bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling pulmonary air embolism
Authors: Cruickshank Steven 
Published: November 2023

Abstract
Pulmonary air embolism (PAE) is a danger in various operative procedures, notably during surgery on cervical spine or structures in the posterior fossa carried out in the sitting position. There are various methods of detecting when this has occurred. One of the long-established methods is end-tidal CO2 (FE’co2) monitoring; the occurrence of venous air embolism is associated with a fall in the level of CO2 in the end-tidal breath, and this is displayed on capnography. We shall model the effects of PAE on the CO2 economy of the body, by building on the steady state and step change in VA models. We shall make some sweeping simplifying assumptions but still end up with a model that is considerably more complex than the previous ones we have met.
Receptors and agonists
Authors: Cruickshank Steven 
Published: November 2023

Abstract
We have studied the time course of drug action and how this may be modelled pharmacokinetics. Now we turn to the effects of the drug at its site of action pharmacodynamics. The concept of drug receptors was formulated by Clark in the 1920s and, despite refinements, the basic concept of a ligand interacting with a receptor in accordance with the Law of Mass Action remains valid. A ligand is a simply a molecule that binds to a receptor site. It may be a natural substance such as noradrenaline or a synthetic one such as isoprenaline. It may or may not pro duce some measurable effect. If an effect is produced, the ligand is an agonist at that receptor. We shall concentrate upon the mathematical models that the receptor concept predicts. Further details of receptor theory are available in any pharmacology text.
Linear functions
Authors: Cruickshank Steven 
Published: November 2023

Abstract
Linear functions are extremely familiar and are easy to handle; they are the mathematics of tea-making-'one spoon per person and one for the pot'. Linear functions are the simplest non-constant functions and are often used as a 'default' even when a more complex relationship is suspected, as we did in the air embolism modelling example ( 1.12). They are so easily manipulated that it is often worth-while to search for a transformation that will convert non-linear relationships to linear ones. This is what we did with the Hill (1.14.4) and Schild plots, (1.15.3) and in estimating rate constants in exponential processes using log transformations (2.9.JO).
IOP revisited
Authors: Cruickshank Steven 
Published: November 2023

Abstract
In many of the models developed in this book, you may have been tempted to question the assumptions made or have felt that the model could be improved in some way by taking account of other factors which may behave differently from the assumptions. For instance, we blithely took a respiratory quotient of unity in all of our respiratory models simply because it made things easier. This does not mean that the RQ actually is unity-it is usually about 0.8. The predictions of our models will not therefore match reality exactly; the general pattern will not usually be affected by such simplifications, but the precise predictions will. It is open to you to improve the models.
Growth and development
Authors: Bender David A , Bender Arnold E 
Published: November 2023

Abstract
As discussed in Chapter 12, children are most at risk from undernutrition, and assessment of growth provides a sensitive index of their nutritional status, albeit confounded by the effects of infection and emotional and metabolic stress. For individual assessment, the child’s measurements are compared with standards for the weight or height achieved at a given age, or weight for height. For population studies, the distribution of weight, height or height for age in the group being studied should be compared with the distribution in a reference population.
Niacin and tryptophan
Authors: Bender David A , Bender Arnold E 
Published: November 2023

Abstract
Niacin is unusual among the vitamins in that it was discovered as a chemical compound, nicotinic acid produced by the oxidation of nicotine, in 1867- long before there was any suspicion that it might have a role in nutrition. Its metabolic function as part of what was then called Coenzyme II (NADP) was discovered in 1935-again before its nutritional significance was known. Therefore, it has never been assigned a number among the B vitamins; although it is conventionally placed between vitamins B2 and B6, it is not correct to refer to niacin as vitamin B3, a name that was originally applied to what was probably pantothenic acid (see section 23.2 and Table 23.1).
Biotin, pantothenic acid and other organic compounds
Authors: Bender David A , Bender Arnold E 
Published: November 2023

Abstract
In addition to the vitamins discussed in previous chapters, a number of compounds have clearly defined functions in the body. Two of them, biotin (vitamin H, see section 23.1) and pantothenic acid (see section 23.2), cannot be synthesized in the body, and are therefore dietary essentials. However, they are not nutritionally important, since they are sufficiently widespread in foods for deficiency to be more or less unknown, and there are no firm estimates of requirements.
Mineral nutrition
Authors: Bender David A , Bender Arnold E 
Published: November 2023

Abstract
Any mineral for which a metabolic or physiological function has been determined is, by definition, a dietary essential. The various functions of minerals include forming the mineral of the skeleton (a structural role), membrane function (trans-membrane ion gradients), prosthetic groups of enzymes (probably one-third of all enzymes require a metal ion or a metal derived prosthetic group), and metabolic and cell regulation and hormone action. In addition, a number of minerals are known to be dietary essentials, but as yet no metabolic functions have been defined, and some minerals have (beneficial) effects in the body, but these are probably pharmacological actions rather than reflecting a true essential function and dietary requirement. In Table 25.1 the minerals are listed under these functions; some have more than one function, and appear . under more than one heading. Table 25.2 shows the total body content, and Table 25.3 the plasma concentrations, of minerals.
Purchasing ultrasonic equipment for use in obstetrics and gynaecology
Authors: McDicken V N 
Published: November 2023

Abstract
The selection of an ultrasonic scanner is a decision which may have to be lived with for as long as 10 years. A thorough professional approach to the selection is, therefore, highly desirable. Taking the advice of a friend or colleague in another department may be very helpful but it is rarely a careful appraisal of all the options. If possible, before any machine is considered, a specification should be drawn up of the requirements for both present and projected future clinical applications. Table 8.1 is an example of a specification for a unit to be used over an extensive range of state-of-the-art clinical applications.
Compendium of prenatal diagnoses using ultrasound
Authors: Connor J M 
Published: November 2023

Abstract
This compendium aims to provide, in tabular form, details of prenatal diagnoses which have been achieved using ultrasound. In addition to diagnosis using ultrasound (349 entries) it also includes prenatal diagnoses accomplished using other imaging modalities (fetoscopy, radiography, magnetic resonance imaging, and fetal echocardiography — 24 entries).
Historical and theoretical background
Authors: Jolly Brian 
Published: November 2023

Abstract
My method, hitherto unknown here, and possibly anywhere else, is to lead my students by the hand to the practice of medicine, taking them every day to see patients in the public hospital, that they may hear the patients’ symptoms and see their physical findings. Then I question the students as to what they have noted in the patients and about their thoughts and perceptions regarding the causes of the illnesses and the principles of treatment. Sylvius 1679, p. 907Clinical exposure is an important part of medical training. The intention of this chapter will be to illuminate some of the characteristics and products of learning, by medical students, in the clinical setting. The studies referred to here were carried out in the context of courses in the UK, Canada, and Australia. Most were completed during a period in which the primary location of clinical teaching was the ward, the lecture theatre, or the out-patient clinic, all usually in a large teaching hospital. As pointed out in Chapters 1 and 4, the movement of clinical education into the community has been slow to materialize and confined to a small number of (mostly new) schools. Nevertheless ‘hospital’ based educational research has covered a wide variety of learning environments and includes the structure and function of clinical attachments, ward based teaching (including bedside teaching), the learning of technical skills, academic work in a clinical context, and the use of out-patients.
Managing change
Authors: Gale Rodney , Grant Janet 
Published: November 2023

Abstract
There is an extensive and rapidly growing literature on the management of change. There is, growing in parallel, a realization that the context of change is important to its process and its outcome (Pettigrew 1985). Beneath all writings on change lie theories and views about the ways organizations function and the ways people operate within them. Spurgeon and Barwell (1991) have reviewed many of these in the context of the National Health Service.
The perception of pain
Authors: Coniam S W , Diamond A W 
Published: November 2023

Abstract
Pain is unlike any of the other sensory modalities. It is not a single measurable sensation like light and sound; it is an experience, the nature of which depends not only on the nature of the stimulus, but on the programming of pain perception mechanisms and their cerebral interpretation. There is no single pathway in the nervous system which is responsible for the perception of pain. The integrated response of many physiological mechanisms may be interpreted as pain.
Acute pain
Authors: Coniam S W , Diamond A W 
Published: November 2023

Abstract
‘Acute’ in medicine means of short duration and coming to a crisis. This applies to the initial pain of an incision, a fracture or a bum. It also applies to the pain of trigeminal neuralgia, the initial overwhelming onset of acute back pain, and even some migraine headaches. There has been a recent surge of interest in the important topic of pain following surgery. This follows publication of a report by the Royal Colleges of Anaesthetists and Surgeons demonstrating that pain after surgery was very poorly managed and that simple measures would relieve a lot of unnecessary suffering.
Pain as a long-term problem
Authors: Coniam S W , Diamond A W 
Published: November 2023

Abstract
Pain is useful. It tells us that we have injured ourselves. We can ignore pain that is not severe enough to affect our enjoyment or quality of life when we are assured that it is not caused by a disease or injury. Hit is caused by a disease or injury and it goes when the cause is cured, the pain is now no longer of any significance. All other pains are significant. They generate suffering, they cause anxiety and then depression. They interfere with the ability to live a normal life. They cause invalidity. These pains are part of chronic disease. In the absence of a causative disease, the pain becomes a disease.
Regional anaesthesia in awake babies
Authors: Peutrell J M 
Published: November 2023

Abstract
Babies born before 37 weeks’ gestation are at risk of postoperative apnoea, and regional anaesthetic techniques have been recommended to reduce this risk. Apnoea is usually defined as either:(1) the cessation of breathing for 15 seconds or longer; or(2) the cessation of breathing for a shorter period if associated with bradycardia or cyanosis.Postoperative apnoea in ex-premature babies has several clinical characteristics:
Some problems of adolescents
Authors: Modell Michael , Mughal Zulf , Boyd Robert 
Published: November 2023

Abstract
A group practice of 10 000 patients will contain on average 1500 between the ages of 10 and 20. In this chapter we discuss some of the features of consultations with adolescents, and some of their common problems not covered elsewhere in the book. Practice leaflets can usefully include a paragraph describing special services provided for adolescents plus reassurance that the under-16s can see their GP or other member of the team for a confidential consultation. This right has been firmly endorsed by the BMA, the GMSC, and the RCGP. Rare exceptions are if the young person is considered to be too immature to understand what is going on or to consent to treatment, or if the safety and welfare of a third person are at risk.
The skin
Authors: Modell Michael , Mughal Zulf , Boyd Robert 
Published: November 2023

Abstract
The epidermis, which is about 0.1 mm thick, is completely replaced every month through the mitotic division of cells in its basal layer. These cells gradually migrate towards the surface, become flattened, lose their nuclei and become filled with keratin. As well as the squamous cells or keratinocytes, which form the bulk of the final layer or stratum corneum, the epidermis contains other cell types including the pigment producing melanocytes. In diseases such as psoriasis, where there is an accelerated turnover of the epidermis, the more rapid movement of the keratinocytes to the surface prevents production of the usual well formed protective layer of dead cells. This surface layer is then an ineffective barrier and is more easily breached.
Bones, joints, and limbs
Authors: Modell Michael , Mughal Zulf , Boyd Robert 
Published: November 2023

Abstract
Parents frequently consult about their toddlers’ posture or gait. Fortunately most children’s legs and feet are normal, even if they point in slightly unusual directions. The best advice is, with few exceptions, to do nothing. Important but rarer deformities, such as congenital dislocation of the hip, which do require prompt attention, or club feet, may result from exposure to an abnormal pressure in utero. For example, they are slightly more common after amniocentesis, presumably from oligohydramnios associated with continued loss of amniotic fluid. Abnormal intrauterine moulding also underlies some of the milder abnormalities of posture.
Chronic disease, malignancy, and death
Authors: Modell Michael , Mughal Zulf , Boyd Robert 
Published: November 2023

Abstract
Most GPs look after several families with chronically unwell children. The range of sickness is wide and includes severe asthma, epilepsy, diabetes, congenital heart disease, and malignancy. A patient may also suffer from one or another of the vast range of rarer disorders. There are many important factors common to the care of these children, although details of management will, of course, vary according to the disease they suffer from. Many professionals are involved in their care: nurses, doctors, social workers, health visitors, physiotherapists, and teachers. These families must have medical advisers who are easily available and who will negotiate an approach to management with the family.
Miscellaneous information
Authors: Modell Michael , Mughal Zulf , Boyd Robert 
Published: November 2023

Abstract
The practice needs a couple of sizes of paediatric sphygmomanometer cuffs. The rubber bag inside the cuff should be long enough to go right round the arm and wide enough to cover two-thirds of the arm between shoulder and elbow. Too small a cuff will produce an abnormally high blood pressure reading-the commonest cause for alleged childhood hypertension. Too large a cuff may have the opposite effect.
True transsexualism
Authors: Volkan Vamik D , Greer William F 
Published: November 2023

Abstract
Among the anomalies of human sexual development, few, if any, seem more enigmatic than that of men and women who claim that they are the victims of cruel trick of nature and are imprisoned in the bodies of the wrong sex. Although they have normal anatomies for their biological sex, they, nonetheless, aver that they are ‘really’ a woman trapped in a man’s body or a man trapped in a woman’s body. So desperate are they to correct nature’s alleged mistake that they often make clamorous demands for surgical and endocrinological treatments.
Rapidly progressive glomcrulonephritis: resolution and scarring
Authors: Wiggins Roger C 
Published: November 2023

Abstract
Scarring takes place in glomeruli and interstitium in patients with the clinical syndrome of rapidly progressive glomerulonephritis (RPGN). The extent of scarring determines outcome, and depends on the balance of pro-and anti-sclerotic forces at particular sites and at particular times during the inflammatory event. In this chapter, two factors affecting this balance will be emphasized: (1) the importance of maintenance of the normal architecture of the kidney (the barrier hypothesis); and (2) the identification of collagen-producing cells in the interstitial compartment and the communication between inflamed glomeruli and these interstitial cells (glomerulointerstitial signals).
Developing an experimental parallel- track medical course: the Cambridge Community-based Clinical Course
Authors: Oswald Nigel 
Published: November 2023

Abstract
The main reasons for this innovation were a wish to explore the extent of the unused medical teaching resources outside hospitals and to seek way1, of developing co-operative teaching between specialist and generalist teachers in medical education. The innovation is about looking for ways to enhance education and not about coping with the difficulties experienced in traditional courses. The essential elements in this programme are that students are attached as a stable, small group to a single practice for 15 months out of the total clinical course of 27 months. This is intended to enable students to focus on patients’ problems, to maintain long-term contact with patients where appropriate, and to develop the skills and attitudes required for effective self-directed learning.
Single-photon emission-computed tomography (SPECT)
Authors: Gemmell Howard G , Staff Roger T 
Published: November 2023

Abstract
Although the principles of single-photon ennssioncomputed tomography (SPECT) have been well understood for many years and several centres were using SPECT clinically in the late 1960s and early 1970s, there has been a dramatic increase in the number of SPECT installations in recent years. In the early 1980s, however, SPECT was a technique in search of a clinical application and, since the rather stringent quality control requirements were not initially appreciated, the image quality from the early gamma-camera systems was often poor. Progress has been made on both fronts. A state-of-the-art gamma camera which is well maintained should produce high-quality SPECT images consistently, and even older cameras can produce acceptable images if care is taken.
Setting the scene
Authors: Heather Nick , Robertson Ian 
Published: November 2023

Abstract
Our task in the second part of this book is to present a credible alternative to the disease perspective through which to understand and respond to problem drinking. This chapter sets the scene for the three remaining in Part 2. This is achieved by an attempt to define the nature of problem drinking and by an outline of the approach known as social-learning theory which will serve as the basis for the alternative paradigm of problem drinking to be described later. We begin, however, with two thoroughly typical case histories.
The shoulder joint
Authors: Wardrope Jim. , English Bryan 
Published: November 2023

Abstract
Normal range of movement—flexion 160 degrees, extension50 degrees, abduction 170 degrees, adduction 50 degrees, internal/external rotation 70 degrees;Capsular pattern—limitation in abduction/external rotation and internal rotation in extension (arm up behind back);Very mobile units with lax capsule—main factors maintaining stability are the rotator cuff muscles;Acromioclavicular joint injury—common, may be a total dislocation of the joint;Supraspintous tear—is a common injury, may need operative repair in young person;Anterior dislocation—usually easily diagnosed and treated, but exclude major fractures and nerve/vascular injury;
Glomerulosclerosis: Insights into Pathogenesis and Treatment
Authors: Anderson Sharon 
Published: November 2023

Abstract
Loss of renal function is progressive; once the glomerular filtration rate (GFR) falls below about 25ml/min, regardless of etiology, most patients will progress to end-stage renal disease (ESRD) [l-3]. Recent investigations have focused on the elucidation of risk factors for progression, and the mechanisms which promote the process. It has long been known that contributing factors include poorly controlled hypertension, urinary tract infection, obstruction, administration of nephrotoxic drugs, and episodes of acute renal failure. More newly validated risk factors include hyperlipidemia, cigarette smoking, poor metabolic control (in diabetes), advancing age, and genetic factors, as are detailed elsewhere in this volume.
Proteinuria: Implications for Progression and Management
Authors: Harris Kevin P G 
Published: November 2023

Abstract
It is a well established observation from both human and animal studies of renal disease, that once a degree of renal damage has occurred then the progression of kidney failure is inexorable, even if the original injurious process has resolved [1]. Such observations have led to the hypothesis that following renal damage of any aetiology a maladaptive response occurs in the remaining nephrons which results in their eventual destruction by a common pathogenic mechanism. In support of this, the histological appearance of the kidney in end-stage renal disease is similar whatever the initial cause of the renal injury; within the glomerulus there are localised areas of cellular proliferation, deposition of excess extracellular matrix (ECM) and there is collapse of the glomerular capillary. Within the interstitium there is tubular cell atrophy, a mononuclear cell infiltrate, fibroblast proliferation, and ECl\:1 deposition. These events lead to the replacement of the functioning renal tissue by scar tissue, and affects both the glomeruli and the tubulo-interstitium, culminating in glomerulosclerosis and tubulo-interstitial fibrosis, respectively.