bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of epidemiological data for prognostication and decision-making
Authors: Sinclair John C , Torrance George W 
Published: October 2023

Abstract
The first part of this chapter will review the physician’s role in using epidemiologic data in predicting the future course of disease (prognostication) and in deciding whether medical intervention is likely to do more good than Harm. By epidemiologic data we mean data obtained from groups of patients with the same disorder who have been observed over the time-course of their disease, or who have been subjected to treatment. By reference to such data, the physician infers the probable course of events if he/she should simply observe his/her patient, or intervene with treatment. Although the viewpoint adopted in this chapter is primarily that of the individual physician caring for the individual patient, we will also consider, when relevant, the factors which enter when comparable decisions are to be made from a societal viewpoint-for example in the planning and financing of treatment programs based on the health-care needs of populations.
Government regulations in the United Kingdom
Authors: Campbell A G M 
Published: October 2023

Abstract
In the United Kingdom, the current position can be stated quite simply. There are no Government Regulations that deal specifically with the care of newborn infants. Traditionally, the regulation and control of medical practice has been left to the medical profession, which through the General Medical Council (established by the Medical Act 1858), sets its own guidelines for professional conduct and discipline. Doctors are expected and, to a large extent, still trusted to act according to various principles or codes of medical ethics that have their roots in the Hippocratic Oath, but which have required reappraisal in the light of modern advances in medicine.
Preparation Of The Workplace And Equipment
Authors: Morton N S , Davis W 
Published: October 2023

Abstract
‘Be prepared’ is an old-fashioned motto but in anaesthesia it is a very important principle. When things go wrong during anaesthesia the speed of change can be alarming and the need for intervention must often be immediate to avoid harm to the patient. A good example is a patient having an abdominal operation; on opening the peritoneum the heart rate can slow dramatically within a few seconds - the treatment must be immediate or the heart rate may slow to dangerously low levels. The surgeon should stop pulling on the peritoneum - this causes the stimulation of the vagus nerves which cause the heart rate to slow - and the anaesthetist should give an intravenous bolus dose of atropine which blocks the effects of the vagus nerve on the heart.
The Airway And The Adequacy Of Ventilation
Authors: Morton N S 
Published: October 2023

Abstract
During maintenance of anaesthesia, keeping the airway open is critical to ensure adequate delivery of oxygen and anaesthetic gases and adequate carbon dioxide removal. If the airway is not open, the oxygen supply to the patient’s lungs will be impaired and transfer of oxygen to arterial blood and to the body tissues will decrease. Within minutes the lack of oxygen supply to brain, heart, muscle and other vital organs will cause damage. At the same time, CO2 elimination from the lungs will be impeded and the CO2 concentration in the blood will build up. High CO2 concentrations stimulate the breathing centre in the brain and cause an increase in heart rate, irritability of the heart muscle, an increase in blood pressure and increased blood flow to the brain. Very high concentrations of CO2 in the blood cause coma and eventually depression of breathing.
Safety In The Anaesthetic Room And Theatre
Authors: Hosie H 
Published: October 2023

Abstract
Hospitals are potentially dangerous places with potent drugs, potentially dangerous chemicals and electrical and mechanical devices used every day. Transmission of infection to or from patients is another major danger. Anaesthetic rooms, theatres and recovery are areas where safety considerations are essential and should involve three groups of people - your patient, your col¬ leagues and yourself. It is your duty to be aware of local protocols, guidelines and procedures which have been drawn up to comply with recommendations and legislation to ensure safe work practices.
Circulation
Authors: Hosie H 
Published: October 2023

Abstract
Cardiac arrest is the cessation of pump action by the heart. This leads to cessation of blood flow to all organs and most importantly the brain. Cessation of blood flow to the brain for 3 min or more will result in hypoxic brain damage in normal circumstances. Recognition of cardiac arrest, prompt treatment of the underlying cause, if possible, and effective cardiopulmonary resuscitation is vital.
Preparation For Return To The Ward
Authors: Holmes E 
Published: October 2023

Abstract
All patients must be assessed prior to their return to the ward. This may be done by the anaesthetist caring for the patient or by a senior nurse within the unit. There should be a unit policy to determine the minimum acceptable criteria for fitness to leave recovery. It is important to take into account the individual needs of the patient and to consider the ward or unit they are being sent to.
Paediatric Surgery
Authors: Morton N S 
Published: October 2023

Abstract
Children are not small adults. The range of diseases they suffer from is different from adults and the child’s physical and psychological responses to these diseases are different. Congenital abnormalities or their complications are often the reason for the child coming into hospital for surgery or for emergency care. The child’s smaller size affects the equipment used for anaesthesia and the relatively large surface area of the small child means that heat loss and fluid losses are more of a problem. There are several differences in anatomy, physiology, psychology and pharmacology which have to be considered. All these variations are especially marked in the newborn and especially the premature baby.
Anaesthesia In The Isolated Location
Authors: Morton N S 
Published: October 2023

Abstract
Anaesthesia or anaesthetist-monitored sedation is often carried out in areas of the hospital which are isolated from the main operating theatre complex e.g. radiology department, CT scanner, MRI scanner, cardiac catheterization laboratory, radiotherapy suite, or the psychiatric unit (electroconvulsive therapy).
The principles are the same in all these areas: there must be adequate supplies of oxygen, suction equipment, anaesthesia equipment and drugs, monitoring as for all general anaesthetics, emergency drugs and equipment and defibrillator. For safety reasons there should be no compromise in these standards. Special problems include difficulty getting near to the patient, (e.g. in a scanner), adaptations of equipment for safety (e.g. non-magnetic equipment in MRI), allergic reactions to X-ray dyes (e.g. must be prepared to treat anaphylactic shock) and radiation protection of staff with lead aprons, thyroid protection collars and goggles.
Pathophysiology of amyloidogenesis
Authors: Campistol Josep M , Cohen Alan S 
Published: October 2023

Abstract
The term ‘amyloidosis’ describes a group of diseases characterized by extracellular deposition of a fibrillar protein, amyloid, with a -pleated sheet conformation (Cohen 1967; Glenner et al. 1970). The growing mass of amyloid fibrils associates with plasma and extracellular matrix proteins and proteoglycans to form amyloid deposits. The amyloid deposits bind Congo red stain and give a green birefringence in polarized light, which is the most common histological criterion used for the presence of amyloid deposits in tissues (Cooper 1974). Characteristic fibrils of 7-10 nm diameter with a random twist are seen using electron microscopy, and a -pleated sheet configuration is viewed with X-ray crystallography (Cohen and Calkins 1959). Amyloid fibrils are known to be highly insoluble under physiological conditions and resistant to normal degradative processes in vivo, and therefore when they deposit within the physiological environment of the cell, thereby replacing normal tissue constituents, the function of the affected organ is often disturbed (Glenner 1980).
Various clinical types of amyloidosis
Authors: Hawkins P N , Tan, S Y , Pepys M B 
Published: October 2023

Abstract
Amyloidosis is a generic term for a heterogeneous group of disorders caused by the extracellular deposition of protein in a characteristic abnormal fibrillar form. There are acquired and hereditary types and amyloid deposits may be focal, localized, or systemic in distribution. When focal or small in amount, amyloid may be only an incidental finding at autopsy and, indeed, such deposition in the brain, heart, seminal vesicles, and joints is an almost universal accompaniment of ageing. In contrast, systemic amyloidosis or significant local deposition disrupt the normal structure and function of the affected tissues and are usually progressive. The systemic forms are frequently fatal. Although there is no specific treatment, intervention that reduces the supply of the protein precursors of amyloid fibrils can be associated with marked regression of amyloid deposits in some cases (Hawkins et al. 1993a, b; Holmgren et al. 1993).
Arthropathy and carpal tunnel syndrome of 2-microglobulin amyloidosis
Authors: Bardin T 
Published: October 2023

Abstract
Rheumatic disorders develop with increasing frequency with length of survival in patients under maintenance haemodialysis (Chou et al. 1985; Benhamou et al. 1987; Hardouin et al. 1987; Bardin and Laredo 1991). They are at present one of the main factors limiting the quality of life of long-term survivors (Goldstein et al. 1985; Brown et al. 1986; Bardin et al. 1988; Fardellone et al. 1988; Hurst et al. 1989; Kessler et al. 1992). The deposition of (32-microglobulin amyloid in osteoarticular tissues plays a major role in the genesis of these complications, but other aetiological factors including aluminium and iron overload, microcrystalline inflammation, and secondary hyperparathyroidism are also important (Bardin et al. 1986; Bardin 1987; Gaucher et al. 1982). This review will describe the clinical features of dialysis amyloid arthropathy and differentiate it from articular symptoms of other aetiologies in dialysis patients.
Determinants of fibril precipitation and aggregation in amyloid deposits
Authors: Campistol Josep M 
Published: October 2023

Abstract
Amyloidoses are complex diseases of pathological conformational change and polymerization, in which insoluble fibrils are derived from normally soluble precursors (Cohen 1967; Glenner et al. 1970). Using nonpolarizing optics, amyloid deposits in tissue sections appear homogenous, eosinophilic, and amorphous when analysed by light microscopy. With polarizing light, unstained amyloid deposits exhibit birefringence, indicating the presence of highly ordered structures. On staining with Congo red dye, the birefringence of amyloid deposits is intensely increased in a manner that is not seen with other fibrillar structures such as collagen, elastin, and fibrin (Cooper 1974). This indicates that the linear dye molecules are arranged in parallel along the amyloid fibril axis. All types of amyloid deposit contain characteristic and specific 10-15 mm fibrils by electron microscopy, as well as common elements in extracted material, such as amyloid P component, glycosaminoglycans, and proteoglycans (Cohen and Calkins 1959; Glenner 1980). X-ray diffraction studies of isolated amyloid fibrils demonstrated that the proteins are arranged in a crossed [3-pleated sheet conformation, with the polypeptide backbones oriented perpendicular to the long axis of the fibril; infrared spectroscopic analysis revealed that the orientation of the polymerized polypeptides is antiparallel (Eanes and Glenner 1968).
Chronic respiratory failure
Authors: Frcp Anita Simonds Md 
Published: October 2023

Abstract
A 54-year-old delivery man was admitted to a medical ward with a 3-day history of breathlessness, wheeze, and cough with purulent sputum. He had smoked 25 cigarettes a day for 40 years, but had never previously been hospitalized for a respiratory problem. His only regular medication was inhaled salbutamol. Exercise tolerance was reported by his family to be around 400 m on the flat until this current episode.
Asthma
Authors: Frca Brian F Keogh 
Published: October 2023

Abstract
An 18-year-old male suffered a severe asthma attack at home in associa tion with a recent upper respiratory tract infection. On arrival in the A&E department, the ambulance officers reported that the patient was initially conscious but unable to speak and had rapidly become unresponsive during transfer. On initial assessment, despite mask oxygen, SpO2 was 65% and the patient essentially apnoeic in gross hyperinflation. The patient was immediately intubated by A&E staff and manually ventilated with FiO.
Multiple trauma
Authors: Frca D R Goldhill 
Published: October 2023

Abstract
A 25-year-old female was found alone in her car, having collided with a tree. lttook 1 hour to extricate her from the wreckage. During that time she was reportedly ‘semi;.conscious’ but deteriorated in the ambulance. On arrival in the emergency room her BP was unrecordable, respiratory rate was .25/min, and she had a Glasgow coma score (GCS) of 5. Initial emergency room resuscitation was according to advanced trauma life support (ATLS) protocols.
Oxygen delivery in trauma
Authors: Frca D Watson , Frca M Hayes Md 
Published: October 2023

Abstract
A 30-year-old male fell from a third-floor window. On admission to hospital he was shocked but conscious. BP was 80/60 mmHg; pulse 120/min. X-ray of the pelvis revealed an acetabular fracture. Peritoneal lavage was positive for blood and laparotomy revealed a massive retroperitoneal haematoma. Prior to transfer to the angiography suite he had been transfused 27 units of packed red cells.
Hypothermia
Authors: Frcs M P Hayward 
Published: October 2023

Abstract
A 28-year-old woman was found,. apparently dead; at 0700 hours on a park bench. The air temperature overnight 2.°C with continuous overnight rain. No discernible pulse could be felt but a passing policeman detected faint infrequent respiratory efforts; ..External cardiac massage was commenced and she was brought to the local A&E department. On admission she had no detectable. cardiac output,. was ranking no respiratory effort, and had fixed, dilated pupils. A low-reading rectal thermometer gave a core temperature below 28°C; ECG showed slow ventricular. fibrillation. She was intubated and ventilated, and external cardiac massage was continued. There was no cardiac response to DC cardioversion or any standard resuscitation drugs.
Hypovolaemia
Authors: Mrcp A Webb Md 
Published: October 2023

Abstract
A 32-year-old female patient was admitted to the ICU from the A&E department. She had presented after collapsing with left loin pain. She had a past history of recurrent urinary tract infections. Pyrexia 38.0°C; pulse 130/min; sinus rhythm respiratory rate 24/min; BP 70/40 mmHg. Jugular venous pulse not visible. Heart sounds normal with no added sounds. Chest normal. Abdomen tender to palpitation in the left loin. Central nervous system normal other than mild drowsiness.
Aortic dissection
Authors: Frcs M P Hayward 
Published: October 2023

Abstract
A 59-year-old man was admitted to ITU. from the A&E department. At the time of admission to A&E, his history was of collapse at home with sudden, severe chest pain radiating to his back, neck, and jaw. He was overweight and had smoked 20 Cigarettes daily for 40 years. He gave a history of hypertension for 10 years. He was cool, sweaty, and in pain. &gt;Pulse 110/min; BP 150/90 mmHg (both arms); soft non-tender abdomen. No neurological abnormalities except for weakness and tingling in the left arm. An initial ECG (during pain) showed non-specific ST - T changes in the lateral leads only.
Heart block
Authors: Frca D Rosser Mrcp 
Published: October 2023

Abstract
You are asked to see a 58-year-old lady on the cardiac surgical ICU who has recurrent ventricular fibrillation. You are told that she has had an aortic valve replacement that day which was uneventful, although she has marked left ventricular hypertrophy. She was otherwise well preoperatively except for controlled hypertension. Postoperatively she was noted to have become bradycardic, rate 40/min, shortly before going into ventricular tachycardia which rapidly regenerated to ventricular fibrillation. She responded to a 220 J DC shock, emerging into a broad complex bradycardia of 40/min with a BP of 95/40 mmHg (MAP 55 mmHg) for some minutes before again degenerating to ventricular tachycardia/fibrillation (VTNF). This sequence of events was repeated twice more despite the administration of 100 mg of lignocaine intravenously. Prior to her first arrest she was ventilated with good blood gases, normal acid-base status, and blood biochemistry.
Human immunodeficiency virus (HIV)
Authors: Mrcp A Severn Phd , Frcp R F Miller 
Published: October 2023

Abstract
Staff Grade Physician, In-Patient HIV/AIDS Unit and, Senior Lecturer, Division of Pathology and Infectious Diseases, UCL Medical School; Consultant Physician, Camden and Islington Community Health Services (NHS) Trust Middlesex Hospital London [AF] A 32-year-,old taucasian, homosexual, male teacher was a:c:lmitted to a general medical ward with a 4 week hist9ry of increasing exertional dyspnoea and unproductive cough. He had been HIV-I aii’tibody positive for 6 years and his most recent CD4 lymphocyte count was 0.22 X 109/1 (normal range = 0.35 -2.2 X 109/1). He had no previous AIDS defining diagnoses and was taking no prophylaxis against Pnevmocystis carinii pneumonia (PCP).
Leptospirosis
Authors: Mrcp D G Sinclair Md 
Published: October 2023

Abstract
A previously-well, 22-year-old male was brought to casualty as an emergency. On admission he gave a history of a pyrexial illness of 3 days duration. There was no history of foreign travel or drug ingestion. Positive findings on examination were marked jaundice; temperature 38°C; a small right-sided inferior subconjunctival haemorrhage; the liver was just palpable; the musculature of both legs was swollen and exquisitely tender; cerebration was sluggish; and he was mildly confused. BP was 120/60 mmHg; pulse 110/min; respiratory rate 20/min. Catheterization of the bladder revealed a small quantity of urine.
The post-operative neurosurgical case
Authors: Frca M Smith 
Published: October 2023

Abstract
A 25-year-old male was admitted with a head injury following a road traffic accident. At the accident site his GCS was 3 and he was intubated and ventilated for transfer. CT scan revealed an acute left-sided extradural haematoma and small frontal lobe contusions. There were no other injuries. The extradural haematoma was evacuated and postoperatively the patient was sedated and ventilated on the intensive care unit. ICP was 12 mmHg. Twelve hours postoperatively his ICP rose to over 30 mmHg and, despite treatment, his left pupil suddenly dilated.
Hyponatraemia
Authors: Frcp(Edin) D Bell Md 
Published: October 2023

Abstract
A 23 year-old, HIV-positive, caucasian, female was admitted to hospital with cough, fever, and dyspnoea. Initial chest X-ray showed bilateral pulmonary infiltrates, and arterial blood gases breathing air showed PaO2 9.5 kPa; PaCO 4.0 kPa; pH 7.36. Other routine bloods, including electrolytes, were normal. The diagnosis of a first episode of PCP was confirmed by bronchoscopy and bronchoalveolar lavage, and treatment started with intravenous co-trimoxazole 120 mg/kg/day in divided doses. Twenty-four hours following admission, the patient developed persistent nausea and vomiting. Metoclopramide was prElscribed.
Rhabdomyolysis
Authors: Mrcp H Cairns Md 
Published: October 2023

Abstract
A 25-year-old man was admitted, having been found unconscious in a local public toilet. On examination he was apyrexial (36.8°C) and drowsy (GCS 10), with bilaterally small pupils and multiple needle tracks in both arms and groins. His left arm and leg were both swollen and clearly tehder to palpitation. Peripheral pulses were all easily felt.
Prevention of acute renal failure (ARF)
Authors: Fanzca N Soni Md , Frca R Juste 
Published: October 2023

Abstract
A 55-year-old man presented to outpatients with abdominal pain radiating to his back. He was overweight arid had a long history of hypertension, treated with atenolol. He was known to have chronic renal failure secondary to a degree of renal artery stenosis in his singleton kidney. The other kidney was congenitally absent. On presentation his creatinine and urea Were 280 µ.mol/1 and 18. mmol/1 respectively; 8P 180/100 mmHg.
Hepatic failure
Authors: Mrcp A J Ellis , Mrcp J A Wendon 
Published: October 2023

Abstract
A 35-year-old lady was found collapsed and disorientated on the floor of her flat. She had previously complained to her partner of abdominal pain, nausea, and vomiting for 24 hours. In casualty a medical history revealed mild asthma, alcohol consumption of 20-30 units per week, and no recreational drug use. On examination her GCS was 12, muscle tone was normal, and there was no neck stiffness. The respiratory rate was 30/min; pulse 120/minute; and BP 90/40 mmHg. The abdomen was soft, there was no organomegaly, and no evidence of jaundice.
Pre-eclampsia
Authors: Mrcp D J Williams 
Published: October 2023

Abstract
A 19-year-old primigravida booked in for antenatalcare at 14 weeks gestation. BP was 100/65 mmHg and there was no significant past medical history. Her pregnancy progressed uneventfully until 28 weeks when .she was admitted from a routine antenatal clinic with a BP of 155/100 mmHg, +++ proteinuria, but no peripheral oedema
Withdrawal of treatment
Authors: Frcp S L Cohen 
Published: October 2023

Abstract
A 22-year-old female patient, married with a young child, was diagnosed as having acute leukaemia. She developed respiratory and renal failure following bone marrow transplantation. She was leucopenic and thrombocytopenic. The haematologists considered both conditions were reversible and she was transferred to the ICU for ventilation and haemofiltration.
Principles of treatment
Authors: Lader Malcolm , Herrington Reginald 
Published: October 2023

Abstract
The management of any problem logically depends on the analysis of its nature and causes and on its likely development if left to itself. In clinical practice, diagnosis and prognosis precede treatment and ‘of these diagnosis is by far the most important, for upon it the success of the other two depends’ (Ryle 1948). Diagnosis contains two processes: firstly, the development of a system of classification of disease or disorders; and secondly, the assignment of an individual patient to the appropriate category. Diagnosis or classification has a number of functions, notably to aid the communication amongst clinicians and scientists and to provide a key to existing knowledge about a particular disorder mcluding knowledge of its course and response to treatment (that 1s, prognosis). To be useful a diagnostic system should provide the basis for describing important similarities and differences between patients. Diagnostic entities should be fairly homogeneous (although patients with the same diagnoses need have only some of a range of symptoms and signs) and it ought to be possible to allocate a diagnosis to most patients (clearly a diagnostic scheme accommodating only half the patients would be of limited use). In short, a diagnostic system aids the recognition of a disorder in an mdividual patient and allows knowledge gained from the management of previous patients with a similar disorder to be applied to him.