bluuebunny/crossref_metadata_2025_split huggingface dataset:
The natural history and management of renovascular disease
Authors: Scoble John E 
Published: November 2023

Abstract
In the recent past the natural history of major renal diseases would not have included a chapter on renovascular disease. The presentations of renovascular disease are diverse and complex (Table 9.1), and this chapter represents a recognition of renovascular disease as a major cause of acute [l] and chronic renal failure [2]. Renovascular disease is important in the pediatric population as a cause of hypertension [3] but the importance of the atherosclerotic renal artery stenosis (ARAS) as a cause of end-stage renal failure in the older population becomes clearer with each year [4-6]. It possibly now represents the single most common cause of end-stage renal failure in patients over the age of 60years [5,6].
Prevalence and predictors of nephropathy in patients with type 2 diabetes
Authors: Estacio Raymond O , Mehler Philip , Schrier Robert W 
Published: November 2023

Abstract
In 1997, the Center for Disease Control and Prevention (CDC) announced their statistics about the prevalence of type 2 diabetes mellitus. The results were alarming. There are about 16 million cases in the United States and that number is growing. The increased prevalence of diabetes in minority populations is equally alarming. Both in the United States and in developing countries, as compared with White Americans with type 2 diabetes, African-Americans, Native-Americans, and Asian-Americans have a two to six times greater prevalence. Estimates are that the rising global burden will increase the worldwide total of diabetics from 123 million to 220 million by the year 2010.
Diabetic nephropathy: animal models of human type 2 diabetes
Authors: Perico Norberto , Remuzzi Giuseppe 
Published: November 2023

Abstract
Diabetic nephropathy is one of the most common disabling complications of diabetes mellitus (Ruggenenti and Remuzzi 1997). It is characterized clinically by the development of persistent proteinuria, hypertension, and progressive loss of renal function. This complication can occur in patients with either insulin dependent (type 1 diabetes) and non-insulin dependent diabetes mellitus (type 2 diabetes) (Gellman et al. 1959; Andersen et al. 1983), and, if left untreated, it frequently leads to progressive renal structural damage, terminating in end-stage renal disease (ESRD).
Lipid management in type 2 diabetes with nephropathy
Authors: Zimmermann Josef , Wanner Christoph , Quaschning Thomas 
Published: November 2023

Abstract
Diabetic nephropathy is one major complication of diabetes mellitus.In about 40% of all dialysis patients today, diabetic nephropathy is the cause for terminal renal failure. In addition to hypertension, glycaemic control, and genetic influence, diabetic dyslipidaemia plays an important role in the pathophysiology and progression of vascular disease and probably also diabetic nephropathy.; About 30% of all patients with diabetes mellitus develop overt nephropathy which additionally impairs lipid metabolism.
Management of the patient with type 2 diabetes and renal failure
Authors: Ritz Eberhard , Rychlik Ivan 
Published: November 2023

Abstract
The high incidence of proteinuria and renal failure in patients with diabetes mellitus has been known for more than a century. At that time little could be done about it. With the relatively recent introduction of effective renal replacement therapies the management of diabetic patients with renal failure has become a major challenge, however. Maintenance haemodialysis in the diabetic was used as early as 1966, but results were poor.
Innovation in primary care for older people - what went wrong?
Authors: Iliffe Steve , Drennan Vari 
Published: November 2023

Abstract
In 1948 the National Health Service (NHS) inherited a massive amount of unmet medical need, especially amongst the older generation that had not been the focus for pre-war efforts to improve child and maternal health, or to eradicate infectious disease. This included a backlog of endlessly-postponed gynaecological surgery, and a cohort of old men sitting at home with catheterized bladders for want of prostate operations. The NHS made dentures for edentulous pensioners previously denied access to dental care through lack of money and a shortage of dentists, and corrected short-sightedness and cataract in the three-quarters of the population who had never had access to free ophthalmic services. It is no surprise that the first recipient generation described their NHS as ‘the envy of the world’, for it rewarded them for their efforts, suffering and sacrifice in wars and economic depression.
Promoting continence with older adults: Mandy Wells, Continence Nurse Specialist
Authors: Iliffe Steve , Drennan Vari 
Published: November 2023

Abstract
The health visitor had arranged a home visit to Mrs N. for an annual over-75 assessment. Mrs N. had some problems with arthritis but had not been seen by anyone at the surgery for some time. Mrs N. opened the front door to her flat, greeted the health visitor, then slowly led the way to the front room. As she did so the health visitor noticed a wet patch on the seat of her skirt. Mrs N. sat down in her armchair and the pungent scent of urine wafted across to the health visitor, seated nearby. After settling themselves down, the health visitor started working her way through her list of areas to be explored, offering health promotion advice and suggestions as problems were identified. She then asked, ‘Any problems with your bladder or bowels?’. ‘No; said Mrs N. looking the health visitor squarely in the eye. ‘So, no difficulties with your waterworks?’ asked the health visitor, checking the language was understood. .
Depression, anxiety, and dementia
Authors: Iliffe Steve , Drennan Vari 
Published: November 2023

Abstract
Old age brings plenty of problems. As we age we may face ill health, disability, dependency in ourselves or our spouse, problems with our housing, growing fear of our own vulnerability to crime, the desolation of social isolation and loneliness, and lower incomes. Our families give us other problems to worry about - separation, illness, failure, tragedy - and may not be willing or able to help us when we need them. Later life’s a problem list, and then you die! Looked at that way, depression and anxiety in old age become understandable, even ‘normal’ responses to declining faculties and dwindling resources. Dementia then becomes the cruellest way of outliving yourself, from which those of sound mind (even if not body) recoil in horror. Professionals and public alike can turn away from such problems, fatalistically attributing them to ageing because they believe that so little can be done.
Pregnancy in women on renal replacement therapy
Authors: Jacobs Claude 
Published: November 2023

Abstract
The hormonal abnormalities that are commonly encountered in women with advanced/ end-stage renal disease (ESRD) strongly interfere ,With conception and successful outcome of pregnancy. They are very incompletely—if at all—corrected with well-conducted dialysis treatment. Pregnancy is, thus, a rare event among women of childbearing age who undergo long-term hemodialysis (IID) or peritoneal dialysis (PD). In contrast, pregnancies are much more common among women whose renal function is restored thanks to a successful transplant, with, in most cases, an excellent outcome and a very low rate of short- or long-term complications in mothers and children.
Renal replacement therapy for diabetic patients with end-stage renal disease (ESRD)
Authors: Jacobs Claude 
Published: November 2023

Abstract
The course of events that have developed over the past 20 years in the domain of ESRD in diabetic patients, well illustrates the current popular saying, according to which ‘one should never make predictions, especially for the future’. Indeed, the paper authored by W.J. Kolff et al. in 1972, based on the outcome of nine insulin-receiving diabetic patients treated ,With maintenance hemodialysis (HD) for a maximum duration of 20 months, stated that ‘Dialysis for such patients should be considered as a palliative measure with little likelihood of long-term survival or improvement in quality of life’ (1). A quarter-century later, diabetic patients account for 15-40% of all the new patients taken yearly on renal replacement therapy (RRT) in most of the economically developed countries, and their survival rates on dialysis or transplantation come steadily closer to that of non-diabetic patients of comparable age-range.
Ethical conflicts in renal replacement therapies
Authors: Kjellstrand J Cecilia , Kjellstrand Carl M 
Published: November 2023

Abstract
The speed of technology in the field of nephrology continues to accelerate, causing unexpected ethical conflicts for physicians. The physician still must balance the four generally recognized ethical principals of beneficence, non-maleficence, autonomy, and justice against each other, but is further called upon to strike this balance in increasingly complex ways. Physicians also have to fulfill an often overlooked ethical obligation, that of advocacy. This is a duty to patient groups, as well as to individuals. For nephrologists it is patients with end-stage renal failure for whom we advocate. Advocacy is necessary to secure enough funds to apply the treatments to all in need and to avoid rationing. It makes physicians compete with the conflicting financial demands of other societal needs, such as defense and education. They also face colleagues who are also advocating for other patient groups for limited funding. The physician-advocate has to harass politicians and bureaucrats and vie with other physicians to secure funds for their patients in need.
Treatment strategies for end-stage renal failure in developing countries
Authors: Davison Alex M , Barsoum Rashad , Lai Kar Neng , Mani M K , Morad Zaki , Rutkowski Boleslaw 
Published: November 2023

Abstract
Hemodialysis was first introduced for the treatment of acute renal failure but it soon became obvious that a number of patients did not have a satisfactory return of renal function and so the clinician was faced with the decision of stopping further dialysis or finding a satisfactory method of providing long-term therapy. In addition, it also became obvious that treatment suitable for acute renal failure could be applied to patients ,With end-stage irreversible renal failure. The major obstacle to overcome was the development of a means of achieving repeated vascular access and, had it not been for the Teflon-silastic® shunt, and subsequently the subcutaneous arteriovenous fistula, it is doubtful whether long-term hemodialysis would ever have become a viable long-term treatment. The remarkable success of dialysis is now obvious, with more than one million people world-wide depending on dialysis for survival. This success, however, is not enjoyed with equity around the world because of the cost-implications of providing such treatment and the differing healthcare priorities that exist in the various communities of the world.
The epidemiology of cancer
Authors: Kee Frank 
Published: November 2023

Abstract
The World Health Organization established a subcommittee on the registration of cancer which provided the initial spur for the establishment of the International Union Against Cancer (UICC) in 1950 and ultimately the International Agency for Research on Cancer (IARC).
Since that time, data collection and quality assurance systems have been established that ensure that national and international comparisons of cancer rates can be made.
The Molecular Biology of Cancer
Authors: Harkin D Paul 
Published: November 2023

Abstract
Cellular growth and division is a carefully regulated process that depends on the precise interaction of multiple regulatory factors. Cancer represents a deregulation of this process, in which some of the normal constraints on cell growth and division have been lost. How this deregulation occurs has been the focus of intense interest over the last three decades. However, it is now generally accepted that tumoursarise through the accumulation of several genetic changes affecting the control of cellular growth. Recent advances in molecular biology have made it possible to define some of the molecular changes that regulate the mechanisms by which certain tumours arise.
The psychology of cancer
Authors: Davidson Robin 
Published: November 2023

Abstract
Behavioural, lifestyle factors contribute to almost half of cancer mortality, whilst smoking behaviour alone accounts for almost 30% of all cancer deaths. Models, which include the Health Belief Model and the Theory of Planned Behaviour, enable us to understand how people reduce carcinogenic behaviours like smoking, alcohol use, or exposure to ultraviolet light, and how they permanently acquire positive behaviours like breast and testicular self-examination, physical exercise, or healthy eating habits.
The principles of cancer surgery
Authors: Spence Roy A J 
Published: November 2023

Abstract
With the current emphasis on a multidisciplinary approach to cancer management, the surgeon is one member of a closely knit team who can all be involved at various stages of the treatment of the patient’s disease. All should be involved in the discussion of the patient’s management in the initial stages. The team may include an oncologist, cancer surgeon, radiologist, pathologist, nurse counsellor, geneticist, plastic surgeon, nursing staff, dietetics, pain team, social worker, and psychologist.
Gynaecological Malignancy
Authors: Price John H 
Published: November 2023

Abstract
Gynaecological cancers account for one in seven cancers in women. Approximately one in 20 women will develop a gynaecological malignancy and one in 40 will die of the disease. In the UK, ovarian cancer is now the commonest gynaecological cancer, although worldwide, cervical cancer remains the most important.
Thoracic tumours
Authors: McManus Kieran 
Published: November 2023

Abstract
Mediastinal tumours fall into three general categories, the commonest being secondary bronchogenic carcinoma. Often the primary tumour is small and asymptomatic, even being undetectable in the case of small cell carcinoma. The second group entails systemic malignancy manifesting itself in the mediastinum. Lymphomas are characteristic of this group, though metastases from breast, renal, and gastrointestinal tract cancers are also common. Primary tumours of the organs or tissues of the mediastinum make up the third group and include thymomas, neurogenic tumours, germ cell tumours, ectopic thyroid and parathyroid tumours, and the rare lipomatous, vascular, and primitive ectodermal (Askin) tumours.
Haematological and lymphoid tumours
Authors: M. (Curly) Morris T C 
Published: November 2023

Abstract
The malignant haematological conditions considered individually (see Box 19.1) are relatively uncommon conditions. However, acute lymphatic leukaemia is the commonest cancer of childhood, and taken together, the haematological malignancies, because of a relatively high incidence in younger patients, are the most common cause of cancer in the working population. Modern therapeutic techniques, including improved supportive measures, dose intensification, and bone marrow transplant procedures, have produced a significant cure rate in many of these conditions over the past four decades.
Lumps in the scrotum and hernias
Authors: Stonebridge Peter , Smith David , Duncan Lesley , Thompson Alastair 
Published: November 2023

Abstract
Chapter contents
Lumps in the scrotum can be caused by a swelling in the testes, fluid around the testes, or from a swelling descending from the groin (an inguinoscrotal hernia).
If you can feel above the lump, this implies that it is arising from within the scrotum rather than descending as with a hernia and is caused by a swelling either within the testis itself or around the testes (the tunica vaginalis).
This means that the cause of the swelling is a hydrocoele, caused by a build up of lymph between the covering of the testis (the tunical vaginalis) and the testis itself. If the swelling was separate from the testis, then it would probably be an epididymal cyst.
Perioperative care
Authors: Stonebridge Peter , Smith David , Duncan Lesley , Thompson Alastair 
Published: November 2023

Abstract
The patient is visited preoperatively by the anaesthetist, to ensure that the patient is in an optimal condition for anaesthesia.
It allows the anaesthetist to reassure the patient and to discuss with her the choices for anaesthesia and postoperative analgesia. Any preoperative investigations should be based on history and examination and should only be performed if they can provide information that will influence the patient’s perioperative care.
In this case the preoperative visit is likely to be largely for reassurance and to discuss options for anaesthesia and analgesia. ‘Routine’ investigations, e.g. U&Es, ECG, and CXR will be extremely unlikely to provide information that will alter the perioperative management. However, women of child-bearing age may be anaemic and, therefore, the haemoglobin (Hb) concentration may be measured.
Summarizing data
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
This chapter covers frequency, histograms, means and standard deviations. A variable has different values for different menders of the population, e.g. Whether people smoke, how many children they have, their height. Qualitative variables have no numerical value, e.g. whether people smoke. Quantitative variables have numerical value and may be discrete, with only a few possible values, e.g. how many children, or continuous, being able to take any value within a range, e.g. height. A set of observations of a variable form a distribution. A frequency is the number of times a particular value occurs. A frequency distribution is the set of frequencies for all possible values. For continuous variables we divide the scale into class intervals and find the frequency for each interval. A frequency distribution may be graphed as a histogram, a frequency5
General questions
Authors: Bland Martin , Peacock Janet 
Published: November 2023

Abstract
In this chapter there is no particular theme or body of material to be covered. Instead, we look at several research papers from start to finish. We have not attempted to reproduce the papers in full but have precise the key points. Many issues of study design, analysis and interpretation are revised. We are grateful to the authors of the five papers in this chapter for agreeing that we could make extensive quotations from their work.
Antenatal emergencies
Authors: Neuberg Roger 
Published: November 2023

Abstract
Severe intractable vomiting of all ingested fluids and solids is now a relatively uncommon problem in early pregnancy. Dehydration, ketosis, and weight loss are early consequences of the condition. If left untreated there is the risk of rapid deterioration. Exceedingly rarely, liver failure, jaundice, and polyneuritis can develop, until finally the continued starvation leads to encephalopathy and death in coma.
Objectives of stroke care
Authors: Ebrahim Shah , Harwood Rowan 
Published: November 2023

Abstract
Are epidemiological ideas and methods of any use to the clinician? Epidemiology is a major tool for public health tasks of monitoring the population’s health, assessing needs, prevention, and commissioning services. Such work may seem remote from the day-to-day work of looking after stroke patients, but should provide a broader context within which the effects of clinical activity can be understood. Increasingly, clinicians are expected to be involved in the commissioning and evaluation of services, and to be aware of the wider health and social consequences of their decisions.
Prevention
Authors: Ebrahim Shah , Harwood Rowan 
Published: November 2023

Abstract
It is better to be healthy than to be ill or dead. That is the beginning and the end of the only real argument for preventive medicine. It is sufficient.(Rose 1992) The idea of prevention is attractive, but preventative interventions must still be judged by the same criteria as any others. They must be effective, affordable, acceptable, humane, accessible, and equitable. Indeed, the target population will be more or less healthy, so evaluation should be even more stringent than usual. The costs of prevention in terms of resources, time, inconvenience, and changes to life style must be carefully weighed against likely benefits. Failure to do this may lead to poor prioritization, and lack of understanding of important motivational factors will lead to poor compliance and reduced effectiveness.
Preventing recurrence
Authors: Ebrahim Shah , Harwood Rowan 
Published: November 2023

Abstract
One in five strokes is a recurrent stroke (Jorgensen et al. 1997), and someone who has had a first stroke is at tenfold increased risk of another. Secondary prevention attempts to reduce the risk of recurrence, and it makes sense to target people who have already had a stroke or TIA as these individuals, with high baseline risk, stand to gain most. The distinction between primary and secondary prevention is not clear-cut (see Chapter 8). Many patients with apparent TIAs can be shown to have infarcts on neuroimaging, and prognostically TIAs and minorischaemic cortical strokes behave similarly (Dennis et al. 1989a). All the risk factors for stroke described in Chapter 3 are likely to remain determinants of increased risk after a TIA or stroke. However, most evaluations of secondary prevention have not been concerned with reducing modifiable risk factors (e.g. alcohol use, smoking, physical inactivity) but have studied pharmacological interventions-anticoagulation, antiplatelet drugs, antihypertensives-and carotid surgery. A change in this emphasis might be of benefit, although trials of life-style modification are more challenging to conduct than drug trials.
Mortality
Authors: Ebrahim Shah , Harwood Rowan 
Published: November 2023

Abstract
Why should doctors bother to understand the pattern and predictors of death after a stroke? Knowing when death is most likely and what causes it should help decide where to concentrate effort and lead to innovations in treatment. Perhaps the devastating nature of some strokes leads doctors to feel that death is not a bad outcome, and indeed preferable to a lengthy period of rehabilitation leading to a nursing home bed. This gloomy outlook is far from the truth for the majority of patients (see Chapter 15). Information about prognosis is useful for the following reasons: patients and relatives need information to plan their lives; to permit triage of patients with different prognoses, thus allowing rationing of resources and balanced comparisons in treatment trials; to permit triage of patients with different prognoses, thus allowing rationing of resources and balanced comparisons in treatment trials; to identify patients with a poor prognosis who may benefit from special efforts, including palliative care; to find predictors of poor prognosis that may be amenable to change, and thus possibly improve prognosis.
Recovery
Authors: Ebrahim Shah , Harwood Rowan 
Published: November 2023

Abstract
Giving a prognosis for recovery is of obvious importance to patients and relatives. Prognostic information is also needed for deciding who should continue to have rehabilitation and should help in planning services and policy. Highlighting the problems of patients who make a poor recovery should make us look for new solutions and treatments. Indicators of recovery may also be used as a yardstick to audit the work done during rehabilitation.