bluuebunny/crossref_metadata_2025_split huggingface dataset:
Final diagnosis
Authors: Guly H R 
Published: November 2023

Abstract
Diagnosis is fundamental to medicine. The diagnosis you make will label the patient. It may be entered into a computer, copied into the general practitioner’s notes, and will be referred to in the absence of the rest of the clinical notes. It may be coded and used to generate statistics. It is therefore important that the diagnosis is as complete as possible. ‘Fall’ or ‘injury right hand’ are not diagnoses. ‘Fractured right 4th metacarpal’ is a diagnosis but better still is ‘Undisplaced transverse fracture base right 4th metacarpal’.
Treatment
Authors: Guly H R 
Published: November 2023

Abstract
The A& E record card may be used for prescribing drugs given in the department. Any prescription made in this way must contain the same information as any other prescription.
Drug dosage, frequency, and duration (or total number of tablets prescribed) should be written down even if the prescribing is being done on a separate form. It is not helpful when a patient returns and requests more medication to find that all that is written in the notes is ‘ibuprofen’ without any mention of dose and frequency of administration or, even worse, ‘NSAIDs’.
Bone injuries
Authors: Guly H R 
Published: November 2023

Abstract
If there is an obvious fracture the limb should not be moved unnecessarily but it may be necessary, even if just to splint the limb. If the limb is moved then the presence of crepitus should be noted. In less severe injuries, the limb will be moved as part of the examination of the joints at either end. If there is doubt as to whether there is a fracture or whether a known fracture has healed, then the bone can be stressed.
Abdominal injury
Authors: Guly H R 
Published: November 2023

Abstract
An accurate history is important as it may not only help in establishing the diagnosis but may assist in the management of the patient. A blow to the abdomen with the force of a kick may cause injury to a solid organ (e.g. spleen), but in these circumstances it can often be treated conservatively. A more severe force such as occurs in a high velocity road accident may injure liver, spleen, or kidney but may also injure a hollow organ. If further investigation reveals intra¬abdominal bleeding, a high velocity injury is much more likely to need to be surgically explored.
Child limping or unable to weight bear
Authors: Guly H R 
Published: November 2023

Abstract
The small child who falls over and refuses to walk without any signs of a major limb injury is a common problem. As the child may be unable to say where the pain is and tenderness may be difficult to localize especially if they are crying, he or she must be examined from the toes to the hip even if the site of injury appears to be in one area. Common injuries causing this problem are greenstick fractures of the first metatarsal, spiral and greenstick fractures of the tibia and, less commonly, greenstick fractures of the femur.
The child who is limping following an injury must be examined similarly but it is less likely there is a fracture of a long bone if the child is walking.
Gene structure and regulation and the application of laboratory techniques
Authors: Jeffery Stephen , Saggar-Malik Anand K 
Published: November 2023

Abstract
Cell activity is essential for cell survival and organ function and is determined by the integrated activity of almost 100 000 genes through control of protein synthesis at the nuclear and cytoplasmic level. It was first believed that proteins were more likely candidates than DNA as components of the genetic code, but by the beginning of the 20th century it was apparent that chromosomes determined inheritance. In the late 1940s, Linus Pauling demonstrated that gene function could be studied not only by gross phenotypic change but also through encoded protein products, e.g. by gel electrophoresis. In 1953, James Watson and Francis Crick, from x-ray crystallographic data, described the double helical structure for DNA of two intertwined chains running in opposite directions.
Chromosomal and development anomalies
Authors: Crawfurd Martin d’ A 
Published: November 2023

Abstract
Although renal and lower urinary tract anomalies are seldom the presenting feature of chromosomal disorders, they frequently form part of a multisystem malformation due to chromosomal anomaly. The renal abnormalities seen in chromosomal disorders include fused kidneys, duplication defects, renal agenesis or hypoplasia, hydronephrosis and hydroureter, renal dysplasia or cystic disease and hypospadias, micropenis, and cryptorchidism.The overall pattern of malformation in individual chromosomal disorders is usually sufficient ly characteristic to enable a clinical diagnosis to be made. However, within the broad picture there is considerable variation from case to case, even for the whole chromosome trisomies and monosomies.
Purine metabolism
Authors: Watts R W E 
Published: November 2023

Abstract
The inherited disorders of purine metabolism associated with renal disease are listed in Table 24.1. They are the sole cause of only a small proportion of all renal disease and are therefore best considered as part of the overall problem of purine, especially uric acid metabolism-related renal disease. Genetic factors may precipitate the occurrence or determine the severity of acquired disorders in this area. Conversely, environmental factors and acquired diseases modify the phenotypic expression of the primary genetic conditions.
Renal manifestations of neurofibromatosis and tuberous sclerosis
Authors: Milliner D S , Torres V E 
Published: November 2023

Abstract
Neurofibromatosis is one of the most common inherited disorders and occurs in approximately one out of every 3000 births (Riccardi 1987). It is fundamentally a hamartomatous disorder of neural crest tissue. Neuroectodermal and mesodermal changes in neural structures and their accompanying blood vessels lead to diverse manifestations in multiple organ systems. Historical ly, as many as eight different subtypes of neurofibromatosis have been described, many with overlapping features (McKusick et al. 1992). In order to provide consistency in diagnosis and widely accepted recommendations for evaluation and management, a National Institutes of Health (NIH) consensus conference in 1987 considered all available information and recognized two main subtypes, termed NFl and NF2 (National Institutes of Health 1988).
Avoiding trouble
Authors: Montague Alan , Hopper Andrew 
Published: November 2023

Abstract
The term ‘defensive medicine’ implies medical practice directed to protect the doctor from being sued rather than care of a patient. In particular it infers excessive and unnecessary investigation. Of course, good lawyers reassure us, this is quite unnecessary for as long as we act in accordance with a responsible body of medical opinion we cannot successfully be sued. Unfortunately this is not the invariable interpretation by hospital management and defence unions. They are known to pay off smaller claims whether meritorious or not.
Classification of cystic kidneys
Authors: Zerres Klaus 
Published: November 2023

Abstract
Renal cysts are common and have an important role in many areas of medicine. Cystic lesions may be hereditary, developmental, or acquired. At least about 5-10 per cent of all patients on dialysis suffer from cystic kidney diseases. In paediatric autopsy material, cystic changes of the kidneys arc among the most common malformations, and the obstetrician is frequently confronted with renal cysts in prenatal ultrasound examination. Autosomal dominant polycystic kidney disease (ADPKD) is one of the most frequent inherited diseases with an incidence of about 1/1000 (Dalgaard 1957).
Acquired renal cystic disease
Authors: Cohen Eric P 
Published: November 2023

Abstract
The development of cysts in non-cystic kidneys has been recognized by pathologists for over a century (Simon 1847; Mallory 1914). Simple cysts of the kidney are more common in older subjects (Laucks and McLachlan 1981) and are uncommon under age 40. They are thus acquired in life, and probably not congenital. They are usually asymptomatic but may cause pain and may become infected. An association between simple cysts and hypertension has been noted, with reduction in blood pressure after cyst puncture or surgical cyst removal (Ltischer et al. 1986).
What do kidneys do?
Authors: Cameron Stewart 
Published: November 2023

Abstract
To understand better what goes wrong when kidneys fail to function, it’s worth knowing a little about what they do in health, and their role in maintaining a healthy state of well-being. If you are a patient, or a patient’s relative, who is already in kidney failure and facing the prospect of dialysis or transplantation, you may prefer to skip to the chapters which deal with the particular disease you suffer from (Chapters 3 and 4), what happens in kidney failure (Chapter 5), or to those on dialysis (Chapters 6 and 7), or after transplantation (Chapter 8).
Potentially treatable causes of chronic kidney failure. how can we prevent kidney failure?
Authors: Cameron Stewart 
Published: November 2023

Abstract
Kidney failure is not nearly so common as a cause of death or medical problems as (for instance) heart and blood vessel disease, or cancers as a whole, which each cause more than 200 000 deaths a year each in the UK alone. In the UK, about 7000 people reach end-stage kidney failure each year. This figure may not seem large for the whole country, but kidney failure is more common than a number of diseases which are well known to the public-for example muscular dystrophy and multiple sclerosis.
National and international patterns of drug use
Authors: Taylor Ross 
Published: November 2023

Abstract
Good data on drug utilization are not readily available. Data for commercial purposes are obtained by the pharmaceutical industry and associated bodies such as the Association of the British Pharmaceutical Industry (ABPI). These data may come from information on sales of medicines or from special studies by commercial survey organizations such as Intercontinental Medical Statistics (IMS). Apart from sales data, the other main source is operational data from general practice.
How doctors choose drugs
Authors: Denig Petra , Bradley[AU] Colin 
Published: November 2023

Abstract
Prescribing drugs is a routine behavior for most doctors. Many prescriptions are written during consultations, apparently without the doctor giving it much thought. However, each time a prescription is written a decision has been made. This decision making can be considered from a prescriptive or normative point of view; discussing how doctors ought to choose drugs and the factors that properly ought to influence that process.
Prescribing a complementary therapy: an introduction to homoeopathy
Authors: Greenfield Sheila , Wearn Andy , Hunton Mollie 
Published: November 2023

Abstract
Homoeopathy is one of an increasing number of therapeutic approaches to health problems that are proving more popular with patients and some doctors. These therapeutic approaches are sometimes referred to as ‘alternative therapies’ but this depiction of them is too antagonistic and rejecting by allopathic medicine based on scientific rationalism. A preferable term is ‘complementary therapies’, which suggest their use alongside allopathic medicine.
Conclusions: psychiatry first
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
We opened this book with the paradox that psychiatry, although the most deeply value-laden area of medicine, has been relatively neglected by bioethics in favour of more high-tech medical specialties. The reason for this neglect, we argued, has been the stigmatization of psychiatry, by bioethics no less than by biomedicine, as a second-class medical citizen. Psychiatry, according to this ‘psychiatry second’ picture, is the muddled end of medicine. Hence the problems (ethical and scientific) to which it is subject will be resolved. in due time, by methods and ideas derived from what are taken to be the unmuddled disciplines of physical medicine.
Imaging and other investigations
Authors: Wrightson Philip , Gronwall Dorothy 
Published: November 2023

Abstract
The major imaging techniques do not play an important part in the long term management of mild head injury. In the acute stage a CT scan is likely to be done if recovery is not rapid or straightforward, and in the next six weeks or so if persistent headache or other symptoms make it necessary to rule out a subdural haematoma. When symptoms persist diagnosis is made essentially on the clinical history and the neuropsychological assessment. If there are, in addition, focal neurological features such as diplopia or atypical headache, CT or MR may be needed to exclude other pathology. However CT, MR, PET, and SPECT have been used extensively in research on the causes of the late effects of mild head injury, as described in the section on mechanisms and pathology.
Assessment of cognition and behaviour
Authors: Wrightson Philip , Gronwall Dorothy 
Published: November 2023

Abstract
Of all the deficits affecting the patient with a severe head injury the behavioural and cognitive changes are usually the most difficult for the clinician to manage, and are those that researchers rate as the most difficult for families to cope with (Lezac 1996). This applies as much if not more to cases of mild head injury, because problems with memory and concentration and mood swings may be the only persistent after- effects. Thus the patients may appear to others to be fully recovered, yet continue to complain that they are forgetful, and that they get tired and irritable very quickly. Further, it may be difficult to accept their claim that they do have problems. They are generally very aware that they cope badly when they are tired, and may prepare themselves for the doctor’s appointment by having a rest or a sleep, so that he or she sees them at their unrepresentative best.
Pharmacologic approaches to preventing hemodialysis access failure
Authors: Himmelfarb Jonathan 
Published: November 2023

Abstract
While intermittent hemodialysis for the treatment of patients with acute renal failure was introduced by Willem Kolff in 1943, the development of chronic hemodialysis therapy for patients with end-stage renal disease was not feasible until the 1960s with the introduction of the external arteriovenous shunt by Quinton and colleagues. The 1960s were further characterized by the development of the endogenous arteriovenous fistula, and the subsequent development of prosthetic subcutaneous interpositional ‘bridge’ graft.
Autosomal recessive inheritance
Authors: Young Ian D 
Published: November 2023

Abstract
The provision of risks to the parents of a child with an autosomal recessive disorder is generally straightforward, as it does not require too much mathematical expertise to establish that there will be a risk of 1 in 4 for siblings of an affected individual. For other family members, however, risk calculation can be much more complex, particularly if there is a history of consanguinity or if only limited carrier testing is available. Several such situations are considered in this chapter.
Cancer genetics
Authors: Young Ian D 
Published: November 2023

Abstract
There is now clear evidence that genetic factors play an important role in causing cancer. In most instances the associated nuclear mutations are not inherited but are acquired somatically, possibly as part of the normal aging process or as a result of prolonged exposure to particular carcinogens. In these situations any observed small increase in risk to close family relatives is much more likely to be due to shared environmental exposure than to an inherited germ line susceptibility. However, in approximately 5 per cent of cases of the common cancers, such as breast and colorectal, there is evidence of a strong inherited susceptibility. In addition, a relatively large number of single gene disorders have been identified in which particular cancers show a high incidence. Although rare individually, recognition of these high-risk family cancer syndromes is important because of the potential for early detection and prevention by screening and possibly also chemoprophylaxis. Increasing aware ness of familial susceptibility to common cancer and the existence of high-risk familial cancer predisposing syndromes has led to the widespread introduction of cancer family clinics at which the assessment of an individual’s risk for developing a particular cancer is an integral component.
Repetitive brain stimulation
Authors: Mills K R 
Published: November 2023

Abstract
The initial magnetic stimulators were limited in their frequency of stimulation by the recharging time of the capacitors and, depending on the intensity used, frequencies no faster than 0.5 Hz were achievable. It had been known for many years that certain effects of brain stimulation were only seen if the brain area was repetitively stimulated, presumably because of some cumulative excitatory (or inhibitory) effect. The develop ment of stimulators capable of producing trains of higher frequency stimuli was therefore an imperative. This required the solving of a number of technical problems by the designers of stimulators, not least of which was the heating of coils by the passage of frequent high currents. A number of repetitive stimulators are now commercially available capable of discharge rates up to 100 Hz; in some the problem of coil heating has been solved by oil (Nielsen et al. 1995b) or water cooling (Pascual Leone et al. 1991). The terms rapid-TMS or rapid-rate-TMS have been used but repetitive TMS (rTMS) is preferred. High-frequency rTMS refers to stimulation at frequencies greater than 1 Hz whereas low-frequency rTMS refers to frequencies below 1 Hz. The effects offrequency modulated rTMS are unexplored.
Degenerative diseases of the nervous system
Authors: Mills K R 
Published: November 2023

Abstract
This chapter considers inherited conditions of the nervous system which tend to affect specific fibre tracts or nuclei. These conditions are increasingly being characterized genetically, but the correlation between genotypes and the variable phenotypes continues to be of interest to clinicians. Central motor conduction studies have a role in the refining of these correlations. The hereditary ataxias are a heterogeneous group of disorders in which gait ataxia and dysarthria are the predominant features. There are a number of inherited conditions with a known metabolic cause (abetalipoproteinaemia, ataxia telangiectasia and xeroderma pigmentosum), but the majority of the inherited ataxias are of unknown cause. The inherited ataxias are divided on clinical grounds into early onset cerebellar ataxias (EOCAs) (onset before 20 years) of which the commonest, comprising about two-thirds of all hereditary ataxias, and the best studied is Friedreich’s ataxia, and the late onset cerebellar ataxias (LOCAs) (onset after 20 years).
Spinal cord diseases
Authors: Mills K R 
Published: November 2023

Abstract
This chapter considers those spinal cord diseases in which there is a structural abnormality such as external compression or syringomyelia. Conditions in which there is a myelopathy of inflammatory or degenerative aetiology are considered elsewhere. Magnetic brain stimulation has been used to address a number of questions in relation to spinal cord injury. It is important to decide whether a spinal cord injury is complete or incomplete. Clearly if brain stimulation results in responses in muscles below the level of the lesion then the injury must be incomplete. Conversely, lack of a response should not lead to the conclusion that the lesion is complete. It should be remembered that magnetic stimulation excites only a small fraction of the total corticospinal outflow and lack of response can only be interpreted as disruption of this small fraction.
Monitoring motor function during surgery
Authors: Mills K R 
Published: November 2023

Abstract
Techniques for monitoring the sensory tracts during surgery on the spinal cord are well established and are routine in many centres (Nash et al. 1977; Tamaki et al. 1984; Forbes et al. 1991; Epstein et al. 1993; Fujioka et al. 1994; Fisher et al. 1995; Nuwer et al. 1995). Equally, it has long been recognized that motor monitoring would be far more useful than sensory monitoring if it could protect against the serious complication of cord surgery, motor paresis. The ‘wake up’ test (Vauzelle et al. 1973) whereby anaesthesia is lightened sufficiently for the patient to cooperate with the surgeon in voluntarily testing the integrity of the sensory and motor tracts is a most unsatisfactory method and has been abandoned in many centres in favour of sensory evoked potential monitoring. There is, however, a small but significant number of cases in whom sensory evoked potential monitoring remains unchanged during the operation but the patient wakes with a neurological deficit (Lesser et al. 1986; Mustain and Kendig 1991), presumably because ischaemic injury has spared the dorsal sensory pathways.
Integrated Cancer Care
Authors: Barraclough Jennifer 
Published: November 2023

Abstract
Complementary therapies such as acupuncture, aromatherapy and spiritual healing are now being offered within many oncology and palliative care settings. Benefits of improved symptom control, quality of life and patient satisfaction have been demonstrated, but various questions remain. Is further integration with mainstream medicine desirable? What are the priorities for service provision and research? Are the specific techniques as important as their shared "holistic" context? Can they have significant unwanted effects? And besides making patients feel better, can they help to improve survival from cancer? Such questions are considered in this book. Jennifer Barraclough, former director of psycho-oncology at the Churchill Hospital in Oxford, has assembled specialist contributions from oncology and palliative care, complementary therapy, general practice, healthcare planning and research. Academic reviews are balanced by personal accounts from patients. The book is relevant to all stages of the "cancer journey" and includes a chapter on childhood cancer. This overview of a controversial and evolving field will interest those with professional or personal involvement in oncology or palliative care.
Healing the whole person
Authors: Neate Ann 
Published: November 2023

Abstract
Tony Neate is a healer, transpersonal counsellor and nutritional adviser. He offers help in these areas as a support to other forms of treatment being received by the patient. Ann Neate is a healer and counsellor, trained in the transpersonal and humanistic traditions. She is particularly interested in psychological causes of illness. ‘The cure of a part should not be attempted without treatment of the whole’ Plato c. 480 BC Healing has existed throughout history. There is evidence among early civilizations dating back to 3000 BC in Mesopotamia; the Egyptian healer Imhotep who founded the tradition of healing in the temples; and around 1200 BC, the famous Greek healer Asclepius who founded healing temples throughout the Greek states and subsequently in various parts of the Roman Empire. In the latter, the patients were clothed in white and slept near the statue of Asclepius. In dream-state, the patient saw the spirit of the healer appear at his side and prescribe appropriate treatment. History shows that cures were frequent (Jones 1983).