bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking and gallstones
Authors: Baron John A , Logan Richard F A 
Published: November 2023

Abstract
The formation of gallstones is an oestrogen-related process. Exogenous oestrogen increases biliary cholesterol saturation and epidemiological studies have shown that the formation of gallstones is associated with endogenous oestrogen excretion and with the therapeutic administration of oestrogen. Any anti-oestrogenic effect of smoking might therefore be expected to reduce the frequency of gallstones and clinical gall-bladder disease (GED). Few studies have examined the relationship between smoking and gallstones. Until recently these studies were only concerned with clinical disease and found no reduction in the frequency of clinical GED in smokers. In fact three of these studies found an approximately twofold increase in clinical GED in smokers. Recently, two large ultrasound surveys have reported that smoking was associated with all GED (clinical and asymptomatic combined) in men and to a lesser extent in women.
Cigarette smoking and skin atrophy 1n women. A possible connection?
Authors: Brincat Mark 
Published: November 2023

Abstract
Smokers as a group have a lower serum oestradiol and an earlier menopause. Both these factors have been shown to lead to thinner skin and a lower skin collagen content. Although direct work on smokers has not yet been carried out, the hypothesis that cigarette smoking could affect the skin, especially in women, through a hormonal mechanism is discussed.
Cigarette smoking and cancer of the large bowel
Authors: Baron John A , Sandler Robert S 
Published: November 2023

Abstract
Several aspects of the epidemiology of large bowel cancer suggest that the risks of this malignancy may be affected by oestrogenic stimuli and may therefore also be modified by cigarette smoking. Available data regarding this relationship, however, are contradictory: while several studies suggest a lowered risk of cancer of the colon among smokers, most do not. Further clarification may require consideration of cancer risks at various subsites in the colon.
Oestrogens and smoking-related disease: theoretical considerations
Authors: Canick Jacob A 
Published: November 2023

Abstract
1. In cycling and pregnant women, the primary site of oestrogen production is glandular and circulating oestrogen levels are high, whereas after the menopause, oestrogen production takes place in peripheral tissues, circulating oestrogen levels are low, and locally produced oestrogen probably functions at its site of synthesis. 2. The availability of androgen substrates, especially in post-menopausal women, is critical to the amount of oestrogen that is produced.
Hormonal factors and cancers of the endometrium and breast
Authors: Pike Malcolm C 
Published: November 2023

Abstract
Ovarian hormones play a key role, probably the key role, in the aetiology of endometrial cancer and of breast cancer. A key epidemiological observation leading to this conclusion is the marked protective effect of early menopause (natural or artificial, i.e. bilateral ovariectomy) on both these cancers.
Smoking and hormone related disorders: a summary of the evidence with implications for public health policy and future research
Authors: Wald Nicholas , Baron John , Doll Sir Richard 
Published: November 2023

Abstract
The findings presented during the Symposium confirmed that smoking had an effect on the incidence of certain hormone related disorders leading to an increase or a decrease in risk. Table 24.1 lists the various conditions examined (all medical disorders apart from age at menopause) and gives for each a judgement on whether the conditions have a real association with smoking and, if so, whether the association is positive or negative. If a real association was judged to be present, an estimate is given of the relative risk in smokers compared with that of lifelong non-smokers. The nature of each of the associations is also specified (i.e. whether it was thought to be causal) and, if causal, whether there was at least one known plausible mechanism that could account for it.
Prevention and the economy
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
Economic theory is conventionally divided into two parts; macro-economics, which is concerned with the economy as a whole, and micro-economics, which is concerned with specific decision-making units in the economy, such as the firm or the household. In the same way that macro-economics is about aggregates, the focus of macro-prevention is on reductions in morbidity and mortality generally, rather than on individual preventable outcomes or specific preventive measures. This chapter examines the relationship between macro-economics and macro-prevention.
Economic appraisal in prevention
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
The emphasis of Chapter 1 was on the notion that since resources will never be sufficient to satisfy all human wants and desires, choices have to be made. There are many ways to choose how to allocate resources, and everything from historical precedent to a system of allocating resources to those with the most political power has at least some advocates. Economics does not claim to offer the only criteria for choice. Rather, economic appraisal is advocated as an aid to decision making and never as a substitute for it.
Case studies in primary prevention
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
It is easy to agree with the principles of economic appraisal while at the same time doubting its practicality. The idea of weighing gains against sacrifices is pleasing in theory, but is it really possible to put a money value on reduced pain and suffering? Is there any point in applying the principles of economic appraisal when the aetiology of a disease is largely unknown or subject to controversy?
Prevention: the contribution of health economics
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
This book has attempted to show that there is much that economics can offer to the analysis of prevention. The contribution of economics can be grouped under seven broad headings: (1) the effect of prevention on the economy; (2) the role of economic policy as part of prevention policy; (3) the role of government in the pursuit of prevention; (4) the appraisal of prevention; (5) the provision of information to assist policy making; (6) an understanding of preventive behaviour; (7) a framework for the setting and implementation of prevention policy.
Spain
Authors: Rodriguez Marisol , Calonge, Samuel , Renѐ Joana 
Published: November 2023

Abstract
Other than the manifest interest of the COMAC-HSR project in itself, and its use as a comparative instrument, we must stress that, in Spain, this type of study is unusual. Equity aspects of the Spanish health care system have received little research and, only from the point of view of geographical inequity in the distribution of resources (expenditures, doctors, hospitals, etc.), and not from the aspect of equity associated with income.
Switzerland
Authors: Leu Robert E , Gerfin Michael 
Published: November 2023

Abstract
Equity and solidarity are key issues in the current political debate concerning the Swiss health care system and possible reforms to it. Equal access to medical care has always been a basic principle which has been strongly supported by all political parties and is reflected in the legal framework. Because the health care system is highly decentralized, assigning most of the responsibilities to the 26 cantons, these legal statements exist predominantly on the cantonal level. For example, the communities are compelled by cantonal law to guarantee access to those who need it but cannot afford it (Undritz 1987, p. 21). However, no such consensus exists with respect to health care financing. The conservative parties favour financing schemes which promote efficiency but are regressive (such as a high share of private financing, high co-insurance rates, and deductibles). By contrast, the parties with a strong social committment support financing schemes which are progressive (high share of tax-financing, low co-insurance rates, and deductibles, free care). In the 1980s, the actual development was characterized by a decreasing share of tax-financing and increased co-insurance rates, thus increasing the regressiveness of the financing system. However, this development is likely to be reversed in the near future. A referendum is pending, proposing a massive increase in the share of tax-financed health care, and seems to have a good chance of winning the vote. These developments should be kept in mind when interpreting our empirical findings which related to the situation in 1982.
Wounds: the extent of the burden
Authors: Harding K G , Boyce D E 
Published: November 2023

Abstract
The epidemiology of wounds is too vast a topic to be considered in one chapter when looking at the great variation in wound aetiology. Wound types can vary from burns, chronic, and non-surgical wounds through to surgical, incisional, or excisional wounds. Surgical wound types vary from area to area, even within one hospital, depending on the practice of individual surgeons. Take, for example, the pilonidal sinus - many surgeons within the United Kingdom treat this condi tion by excision with open treatment and formation of granulation tissue (secondary intention), whereas in the United States, more patients are treated by primary suture.
Infection
Authors: Williams N A , Leaper D J 
Published: November 2023

Abstract
multiply in vivo, (iii) interfere with host defencemechanisms, and (iv) cause damage to the host. Possession of strat egies for all of these steps are found in those organisms which are associated with human infectious disease (termed ‘primary pathogens’). However, such organisms are rare in the microbial world. The vast majority of microorganisms lack a means of overcoming one or more of these hurdles to infection of the normal human body. The major barrier to infection is provided by the physical and chemical environment at the body surfaces. In the case of the skin, the tough layer of dead cells and keratin, together with the secretions of the sweat and sebaceous glands, create a formidable barrier. The mucosal surfaces of the respiratory, gastrointestinal, and urogenital tracts as well as the eye have specialized physiological functions which rely on them being more permeable, and thus other mechanisms have evolved to protect these sites.
Management of traumatic wounds
Authors: Whiteside M C R , Moorehead R J 
Published: November 2023

Abstract
A traumatic wound occurs when the body is subjected to a force which exceeds the strength of the skin or the underlying supporting tissues (1).These wounds range from minor cuts or abrasions to extensive tissue injuries which can be life threatening. It is the extent and character of the force which deter mines the nature of the injury and in practical terms wounds can be classified as tidy or untidy (2). In general terms a tidy wound may present a clean incision or laceration, is uncontaminated, less than 6h old, and is caused by low-energy trauma. Conversely an untidy wound has an irregular ragged edge, is contaminated, more than 12h old, and is usually caused by high-energy trauma. These include wounds with crushed tissue or bums.
Clinical aspects of healing by secondary intention
Authors: Mulder G D , Brazinsky B A , Faria D , Harding K G , Rodriguez J L , Baragwanath P , Salaman R , Salaman J 
Published: November 2023

Abstract
Despite their prevalence, venous ulcers remain a multidisciplinary problem and a clinical challenge. For exam ple in the United States alone, between 500000 and 1000000 people are afflicted with venous ulcers. As the elderly popula tion increases, a rise in this number can be expected. This section addresses the pathogenesis, clinical features, and non surgical options for venous ulcerations.
It happens all the time
Authors: Furedi Ann 
Published: November 2023

Abstract
It is a striking fact that in an age when we can send space shuttles to Mars, build computers smaller than postage stamps’ and carry out complex organ transplants, we still can’t control our own fertility. Despite modern methods of family planning, and widespread information about how to use it, unplanned pregnancy is one of the most common medical problems faced by sexually active women under 45.
Enteric infections and arthritis: clinical aspects
Authors: Leirisalo-Repo Marjatta 
Published: November 2023

Abstract
Enteric infections associated with sterile joint inflammation include infections with Gramnegative bacteria such as yersinia (especially Y. enterocolitica, less frequently Y. pseudotuberculosis), salmonella, shigella, and campylobacter (Aho et al. 1985). There are also sporadic reports on the association of joint symptoms with Clostridium difficile (Putterman and Rubinow 1993). On the other hand, bacteria belonging to the normal gut flora (such as Escherichia coli or Klebsiella spp.) are not associated with reactive arthritis.
HLA-B27 subtypes, disease susceptibility, and peptide binding specificity
Authors: Taurog Joel D 
Published: November 2023

Abstract
As documented in Chapters 2 and 12, a great deal of effort has been expended in the investigation of the subtypes of B27. Although the demonstration of disease association with multiple B27 subtypes supported the concept that the B27 molecule itself is a susceptibility factor, until recently it could accurately be stated that B27 subtyping was unhelpful in favoring any particular disease mechanism (MacLean 1992). However, recent application of powerful methodologies, including PCR-based DNA typing of large populations, X-ray crystallography, and sequence analysis of peptides eluted from HLA molecules, has generated epidemiologic and biochemical data regarding the HLA-B27 subtypes that should prove valuable in guiding further research. These recent data are reviewed in this chapter.
Background and overview
Authors: Hope R A , Fulford, K W M , Yates Anne 
Published: November 2023

Abstract
This Manual outlines a course in professional practice skills, The Oxford Practice Skills Course, developed in the University of Oxford Medical School for clinical medical students. The course is described in detail, including tutor’s instructions, student handouts and background materials and methods. Additional notes on practical aspects of developing a course in this area, such as designing a new seminar, introducing a course into the curriculum, and teaching methods and resources, are given in the appendices. The Oxford Practice Skills Course is only one among many possible approaches to this aspect of clinical training. We hope however that our experience, methods and materials as outlined in this manual will be helpful to other medical schools. The Manual is designed to be used on its own, but we welcome enquiries and visits from anyone concerned with teaching in this area.
Syllabus
Authors: Hope R A , Fulford, K W M , Yates Anne 
Published: November 2023

Abstract
Introduction In this chapter we describe the syllabus for the Practice Skills Course by way of: An overview of the course as a whole. An overview of the tutorials in General Communication Skills. Topic lists for ethics, law and communication skills (from which the course is built up). A ‘topic grid’ showing how the main syllabus areas in ethics, law and communication skills are integrated into the Practice Skills Course . There is no overall consensus on the subjects which should be covered in courses of this kind. A core syllabus is beginning to emerge but the details will vary with the needs and resources of different medical schools.
Neuropathological Consequences of Schizophrenia Treatments
Authors: Harrison Paul J 
Published: November 2023

Abstract
The confounding effects of antipsychotic medication on neurochemical studies of schizo phrenia are well known (Harrison, 1999a). Their influence on brain structure, though less well documented, has become apparent from imaging studies indicating that antipsychotics produce striatal enlargement in patients (Chakos et al., 1994; Keshavan et al., 1994; Doraiswamy et al., 1995; see Chapter 1) and in rats (Chakos et al., 1998). Of partic ular relevance here, the drugs also produce neuronal morphometric and synaptic changes which may overlap with and hence confound the cytoarchitectural alterations reported in schizophrenia. This chapter reviews the histological effects of antipsychotics. Brief mention is also made of neuropathological implications of other schizophrenia treatments, and of substances which are commonly abused by people with (or without) schizophrenia.
Psychoimmunology today: mechanisms mediating the effects of psychological status on the immune system
Authors: Bellinger D L , Thyagarajan S , Lorton D , Madden K S , Tran L , Felten D L 
Published: November 2023

Abstract
Psychosocial factors and stressors can influence the health and well-being of an individual. These environmental stimuli are transduced by the brain into chemical signals that can affect the immune system. Behavioural conditioning studies reveal that the CNS also can detect alterations in immune responses and, subsequent to detection, is able to initiate a change in immune response upon re-exposure to the conditioned stimulus. The specific neural circuits in the brain that mediate these changes in immune function have been the focus of much research over the past ten years. However, these neural circuits are still not well defined, and the functional significance of brain-immune inter actions under a variety of conditions is not fully understood.
Anti-cancer mechanisms involving the immune system
Authors: Szlosarek P W , Dalgleish A G 
Published: November 2023

Abstract
The past five years have witnessed a sustained period of growth in our under standing of the immune system and its interaction with solid tumours. The continuing molecular revolution has undoubtedly been the single most import ant factor in these developments, enabling a redefinition of both the immune mechanisms involved and the pathobiology of the disease at a structural and functional molecular level. New methodologies, including cloning techniques for tumour antigens and hence their characterization (the so-called human cancer ‘immunome’ project), and new quantitative and functional assays detailing the immune response such as ELISPOT and tetrameter analysis have been particularly important. This detailed knowledge has subsequently generated exciting new ideas and treatment strategies, which are based on a rational, scientific approach to the problem of cancer (1–3).
Psychospiritual healing and the immune system in cancer
Authors: Booth R J 
Published: November 2023

Abstract
‘Psychospiritual healing’ combines three terms often nebulously understood or at least interpreted in a variety of ways by different people. What is clear, how ever, is that when people use the terms ‘psychological’, ‘spiritual’, or ‘healing’, they are referring to aspects of human experience that are beyond purely physical dimensions. In order to discuss psychospiritual aspects of healing and the immune system in relation to cancer, we therefore need to address human experience. We will begin by considering something of the nature of human biological existence and then explore how a concept of ‘self’ emerges from the ways in which we interact in the world and make distinctions. This will lead us to a concept of body and mind as mutually influential domains of self-expression which are shaped by spiritual factors. Finally, we will discuss psychospiritual healing and its possible impact on cancer and cancer therapy and treatment.
Can psychosocial interventions extend survival? A critical evaluation of clinical trials of group and individual therapies
Authors: Calde K , Classen C , Spiegel D 
Published: November 2023

Abstract
Does living better mean living longer? A small number of studies published over the last two decades have examined the provocative question of whether or not providing psychotherapeutic support can increase survival time for cancer patients. While initially such an effect would seem implausible, it must be borne in mind that there are two components to the equation that can account for variance in cancer progression: (a) the tumour’s characteristics; and (b) host resistance. The former is largely determined by genetic damage—the tumour’s anaplasty, loss of contact inhibition, ability to induce a vascular supply, and tendency to metastasize. The latter involves the host’s ability to respond to tumour invasion, including physiological systems subject to neural control. These include behaviour, adherence to medical treatment, and the endocrine, immune, and autonomic nervous systems. It is thus not entirely mysterious (if also not well understood) how participation in various psycho therapeutic programmes could affect survival time with cancer.
Psychological factors and cancer progression: involvement of behavioural pathways
Authors: Anderson J , Walker L G 
Published: November 2023

Abstract
Psychological reactions to stressful life events, mood disturbance, personality, coping styles, and compliance with medical treatment have all been implicated in altering the prognosis of individuals with cancer. Research to date has inherent methodological limitations and the evidence that psychological factors independently predict survival is inconsistent. The most compelling evidence for a causal relationship comes from prospective, randomized, controlled trials in which psychological and/or behavioural factors have been manipulated and the effects on survival evaluated. A systematic review of the literature revealed ten randomized trials comparing one or more psychological interventions with a control condition that excluded a formal intervention. Four of these studies indicated that participating in a psychological intervention resulted in a significant survival benefit. Behavioural as well as biological pathways may be involved.
Historical Introduction
Authors: Cameron J Stewart 
Published: November 2023

Abstract
Some years have passed since the first edition of this book, but this brief extension in time has not blunted the truth of this statement by one of the great clinical nephrologists of the last century. Doctors have been looking at the urine for diagnostic information for at least one and a half millennia [2, 3], and the examination of the urine was already part of the Hippocratic system 500 years before the beginning of the past millennium. However, for the first thousand years or more, this enquiry was pursued by eye, unaided by either microscopy or chemistry (Figure 1).
The Formed Elements Of The Urinary Sediment Cells
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard 
Published: November 2023

Abstract
The urine can contain different types of cells, some of which derive from the circulation, while others derive from the epithelia of the urinary system (Table 2.1). The majority of these cells include several subtypes, some of which can be identified only by using general or specific stains. Other cells, such as glomerular cells [I], basophilic leukocytes [2], platelets [3] or monocytes [4] have also been described in urine. However, they were identified by special techniques, and their meaning was not always clear. New approaches for studying urine sediments such as those described in Chapter 7 might in the future better clarify the meaning of these cells or might even reveal the presence of other elements unsuspected today. For the time being, however, we base our classification and discussion on the cells which can be identified by conventional techniques.