bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal cord stimulation
Authors: Budd Keith 
Published: October 2023

Abstract
The ‘gate theory’ of Melzack and Wall (1965) has had an astonishing effect upon research into pain and its treatment. The precision of its formulation enables scientists to design experiments to test its predictions and clinicians to devise new forms of pain relieving therapy. Many scientific experiments supported the concept of a spinal gate. Clinical work gave rise to transcutaneous neural and spinal cord stimulation and offered an intriguing scientific basis for some forms of acupuncture. The relationship of therapeutic spinal cord stimulation (SCS) to the gating mechanisms remains unclear at present even though it was the gate control theory that inspired its inception. The first patient to receive SCS was successfully treated for cancer-related pain. However, since that time, the response of nociceptive pain to SCS has not always been as successful.
Radiotherapy
Authors: Makin Wendy P 
Published: October 2023

Abstract
Radiotherapy can achieve pain relief by directly influencing the disease process. Intensive or ‘radical’ treatment may be given with the intention of eradicating cancer completely and thereby curing the patient. If successful, there is resolution of pain and other symptoms associated with the presence of tumour. Radiotherapy also has an important role in palliation, especially for metastatic disease. Although the patient cannot be cured, treatment to symptomatic tumour sites may contribute considerably to quality of life without necessarily influencing survival. Such palliative treatments account for up to half of the workload of a radiotherapy department, and many of these are given to help pain. The aim of this chapter is to provide the non-radiotherapist with an understanding of the principles of treatment, what can be achieved and what it entails for the patient, to help clinical decisions concerning pain management.
Health considerations
Authors: McDonald F , Ireland A J 
Published: October 2023

Abstract
In the determination of an orthodontic treatment plan, health, and in particular dental health, is a most important consideration. Along with improved oral function and improved aesthetics, health gain is one of the three principal reasons for performing orthodontic treatment. An assessment of dental health in terms of past history, and present and possible future status therefore needs to be made as part of the diagnostic process. Each presenting malocclusion can usually be treated in different ways but whatever the chosen treatment plan, it is important that health is improved, not compromised, as a result of the orthodontic treatment. Health considerations will therefore assist in the setting of realistic treatment objectives and thus help determine the most appropriate treatment plan for a particular patient. Important health considerations are dental caries, periodontal disease, prevention of traumatic injury, and psychosocial well-being. These will now be considered in more detail.
Evidence based practice
Authors: McDonald F , Ireland A J 
Published: October 2023

Abstract
In both medicine and dentistry many of the available treatments in use by clinicians are based on personal training, clinical experience, the authoritative views of colleagues, or as a result of research findings. Such a varied background can lead to slow acceptance of new and effective treatment modalities by clinicians as a whole, and, equally, outdated and ineffective treatments may only slowly be discarded. The purpose of an evidence based approach to dentistry.
Problem solving
Authors: Leung Wai-Ching 
Published: October 2023

Abstract
A GP was called out at midnight to visit a 24 year old man with a one day history of increasing shortness of breath and wheezing. He was known to suffer from asthma since childhood and had been maintained on regular salbutamol and steroid inhaler. His usual peak flow had been 550 litre/min. On examination, his pulse was 120 beats/min and his respiratory rate was 50 beats/min. His respiration was very shallow. He had very quiet breath sounds, but no wheeze was detected on auscultation. His peak flow was 120 litre/min.
Pharmacology of drugs, gases, and vapours used during general anaesthesia
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
Intravenous anaesthetic induction agents must be given slowly and in reduced doses to shocked or elderly patients to avoid profound cardiorespiratory depression. Etomidate has less effect on the cardiovascular system than barbiturates or propofol and may be the drug of choice when cardiovascular stability is needed. Nitrous oxide should be avoided if there is air in body cavities, for example a pneumothorax, (unless a chest drain is in situ), air embolus, or intracranial air. Volatile anaesthesia increases cerebral blood flow and should be avoided if intracranial pressure is elevated. The use of naloxone to reverse the effects of opioids at the end of anaesthesia is not recommended.
Common problems in airway and ventilation management
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
Any patient with depressed consciousness is at risk of airway obstruction, ventilatory depression, and aspiration of gastric contents. Airway or breathing problems may cause hypoxaemia. Adequate oxygenation is essential. Asthma may be fatal if the severity is underestimated or treatment is inadequate. Respiratory arrest in children may be due to infection, poisoning, trauma, or inhalation of a foreign body.
Nerve blocks of the lower limb
Authors: Illingworth Karen A , Simpson Karen H , Swales Sue 
Published: October 2023

Abstract
Anaesthesia and analgesia of the lower limb if combined with a femoral or 3 in 1 block (see p. 343). The pain of hip, tibial, or femoral shaft fracture may be treated by combined sciatic and femoral nerve blocks. Posterior and anterior approaches to the sciatic nerve are described. In the A & E setting, when the block is used during the management of trauma, the anterior approach is preferable, as it can be performed with the patient supine. The posterior approach requires that the patient is turned laterally.
Pyrimidine antimetabolites
Authors: Milano Gerard , Schellens Jan H M 
Published: October 2023

Abstract
Antimetabolites have structural similarities with intermediates of normal metabolism and they interact with the synthesis of RNA and DNA precursors.In the majority of cases antimetabolites are enzyme substrates and act by inhibiting enzymes which are essential for RNA and DNA synthesis. Alternatively, antimetabolites may be cytotoxic because of their incorporation into nucleic acids; this is well characterized
Alkylating agents
Authors: Boddy Alan V 
Published: October 2023

Abstract
Alkylating agents were among the first drugs to be used to treat malignant disease and form a major component of many regimens employed against both haematological and solid tumours. Their common mechanism of action is the formation of covalent adducts with the nucleotides of DNA. Subsequent processing or repair of these lesions leads to single- or double-strand breaks in the DNA and subsequently to cell death.
Cognitive Effects of Typical Antipsychotic Treatment: Another Look
Authors: Blyler Crystal R , Gold James M 
Published: October 2023

Abstract
The introduction of several new ‘atypical’or new generation antipsychotic compounds in the last decade represents a major advance in schizophrenia therapeutics. Evidence suggests that some of these compounds, particularly clozapine, may be differentially effective for a significant percentage of treatment-resistant patients, and the presence of fewer undesirable side effects relative to traditional antipsychotics may enhance treatment compliance (Kane et al., 1988; Buchanan et al., 1998). These drugs, therefore, may be superior antipsychotics, both because of true differential efficacy and because increased compliance with treatment reduces the relapse risk associated with medication discontinuation. Far less clear, however, is whether these newer compounds are more than better antipsychotics, i.e. the data are much less compelling regarding whether these compounds are truly differentially effective in the treatment of the cognitive impairments that are characteristic of schizophrenia (Buchanan et al., 1994). In light of evidence that cognitive deficits are critically important mediators of functional disability (Green, 1996), the establishment of whether these newer compounds truly act as cognitive enhancers rather than being simply better antipsychotics is necessary. In formulating the issue in this way, we do not mean to in any way diminish the importance of antipsychotic effects. Clearly, such effects are crucial in the clinical management of the illness. If the goal of treatment is to have a major impact on long-term functional outcome, however, the problem of cognitive impairment remains a major hurdle in the evaluation of the broad scope of drug efficacy.
The Pathology Of Bladder Cancer
Authors: Johansson Sonny L , Cohen Samuel M 
Published: October 2023

Abstract
Tumours of the lower urinary tract comprise approximately 10% of all male cancers and less than half of that figure in females. The incidence has been rising and over 50 000 new cases are diagnosed annually in the United States. In Sweden, 23% more cases were diagnosed in 1994 compared with 1983 (1). In Europe and the United States more than 90% of the tumours are of urothelial (transitional cell) origin. Transitional cell is a misnomer, but because it is so widely used in the literature and in clinical practice it can be used synonymously with urothelial, a term which we prefer. Approximately 5% of bladder tumours are squamous cell carcinomas (SCCs) and 1% adenocarcinomas, the remainder comprising uncommon variants of bladder carcinoma and various sarcomas such as rhabdomyosarcoma and leiomyosarcoma (2) (Table 6.1).
The Biology Of Bladder Cancer
Authors: Stadler Walter M , Brendler Charles B 
Published: October 2023

Abstract
Bladder cancer is predicted to develop in 54 500 Americans in 1997 and lead to 11 700 deaths in the same year (1). The death rate from this disease has slowly been declining over the last 2 decades, probably due to improvements in the diagnosis and therapy of localized disease (2). None the less, for certain sub¬ groups the risk of developing progressive muscle invasive disease is significant and approximately one-half of these patients will go on to develop metastatic disease (3). Furthermore, the treatment options available for metastatic bladder cancer are woefully limited, and less than 5% of patients with metastatic disease who are treated with the standard methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) chemotherapy regimen are longterm survivors (4,5). There thus continues to be a need for better diagnosis of localized disease, better prognostic and predictive markers of future disease activity, and better treatment options for those who develop metastatic disease. These improvements will likely arise directly from some of the new knowledge regarding the biology of bladder oncogenesis that has been elucidated over the last several years.
Systemic Chemotherapy Of Muscle-Invasive Bladder Cancer
Authors: Sternberg Cora N , Calabró Fabio , Marini Luca , Scavina Paola 
Published: October 2023

Abstract
Bladder cancer is the fifth most common cancer in men and the seventh in women, with 52 900 cases in the United States in 1996 and 11 700 deaths (1,2). The male to female occurrence is 3: 1. It is, primarily a disease of the elderly, with 80% of cases in the 50–79 year age group, and a peak incidence in the seventh decade. The majority of patients are diagnosed at an early, treatable stage. At initial presentation 75% of bladder tumours are superficial, limited to the mucosa, submucosa, or lamina propria. Recurrence after initial treatment for superficial tumours is discovered in 50–80% of patients. Progression to muscle-invasive disease occurs in 10–25%. For patients with muscle-invasive bladder cancers, there is a 50% risk of distant metastases. It is important to identify those tumours that are biologically aggressive and that have the potential to result in mortality. For patients with metastatic disease progress continues to be made with the development of new chemotherapeutic regimens.
Gene Therapy Of Bladder Cancer
Authors: Freund Christian T F , Lerner Seth P 
Published: October 2023

Abstract
Gene therapy is a novel treatment approach based on direct genetic modification of gene expression in somatic cells to treat both acquired and inherited diseases (1). Gene therapy is also referred to as ‘molecular medicine’ because it attempts to correct or eliminate the specific molecular reason for disease on a cellular level rather than to treat its symptoms in an overall and non-specific manner (2). Gene therapy applies the principles we have learned from studying disease on a molecular level and integrates techniques derived from molecular biology, genetics, and virology to form a new treatment modality. Gene therapy is a new form of pharmacology, and we are in the earliest stages of drug development. In this chapter we present a rationale for applying gene therapy to the treatment of bladder cancer, give a brief introduction to the complex field of vector systems for delivery of genes, and review the abundant preclinical data providing proof of principle in bladder cancer cell lines and animal models. The first human clinical phase I trials are currently under way and will provide the basis for establishing the safe and effective application of gene therapy to human bladder cancer.
Alternative Urinary Reservoirs And Conduits: State Of The Science
Authors: Desgrandchamps Francois , Griffith Donald P 
Published: October 2023

Abstract
Bladder augmentation or bladder replacement is required in some patients with malignancies or other advanced pathological problems. Conduits and reservoirs constructed from reconstituted autologous large and small intestine have worked reasonably well for the past 75+ years. A robust literature thoroughly documents the advantages, disadvantages, and limitations of the many variations of intestinal alternatives. Common to all intestinal alternatives is a need for: (i) a general anaesthetic; (ii) a major operation with attendant stress, morbidity, and convalescence; (iii) significant expense; and (iv) significant recurrent medical problems in managing the conduit or reservoir. Despite the successful use of bowel many investigators have dreamed and worked toward other alternatives.
Mental fatigue and cognitive dysfunction
Authors: Meyers Christina A 
Published: October 2023

Abstract
Fatigue is the most widespread adverse symptom related to cancer and cancer therapy (Cleeland 2000). Although there is growing awareness of the prevalence of cancer-related fatigue, there is very little scientific literature about the aetiology and natural history of this debilitating symptom, unlike other illnesses with associated fatigue such as multiple sclerosis and lupus erythematosus. Fatigue can be physical (e.g. associated with muscle weakness or lack of stamina), mental (including poor concentration and lack of motivation), or both. Fatigue can have adverse effects on cognitive function and mood.
Medical management and treatment of muscular dystrophy
Authors: Manzur Adnan Y 
Published: October 2023

Abstract
The last decade has seen major advances in the understanding of the molecular genetics and pathogenesis of the muscular dystrophies (Dubowitz 1998; Emery 1997; 1998), and this in turn has raised expectations of a curative treatment. This is not yet available and symptomatic and palliative treatment is essential to enhance the patient2019s quality of life. Physical therapy for prevention of contractures and promotion of ambulation is the mainstay of treatment. Judicious surgical intervention may improve or stabilize motor function in carefully selected patients. Early detection and treatment of function and quality of life. The early detection and treatment of cardiac and respiratory complications, so crucial to improve survival, is covered in Chapters 11 and 13.
Surgical management of muscular dystrophy
Authors: Merlini Luciano , Forst Jürgen 
Published: October 2023

Abstract
Proper management can only be achieved if the natural history of the disease is precisely known. This principle pertains to all diseases, particularly neuromuscular disorders. In Duchenne muscular dystrophy (DMD), strength is near normal in the early stages; a rapid downhill progression follows with loss of the ability to walk, respiratory involvement, and eventual cardiac failure. We have subdivided orthopedic treatment in DMD according to the stage of the disease; early lower limb surgery, combined limb surgery and orthosis in the late stage of walking ability, and spinal surgery for scoliosis. In addition, two other orthopedic interventions are mentioned: scapular fixation in facioscapulohumeral muscular dystrophy (FSH) and neck hyperextension correction in rigid spine syndrome.
Must (should) all ESRD patients be treated?
Authors: Friedman Eli A 
Published: October 2023

Abstract
Allocation, defined as ‘the action of apportioning or assigning to a special person or purpose’ (Oxford English Dictionary, 1971) has as synonyms: appropriation, ration, allotment, distribution, quota, and share. In terms of treatment for end-stage renal dis ease (ESRD) it is evident that throughout the world rationing (allotment, quotas) of ESRD treatment are realities forced by financial limitation. As shown in Fig. 4.1, there are sharp national differences in the rate of treatment for ESRD depending on the income of individual countries (United States Renal Data System, 1999).
Equity and patient autonomy in dialysis
Authors: Levinsky Norman G 
Published: October 2023

Abstract
Which patients with end-stage renal disease (ESRD) should receive chronic dialysis? Perhaps the question is better formulated as: Should any patients with ESRD who want the therapy not receive dialysis? This chapter explores these questions with respect to a number of patient criteria: age, comorbidities, terminal illnesses, persistent vegetative state, diminished mental status, non-compliance, and destructive behavior. Broader issues of societal allocation of resources for costly ESRD programs in nations at various economic levels are discussed in several other chapters.
Allocation of kidneys for transplantation
Authors: Sells Robert A 
Published: October 2023

Abstract
There is general agreement that for the great majority of persons with end-stage renal failure, a kidney transplant is preferable to chronic dialysis. With the progressive expansion in the number of patients suitable for transplantation over the past several decades, the demand for kidney transplants has increased. Even though there is evidence that a significant number of suitable dialysis patients may not be referred for kidney transplantation (Tilney, 1998), the gap between supply and demand has in creased relentlessly since the late 1980s.
Criteria for primary implant selection in total hip arthroplasty: a North American perspective
Authors: Bourne Robert B 
Published: October 2023

Abstract
Total hip arthroplasty (THA) has been one of the most significant medical breakthroughs of the twentieth century, revolutionizing the care of patients with end-stage arthritic conditions of their hip joints. HJ Comparative clinical research has revealed that THAs, both cemented and cement less, are among the most cost-effective medical or surgical interventions utilized, are cost saving, and are durable for up to 20 or more years following implantation (Fig. 7.1).
Criteria for implant selection in revision total hip arthroplasty: a European perspective
Authors: Wagner H , Wagner M 
Published: October 2023

Abstract
If the bone in the old prosthesis bed is still in relatively good condition and the patient is elderly, a new prosthesis can be fixed at the old site with bone cement. This is a simple operative technique, although cement fixation of a replacement prosthesis is less stable than in primary implantation because of the smooth inner surface of the medullary cavity, so that a shorter lifespan may be expected.
Background-behavioural and psychological symptoms in dementia
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Dementia is a syndrome characterized by cognitive and non-cognitive symptoms. Traditionally it is the cognitive impairments which have been the main focus of attention, although over the last 15 years the importance of non-cognitive symptoms has become increasingly recognized. Their pronounced and diverse impact is discussed in the relevant chapters dealing with the respective individual symptoms. There are several clinically distinct categories of frequent and troublesome non-cognitive symptoms.
Identification and measurement of behavioural and psychological symptoms in dementia
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
There are two key questions: (i) Why do we need standardized rating scales? and (ii) Why can scales that have been developed to measure mood and psychosis in the absence of cognitive impairment not serve the same purpose in the assessment of behavioural and psychological symptoms in dementia (BPSD)? The first question is best addressed by comparing some of the studies that evaluated the prevalence of BPSD from case-note reviews or clinical interviews with those that utilized a standardized schedule.
Other behavioural and psychological symptoms in dementia
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
There are almost as many types of behavioural and psychological symptoms in dementia (BPSD) as there are people with dementia. Although, for convenience and to facilitate treatment, they are usually grouped into clusters, some defy classification. For every problem, a better understanding is facilitated by a detailed description and evaluation; an approach which is far more helpful than trying to label a unique symptom ‘artificially’.
The person and the environment
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
This chapter focuses mainly on the care of the person with dementia within institutional environments. While these settings are equipped to deal with problem behaviours, the environments are often associated with high levels of ill-being (Kitwood 1997). For example, Novaco (1993) claims that institutional settings are often conducive to the displaying of challenging behaviour. He argues that these environments tend to limit satisfaction and are intrinsically constraining, leading to frequent incidences of aggression and distress. Clegg (1993), describing parallel settings with people with learning difficulties, suggests that institutional environments foster lives of ‘social emptiness’.
Managing carers’ psychological needs
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Caregivers looking after a person with dementia are often highly stressed, and frequently experience clinically significant depression. Behavioural and psycho logical symptoms in dementia (BPSD) are a major trigger of both increased burden and depression amongst caregivers (Donaldson et al. 1997). BPSD also accelerate admission to institutional care (Steele et al. 1990), probably largely as a result of the additional strain that they place upon caregivers. Treatment issues, such as developing more effective management strategies for the spectrum of BPSD symptoms, and specific treatment interventions for caregivers are of prime importance.