bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurasthenia
Authors: Wessely Professor Simon , Hotopf Dr Matthew , Sharpe Dr Michael 
Published: October 2023

Abstract
So far we have considered the question of fatigue, or more specifically chronic fatigue, as an isolated symptom. However, fatigue can be more than just a symptom. Recently the popular imagination has been caught by the concept of fatigue as specific illness, encapsulated in the term ‘chronic fatigue syndrome’ (CFS), or, as it is better known in the vernacular, ME. It is frequently stated that these illnesses are either new, or at least on the increase, and the popular and professional literature contains numerous possible explanations for this phenomenon.
Introduction To Toxicity
Authors: Fairweather Frank A 
Published: October 2023

Abstract
Toxicology, whether in relation to therapeutics, food, pesticides, the environment, occupational health, or indeed smoking, has come to mean that if a chemical compound produces a biological response within a living system, and that response is deemed hazardous, then the cause of this effect should be sought and where possible eliminated. Clearly, for a chemical agent to produce such an effect in a biological system, there is a need for the toxic substance or its metabolites to reach an end organ, at a sufficiently high concentration and for an extended period of time, to produce the observed toxic response. These principles, accepted now for many centuries, must be applied today when considering any potentially toxic material. It is the responsibility of all involved in the toxicological field to minimize the risk, to strive to ensure the acceptance of the doctrine that the better the decision, the better it is for the individual who will be exposed to the agent in question. Toxicology is now accepted as an integral part of the regulatory scene and it has become an intrinsic part of business. With respect to the latter it is refreshing to realize that test results can have a significant effect on marketing questions and toxicologists are now seeking to interpret adverse effects observed in animals and establish their relevance to humans.
Effects Of Maternal Tobacco Smoke Inhalation On Early Embryonic Growth
Authors: Seller Mary J , Bnait Kulwinder S , Cairns Nigel J 
Published: October 2023

Abstract
Maternal cigarette smoking in pregnancy is associated with two well recognized effects-an increase in pregnancy wastage and low birth weight babies (Butler et al. 1972). These phenomena are well researched and it is known there is an inverse relationship between the number of cigarettes smoked and the decrease in birth weight and reduced fetal survival (reviewed by Abel 1980). Further, if a woman changes her smoking behaviour before the fourth month of pregnancy, then her outcome at delivery is appropriate to her pattern of smoking in the second part of pregnancy (Butler et al. 1972). There are also data which suggest that, overall, congenital malformations are not increased in frequency in women who smoke during pregnancy, although in some populations specific abnormalities might occur more often. Examples are cleft lip, cleft palate (Andrews and McGarry 1972; Saxen 1974; Ericson et al. 1979), congenital heart disease (Fedrick et al. 1971), and neural tube defects (Evans et al. 1979). In the face of no real diminution in tobacco consumption, the Independent Scientific Committee on Smoking and Health (ISCSH) has urged the modification of tobacco products so that the yields of tar, nicotine, and carbon monoxide of cigarettes is reduced. This has taken place to some extent, and it would appear to have reduced the frequency of some of the smoking-related diseases. However, there is evidence that some people compensate for the reduction in cigarette nicotine content by increasing their intake (ISCSH 1988).
Introduction
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
In common usage the term epidemiology has two meanings. The first is the description of the occurrence of a disease and the risk factors: demographic, genetic, and environmental, for its development. The second covers a methodological approach to investigate not only disease occurrence and aetiology but also, and increasingly, to the development of criteria for disease classification, studies of natural history, intervention studies including clinical trials and the evaluation of clinical tests. Thus textbooks of epidemiology are either reviews of data on disease occurrence and causation or are manuals for those wishing to apply epidemiological methods to a wider field.
Rheumatoid arthritis
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
Problems with criteria assignment in rheumatoid arthritis (RA) Agreement on the criteria for the inclusion of an individual as a case of RA has not been easily achieved. The problem in defining RA has been the lack of a distinct clinical, laboratory, or radiological marker. At one end of the spectrum there is an acceptance that the condition ‘benign self-limiting polyarthritis’-the occurrence of a short—lived episode of inflammatory polyarthritis with no obvious predisposing cause and which resolves spontaneously without sequelae—despite the similarity at presentation, should be distinguished from RA. In practice this is difficult given the lack of follow-up data. At the other end is the requirement to distinguish RA from those arthropathies which, in some individuals, may be similar but have an identifiable ‘cause’ such as ankylosing spondylitis and psoriatic arthritis. More problematic for epidemiological studies is that many individuals with RA, that has remitted by the time of study, can only be categorized on the basis of self-reported history or contemporary medical records. These approaches may not easily allow the application of criteria for current disease. Older criteria sets had different rules for ‘past’ arthritis (Kellgren 1962) but these tend not to be used currently.
Juvenile arthritis
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
Juvenile arthritis encompasses the universe of disorders which are associated with the presence and/or development of either axial or peripheral arthritis in children and adolescents aged 15 and below. These disorders can be classified into groupings including infectious arthritis, reactive arthritis, connective tissue diseases, and congenital and developmental diseases among others (Table 3.1). Prominent among these diseases is juvenile rheumatoid arthritis, a diagnostic classification reserved for children with idiopathic inflammatory arthritis. Numerous other terms including juvenile chronic polyarthritis, juvenile chronic arthritis, and Still’s disease have been used for this group of patients; Singsen (1990) has recently reviewed the historical evolution of the nomenclature and concluded that juvenile rheumatoid arthritis ‘... is the most widely used term, and the only one subjected to studies of criteria and classification’.
Osteoarthritis
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
Osteoarthritis, also referred to as osteoarthrosis and degenerative joint disease, is the most common form of arthritis (Kelsey and Hochberg 1988, 1992). Prior to 1986, no standard definition of osteoarthritis existed; most authors described osteoarthritis as a disorder of unknown aetiology in which articular cartilage and subchondral bone were primarily affected in contrast to rheumatoid arthritis which primarily affects the synovial membrane. A standard definition of osteoarthritis, developed by the Subcommittee on Osteoarthritis of the American College of Rheumatology Diagnostic and Therapeutic Criteria Committee, follows (Altman et al. 1986): A heterogeneous group of conditions that lead to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins.
Gout
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
Gout is an ancient disease with a great deal known of both its pathophysiology and treatment. Clinically, it is characterized by: (1) recurrent attacks of acute arthritis involving one or more joints, (2) deposits of monosodium urate crystals in articular cartilage and/or synovial membrane which, when released into synovial fluid, provoke an acute inflammatory response, (3) elevation of serum and plasma concentrations of uric acid, and (4) the variable presence of renal disease including uric acid nephrolithiasis.
Back pain
Authors: Raspe Hans-Heinrich 
Published: October 2023

Abstract
There is a vast literature on the epidemiology of back pain but this chapter restricts itself to back pain in open populations. It concentrates mainly on investigations that have included both sexes, a broad range of age groups, all types of work (including housework), and work status including schooling, unemployment, and retirement. Thus studies of back pain in patient populations (for example Frymoyer et al. 1980) as well as ‘back pain in workers’ (for example Bombardier et al. 1985; Anderson 1981; Deyo 1988; Carey 1989) are virtually excluded. The subject of occupational back pain is so extensive as to be outside the scope of this book. Another area not considered in detail is that of ‘psychosomatic’ back pain, though many clinicians maintain that nonspecific back pain is often a result of psychological disturbances or conflicts. This neglect is due mostly to the fact that epidemiological studies have only very rarely included psychological variables. There is however sufficient common ground that this review will cover many relevant areas to those who are mainly interested in the epidemiology of occupational and psychosomatic back pain.
Neurosurgery
Authors: Walker D 
Published: October 2023

Abstract
The central nervous system is metabolically very active and is readily damaged by episodes of ischaemia which would not cause permanent injury to other organs. Already injured neural tissue is even more susceptible to further damage by otherwise minor episodes of hypoxaemia or reduced perfusion. The aim of neuroanaesthesia is therefore firstly to provide anaesthesia (analgesia and lack of awareness) to enable the surgical procedure to be performed, secondly to optimize operating conditions for the surgeon and thirdly to minimize the potential of adverse effects (particularly ischaemia) in the perioperative period.
Assistance In Maternity Hospitals
Authors: McNeil M 
Published: October 2023

Abstract
Anaesthesia for the pregnant woman poses a number of unique problems for the anaesthetist. Firstly, the presence of the fetus means that any intervention to the mother may have an effect on the fetus. Secondly, pregnancy is associated with profound changes in the mother’s cardiovascular and respiratory systems, which will alter her response to anaesthetic agents. Thirdly, childbirth is a highly emotional experience for the mother and her partner. A great deal of sensitivity and understanding will be required from those attending a woman in labour. These factors may also be compounded by religious or cultural factors which, although unfamiliar to the staff, must be respected.
Biological Rhythms And Exercise
Authors: Reilly T , Atkinson G , Waterhouse J 
Published: October 2023

Abstract
The effects of circadian rhythms on human performance in general and on response to exercise in particular are a well-known phenomenon. Often after a poor night's sleep or taking a "red-eye" flight into a different time-zone, one just doesn't feel like "themselves." This book aims to provide a comprehensive account of biological rhythms and how they affect exercise. Particular attention is given to sleep, its biological function, and the consequences for exercise performance of sleep loss. There are chapters devoted to the effects of disturbing the circadian body clock, such as when multiple time zones are crossed and jet-lag experienced. The effects of nocturnal shift work and seasonal variation are also covered. The interactions between exercise and the female menstrual cycle are explained and the issue of exercise during pregnancy discussed. Finally, there is a chapter devoted to research methods in chronobiology, the scientific discipline underpinning the content of the book.
The causes of epilepsy
Authors: Hopkins Anthony , Appleton Richard 
Published: October 2023

Abstract
One aspect of human nature is to search for causal links between events. The onset of epileptic seizures in a previously healthy child or adult results in great heart-searching in the family, and raking over past events in an attempt to find some reasons. Yet it has to be admitted that the most careful medical assessment of past events or current state allows a paediatrician or neurologist to assign a cause or causes of epilepsy in only a minority of subjects, and then often on the basis of circumstantial evidence.
Trauma
Authors: Armstrong R F , Aveling W , Grundy E M 
Published: October 2023

Abstract
After major trauma, mortality patterns can be divided into three groups: Inevitable. Victims so severely injured that even if medical treatment was immediately available, death would still occur within a few minutes. Salvageable. These victims have suffered injuries that are potentially recoverable, but are liable to die within a few hours with substandard treatment. Death is often due to blood loss. Late. Death occurs several days later from sepsis, head injuries, etc. The concept of the golden hour states that most victims in the salvageablegroup will survive if within one hour from the time of the injury the victimcan : (a) be transported to a hospital; (b) receive the ABC of resuscitation;(c)receive the DE of full clinical examination and evaluation; (d) betransferred for definitive treatment. With high-speed trauma it should be assumed that there is damage to thecervical spine until proved otherwise. Thus a hard cervical collar or manualin-line neck stabilization (MILNS) should be applied. If tracheal intubation is required in the presence of faciomaxillary traumaand a potential cervical injury, there is no consensus regarding idealtreatment. Several authors recommend cricoid pressure with MILNS andjudicious axial traction throughout the procedure. Gum elastic catheter,the use of the large Macintosh blade, or a McCoy laryngoscope may help.North American authors advise blind nasal intubation though this can bedifficult, causes bleeding, and may result in more cervical movementthan an oral approach. LMAs can be useful and allow the passage of an intubating bougie. Surgical or percutaneous tracheostomymay be needed. Two large-bore venous cannulae should be positioned in different limbs and2 litres of warm Hartmanns solution given. When these bags have beeninfused and further fluid is required, blood is recommended.
Anaesthetic emergencies
Authors: Armstrong R F , Aveling W , Grundy E M 
Published: October 2023

Abstract
This can result from (a) difficulty in positioning; (b) difficulty inlaryngoscopy; (c) difficulty in passing tracheal tube. If difficulty isanticipated in positioning the patient or in laryngoscopy, an alternativemethod of airway management such as fibreoptic intubation may be used. In the majority of cases, difficult intubation is synonymous with difficultlaryngoscopy. In a recent editorial it was pointed out that if the epiglottiscan be seen then with the aid of a gum elastic bougie successful intubationcan be anticipated. Thus difficult intubation means inability to visualizeeither larynx or epiglottis. Although there have been numerous methods suggested to predict difficultintubation none have gained universal clinical acceptance. The view seen ofthe pharynx (Mallampati classification) and the thyromental distance arecurrently accepted as giving the best indication of a difficult intubation(and even better if combined) but many false positives and some falsenegatives do occur. If there is a risk of aspiration, cricoid pressure should have been applied andmust continue. Some protocols recommend turning the patient on their sideand emptying the stomach with an orogastric tube. Currently enthusiasm forthis manoeuvre appears to be waning.
Depression and antidepressants
Authors: Lader Malcolm , Herrington Reginald 
Published: October 2023

Abstract
Of the three main groups of psychotropic drugs, the antipsychotics are useful in treating all forms of psychosis and the anti-anxiety compounds are really anti-arousal or anti-emotion compounds and therefore less specific than thelf names would imply. Only the antidepressants appear to exert a specific or selective action on a recognizable psychiatric entity. For this reason an outline of the features of depression is presented including some of the problems of classifying this condition.
Drug treatment in children
Authors: Lader Malcolm , Herrington Reginald 
Published: October 2023

Abstract
Child psychiatrists in the UK tend to be conservative in their use of psychotropic drugs (for review see Werry 1979; Campbell and Cohen 1981). This stems from several factors: the emphasis on social and educational manipulations as forms of treatment; the psychoanalytic or psychosocial background of many child psychiatrists; the realization that many disturbed children are reflecting tensions in the family rather than intrinsic difficulties; the reluctance to use drugs in a developing organism, in particular on a developing brain; a healthy and often well founded scepticism concerning the efficacy of drug therapy in psychiatrically disturbed children; and public controversy and anti-psychiatric postures by special interest groups. Also the ready use of drugs in children leads to the impression by child, parents, and by other medical attendants that the problem lies within the child and is amenable to drugs so that recourse to drugs in the future becomes too facile.
Epilogue: changing perspectives
Authors: Lader Malcolm , Herrington Reginald 
Published: October 2023

Abstract
The modern era of psychopharmacology dates back to about 1950, the extant physical treatments such as ECT a decade further still. The intervening period has seen increases in our understanding of the actions of these physical therapies and drugs although some crucial questions concerning them have not been answered. Thus, we still do not know the mechanisms by which they effect clinical improvement. For example, how does inhibition of monoamine oxidase result in alleviation of panic attacks!
Introduction to cardiopulmonary resuscitation
Authors: Skinner David V , Vincent Richard 
Published: October 2023

Abstract
In the United Kingdom approximately 160 000 deaths occur each year as a result of coronary artery disease; in the United States the annual mortality from this condition is around 650 000. Although trauma is the commonest cause of death in the first four decades of life, coronary artery disease rapidly overtakes trauma as a killer and, in later years, competes with malignancy as the leading cause of death. The incidence of coronary artery disease in the United Kingdom varies geographically, being about twice as common in the west of Scotland as in the south-east of England.
Cardiopulmonary resuscitation and the seriously ill child
Authors: Morton Rosemary J , Phillips Barbara M 
Published: October 2023

Abstract
1 Respiratory and/or circulatory failure are the usual causes of cardiac arrest in children.
2 Airway control and ventilation with 100 per cent oxygen are of prime importance.
3 Venous or intraosseous access must be gained as soon as possible for circulatory support and administration of drugs.
4 Earlier recognition and treatment of imminent respiratory and circulatory failure will improve outcome.
5 Overwhelming infection is a frequent precursor of collapse, especially in infancy. After initial resuscitation early consideration should be given to the use of intravenous broad-spectrum antibiotics.
Major trauma
Authors: Morton Rosemary J , Phillips Barbara M 
Published: October 2023

Abstract
1 The first priority is to ensure a patent airway and adequate ventilation with 100 per cent oxygen.
2 Intravenous access should be obtained with two large cannulae. A child can sustain a relatively large blood loss with initial compensation. Shock then develops rapidly.
3 A detailed history of the accident will help to anticipate the nature and severity of injuries.
4 Suspect internal chest injury if there is continuing hypoxia in a ventilated patient. Children may have severe chest cavity injuries despite intact ribs.
5 Abdominal and pelvic injury are particularly common and difficult to detect in children. Repeated abdominal examination, CT and ultrasound scans, and peritoneal lavage will all help in assessment. The patient with suspected abdominal injury who cannot be made haemodynamically stable with ventilation and transfusion must go for urgent surgical exploration. Exact pre-operative diagnosis is unnecessary.
6 The management of head injuries should focus on prevention of secondary damage from hypoxia, hypotension, and raised intracranial pressure.
Fractures and orthopaedic problems
Authors: Morton Rosemary J , Phillips Barbara M 
Published: October 2023

Abstract
1 Children’s injuries differ from those of adults. They are less likely to sprain a ligament and more likely to sustain a greenstick or avulsion fracture. Radiographs should be taken more readily than in adults.
2 Injuries which involve the growth plate must be treated carefully as later growth disturbance may occur. However, a greater degree of fracture angulation can be tolerated in children compared with adults as growth will remodel the bone.
3 A limp should be thoroughly assessed as there are several possible underlying causes which may lead to problems if untreated.
Gastrointestinal and genitourinary problems
Authors: Morton Rosemary J , Phillips Barbara M 
Published: October 2023

Abstract
1 Oral rehydration therapy is the mainstay of treatment in gastroenteritis.
2 Vomiting is a non-specific symptom of many illnesses, some of which are serious. A child should not be discharged with undiagnosed vomiting.
3 The concern in acute abdominal pain in childhood is whether appendicitis, or less frequently intussusception, is present.
4 There should be a high index of suspicion for urinary tract infections in infants and young children. All children with urinary tract infection or haematuria must be followed up.
Skin and infectious diseases
Authors: Morton Rosemary J , Phillips Barbara M 
Published: October 2023

Abstract
Children may be brought to the A & E department because of the sudden appearance, or worsening, of a rash or its poor response to treatment.
The diagnosis of a rash is based on its history, appearance, distribution, and associated physical signs. An ophthalmoscope set at about 8 dioptres is often helpful for close inspection of skin lesions.
1 Erythematous maculopapular rashes are usually due to an infectious disease or an allergic reaction.
2 Itchy skin lesions suggest eczema, scabies, or insect bites.
3 Vesicobullous eruptions are characteristic of chickenpox, herpes simplex, and hand, foot, and mouth disease. Staphylococcal infection, bullous erythema multiforme, and drug reactions are less common but potentially more serious causes of a vesicobullous rash.
4 A sore mouth may be due to primary herpes simplex, candida infection, scarlet fever, or rarer more serious diseases such as Stevens-Johnson syndrome or Kawasaki’s disease.