bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemic Heart Disease in end-stage Renal Failure
Authors: Andrews Thomas C , Brickner M Elizabeth , Rutherford John D 
Published: October 2023

Abstract
The prevalence of end-stage renal failure (ESRF) in the United States is growing at the rate of 7 to 9% per year, and by the year 2010 an estimated 350 000 patients will be afflicted. Diabetes mellitus is the cause of 35% of new cases of ESRF and hypertension accounts for an additional 30% of new cases. Therefore, since ESRF is an end-stage manifestation of two conditions that increase the risk of atherosclerosis, it is not surprising that cardiovascular disease is the leading cause of death in this patient population.
Structural basis of Cardiovascular Dysfunction in Uremia
Authors: Amann Kerstin , Ritz Eberhard 
Published: October 2023

Abstract
As early as 1827 Richard Bright drew attention to the common presence of left ventricular hypertrophy and thickening of the aortic wall in patients with end-stage renal failure. He postulated that the cause ‘for the unusual efforts to which the heart has been impelled’ were ‘that it so affects the minute and capillary circulation, as to render greater action necessary to force the blood through the distant subdivisions of the vascular system.’ Today, cardiovascular complications are a major clinical problem in uremic patients.
Cerebrovascular disease in end-stage renal failure
Authors: lseki Kunitoshi 
Published: October 2023

Abstract
The number of dialysis patients is increasing worldwide and becoming an economic burden. This study, of a local registry in Okinawa, is intended to complement other studies, with a view on the morbid effects of dialysis. Okinawa is situated in the southernmost part of Japan, and its inhabitants have the longest average life span in the country (85.08 years in women and 77.22 years in men). Okinawa is made up of a number of subtropical islands, and the population is stable at approximately 1.2 million. The number of hemodialysis facilities on the islands, which was 27 in 1990, had increased to 39 in 1998, including 9 public hospitals, 16 private hospitals, and 14 private clinics.
Cognitive enhancement as a treatment strategy in schizophrenia
Authors: Sharma Tonmoy , Harvey Philip D 
Published: October 2023

Abstract
Cognitive dysfunction, a symptom of schizophrenia, is a core and enduring feature of the illness. It recently has been identified as an important measure of long-term outcome and is probably more important than the characteristic psychotic symptoms in the treatment of this disorder. Deficits in cognition are the most consistent findings in the schizophrenia literature. These deficits are pervasive, with virtually all patients affected to some degree, when compared with healthy peers or relatives. Since Kraepelin’s (1919) first clinical accounts, it has been recognized that they are a prominent feature of schizophrenia. It is well established that schizophrenic patients exhibit significant pervasive cognitive impairments when compared with healthy controls. Furthermore, it would appear that a vast array of cognitive domains are affected by the disease, as outlined in Section 1 of this book. Thus, understanding of the pattern and reversibility of specific cognitive dysfunctions may provide important clues to pathophysiological processes and the mechanisms of effective treatments. This chapter focuses on neurocognitive impairments that occur in schizophrenia, with the possibility that cognitive enhancement or reversal of these deficits may have an impact on the longer term outcome of the illness.
Structural Imaging
Authors: Stevens John M , Fox Nick C 
Published: October 2023

Abstract
Structural neuroimaging traditionally has been used to exclude potentially treatable surgical causes of dementia, such as neoplasm, subdural haematomas, and hydrocephalus (Moseley 1995; Alexander et al. 1995). In recent years, newly recognized entities such as AIDS dementia complex (Barker et al. 1995), and venous hypertensive encephalopathy associated with arterio-venous malformations (Deveikis 1998) have entered the list of diagnosable causes, along with a legion of medical conditions which include multiple sclerosis, neurosarcoidosis, and metabolic disorders (Moseley 1995). In most of these conditions, structural neuroimaging plays a central role in confirming central nervous system involvement.
Molecular pathology of early onset dementia
Authors: McLean Catriona A , Beyreuther Konrad , Masters Colin L 
Published: October 2023

Abstract
An understanding of the molecular basis of the more common neurodegenerative diseases of late adulthood has advanced rapidly in the last decade. Accumulation of various proteins either within neurons, glia, or the extracellular space is becoming recognized as a common feature of many of the diverse forms of early onset dementia. These host-encoded proteins accumulate in aggregated insoluble complexes that serve as markers of the underlying molecular pathology. At some stage during the process of protein aggregation, the protein undergoes a ‘toxic gain of function’ which causes neurodegeneration. While the mechanisms of pathogenesis are only partly understood or remain speculative, the genes encoding these proteins and the mechanisms of the neurodegenerative changes are areas of intense research (Table 8.1).
Familial and sporadic Alzheimer’s disease
Authors: Kennedy A M , Rossor M N , Hodges John R 
Published: October 2023

Abstract
Ever since the original descriptions of Alzheimer’s disease (AD) debate has raged concerning the nosological status of the condition (Alzheimer 1907). For many years a distinction between ‘presenile’ and ‘senile’ forms was widely accepted with an arbitrary cut-off at 65 years. More recently, however, a classification based upon age has become less tenable and with the discovery of a range of genetic mutations in familial cases the subdivision of ‘familial’ versus ‘sporadic’ has been adopted.
Huntington’s disease
Authors: Paulsen Jane S , Robinson Robert G 
Published: October 2023

Abstract
Numerous collaborative efforts have been formed in the spirit understanding and conquering Huntington’s disease (HD), many of which have resulted in significant changes to our under- standing of and care for people with the disease. The goal of this chapter is to summarize what is known about HD and what challenges remain. Several aspects of the disease will be covered, including genetics, pathophysiology, clinical characteristics, treatment, and predictive testing. When possible, manifestions of HD will be addressed in terms of basal ganglia circuitry dys- function.
Introduction
Authors: Burn Loïc 
Published: October 2023

Abstract
When someone has a medical problem they ask four main questions. What IS it? What will it DO to me? What will THEY (the clinicians) do to me? What can I (self-help) do about it? Back and neck pain raises some additional complications. Firstly, for unknown reasons, it is a neglected subject in medical education. This means that your doctor is likely to be less informed about it than about other common conditions. Secondly, there are specific problems in making an accurate diagnosis (which we cover in some detail later). Thirdly, and probably as a result of the first two, there are many different groups all offering you various treatments and advice —much more so than for other medical problems. This may be very confusing for you and in this book we try to provide a balanced view of everything that is on offer. However, there are few areas where actually more information for patients is needed.
Self Help —What You Can Do About Your Acute Pain
Authors: Burn Loïc 
Published: October 2023

Abstract
The last chapter outlined new advice for the management of acute back and neck pain —namely, stay out of bed, consider manipulation, exercise, stay active, and continue working. In this chapter we spell out the practicalities of this advice as it is applied on ‘day one’, ‘day four’, and ‘day seven and beyond’.
Your Consultation —The Good, The Bad, And How To Prepare For It
Authors: Burn Loïc 
Published: October 2023

Abstract
We have discussed a considerable number of people and treatments that you may come across. We will now give you some general ideas on how to detect whether your consultation is good or bad, whoever you are consulting. This is not only to ensure that you are getting the right help and advice but is also to prevent you being taken advantage of financially by the unscrupulous. We detail what should or should not happen to you, on the basis that forewarned is forearmed.
The limb-girdle muscular dystrophies
Authors: Bushby Katharine M D 
Published: October 2023

Abstract
Literature on any disease is merely a snapshot of the level of understanding of a condition at that time. Since the introduction of the term in the mid 1950s someone reviewing the literature on the limb-girdle muscular dystrophies (LGMD) would recognize immediately that the field has often been confused and controversial over this period, inciting at times quite extreme views and vigorous debate.
Gene and cell therapy for primary myopathies
Authors: Cossu Giulio , Clemens Paula R 
Published: October 2023

Abstract
During the last 15 years, following the identification of dystrophin as the gene responsible for Duchenne Muscular Dystrophy (Hoffmann et al. 1987), the genes responsible for the large majority of primary myopathies have been identified.Most of these genes encode for proteins that form a supra-molecular link between the cytoskeleton and the extra-cellular matrix (Nawrotzki et al. 1996). In the absence of one of these proteins, the mechanical stress associated with contraction progressively leads to degeneration of the muscle fibre, though the molecular mechanism is not yet understood in detail.
Animal models of muscular dystrophy
Authors: Noguchi Satoru , Hayashi Yukiko K 
Published: October 2023

Abstract
Scientists have employed animal models for research into muscular dystrophy over the last two decades. These models have been used for pathophysiological analysis as well as for biochemical studies. The clinical symptoms and pathological features observed in animal models are somewhat different from those in human patients.However, they provide us with valuable information and experimental material, and contribute to our progress in understanding human diseases and help in devising possible therapies. There is no doubt about the benefits of animal models.
Xenotransplantation: An ethical dilemma
Authors: Levinsky Norman G 
Published: October 2023

Abstract
There is a shortage of transplantable organs, and because of this many people who need them do not benefit from one of the major medical advances of the past 50 years. In the United States in 1999, 6448 individuals on waiting lists for an organ died before they could get a transplant (UNOS, 2000). Such preventable deaths have been the principal impetus to scientific exploration of the possible use of animal organs for transplantation into humans. Xenotransplantation was tested as early as the turn of the twentieth century.
Slipped capital femoral epiphysis: natural history, results of treatment, and controversies
Authors: Willis R Baxter 
Published: October 2023

Abstract
Slipped capital femoral epiphysis (SCFE) is a condition which occurs during a period of rapid growth in adolescence. Owing to a weakening of the proximal femoral growth plate and increased shear stress most commonly associated with obesity, the capital femoral epiphysis displaces posteriorly and medially, resulting in a deformity of the hip which alters normal hip motion, causes pain, and may eventually lead to degenerative joint disease.
Wandering and restlessness
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
The term ‘wandering’ is commonly used both clinically and in the literature to describe a wide range of different behavioural abnormalities. The looseness of the term is evident by the wide range of definitions used in various studies. One useful definition is ‘a tendency to move about in either the seemingly aimless or disorientated fashion or in pursuit of an indefinable or unobtainable goal’. (Snyder et al. 1978, Stokes 1986). De Leon et al. (1984) suggest a putative causal mechanism by stating that ‘wanderers are patients with navigational difficulties.’
Side effects of psychotropic medication
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Before discussing individual classes of drugs and specific compounds, it is important to make some general observations regarding pharmacotherapy in the elderly and, in particular, those with dementia. Although changes in normal ageing are often complex (for example, a decline in a neurotransmitter may be accompanied by a compensatory increase in its receptors) and controversial, decreases in dopaminergic, noradrenergic, cholinergic and serotonergic neurones and/or neurotransmitter have been described in association with normal ageing (Blennow and Gottfries 1998).
Pharmacotherapy of agitation, aggression and restlessness
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
The majority of treatment trials have grouped together different behavioural and psychological symptoms in dementia (BPSD), as discussed in Chapter 3. As the trials of neuroleptics are covered in detail in that chapter, the focus of this chapter will be mainly on the use of non-neuroleptic drug treatments. The use of varying and overlapping terminologies makes it difficult on occasion to pull the literature together in a meaningful way. Most studies combine different BPSD syndromes, whilst others focus upon symptom clusters such as agitation. Others evaluate the treatment of specific symptoms, such as aggression or restlessness.
Narrative and patient choice
Authors: Greenhalgh Trisha 
Published: October 2023

Abstract
This chapter is about the patient’s unique story and how it fits in with ‘evidence-based decision making’ and ‘shared decision making’ about health interventions. As Brian Hurwitz and I have argued in more detail elsewhere (Greenhalgh and Hurwitz 1998), five features of narrative distinguish it from other linguistic forms: It has a finite and longitudinal time sequence—that is, it has a beginning, a series of unfolding events, and (we anticipate) an ending.
Developing a Culture of Change in the Workplace: Applying Processes and Principles from Action Research to Sports Injury Settings
Authors: Gilbourne David 
Published: October 2023

Abstract
This chapter outlines how a process of systematic reflection can enhance working practice. The thinking behind a chapter of this nature is built around a series of intuitive connections. First of all, it is clear that an the chapters within this textbook are written with the sports medicine practitioner in mind. Second, it is likely that certain ideas and guidelines, embedded within the preceding chapters, will motivate practitioners to instigate ‘changes’ into their own working practice. It is proposed here that an aware ness of certain action-research themes and processes might help to facilitate this process. In making the above observations there is no intention to suggest that, somehow, bringing about workplace change is straightforward.
Judgement in the clinic
Authors: Downie R S , Macnaughton Jane , Randall Fiona 
Published: October 2023

Abstract
We have argued that if we adopt a broad interpretation of ‘science’ we can assert that all medical research is in some sense scientific, or evidence-based, although not necessarily quantitative. It follows from this that the research base of clinical practice is scientific in a broad sense. It does not follow, however, that clinical practice itself is, or indeed ought to be, fully scientific or evidence-based. If medical research is ‘science’, our question in this chapter is: To what extent is a clinical consultation simply a matter of applying that science? It will emerge that there is much more to the consultation, or to good clinical practice, than simply applying science, or applying the evidence, to a given patient. Our discussion will be concerned with the extent and nature of the ‘much more’.
Conclusion: clinical judgement
Authors: Downie R S , Macnaughton Jane , Randall Fiona 
Published: October 2023

Abstract
The title of our book is Clinical Judgement: Evidence in Practice. We have examined the concepts in the title as they apply to medical research, to clinical practice, to public health, and to resource management. The concept of evidence, as it is used by scientists, is logically related to that of an hypothesis. Information, data, observations, and experiments become ‘evidence’ when they are for or against a specific hypothesis. Moreover, the hypothesis concerns what is universally, or at least generally, believed to be the case. The concept of evidence as used by detectives or forensically differs in two respects: the data and observations suggest a hypothesis, rather than confirm or disconfirm one; and the hypothesis is about a particular or specific state of affairs, rather than one which is more generally the case. The concept of evidence that applies to medical research is like that of the scientist, and the concept that applies to clinical consultations is like that of the detective. The reason that the detective model of evidence is appropriate for the clinician is that he is dealing with specific patients. The relevant evidence for the clinician to establish diagnosis, prognosis, and treatment comes from or applies to this particular patient.
Pain – there’s a lot of it about
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Pain relief has been a major medical interest since Sumerian times 6000 years ago, when poppy juice was first used. Yet there is still a lot of pain about, it is a source of great disability, it detracts from the quality of life, and is often poorly treated. What is needed is more (and perhaps different) research, a concentration on evidence of what works and what does not, and education and dissemination of knowledge to make better use of what we have now. What is not likely is a magic bullet of a treatment that cures all pain without doing any harm. What we have is actually quite effective. The problem is that while the best pain relief can be very good indeed, all too often the best is not attained. Reasons are often simple, and have nothing to do with complicated science.
Outputs and utility
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Output – ‘quantity produced or turned out; data after processing by a computer’. This dictionary definition is the first clue to what this section is all about. If our best evidence comes from systematic reviews, then one of the most important things is how that systematic review gives us the result. From a clinical point of view we want to know how much benefit (or harm) a treatment will produce, and results of data processing might not be much help.
Adverse events
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
One of the problems with adverse events is that they can be various things at various times. Some of the properties of adverse events are shown in Figure 1.8.1. There are at least three dimensions – common or rare, minor or major, reversible or permanent. By and large, though, they fall into two distinct groups: they tend to be common, minor and reversible on the one hand, or rare, major and permanent on the other. Examples might be dry mouth with antidepressants, and upper gastrointestinal bleeding on the other.
Placebo
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
This is perhaps one of the most difficult of all topics, especially with a subjective outcome like pain. If we were discussing a topic like myocardial infarction and our outcome were death, then we might be reasonably sure that a placebo would have no effect on the outcome. But with pain, we might surmise that patients would feel better, and consequently have less pain, if the doctor or nurse was nice to them, or appeared authoritative, or the placebo were given as a big red capsule instead of a tiny white pill, or as an injection and not a tablet. Whatever we think, proving it will be difficult because of the problems of size, as discussed in section 1.6.
Introduction
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Acute pain is not always well treated. For instance, a survey of UK hospitals [1] showed that many patients (medical and surgical) had moderate or severe pain in hospital (Table 2.1.1). The problem is not that we have ineffective treatments, but that the delivery of effective treatments is often ineffective. Dealing with acute pain is not just a question of doling out analgesics effectively, and there are many other features to dealing with acute pain in hospital [2] and elsewhere. This section is not a comprehensive survey of everything that might be done in any particular circumstance, but a look at the evidence behind what might commonly be used in many circumstances.
League table of analgesics in acute pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
This league table was constructed for analgesics in acute pain. Data were taken from systematic reviews of randomised, double blind, single-dose studies in patients with moderate to severe pain. For each review the outcome was identical – that is at least 50% pain relief over 4–6 h. The pain measurements were standardised, and have been validated. The league table works because it only has apples, and is not a fruit salad. Only like is compared with like, and there is a common comparator throughout, namely placebo.
Aspirin in postoperative pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. A single oral dose of aspirin is effective in the relief of postoperative pain (doses 600–1200 mg). A dose of 600/650 mg had an NNT of 4.4 (4.0–4.9) for at least 50% pain relief over 4–6 h compared with placebo in pain of moderate to severe intensity with information on over 5000 patients. It was associated with increased adverse effects (gastric irritation and nausea). Aspirin (acetylsalicylic acid) is an important analgesic. It is widely available, and prescriptions of 300 mg tablets total approximately three quarters of a million annually in England alone (1996).
Ibuprofen in postoperative pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. Ibuprofen is an effective analgesic. A single dose administration of 400 mg had an NNT of 2.4 (2.3–2.6) for at least 50% pain relief over 4–6 h compared with placebo in pain of moderate to severe intensity. This is as effective as 10 mg intramuscular morphine. Ibuprofen is an NSAID with prominent anti-inflammatory, antipyretic and analgesic actions. Analgesic effects are due to both peripheral and central effects. It is a potent inhibitor of cyclooxygenase, which results in marked reductions in prostaglandin synthesis. In 1996 ibuprofen accounted for nearly 5.5 million prescriptions in England.
Paracetamol (acetaminophen) in acute postoperative pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. Paracetamol is an effective analgesic. A single dose of 1000 mg paracetamol had an NNT of 3.8 (3.4–4.4) for at least 50% pain relief over 4–6 h in patients with moderate or severe pain compared with placebo based on information from 2759 patients. Paracetamol 600/650 mg had an NNT of 4.6 (3.9–5.5) based on information from 1886 patients. Paracetamol is not associated with increased adverse effects in single dose administration. Paracetamol (acetaminophen) is an important non-opiate analgesic. It accounts for over 5 million prescriptions in England alone (1995), as well as being widely available without prescription.