bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progressive, Cutaneous Nodules in an Immunocompromised Patient
Authors: Fida Madiha , Abu Saleh Omar M. 
Published: January 2022

Abstract
Mycobacterium chelonae is one of the rapidly growing nontuberculous mycobacteria. It can cause localized and disseminated cutaneous infections, especially in immunocompromised individuals. Cutaneous lesions are typically painful and nodular, and they present most commonly on the lower extremities. Diagnosis of M chelonae infection is made by culturing the organism from the tissue biopsy specimen. Treatment generally depends on the location and severity of the infection and the underlying immune status of the patient. Treatment typically is a course of combination therapy with 2 to 4 agents, followed by several months’ therapy with 1 to 2 agents. Tobramycin is the aminoglycoside of choice.
Cutaneous Clue to a Fever of Unknown Origin
Authors: Sia Irene G. , Wieland Carilyn N. 
Published: January 2022

Abstract
Sweet syndrome is an uncommon inflammatory disorder with main features of fever, edematous and reddish plaques, neutrophilia, and the histologic finding of diffuse dermal neutrophilic infiltrates. Patients with Sweet syndrome may have multisystem involvement with neutrophilic infiltration of other organs, and Sweet syndrome may affect the joints, gastrointestinal system, and central nervous system. The 2 major diagnosis criteria are 1) acute onset of painful, tender, and erythematous plaques or nodules and 2) histopathologic evidence of neutrophilic dermal infiltrates without vasculitis. First-line therapy for Sweet syndrome is systemic corticosteroids, which will promptly improve symptoms and skin lesions.
Phronesis (Practical Wisdom)
Authors: Kroll Jerome , Mason Perry C. 
Published: January 2022

Abstract
Phronesis, classically defined by Aristotle as knowledge of what is good and what is bad for humans, is best understood as practical wisdom, that is, the wisdom of action. The main difficulties in possessing phronesis and acting on it are that both human goods and ills come in degrees (so that it is hard to tell how much of the one is enough and how much of the other is too much) and that the goods frequently compete with each other (so that it is hard to determine which to pursue at the expense of the other). In the end, phronesis amounts to sound judgment and intuition in identifying the specific goods to be pursued and the ills to be combated in a given context. In the context of psychiatric practice, the goods and ills must be preeminently those for the patient, mainly the goods of mental health and the ills of mental disorder. But in addition to facing competing goods and subtly varying degrees of goods and ills, the psychiatrist also faces both nonmedical goods and ills and other persons to be taken into account—family members, translators, and consultants, sometimes embodying cultural attitudes different from those of the psychiatrist, as well as such nonpersons as their clinics or health maintenance organizations, insurance companies, and governmental agencies. A look at several cases of community psychiatric practice reveals the complexities that require seasoned phronesis for successful treatment.
Gratitude
Authors: Jans-Beken Lilian 
Published: January 2022

Abstract
Gratitude has been omnipresent in religious, spiritual, and philosophical ideologies since ancient times. All these ideologies believed that gratitude contributes to the well-being of individuals, to strong relationships between people, and to societal cohesion, and it is seen as an essential part of living a meaningful life. In positive psychology, gratitude is viewed as a general tendency to recognize small to large benefits, to experience sufficiency, and to acknowledge anything in the world, both human and nonhuman, with grateful emotion; expression of this emotion promotes one’s own well-being and the well-being of others; also called mature gratitude. An important aspect of mature gratitude as a contributor to well-being is the ability to be grateful for broken belongings, hurtful people, or any other kind of adversity. Health and well-being cannot be understood merely by analysis of the individual psychopathological symptoms but by the synthesis of all domains of mental health, each of which is associated with gratitude: physical well-being, psychological well-being, and social well-being. Gratitude contributes more or less to each of these areas. In clinical practice, gratitude can play a positive role regarding several diagnoses, including burnout, addiction, chronic pain, and bereavement. This chapter illustrates the effect gratitude has on the mental health of people with these serious conditions. Mature gratitude plays a vital role in preventing people from experiencing depression, anger, and anxiety because of suffering. It teaches people a better and more adaptive way to embrace their hardship.
Key considerations for continuing professional development and specialization
Authors: Neubeck Lis , Jones Jennifer , Uchmanowicz Izabella , Koob Sue , Jennings Catriona , Lira María Teresa , Ingram Shirley , Fitzsimons Donna 
Published: January 2022

Abstract
Nurses are on a lifelong learning journey. The Association of Cardiovascular Nursing and Allied Professions Core Curriculum for the Continuing Professional Development of Nurses Working in Cardiovascular Settings provides a ‘map’ to guide learning. Although there are challenges in defining what a clinical nurse specialist and advanced nurse practitioner are, advanced nursing practice must be ‘grounded in direct care or clinical work’ and requires additional and ongoing education beyond initial qualification. Continuing professional development is essential to increase skills, and is widely endorsed as an essential part of every nurse’s role. It is therefore critical that we work together as a team to best deliver patient- and family-centred care. Nurses exist as part of a skilled transdisciplinary team which is fostered by mutual trust, positive working relationships, and clear roles and responsibilities. Learning in, and on, practice is an important part of professional development. Skilled reflection is important for nurse leaders, who need to be able to reflect on how a team works together to improve patient- and family-centred care. Developing new nursing leaders is critical to the future success of healthcare. It is important for nursing staff at all levels to build effective nursing leadership skills such as team leadership and compassionate leadership, among others, for better clinical care and patient safety outcomes every day in nursing practice. Professional societies and associations such as the Association of Cardiovascular Nursing and Allied Professions provide an important support for lifelong learning and development of core skills.
Nursing assessment and care planning in the context of cardiovascular care
Authors: Lambrinou Ekaterini , Carroll Diane L. , Blanchard Howard T. , Kletsiou Eleni , Astin Felicity , Woolley Alison , Tillman Jo , Leal Ricardo , Cervera-Jackson Rosie 
Published: January 2022

Abstract
Nursing assessment addresses health promotion, prevention of illness, and the nursing care of ill people. It identifies immediate and future responses to potential and actual health problems of the cardiovascular patient. Care planning aims to address problems with collaborative goals identified by the cardiovascular patient. A physical examination is an essential part of comprehensive nursing assessment providing a wealth of information about the patient. The early detection of clinical deterioration is a key component in the care quality and safety agenda. The initial assessment in an acute care setting reviews the reason for seeking care and determines adequate ventilation and perfusion to identify the need for early intervention. Recognition of deterioration using appropriate track and trigger tools outlined in hospital policies allows nurses to identify the need for escalation of care. Timely management of deterioration of patients in emergency situations is facilitated by effective communication with specialist teams with intensive care skills. A comprehensive, holistic assessment using a patient-centred approach is completed after the initial assessment to gather further data for care planning. Nurses use their clinical knowledge and reasoning to make judgements that identify problems that are responsive to nursing care.
Care of the patient with valvular heart disease
Authors: Norekvål Tone M. , Borregaard Britt , Hansen Tina B. , Rasmussen Trine B. , Lauck Sandra B. 
Published: January 2022

Abstract
Valvular heart disease is associated with significant mortality and morbidity, increased symptoms, and poor quality of life, as well as high rates of hospital readmission. There has been a rapid emergence in the past decade of minimally invasive transcatheter options for patients for high surgical risk patients with valve disease. Acquired valvular heart disease is primarily a disease of ageing and requires an understanding of frailty, as well as pathophysiology, screening, and clinical implications. This is a core competency of cardiovascular nurses who provide care to patients with complex valvular heart disease and are also an integral part of a team-based approach which aims to leverage the strengths and skills of its members to optimize the safety and quality of patient care. Endocarditis is an infection of the endocardial surface involving the heart valves and/or surrounding structures typically caused by bacteria. Close monitoring for early signs of disease progression, inadequate infection control, and complications is essential to prevent clinical deterioration. Patients recovering from infective endocarditis will often have been physically inactive for weeks or months due to diagnostic delay, symptom burden, long-term hospitalization, and postsurgical restrictions. The implications of changes in haemodynamics, the trajectory of heart failure, and the variation in clinical presentation across age groups and pathologies create unique challenges. Effective nursing interventions have the potential to optimize outcomes and support patients and their family.
Cardiovascular prevention and rehabilitation
Authors: Jennings Catriona , Berra Kathy , Hayman Laura L. , Gibson Irene , Jones Jennifer , Atrey Alison , Thompson David R. , Ski Chantal F. , Kerins Mary , Conboy Tara , Neubeck Lis , Gallagher Robyn , Koob Sue 
Published: January 2022

Abstract
There is a global imperative for the prevention of cardiovascular disease which includes primordial, primary, and secondary prevention. Prevention requires a multifactor risk reduction approach because of the multifaceted aetiology of cardiovascular disease. Components of cardiovascular disease prevention include behavioural strategies to encourage the adoption of healthy lifestyle habits (abstaining from tobacco, adopting a cardioprotective diet, achieving optimal physical activity and exercise levels, and achieving a healthy body weight and shape), the use of medications to manage biological risk factors, and strategies to manage psychological conditions such as anxiety and depression. Nurses have an important role to play in the implementation of prevention programmes which, when led by this professional group working in interdisciplinary models with physicians and allied professionals, are successful in reducing total mortality. Risk estimation allows the detection of those at highest risk, so they can be identified for management as a priority. Settings for the delivery of prevention and rehabilitation programmes include hospital-based conventional cardiac rehabilitation and initiatives based in primary care and the community. All have been shown to be successful when all of the components described previously are included. Integrating digital technology can address barriers to participation in programmes and improve adherence. Professional societies, associations, and heart foundations play an important role in supporting healthcare professionals, patients, and caregivers to maximize the effectiveness of prevention initiatives.
Pharmacology for cardiovascular nurses
Authors: Keenan Jan , Khatib Rani , McKee Gabrielle , Ruppar Todd , Wilson Franki 
Published: January 2022

Abstract
Pharmacological therapies are the mainstay in the management of primary and secondary prevention of cardiovascular disease. Nurses have an important role in medicines management in collaboration with professional colleagues, particularly physicians and pharmacists. Training nurses in advanced practice skills in relation to medications can improve post-acute event care. Approaches to nursing and allied health professional prescribing are described in three different ways, referred to as ‘independent’, ‘supplementary’, and ‘dependent’ prescribing. Up to half of patients prescribed medication for long-term conditions are not adherent to their prescribed regimen. It is important for nurses to identify the reason for non-adherence before attempting to implement strategies to address it. In cases of intentional non-adherence, it is essential to address patients’ beliefs or concerns, or advocate for the patient to have the treatment plan modified to an approach that fits the patient’s needs. Medications used in cardiovascular care include lipid-lowering agents, anticoagulants, antiplatelets, antiarrhythmics, new drugs to treat diabetes with cardiovascular benefits, drugs used to promote tissue perfusion, drugs that affect the renin–angiotensin–aldosterone system, beta-blockers, calcium channel blockers, and those used in emergencies and cardiogenic shock.
Endocrinology and Evolution
Authors: Danks Janine A. , Richardson Samantha J. 
Published: January 2022

Abstract
Molecular biology advances have assisted comparative endocrinology. Previously the characterization of hormones in ‘lower’ vertebrates relied upon biological assays and protein chemistry, whereas now genes are readily revealed in whole genome sequences, and specific antibodies and other reagents for sensitive assays can rapidly be developed, enabling revealing physiological experiments. Comparative endocrinology only became a special field in the last 50 years as endocrinologists concentrated on rodents as their preferred animal model. In the past many of the known hormones were originally identified in ‘lower’ vertebrates. Two paradigmatic examples of the value of comparative endocrinology will be highlighted. Calcium regulating factors, both hypercalcaemic and hypocalcaemic, will be discussed before thyroid hormones. Both groups of hormones are essential for human life during development and in adulthood, and pivotal insights have been gained from non-mammalian vertebrates.
Hypopituitarism
Authors: Levy Miles J. , Bhake Ragini , Reddy Narendra 
Published: January 2022

Abstract
Hypopituitarism is the consequence of diseases or interventions resulting in deficiency of pituitary hormones. Pituitary hormone replacement is one of the most frequent clinical interventions in pituitary disease, yet is rarely been the subject of rigorous scientific evaluation. With the exception of growth hormone, anterior pituitary hormones are replaced with target hormones (sex steroids, cortisol, and thyroxine), in preference to pituitary trophic hormones, as the former have longer half-lives allowing for oral administration. The precise reason for increased morbidity and mortality associated with hypopituitarism is unclear, but underlines the importance of replacing hormones close to physiological patterns. In an era of ‘evidence-based’ medicine, recommendations are frequently based on clinical experience, consensus guidelines, and retrospective reviews rather than on randomized trials. Within these limitations, this chapter will attempt to give a balanced view on current best practice for replacement therapy in adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), and gonadotrophin deficiency.
Pituitary Radiotherapy
Authors: Fersht Naomi , Soldà Francesca 
Published: January 2022

Abstract
Pituitary adenomas are usually benign intracranial tumours accounting for about 10 to 15% of all intracranial malignancies. They are managed with a combination of surgery, medical therapy, and radiotherapy to control symptoms related to mass-effect and hypersecretion of hormones. Trans-sphenoidal surgery is the standard initial approach in the majority of patients and provides long-term local and hormonal control in completely excised lesions. Radiotherapy is indicated in progressive residual and recurrent adenomas, or in lesions not amenable for surgery or medical treatment. Radiotherapy achieves local tumour control rates of over 90% in most series. In secreting tumours, hormonal control is attained after radiotherapy in the majority of patients, independent of the secreting tumour subtype. Modern radiotherapy techniques allow the delivery of an effective therapeutic dose to the tumour while permitting a substantial reduction in the amount of dose to the surrounding healthy brain, limiting the risk of treatment-related long-term complications.
Thyrotropinomas
Authors: Gurnell Mark , Koulouri Olympia , Bashari Waiel 
Published: January 2022

Abstract
Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas (thyrotropinomas) are a rare but important cause of hyperthyroidism. Recent studies point to a higher incidence than previously suspected, with a greater proportion of microadenomas. This is likely to reflect, at least in part, the increased use of combined free hormone and TSH measurements to screen for thyroid dysfunction, coupled with improvements in modern magnetic resonance (MR) imaging. The latter has allowed the detection of smaller tumours, but at the same time carries the risk of identifying pituitary incidentalomas that are then falsely identified as the cause of hyperthyroxinaemia with non-suppressed TSH. Accordingly, a systematic approach (combining clinical, biochemical, radiological, and genetic investigations) is required to ensure a robust diagnosis. For most patients transsphenoidal surgery remains the preferred treatment, with somatostatin analogues (SSAs) used to facilitate safe surgery (by normalizing thyroid hormone levels) and as adjunctive therapy when complete surgical resection is not possible. However, emerging data suggests that primary SSA therapy alone is a reasonable option for some patients. Radiotherapy is generally reserved for aggressive (especially SSA resistant) tumours.
Pituitary Carcinoma
Authors: McCormack Ann 
Published: January 2022

Abstract
Pituitary carcinomas (PC) are very rare, comprising just 0.2% of all pituitary tumours, but have a high mortality rate. Diagnosis of PC requires the documentation of craniospinal or systemic metastases. PC are thought to arise from a multistep genetic progression from a benign pituitary tumour. Certain subtypes of pituitary adenoma, such as silent corticotroph adenoma and plurihormonal PIT-1 positive adenomas, present a higher risk of aggressive behaviour. Clinical features such as the emergence of resistance to medical therapy or rapid tumour growth may also herald malignant transformation. PC frequently have an elevated Ki67 index (&gt;3%), p53 overexpression, and increased mitotic activity, but the prognostic use of these histopathological markers is limited. The management of PC is challenging and requires a multimodal approach involving surgery, radiotherapy, and medical therapy. Temozolomide is used as first-line chemotherapy. Emerging second-line treatments include targeted therapies such as vascular endothelial growth factor (VEGF) inhibition and immunotherapy.
Pineal Physiology and Pathophysiology, Including Pineal Tumours
Authors: Webb Susan M. , Aulinas Anna , Colom Cristina , Barahona María-José 
Published: January 2022

Abstract
Pineal physiology and tumours are briefly summarized in this chapter. The main pineal hormone melatonin is secreted at night and entrains endogenous rhythms to the environment. Melatonin deficiency has been associated to sleeping disorders, behavioural problems, and abnormal puberty, while its excess has been described in hypogonadotropic hypogonadism. Outcome after diagnosis of a pineal tumour have improved in the last decades after better understanding of the natural history of these tumours, neurosurgical experience, use of chemotherapy, and current irradiation techniques. The low prevalence of these pineal tumours has prevented any large prospective multicentre international studies aimed at identifying optimal management. The most recent World Health Organization (WHO) classification of central nervous system tumours published in 2016, defines molecular parameters as well as histology to classify these tumour entities, formulating a molecular diagnosis for these tumours.
Thyroid Function Tests and the Effects of Drugs
Authors: Feldt-Rasmussen Ulla 
Published: January 2022

Abstract
Analytical improvements of thyroid function tests have dramatically improved the management of thyroid disorders. This applies to total and free thyroid hormones, thyrotropin (TSH), relevant antibodies against thyroid antigens (thyroglobulin, thyroperoxidase, and TSH receptor), thyroglobulin, and binding proteins. Despite these improvements there are still many challenges for the clinicians to be aware of while interpreting thyroid function variables. Some are related to thyroid hormones being bound to plasma proteins, all liable to changes by physiological, pathophysiological, and methodological factors. Total hormone concentrations, considered methodologically most robust, become flawed and the active free hormones then most often used. These are also influenced by binding protein abnormalities and other interfering factors (drugs and reagent antibodies), and thus very often puzzle the clinician. TSH methods are more reliable and easier standardized among laboratories, but not sufficient as sole variable of thyroid function. The area still calls for laboratory improvements to aid clinicians.
Epidemiology of Thyroid Disease and Swelling
Authors: Vanderpump Mark P.J. 
Published: January 2022

Abstract
The manifestations of thyroid diseases vary and are determined by iodine intake. Almost one-third of the world’s population live in areas of iodine deficiency. Iodine deficiency is an emerging issue in industrialized countries, previously thought of as iodine sufficient. In iodine-replete areas, most persons with thyroid disorders have autoimmune disease. In women the prevalence of hypothyroidism is 1–2% and hyperthyroidism is 0.5–2%, and both are ten times more common than in men. Approximately 5% of women and 1% of men have thyroid nodules detected clinically and the frequency increases with age and in iodine-deficient populations. Congenital hypothyroidism occurs in one in 3500 to 4000 births and justifies screening in heel-prick blood specimens. A substantial proportion of healthy subjects screened have evidence of mild thyroid dysfunction, with approximately 10% with subclinical hypothyroidism and 1% with subclinical hyperthyroidism. No appropriately powered prospective, randomized, controlled, double-blinded interventional trial for subclinical thyroid disease exists.