bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient compliance/ concordance
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
Patient compliance with drug therapy can be defined as the extent to which the patient follows a prescribed drug regimen. The extent of non-compliance varies widely, and in different studies has been recorded to be as low as 10 per cent and as high as 92 per cent. Some regard the term ‘non-compliance’ as being pejorative, implying as it does that the patient is behaving badly; they prefer other terms, such as ‘adherence’, ‘observance’, or ‘concordance’. Of course, patients have the right to refuse to accept any help that the doctor offers, whether outright or tacitly, and currently medicine taking is regarded as a partnership between doctor and patient; however, it helps if the doctor understands the factors that encourage concordance.
Drug discovery and development: the pharmaceutical industry and the regulatory authorities
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
Almost all the drugs mentioned in this book have been synthesized and developed by pharmaceutical companies. Doctors and patients depend on high and predictable standards of quality of formulation and proper ethical evaluation of the safety and efficacy of drugs, and the standards of the pharmaceutical industry with regard to the development of new drugs are in general high and are regulated by law.
Introduction to drug therapy
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
In Section I, we discussed the basic principles of clinical pharmacology, breaking down drug therapy into its component processes (pharmaceutical, pharmacokinetic, pharmacodynamic, and therapeutic). In Section II, we discussed some principles relating to the prescribing of drugs. Section IV (the Pharmacopoeia) contains details of the properties of individual drugs or groups of drugs. In this section, it is our aim to marry the properties of the drugs with the basic principles, and to link both with the pathology of the disease and its manifestations, in order to illustrate the ways in which drugs are used in the treatment of disease.
The drug therapy of infectious diseases
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
We shall deal with each of these classes of drug separately, and shall also cover the prevention of infections using vaccines and immunoglobulins. Many specific infections are dealt with in other Chapters (for example infective endocarditis in Chapter 23, pneumonias in Chapter 24, meningitis in Chapter 30).However, because sexually transmitted disorders are generally dealt with by specialists in the branch of infectious diseases known as genitourinary medicine, we shall deal with them in a separate section at the end of this Chapter.
The drug therapy ofcardiovascular disorders
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
Hypertension can be either of unknown cause (so-called ‘essential’) or secondary to some definite abnormality, for example renal parenchymal disease, renovascular disease, a variety of endocrine diseases, coarctation of the aorta, and drugs. In the majority of cases, there is no underlying cause, but an underlying cause should always be sought and should be particularly actively pursued in young patients with severe hypertension resistant to therapy.
The drug therapy of respiratory disorders
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
When there is hypoxia (as in the conditions listed in Table 24.1), it is therapeutically useful to increase the concentration of oxygen in the inspired air (normal oxygen concentration about 20 per cent). Oxygen can be added to the inspired air to produce concentrations ranging from 24 to 60 per cent. The dose depends not simply on the degree of hypoxia, but also on the presence or absence of hypercapnia.
The drug therapy of endocrine and metabolic disorders
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
Reduced function of the anterior pituitary gland results in underactivity of the organs that are normally stimulated by the pituitary trophic hormones, of which the most important, because deficiency is life-threatening, are ACTH (the adrenocorticotrophic hormone, corticotrophin) and TSH (thyroid-stimulating hormone). In children, growth hormone deficiency is also important, although deficiency in adults may be more important than has been previously recognized. Gonadotrophin deficiency, although not directly life-threatening, requires treatment. ACTH deﬁciency For adrenal insufficiency secondary to hypopituitarism, it is usual to use a glucocorticoid that also has some mineralocorticoid activity, such as hydrocortisone 20–30 mg orally. In order to mimic diurnal variation in the normal daily production of endogenous corticosteroids, the total dose can be divided into two doses, two-thirds to be taken in the morning and one-third in the evening; however, some divide the daily requirements into three doses, on the grounds that it produces a more desirable pattern of serum cortisol concentrations during the day (see adrenocortical insufficiency below).
The drug therapy of blood disorders
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
The aims in treating iron deficiency anaemia are to remove the cause and to increase red cell mass by giving iron. The main causes of iron deficiency anaemia are listed in Table 28.1. Iron can be given orally or parenterally, and in almost all patients the oral route is satisfactory. Iron in oral formulations is in the ferrous form, since that is the form in which iron is absorbed, mostly from the upper jejunum. Normal dietary iron absorption is 1–2 mg from a dietary intake of 10–20 mg, balancing the daily losses, which are mainly from sloughing of cells from the gastrointestinal tract and skin, and from urinary losses.
The drug therapy of disorders of bones and joints
Authors: Grahame-Smith D G , Aronson J K 
Published: November 2023

Abstract
The drug therapy of the most common types of arthritis, osteoarthritis and rheumatoid arthritis, was not one of the great successes of 20th century therapeutics. Simple non-opioid analgesia has not progressed beyond aspirin and paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs), although partly effective as both analgesics and anti-inflammatory drugs, cause many serious adverse reactions, particularly in elderly people, in whom they are used very commonly. In rheumatoid and other inflammatory types of arthritis (in contrast to osteoarthritis), there are several so-called ‘disease-modifying drugs’ (DMARDs), now often called ‘slow-acting anti-rheumatic drugs’ (SAARDs), each of which is only partly effective and has its own range of serious adverse reactions.
Immunosuppression and the drug therapy of allergies, connective tissue disorders, and primary immunodeﬁciencies
Authors: Grahame-Smith D G 
Published: November 2023

Abstract
Although the precise details of the mechanisms of action of the drugs that are used in the treatment of allergic and immune diseases have not been fully worked out, sufficient is known to fit them into a scheme that depends on an understanding of the four different types of immune reaction. The drugs used are listed in Table 37.1.Type I allergic reactions are those in which exposure to an antigen in a predisposed individual leads to the production of IgE antibodies, which bind to the cell surfaces of mast cells and basophil polymorphonuclear leukocytes. A subsequent exposure of the individual to the antigen leads to an antigen–antibody reaction at the cell surface and the activation of a system that leads to the release of inflammatory mediators from the cell.
Pretransplant medical evaluation for pancreas transplant candidates
Authors: McCauley Jerry , Corry Robert J 
Published: November 2023

Abstract
Pancreas transplantation has rapidly moved from an experimental procedure associated with high rates of morbidity and mortality to a mainstream technique with excellent patient and graft survival. The rate of pancreas transplantation increased from less than 200 per year in 1987 to approximately 1000 per year in 1998. [1,2] Recent Medicare funding for simultaneous kidney and pancreas transplantation (SPK) and pancreas after kidney (PAK) transplantation in the United States will likely fuel more rapid growth. The recent proliferation of new immunosuppressant agents will also likely contribute further to improve graft survival in patients with PAK and pancreas transplantation alone (PTA) and increase the rate of transplantation in these patients as well. The medical evaluation prior to transplantation is crucial since many arrive with pre-existing cardiac disease and other complications of diabetes, which may substantially increase the risk of graft loss and death. The indications for pancreas transplantation is in evolution and may be highly affected by the preferences of the transplant centre, improvements in allograft survival related to improved immunosuppression, and surgical technique. The indications for pancreas transplantation are also evolving and are not uniformly accepted by the rapidly growing number of pancreas transplant centres.
Donor management and selection for pancreas transplantation
Authors: Frezza Eldo Ermenegildo , Corry Robert J 
Published: November 2023

Abstract
Pancreas transplantation is a well-established treatment for patients with insulin-dependent diabetes. Over the last decade, the procedure has been refined, and immunosuppressive regimens have improved such that, at major centres, 1-year graft survival routinely exceeds 80 per cent [1]. Recent evidence supports the beneficial effect of pancreas transplantation on the maintenance of normoglycaemia, and the arrest and possible reversal of diabetic complications such as vasculopathy, neuropathy, and nephropathy [2–4].
Procurement and benchwork preparation of the pancreatic graft
Authors: Hakim Nadey S , Papalois Vassilios E 
Published: November 2023

Abstract
The selection criteria for pancreas donors are similar to those for other solid organs [1,2]. Ideally, donor age ranges between 18 and 45 years and donor weight between 40 to 100 kg. A history of diabetes mellitus, acute necrotizing pancreatitis, and chronic pancreatitis are obvious contraindications. Despite a reported history of pancreatitis, it is always worthwhile examining the pancreas at the time of procurement to assess the suitability of the organ. It should be remembered that after brain death the serum amylase levels are often high in the absence of pancreatitis, and hyperglycaemia may occur in the absence of diabetes. The direct inspection of the pancreas is therefore justified before deciding whether or not to procure.
Pancreas preservation
Authors: Spiegel H U , Palmes D 
Published: November 2023

Abstract
The evolution of organ transplantation into a clinical reality is due mainly to the development of surgical technique, the introduction of immunosuppressant drugs with better selectivity and fewer side effects, and the devising of more effective means of organ preservation and protection. The immense success of organ transplantation has broadened its indications to include conditions which do not threaten life, but where the gain in quality of life out weights the risks of lifelong immunosuppression, for example, pancreas transplants in patients with insulin-dependent type I diabetes mellitus (IDDM) who are not adequately controlled even by carefully adjusted insulin therapy [1–5]. The steadily rising demand for donor organs can no longer be met by the numbers of potential organ donors. New strategies will therefore have to be devised for procuring better supplies of donor organs, for example, enlargement of the donor pool by recruitment of living donors and of ‘marginal’ donors with minor impairment of organ function; adequate utilization of available donor organs must be also ensured.
Surgical techniques of pancreas transplantation
Authors: Krishnamurthi Venkatesh , Stephen T Bartlett 
Published: November 2023

Abstract
Insulin-dependent diabetes mellitus (IDDM) affects 1 million people in the United States and 30 000 new patients annually [1]. In addition to being the leading cause of endstage renal disease (ESRD), IDDM is also the leading cause of blindness, amputations, and impotence in adults. Data from the Diabetes Control and Complication Trial (DCCT) conclusively demonstrate that tight glucose control reduces the incidence of secondary complications [2]. The benefits of intensive control were not without risk however, as severe hypoglycaemia episodes and weight gain occurred more frequently in patients treated with intensive control. Moreover, as was concluded by the DCCT Research Group, there was no minimal glycaemic threshold below which complications would not occur [3]. These findings reinforce the belief that exogenous insulin administration is, at best, an imperfect solution for IDDM.
Surgical complications of pancreas transplantation
Authors: Benedetti Enrico , Sileri Pierpaolo , Gruessner Angelika C , Cicalese Luca 
Published: November 2023

Abstract
Pancreas transplantation is currently considered an extremely effective therapeutic option for selected patients affected by type I diabetes. According to the International Pancreas Transplantation Registry 2000 Midyear Update [1], over 1400 pancreas transplants have been performed annually worldwide since 1995. In 1999, the majority of cases were simultaneous kidney and pancreas transplants (SPK, 86 per cent), followed by pancreas after kidney (PAK, 10 per cent), and pancreas transplant alone (PTA, 4 per cent). Current 1-year and 5-year patient survival rates exceed 90 and 80 per cent, respectively, without significant differences between the different procedures for cases performed between 1996 and July 2000. Pancreatic graft survival rates at 1 year were 84 per cent for SKP, 73 per cent for sequential PAK, and 70 percent for PTA. These excellent outcomes, much improved in comparison to older data, have been achieved due to a marked decrease in immunological graft loss and technical failures over the last 10 years. This chapter will focus on surgical complications after pancreas transplantation.
Medical and urological complications of pancreas and kidney/pancreas transplantation
Authors: Pham Phuong-Thu T , Pham Phuong-Chi T , Wilkinson Alan H 
Published: November 2023

Abstract
Simultaneous pancreas and kidney transplantation (SPKTx) is a well-established therapeutic option for selected patients with endstage renal disease (ESRD) secondary to type I diabetes mellitus. Refinements in surgical techniques and important advances in immunosuppressive therapy have allowed patient and graft survival to reach levels comparable to those seen in kidney alone (KA) transplantation. Nevertheless, morbidity in pancreas transplants remains high, in part due to special problems that are inherent to pancreas transplantation. Variations in surgical techniques may result in different types and incidence of both surgical and medical complications. Urinary diversion of exocrine secretions of pancreas allografts may result in unique acid–base and electrolyte disorders, whereas systemic venous drainage of the endocrine system may lead to peripheral hyperinsulinaemia and peripheral insulin resistance.
Histology of the pancreas transplant
Authors: Klassen David K 
Published: November 2023

Abstract
The early detection and effective treatment of acute rejection has been a major challenge in pancreas transplantation. Numerous non-invasive markers of pancreas rejection and function have been studied such as serum or urine levels of amylase, lipase, or anodal trypsinogen or functional measures such as glucose disappearance rates. [1–3]. Although widely used, none of these biochemical markers or functional measures have proven to be specific for acute rejection. Similarly imaging studies such as magnetic resonance imaging (MRI) scanning or ultrasound have not shown adequate sensitivity or specificity on which to base treatment of rejection [4–6]. The diagnosis of acute pancreas rejection has until recently relied on evidence of renal allograft rejection in patients receiving simultaneous kidney and pancreas transplantation. In these patients, renal allograft dysfunction is used as a surrogate marker for pancreas rejection as most rejection episodes occur simultaneously in both the kidney and pancreas, and the renal allograft is easily biopsied.
Fetal and neonatal pancreatic tissue transplantation
Authors: Tuch Bernard E 
Published: November 2023

Abstract
The first record of transplanting fetal pancreatic tissue into humans was by Fischera in 1928. He allografted the tissue in three sites, beneath the tunica vaginalis, into muscle, and preperitoneally (reported in [1]). More systematic transplants of fetal pancreas did not occur until six decades later [2–4].
The systematic desire to examine the use of immature pancreatic tissue occurred in the 1970s at a time when all types of pancreatic tissue were being examined as possible sources for replacing the -cells destroyed in type 1 diabetes. Whole pancreas, islets, and fetal tissue were identified as possible sources of viable -cells.
At the dawn of the new millennium, the role of the whole pancreas as a therapy for type 1 diabetes is known [5]. Problems that had to be overcome to achieve this goal have included optimizing methods to retrieve the pancreas from brain-dead donors, which immunosuppressive drugs are needed to prevent rejection, and the best site to transplant the pancreas. These issues are discussed elsewhere in this book. Whole pancreas transplants are reserved for those people with advanced complications, especially those with renal failure requiring a kidney transplant. Success rates are on a par with other whole organ transplants. The percentage of grafts still functioning 1 year after being transplanted is 83 per cent [5].
Experimental approaches to the prevention of islet rejection
Authors: Kenyon Norma Sue 
Published: November 2023

Abstract
Various animal models of pancreatic islet cell transplantation have been utilized to test novel approaches for the prevention of graft rejection. In the setting of type 1 diabetes, prevention of recurrent autoimmunity has also been a critical focus. Production of proinflammatory mediators by macrophages and endothelial cells that are activated subsequent to intrahepatic islet infusion can be detrimental to islet survival and function, thus leading to early islet loss or primary non-function (PNF), and can also serve to augment specific immune responses to the graft. Experimental approaches to the prevention of rejection must, therefore, target rejection, recurrent autoimmunity, and events associated with PNF. Furthermore, agents must be identified that do not have adverse effects on islet cell function.
Normal Tendon
Authors: Stanish William D , Curwin Sandra , Mandel Scott 
Published: November 2023

Abstract
Muscles vary greatly in size, shape, and complexity (Fig. 1.1). Some are broad and flat, with wide, short tendons such as the gluteus maximus or rectus abdominis. Others, such as the fusiform biceps, have smaller, rounded, cord-like tendons. In general, the shorter and broader tendons are associated with muscles that create high levels of force, while longer and narrower ten¬ dons are associated with muscles that make precision movements, such as those seen in the hand (Jozsa and Kannus 1997). it is unrealistic to consider and discuss tendon in isolation from its accompanying muscle, and we encourage the reader to bear this in mind throughout the following pages.
Etiology of tendinitis
Authors: Stanish William D , Curwin Sandra , Mandel Scott 
Published: November 2023

Abstract
with one oriented in the tendon’s long axis. The size of each vector is determined by the angle of orientation of the muscle fibres. The lateral components largely cancel each other out, if both parts of pennate muscle are equally active, leaving a tensile force to be applied to the tendon in series with the muscle. Pennate muscles, therefore, exert less ten¬ sile force on the tendon because of the greater angle between the longitudinal axis of the muscle and the tendon. This is true even though muscle fibres of fusiform and pennate muscles are capable of producing equal amounts of force (Alexander and Vernon 1975).
Humeral epicondylitis
Authors: Stanish William D , Curwin Sandra , Mandel Scott 
Published: November 2023

Abstract
We concur with this opinion, but narrow our definition of tennis elbow to elbow pain that can be related to the extensor movements of the wrist joint. These extensors commonly attach to the lateral epicondyle, so the term lateral epicondylitis is preferable to tennis elbow, especially since the syndrome com monly occurs in non-athletes whose occupations involved repeated gripping activities, such as carpenters, The lateral epicondyle of the humerus is a point of origin for the wrist extensors, including extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, and extensor digitiminimi. These muscles attach jointly to the lateral epicondyle via a tendinous expansion known as the common extensor tendon, or extensor aponeurosis (Fig. 6.1). In addition, the supinator muscle partially attaches to the lateral epicondyle and lies underneath the wrist extensor muscles mentioned above
Othertendinitides
Authors: Stanish William D , Curwin Sandra , Mandel Scott 
Published: November 2023

Abstract
There are numerous other tendinitides that can be equally difficult to treat. The purpose of this chapter is to review some of these disorders, their etiologies, and possible avenues of treatment. We do not advocate the use of eccentric exercises in treating all types of tendinitis and not all the clinical entities mentioned in this chapter are necessarily amenable to treatment with eccentric exercise. We present what we feel is the best method of treatment or the most widely used.
Clinical results
Authors: Stanish William D , Curwin Sandra , Mandel Scott 
Published: November 2023

Abstract
The development of the eccentric exercise program was prompted by our disappointment with traditional treatment methods and the growing realization that we were not employing our knowledge of the behavior of soft tissue under different physical conditions. Dr Howard Lamb, research fellow at the Nova Scotia Sport Medicine Clinic in 1978, questioned our ‘standard’ treatment of tendinitis, which at that time consisted of physical modalities, oral anti-inflammatories, flexibility exercises, ice application, transcutaneous neurologic stimulation (TNS), and so forth. Dr Lamb reasoned that the tensile strength of the tendon was being exceeded during activity and that this action was causing the micro ruptures that led to injury. Moreover, he felt that only by addressing the problem of tensile strength instability directly would it be solved. That is, the tendon must be gradually and progressively overloaded, thereby increasing its tensile strength. Immobility or disuse of the tendon (and, in fact, all soft tissues) simply weakened it. Thus, we encouraged our patients to remain active, and we avoided the use of rest as a treatment modality except where absolutely necessary.
Franklin ‘s Experiment: The Observation
Authors: Tanford Charles 
Published: November 2023

Abstract
It is appropriate to divide the published account of Franklin ‘s experiment into two parts: the observation and the interpretation. This chapter describes the observation and includes the experiment itself and the circumstances that led to it. Chapter 13 will give Franklin ‘s attempt to interpret his observations in molecular terms. Most of the present chapter consists of a verbatim copy of Franklin ‘s own words, with a minimum of annotation.