally, patients with an ejection fraction of more than 40 per cent do not require inotropic support when separating from cardiopulmonary bypass, provided that the heart rate is maintained at more than 90 beats/min.
Management of cardiopulmonary bypass
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
Normocarbia should be maintained. Blood should be sampled for acid-base balance and a baseline activated clotting time. Except for the patient with aortic stenosis, an infusion of a vasodilator such as sodium nitroprusside or nitroglycerin can usually be started via the central venous catheter at a low dose and the rate titrated according to the blood pressure response. Remember that the cardiac output is fixed in aortic stenosis and that any reduction in systemic vascular resistance may lead to hypotension and decreased coronary perfusion. Blood glucose concentration should be assessed in the diabetic patient and an infusion of insulin started to treat hyperglycaemia.
Hormone mechanisms of action (Physiology)
Authors: Laycock John , Wise Peter 
Published: October 2023

Abstract
a generally binds to receptors in target cell membranes b can only bind to its one (unique) receptor produces its effects by stimulating an intracellular second messenger system cannot have a genomic effect on protein synthesis always exerts its effects by generating intracellular cyclic AMP have a high affinity for that hormone can also bind other molecules (ligands) are often associated with membrane-bound G proteins d can have intrinsic tyrosine kinase activity
Calcium regulation, bone, and its metabolic disorders (Physiology)
Authors: Laycock John , Wise Peter 
Published: October 2023

Abstract
is mostly stored in the bones circulates in the blood partly bound to plasma proteins is present in muscle cells as the crystalline complex hydrated calcium phosphate apatite salt is generally present in cell cytoplasm at a concentration greater than in the blood is an essential component of cell membranes are in dynamic equilibrium with the circulating bound calcium component are transported mainly within the red blood cells in association with a globulin protein are normally present at a concentration of approximately 1.2-1.3 mmol/ litre
Homeopathic medicine
Authors: Thompson Elizabeth A 
Published: October 2023

Abstract
Much has been achieved in the management of cancer pain with the range of effective pain relieving drugs now available. However these drugs do not necessarily impinge on the emotional, psychological, and existential aspects of human suffering. There is clearly a need for modalities of care that can, when used alongside orthodox treatments, address these areas of hurt. The homeopathic approach to pain is one such modality that does not attempt to separate the psyche from the soma, but offers a truly holistic perspective. The person in pain is encouraged to tell their story in their own language, placing weight on those issues that are uppermost in their mind. An individual picture is thereby built up which embraces the many influences that have come to bear on that person.
Malocclusion: aetiology and classification
Authors: McDonald F , Ireland A J 
Published: October 2023

Abstract
The factors involved in the aetiology of malocclusion are numerous but traditionally have been divided into general and local factors. General factors are often quoted as being skeletal factors, soft tissue factors, and habits, whilst dento-alveolar factors are often referred to as local. This division into general and local factors can give the wrong impression as to how each of these aetiological agents act in the production of a malocclusion. For example, the effect on the occlusion of incompetent lips might be limited to proclination of the upper incisors, whilst having no effect on the buccal segment teeth or lower incisors. On the other hand, the dento-alveolar factor of crowding, due to one or more large teeth, is often described as a local factor.
Patient and parent interview
Authors: McDonald F , Ireland A J 
Published: October 2023

Abstract
The patient and parent interview serves a number of important functions. To begin with it is likely to be the first experience the patient has of the processes involved in orthodontic treatment. It is also a time when the clinician must obtain information from the patient not only on their orthodontic concerns, but on factors which might have a bearing on any proposed treatment. Specific factors may come to light on questioning the patient about their medical and dental history. Less specific information, including straightforward and obvious domestic issues such as ease of travel for treatment, also needs to be determined. Such information might influence the clinician to modify the complexity of any proposed treatment plan.
General medicine
Authors: Leung Wai-Ching 
Published: October 2023

Abstract
Which of the following statements about hypothermia is/are true? a it is defined as fall of oral temperature to below 35°C b it may be caused by hypothyroidism c the] wave on the ECG is characteristic d it is often associated with a low blood pressure e death may be diagnosed in hypothermic patients with absent pupillary reflex.
Surgery
Authors: Leung Wai-Ching 
Published: October 2023

Abstract
Risk factors for the development of carcinoma of the breast includea a positive family history b increased agec early menopause d delayed menarche e nulliparityWhich of the following factors in breast carcinoma indicate a favourable prognosis? a high oestrogen receptor (ER) activity b smooth contour c presence of undifferentiated cells d reactive hyperplasia in the regional lymph nodes e large size.
Pathology
Authors: Leung Wai-Ching 
Published: October 2023

Abstract
Which of the following are examples of response of tissue by hypertrophy? a breast enlargement in puberty b prostate enlargement in advancing agec liver nodule formation in cirrhosis of the liver d enlargement of the left v ncricle as a response to hypertension e adrenal gland enlargement as a response to inappropriate ACTH secretion.
Assessment of patients, general anaesthesia, and monitoring during anaesthesia
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
A & E staff should assess each patient before contacting the anaesthetist: checklists can be useful. Anaesthetists should only give anaesthetics in the A & E department if they are happy about the condition of the patient and the equipment and assistance available. Rapid sequence induction is mandatory in patients who may have a full stomach or intra-abdominal pathology. It is also advisable in obese patients and in those given opioid analgesics. Monitoring apparatus should be checked before use.
Resuscitation techniques: airway management, ventilation, and defibrillation
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
It is essential to follow the ABC of resuscitation: A clear and maintain the Airway ensure adequate Breathing ensure adequate Circulation. Use 100 per cent oxygen during resuscitation. When a cervical spine injury is suspected, use cervical spine control while maintaining the airway. Some patients will need total spinal immobilization. In epiglottitis, interference with the airway may cause total airway obstruction.
Other nerve blocks and field blocks
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
The supraorbital nerve leaves the orbit as two branches through two holes or notches on the superior orbital margin about 2.5 cm from the midline. It supplies the skin of the forehead, including adjacent scalp. The supratrochlear nerve leaves the orbit medial to the supraorbital nerve. It provides cutaneous sensation to the medial part of the forehead.
Topical anaesthesia
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
A thick layer of cream is applied to the proposed site(s) of injection. This is covered with an occlusive dressing and left for 1 hour with EMLA or 30 minutes with amethocaine. The procedure should commence within 30 minutes after the dressing has been removed.
The public perspective
Authors: Girling David J , Parmar Mahesh K B , Stenning Sally P , Stephens Richard J , Stewart Lesley A 
Published: October 2023

Abstract
Clinical trials are a special type of research involving human participants, sometimes with healthy volunteers, but often with patients who agree to participate in trials as part of their treatment and medical care. Trials therefore carry particular responsibilities both to ensure the welfare of their participants and to be publicly accountable. In the quest to design, conduct and report the results of the ‘perfect’ trial, we must not lose sight of the fact that the whole purpose of trials is ultimately to benefit patients and the community at large. Clinical trials cannot be done without patients, and success depends upon establishing effective partnerships between researchers, clinicians and patients.
Putting plans into practice
Authors: Girling David J , Parmar Mahesh K B , Stenning Sally P , Stephens Richard J , Stewart Lesley A 
Published: October 2023

Abstract
Some trials will be planned and conducted by an individual person, others as part of a programme of multi centre randomized trials by an established trials office. Setting up and conducting a single trial or a programme of trials is, however, a major and specialized activity which should only be undertaken by persons or groups with the necessary expertise and experience, whether or not they constitute an established long- standing group. Individuals conducting the trial should include, or have access to, the necessary statistical, medical, computing and data management expertise. Such expertise is essential and can be provided in a number of ways through the course of the trial. It is important to recognize, however, the need for continuity of personnel and for the non-clinical staff to be conversant with the medical issues.
Analysis
Authors: Girling David J , Parmar Mahesh K B , Stenning Sally P , Stephens Richard J , Stewart Lesley A 
Published: October 2023

Abstract
In this chapter we present the principles of, and approaches to, analysis. A central component of this chapter are the practical issues for the analysis of a typical randomized trial, which should give the practitioner guidance on many aspects of analysis. Within this section there is, in particular, guidance on the analysis and presentation of quality of life data. There is also a statistical methods section which outlines the methods available for different types of data. This section is brief and can be omitted without loss of continuity. The aim is to emphasize principles and limit the number of formulae and equations. For a more detailed technical presentation of these methods the reader is referred to more specialized books, such as Altman [1].
Systematic review and meta-analysis
Authors: Girling David J , Parmar Mahesh K B , Stenning Sally P , Stephens Richard J , Stewart Lesley A 
Published: October 2023

Abstract
It should be self-evident that healthcare decisions should be based on the best possible evidence; that effective treatments should be used whilst ineffective or harmful ones should not. Yet it is only relatively recently that the principles of evidence-based medicine have been explicitly discussed and gained widespread acceptance. There is an increasing awareness that the evidence for and against medical treatments must be evaluated properly and with appropriate scientific rigour. So far this book has set out the rationale for randomized controlled trials (RCTs) and described their role as main building blocks in clinical research. Undoubtedly, RCTs provide the most appropriate methods for the unbiased primary assessment of competing therapies. However, individual trials do not always provide the solutions that we seek and we need to look across trials at the totality of evidence. Consequently, there has been a vast increase in the number of systematic reviews and meta-analyses that have been undertaken in recent years [1] (Fig. 11.1).
Epipodophyllotoxins
Authors: McLeod Howard L 
Published: October 2023

Abstract
The podophyllotoxins have a long therapeutic history, with references as early as AD 900 to the use of the roots of wild chervil to treat cancer. Sandoz Pharmaceuticals synthesized nearly 600 derivatives of podophyllin in the 1950s and 1960s and identified two active compounds, etoposide and teniposide (Fig. 8.1) with a unique mechanism of action.1 Previous analogues had arrested cells in mitosis, but the new derivatives prevented proliferating cells from entering mitosis and reduced the mitotic index to zero. Subsequent studies identified topoisomerase II as a primary cellular target of epipodophyllotoxins.
Hypertension in end-stage renal failure
Authors: Ribstein Jean , Mourad Georges , Argiles Angel , Mimran Albert 
Published: October 2023

Abstract
Hypertension can cause or promote renal failure. In most cases, the process of renal deterioration is quite slow, and coronary or cerebrovascular events occur beforehand as indirect complications of the hypertensive process. In recent years, a decrease in cerebrovascular and coronary mortality has been observed in several (but not all) countries, whereas the prevalence of end-stage renal failure (ESRF), as well as congestive heart failure, has increased. The follow-up of large cohorts within a substantial number of years has indicated that hypertension is an independent risk factor for ESRF, particularly in African-Americans.