bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathogenesis
Authors: Wallace Daniel J 
Published: November 2023

Abstract
Lupus is brought on when predisposing genetic factors activated by environmental factors, drugs, or infectious agents result in an abnormal immune response. This occurs when suppressor T cells fail to suppress, there are defects in cell signaling, there are defects in immune tolerance, apoptotic cells promote the creation of autoantibodies, and/or there is loss of regulatory cells that control autoreactivity. The latter results in the proliferation of B cells, leading to the formation of autoantibodies and immune complexes, which promote in?ammation and tissue damage. Pathogenesis undergoes an often gradual process consisting of several phases: predisposition, benign autoimmunity, prodrome, and clinical systemic lupus erythematosus (SLE). Only 1 person in 10 who possess lupus susceptibility genes ever develops full-blown lupus. Many individuals have “subclinical autoimmunity,” or undifferentiated connective tissue disorders where the process is attenuated.
Clinical symptoms and signs
Authors: Wallace Daniel J 
Published: November 2023

Abstract
Half of persons with systemic lupus erythematosus (SLE) present with organ-threatening disease. The remaining individuals do not present with cardiopulmonary, hepatic, or renal symptoms; central nervous system (CNS) vasculitis; hemolytic anemia; or thrombocytopenia on initial evaluation. Organ involvement is relatively easy to diagnose—a chest radiograph, electrocardiogram, blood chemistry panel, complete blood count, and urinalysis usually point the physician in the correct direction. It takes a mean of 3 months from the onset of symptoms to diagnose these individuals. On the other hand, it can often take 1 to 2 years and several physician consultations before the presence of organ-sparing lupus is ascertained. Rashes can shorten the length to time of diagnosis, but young, healthy-appearing women with nonspecific symptoms of fatigue and aching are often thought to have other processes or are given psychosocial explanations. A review of the chief complaint of new lupus patients revealed that the principal manifestations were arthralgia (62%) and cutaneous symptoms (especially newly discovered photosensitivity) (20%), followed by fever and malaise.
General treatment concepts
Authors: Wallace Daniel J 
Published: November 2023

Abstract
Lupus patients can help themselves improve their disease by initiating lifestyle changes that, in controlled studies, diminish morbidity and mortality.Sun avoidance is advised. Outdoor activities should be undertaken in the early morning, late afternoon, or early evening. Individuals living at sea level get less ultraviolet exposure than those at higher altitudes. Sunprotective clothing is available for purchase from several Web sites. Table contains a list of sunscreens that block ultraviolet A and B light. Painful joints respond to moist heat. Changes in barometric pressure may increase stiffness or aching. Fatigue is managed with pacing, alternating periods of activity with rest. Restful sleep is important. Physical and occupational therapists can teach patients how to maximize their body mechanics, perform an evaluation of activities of daily living, recommend ergonomic saving measures, and promote the use of assistive devices. Exercise diminishes in?ammation and steroid-induced muscular atrophy and demineralization. In?amed joints should not be isotonically exercised, but range of motion activities decrease risks for contractures and deformity. Pilates-based stretching and isometric-based strengthening are recommended along with walking and low-impact aerobics. If fibromyalgia is present, weight-lifting, rowing, tennis, bowling, and golf should be restricted, as they tend to increase upper back and neck discomfort.
Economic impact and disability issues
Authors: Wallace Daniel J 
Published: November 2023

Abstract
Lupus costs the U.S. public approximately $20 billion a year in lost wages, disability, hospitalizations, medical visits, and medication. Direct costs account for one third, and indirect costs two thirds, of this amount.The overwhelming majority of lupus patients with non-organthreatening disease are employed full time, while 50% with organ involvement are disabled. U.S. government guidelines are written in a way that makes it relatively easy for the latter group to obtain Medicare insurance and receive Social Security disability payments if they have contributed money to the system. Patients with cutaneous disease should avoid outdoor jobs, cold avoidance is desirable if Raynaud’s phenomenon is present, and those with musculoskeletal impairments may benefit from vocational rehabilitation and an ergonomic evaluation of their workstation. Flexible hours are often desirable to accommodate fatigue and pacing issues. Parttime employment is possible for many lupus patients. Total permanent disability is not to be taken lightly. Disabled patients tend to be less independent, less socially interactive, and more depressed and to have less self-esteem.
From methane to chemical communication
Authors: Cordes Eugene H 
Published: November 2023

Abstract
When I was a child, I had three toys that provided endless possibilities: a set of wooden blocks, a set of Tinkertoys, and an Erector Set. These three toys had a lot in common. Each had a number of distinct structural elements that could be assembled in an amazing number of ways to create something new and different. This has a direct analogy to the concept of assembling molecules from atoms: the atoms are the structural elements and they can be hooked together to make molecular constructs in a great many ways.
Generating energy from catabolism
Authors: Cordes Eugene H 
Published: November 2023

Abstract
In the preceding chapter, I emphasized the importance of carbohydrates as sources of metabolic energy. I also introduced the idea of metabolic pathways. Now it is time to pull those two themes together and understand how the pathways for metabolism of carbohydrates yield useful metabolic energy and how these processes are controlled. On the way, we will learn how a number of important drugs for human medicine work their therapeutic magic.
Antibiotics The never-ending war against infectious disease
Authors: Cordes Eugene H 
Published: November 2023

Abstract
Cemeteries can be useful sources of insight and information. The next time that you have the occasion to explore a cemetery have a look at the tombstones for people born around 1900. A lot of those tombstones will reveal that the date of death is within 10 years of the date of birth. Put succinctly, a lot of people born around 1900 did not live to be 10 years old. Now have a look at the tombstones for people born in 1940 or later. A much smaller fraction of people born in that era died before the age of 10 years old. A goal of this chapter is to explore and explain the reasons for this striking difference.
Cancer What it is and what we can do about it
Authors: Cordes Eugene H 
Published: November 2023

Abstract
Cancer! It is a most disagreeable word. Cancer is one of the most feared of all medical diagnoses. It rightly conjures up images of radical, and sometimes mutilating, surgery, lengthy and debilitating courses of drug treatment, incapacitation, the end of normal activities of life, and death. Dying of cancer is often a painful and protracted process. Cancer is feared for good reason. About 1 million people die of cancer each year in the United States.
Babinski and the Anatomical Society
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
It is not clear what prompted Babinski to spend his second year of residency under Victor Cornil, or his third year with Alfred Vulpian. Some suggest his choice was influenced by the availability of residency positions, rather than personal preference, but there are no objective data to validate or refute this hypothesis. Whatever the reasons for his choice, the beginning of the residency program meant for him a career in pathological anatomy, as suggested by the title of his thesis, supervised by Vulpian and defended in March 1885: “Étude anatomique et clinique sur la sclérose en plaques” [Anatomical and clinical study on multiple sclerosis], by “Dr. J. Babinski, former resident and prize winner of the Paris hospitals, instructor in pathological anatomy at the medical school, member of the Anatomical Society” (Figs. 7-1 and 7-2).
Babinski, Head of a Department at La Pitié
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
Speaking on behalf of the Académie de médecine at the funeral of Dr. Duguet in 1914, Babinski gave an eulogy that could well have been written with himself in mind: It was to the hospital that he devoted the best of his intellect, to this hospital which apparently took up a very large place in his heart; it is through his clinical teaching in the department, which he delighted to dispense, that his influence on the young generations was the best expressed and will most certainly remain. [ . . . ] Finally, he did not limit his work to the purely clinical aspects. In therapeutics, he was not afraid to adopt new methods and did not hesitate to be bold.1
The Reflexes and the Sign*
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
When Babinski prepared his candidacy for the agrégation in January 1892, the bibliographical notes on his clinical research did not reflect any particular interest in cutaneous or tendon reflexes. Only a few years later did the subject of reflexes become his predominant focus, a leitmotiv that emerged as a unifying thread of his work: “find objective signs that allow the distinction between organic neurological disorders and those of a functional or hysteric origin, separating with certitude organic and functional problems.”1
Babinski and the Birth of French Neurosurgery
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
A few days before Babinski’s death in 1932, when his friend Jean Ferdinand Darier asked him what had been his greatest medical achievement, his answer was: “You may think it is the sign. I would rather say that the most important was showing the way to neurosurgery to de Martel and Vincent.”ms.
Babinski as Therapist
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
Babinski’s interest in therapy was unusual at the beginning of the last century, a time when French medicine was more interested in clinical research than patient treatment. 9ese evocative lines, taken from an article by Octave Mirbeau (1848–1917), appeared in the newspaper Le Matin on June 27, 1907: I timidly asked the professor after his lesson: “What about the treatment, sir?” “Well! . . . Yes, of course! Whatever you want . . . exactly what you want!” I wrote rapidly at random, a short prescription, and, showing to him: “Is it like that?” He did not even give a glance, and said to me, looking tired, irritated: “Naturally, of course! . . . It does not matter.
Neurology in the Time of Babinski
Authors: Philippon Jacques , Poirier Jacques 
Published: November 2023

Abstract
During Babinski’s lifetime, neurology was progressively recognized in France as a distinct discipline with its own institutional framework. 9e starting point had been the creation in 1882 for Jean-Martin Charcot of the chair for the study of diseases of the nervous system at the Salpêtrière. However, the neurological scene was complex and widespread. Aside from Charcot’s at the Salpêtrière, there were other neurological centers of equal importance, such as those at Bicêtre, Ivry, elsewhere at the Salpêtrière itself, in Villejuif, and naturally at La Pitié with Babinski. Leadership of these departments was o[en a stepping-stone to the Salpêtrière and possibly to the chair (Table 16-1). From the beginning of his residency in 1880 until his retirement in 1922, Babinski was in continual contact with all the famous names in medicine throughout the Paris hospital system and especially in neurology. In 1896, when he took over as head of department at La Pitié, Victor Cornil, professor of pathological anatomy, was working at the Hôtel-Dieu, Gilles de la Tourette had a post at Hérold, Pierre Marie and alienist Désiré Bourneville were at Bicêtre (note that the médecins alienists des Hôpitaux de Paris, found only at the Bicêtre and Salpêtrière hospitals, were different from the aliénists des asiles assigned to psychiatric hospitals such as Ste. Anne and were recruited through a different competition system), Fulgence Raymond held the chair at the Salpêtrière, Jules Dejerine was working in another department (Jacquart) at the Salpêtrière, and Albert Gombault was in Ivry.1
Cervical Plexus
Authors: Fisch Adam 
Published: November 2023

Abstract
The Cervical Plexus is formed from the ventral rami of the C1–C4 spinal nerves and provides motor and sensory coverage to the head and neck and also helps activate the diaphragm. Cervical roots exit their respective cervical foramina underneath the sternocleidomastoid muscle and emerge into the anterior and posterior cervical triangles. We will group the motor nerves that emanate from the cervical plexus based on whether they enter the anterior or posterior cervical triangle, so let’s first demonstrate the anatomical boundaries of these triangles.
Sensory Maps of the Body
Authors: Fisch Adam 
Published: November 2023

Abstract
The 1953 edition of Woodhall and Haymaker’s book, Peripheral Nerve Injuries, contains two separate sensory maps: one based on Keegan and Garrett’s 1948 work and the other based on sensory maps from O. Foerster’s 1933 Brain publication. Now, no neurologist is clear about which map to follow. Both maps work well, though, so we will use elements of both of them in this chapter. We also include Keegan and Garrett’s 1948 dermatomal maps for reference, here.
Cerebellum
Authors: Fisch Adam 
Published: November 2023

Abstract
In This Chapter, we will learn the gross structure and functional pathways of the cerebellum. Amazingly, the cerebellum is packed with more neurons than the cerebrum and yet it is able to fit into the compact posterior fossa because of its unique crystalline structure. To learn the anatomy of the cerebellum, we will begin with a mid-sagittal section; then we will create a coronal view of the anterior cerebellum in its folded state; then of the posterior cerebellum in its unfolded state; and afterward, we will learn the cerebellar somatotopic map. Let’s now draw the mid-sagittal section of the cerebellum. First, draw the triangular-shaped fourth ventricle, and around it, draw the oval-shaped cerebellum. Next, create a small fissure along the rostral-posterior surface of the cerebellum; label it as the primary fissure. The primary fissure divides the majority of the cerebellum into anterior and posterior lobes. Label the anterior-superior cerebellum as the anterior lobe and the posterior-inferior cerebellum as the posterior lobe.
Basal Ganglia
Authors: Fisch Adam 
Published: November 2023

Abstract
The Basal Ganglia lie deep within the brain and surround the diencephalon, which comprises the thalamic structures. They were classically considered a solely motor area, but are now understood to play an intrinsic role in neurobehavioral activities, as well. Basal ganglia motor disorders are commonly divided into hypokinetic (slow, rigid movement) versus hyperkinetic (fast, chaotic movement) disorders. Parkinson’s disease is the classic hypokinetic disorder and Huntington’s disease is the classic hyperkinetic disorder. Perhaps the most disabling features of these two disease states, however, are their neurobehavioral dysfunctions—cognitive slowing/dementia and psychosis, and it is important to think about them in the management of movement disorders patients.
Arterial Supply To The Central Nervous System
Authors: Fisch Adam 
Published: November 2023

Abstract
In This Chapter, we will diagram both the arterial vessel pattern and the vascular territories of the central nervous system. Our goal is to learn the course of each vessel and the major region it supplies. Fluoroscopic cerebral arteriography and non-invasive imaging modalities, such as magnetic resonance imaging (MRI), give us excellent views of arterial circulation and bolster our knowledge of vascular territories. From these technologies, and a long history of pathologic studies, we know that the central nervous system vascular territories are highly variable. Therefore, when we review an MRI of a stroke (aka infarct), we should look at the central area of injury to determine the infarcted vessel and avoid temptation to determine the vessel territory by reviewing its borders. In this chapter, we will specifically focus on the central region each vessel supplies and try to neglect the vessel borders.
Eye Movements
Authors: Fisch Adam 
Published: November 2023

Abstract
There Are Many different classes of eye movements dedicated to keeping the visual world in focus; two main categories are those that keep the world steady on the retina and those that keep the object of focus in the center of vision, in the fovea. Different areas of the nervous system initiate different eye movements but they all share the same final brainstem pathways. One brainstem pathway is for conjugate eye movements, which drive the eyes in the same direction (horizontally or vertically), and the other is for vergence eye movements, which drive the eyes in opposite directions (inward or outward). Let’s start with a discussion of the different types of eye movements and then learn their anatomy.
Problems That May Surface during the First Few Years of Levodopa Treatment
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
The first years on levodopa therapy usually go relatively smoothly. In contrast to drugs such as narcotics that require progressively higher doses, the individual carbidopa/levodopa dose usually remains relatively constant over subsequent years, provided that doses were initially optimized (chapter 12). Patients who have carefully titrated their initial dosage will probably still be taking approximately the same amount of levodopa per dose years later; note, this is per dose, not per day.
Adjunctive Drugs for Motor Fluctuations and Dyskinesias
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
Levodopa adjustments are the quickest and simplest means of treating fluctuations or dyskinesias, as discussed in the previous chapter. However, when motor fluctuations with short-duration levodopa responses become problematic, adjunctive medications can be very helpful. Dopamine agonists with longer half-lives or adjunctive drugs that prolong levodopa action tend to stabilize fluctuations, although rarely completely. The pharmacologies of all of these drugs were discussed in chapter 10, whereas in this chapter, we will apply that knowledge to treatment of levodopa fluctuations.
Hallucinations, Delusions, and Pathologic Behaviors
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
Hallucinations in Parkinson’s disease (PD) are usually visual, that is, seeing things that are not there. Auditory hallucinations do occur, but very infrequently. Although hallucinations are common in advanced Parkinson’s disease, they may also surface in early PD after medications are introduced.1, 2 They are central clinical features in PD dementia and Dementia with Lewy Bodies (DLB), but drug-induced hallucinations may occur without dementia.
Future Parkinson’s Disease Treatment: Directing Resources and Counseling Patients
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
We can effectively treat many Parkinson’s disease (PD) symptoms but obviously fall short in important areas. Moreover, we have no specific treatment for slowing PD progression or attacking the underlying cause. These are areas that demand progress and patients typically want to know what the medical community is doing to accomplish this. Obviously, major scientific advances cannot be predicted; often the unexpected discovery of a crucial missing piece to the medical puzzle leads to a cascade of subsequent medical breakthroughs. In this chapter, several issues are highlighted that bear on future PD treatment, including research avenues that can be exploited, and reasons to be optimistic. For success, however, we collectively need to be intellectually flexible, learning from past experience and redirecting resources where good science takes us.
Multiple Sclerosis
Authors: Birnbaum Gary 
Published: November 2023

Abstract
Multiple Sclerosis (MS) is an inflammatory, often progressive, and potentially disabling disease of the central nervous system. Onset of the disease is usually between the ages of 15 and 50, with the incidence nearly twice as high in women. While the cause of MS is still unknown, the predominant theory is that it is an autoimmune disease, triggered by an unknown environmental factor that results in both loss of central nervous system myelin and degeneration of axons and neurons. Although there have been a number of publications addressing different aspects of MS treatment in the neurological literature, there is a dearth of material on MS designed for internists and primary care physicians, who are often the first to see patients presenting symptons of MS. Therefore, this concise, clinically focused volume will serve as a valuable resource tailored to the specific needs of internists and primary care physicians. Part of the Oxford Neurology Library, this highly practical pocketbook covers current approaches and new developments in the diagnosis, treatment, and management of MS, including both early and advanced stages of the disease. The book offers in-depth coverage of special populations, as well as the more unusual manifestations of MS, which are less familiar to the internal medicine audience. It will also address the role of imaging studies in the diagnosis, differential diagnosis and monitoring of the progression of MS. In addition to providing up-to-date information on pharmacological therapies for MS, the book also describes an array of non-pharmacological treatment options.
Introduction
Authors: Birnbaum Gary 
Published: November 2023

Abstract
Many books have been written on the pathology, immunology, diagnosis, and treatment of persons with multiple sclerosis (MS). Most of these have been directed at neurologists and other specialists in the field, with details commensurate with the expertise of these readers. This book has a different purpose. Its goal is to present a practical and reasonable approach to the diagnosis and treatment of MS to those health professionals most likely to first see persons with MS, namely primary care physicians and clinical nurse specialists. The long-term care of persons with MS often is dependent on the expertise of such non-neurologists, but with the multitude of other illnesses cared for by primary care health professionals, providing a compendium of all known information about MS is not useful. Rather, I hope that this book will provide an algorithm for the diagnosis and treatment of persons with MS, as well as providing a foundation for more detailed readings on the subject.