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1
Tagi tote e loto haaku =: My heart is crying a little : Niue Island involvement in the great war, 1914-1918. Alofi, Niue: Government of Niue, 2000.
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2
Platt, Stephen. Heard or ignored: Tenant involvement in housing associations. London: National Federation of Housing Associations, 1987.
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Cesal, Barbara P. Heart to Heart for Primary Grades: Family Involvement in Primary Reading. Innovative Learning, 1993.
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Popova, Svetlana, and Jürgen Rehm. Substance Involvement and Physical Health. Edited by Kenneth J. Sher. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199381708.013.13.
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Substance use, mainly defined as the consumption of alcohol, tobacco, and illegal drugs, is a major risk factor for disease, disability, and mortality. Alcohol consumption can cause a number of chronic diseases, including several types of cancer, diseases of the gastrointestinal tract, various cardiovascular diseases, alcohol use disorders and infectious diseases, such as tuberculosis and pneumonia. Certain patterns of light moderate drinking, without heavy drinking occasions, may incur a protective effect on ischemic disease categories and diabetes. Finally, alcohol has been established as a causal factor for unintentional and intentional injury. Illegal drug use has been mainly linked to four health outcomes: overdose and other injury, noncommunicable diseases, certain mental disorders, and infectious diseases. In the final section, a comprehensive list of diseases attributable to tobacco smoking is provided, and the most important selected medical conditions are described. These include lung cancer, chronic obstructive pulmonary disease, and ischemic heart disease.
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Hagendorff, Andreas. Cardiac involvement in systemic diseases. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0020.
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Systemic diseases are generally an interdisciplinary challenge in clinical practice. Systemic diseases are able to induce tissue damage in different organs with ongoing duration of the illness. The heart and the circulation are important targets in systemic diseases. The cardiac involvement in systemic diseases normally introduces a chronic process of alterations in cardiac tissue, which causes cardiac failure in the end stage of the diseases or causes dangerous and life-threatening problems by induced acute cardiac events, such as myocardial infarction due to coronary thrombosis. Thus, diagnostic methods—especially imaging techniques—are required, which can be used for screening as well as for the detection of early stages of the diseases. Two-dimensional echocardiography is the predominant diagnostic technique in cardiology for the detection of injuries in cardiac tissue—e.g. the myocardium, endocardium, and the pericardium—due to the overall availability of the non-invasive procedure.The quality of the echocardiography and the success rate of detecting cardiac pathologies in patients with primary non-cardiac problems depend on the competence and expertise of the investigator. Especially in this scenario clinical knowledge about the influence of the systemic disease on cardiac anatomy and physiology is essential for central diagnostic problem. Therefore the primary echocardiography in these patients should be performed by an experienced clinician or investigator. It is possible to detect changes of cardiac morphology and function at different stages of systemic diseases as well as complications of the systemic diseases by echocardiography.The different parts of this chapter will show proposals for qualified transthoracic echocardiography focusing on cardiac structures which are mainly involved in different systemic diseases.
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Ogbunugafor, Fanny. MY HEART BEATS FAST AND MY STOMACH HURTS: A True Story of Parental Involvement in Education. AuthorHouse, 2004.
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7
Elliott, Perry, and Giuseppe Limongelli. Cardiac Aspects of INHERITED METABOLIC DISEASES. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0070.
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More than 40 inherited metabolic disorders cause heart disease, including fatty acid oxidation defects, glycogen storage disorders, lysosomal storage disorders, peroxisomal diseases, mitochondrial cytopathies, organic acidemias, aminoacidopathies, and congenital disorders of glycosylation. The pattern and severity of cardiac involvement varies between disorders but includes congenital heart diseases, heart muscle diseases, arrhythmias and sudden death, and heart failure. The majority of IMDs are multisystem diseases, but in a few cases cardiac disease is the predominant clinical feature and the main determinant of prognosis. For an increasing number of IEMs there are specific therapies designed to treat or ameliorate the effects of the underlying metabolic defect. In some cases, these therapies have an important effect on the progression of cardiac disease.
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Schmidt, Jens. Extramuscular complications occurring in myositis. Edited by Hector Chinoy and Robert Cooper. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198754121.003.0004.
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Extra-muscular complications affecting patients suffering from the idiopathic inflammatory myopathies (IIM) are common, and appear in recognizable patterns affecting the skin, lungs, joints, oesophagus or heart, although these complications rarely all occur simultaneously. During the initial presentation of symptoms, involvement of organs other than muscle can aid the confirmation of the correct IIM subtype. Extra-muscular manifestations can be severe and life-threatening, e.g. with respiratory or cardiac involvement. Escalations of immunosuppression and other treatment modalities will likely be required in such cases since standard immunosuppression usually is not sufficient for an effective treatment of e.g. interstitial lung disease. IIM patients should therefore be regularly checked for extra-muscular manifestations, and management altered as appropriate.
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Lancellotti, Patrizio, and Bernard Cosyns. Systemic Disease and Other Conditions. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0017.
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This chapter describes the effect of various activities on the heart and associated disorders. It details the echocardiographic findings of athlete’s heart and differential diagnosis. It considers pregnancy which induces several haemodynamic changes: increase in heart rate, stroke volume, cardiac output, and decrease in systemic vascular resistance. Several echocardiographic changes may also present in normal pregnancy and these must be recognized. Echocardiography should be performed in each pregnant woman with cardiac signs or symptoms to search for new cardiac disease occurring during pregnancy and especially peripartum cardiomyopathy. Pregnancy is well tolerated by most woman with cardiac disease. Pregnancy in contraindicated in woman with pulmonary hypertension. Although the heart is not the principal affected organ in systemic disease there is some involvement. This chapter also details the echo findings of a range of systemic diseases including amyloidosis, connective tissue disease, endocrine disease, and HIV.
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Bass, Cristina, Barbara Bauce, and Gaetano Thiene. Arrhythmogenic right ventricular cardiomyopathy: diagnosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0360.
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Arrhythmogenic cardiomyopathy is a heart muscle disease clinically characterized by life-threatening ventricular arrhythmias and pathologically by an acquired and progressive dystrophy of the ventricular myocardium with fibrofatty replacement. The clinical manifestations of arrhythmogenic cardiomyopathy vary according to the ‘phenotypic’ stage of the underlying disease process. Since there is no ‘gold standard’ to reach the diagnosis of arrhythmogenic cardiomyopathy, multiple categories of diagnostic information have been combined. Different diagnostic categories include right ventricular morphofunctional abnormalities (by echocardiography and/or angiography and/or cardiovascular magnetic resonance imaging), histopathological features on endomyocardial biopsy, electrocardiogram, arrhythmias, and family history, including genetics. The diagnostic criteria were revised in 2010 to improve diagnostic sensitivity, but with the important prerequisite of maintaining diagnostic specificity. Quantitative parameters have been put forward and abnormalities are defined based on the comparison with normal subject data. A definite diagnosis of arrhythmogenic cardiomyopathy is achieved when two major, or one major and two minor, or four minor criteria from different categories are met. The main differential diagnoses are idiopathic right ventricular outflow tract tachycardia, myocarditis, sarcoidosis, dilated cardiomyopathy, right ventricular infarction, congenital heart diseases with right ventricular overload, and athlete’s heart. Among diagnostic tools, contrast-enhanced cardiovascular magnetic resonance is playing a major role in detecting subepicardial-midmural left ventricular free wall involvement, even preceding morphofunctional abnormalities. Moreover, electroanatomical mapping is an invasive tool able to detect early right ventricular free wall involvement in terms of low-voltage areas. Both techniques are increasingly used in the diagnostic work-up although are not yet part of diagnostic criteria.
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Caplan, Lisa. Mediastinal Mass Biopsy. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0037.
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Anterior mediastinal masses (AMMs) comprise a heterogeneous collection of neoplasms. The mass effect of these neoplasms can compress the trachea, main stem bronchi, heart, or large vessels. Preoperative anesthetic plans should consider presenting signs, symptoms, and cardiopulmonary involvement to help risk stratify and select the proper airway technique and sedation plan. This chapter will enable readers to identify signs and symptoms that contribute to the pathophysiology of children who present with AMMs, perform a risk assessment of patient symptomatology, design a perioperative care plan, and risk stratify patients and procedures to determine appropriate anesthetic and airway techniques.
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Levy, David. Macrovascular complications, hypertension, and lipids. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198766452.003.0008.
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Premature vascular disease is common in Type 1 diabetes, especially in women and those with long duration. Many studies have identified early vascular involvement, using carotid Doppler and coronary artery calcification. Symptoms of coronary heart disease are often absent or muted, and the best methods for identifying occult coronary heart disease in Type 1 patients are not known. The concept of ideal cardiovascular health is valuable in planning preventive lifestyle and medical interventions. ‘Essential’ hypertension in young Type 1 patients is common, and reflects increased arterial stiffness. Hypertension is invariable in patients with any degree of albuminuria or renal impairment. Statin treatment in patients over 40 years old is recommended, but the evidence base is weak. Statins and ezetimibe are the only agents of prognostic value currently available for prevention of vascular events. Primary prevention with aspirin needs individual assessment. Insulin resistance/metabolic syndrome is frequent in Type 1 diabetes.
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Moreau, Anne-Sophie, Raphaël Favory, and Alain Durocher. Special considerations in the immunosuppressed patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0075.
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Because of improved treatment of haematological malignancies, autoimmune diseases, and HIV infection, an increasing number of patients are being immunocompromised. Immunosuppression varies according to the underlying disease, and different patterns of complications may be encountered. Among the complications of immunosuppressive treatments, infectious diseases are the most frequently encountered, but drug-related toxicities and secondary neoplasias have to be recognized. Making a rapid diagnosis is the most important step in taking these patients in charge. In such setting, cardiac involvement is severe and often leads to admission to intensive care units. This chapter will focus on the cardiac complications of immunosuppression, from heart transplantation to HIV treatment-related toxicity and cardiac infections.
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Lynch, Bernadette, and Aine Burns. The patient with scleroderma. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0165.
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Scleroderma is tightness, thickening, and non-pitting induration of skin. Two forms of the skin disease are described. Limited cutaneous systemic sclerosis (lcSSc) which occurs distal to the wrists (or ankles) and/or over the face and neck, often associated with longstanding Raynaud’s phenomenon, and diffuse cutaneous systemic sclerosis (dcSSc) where truncal as well as acral skin involvement occurs as well as tendon friction rubs. In this latter condition the onset of the skin changes occurs within 1 year of onset of Raynaud’s phenomenon; however, the skin involvement may precede onset of vascular symptoms.The skin manifestations are the outward manifestation of a systemic disease, systemic sclerosis. Lung, heart, and gut involvement are frequent. Scleroderma renal crisis, usually presenting as accelerated hypertension and acute kidney injury, is one of the most severe complications of this disease. Autoantibodies against RNA polymerase are associated with scleroderma renal crisis. It occurs in 12% of dcSSc and 2% of lcSSc patients (men and women) and carries a high morbidity and mortality although careful supportive care and blood pressure management using angiotensin converting enzyme inhibitors (ACEI) or angiotensin-II receptor blockers have improved short-term outcomes. In general, beta blockers should be avoided in the early management.Approximately two-thirds of patients require dialysis, of these many recover enough function to come off dialysis. Higher blood pressure and younger age at presentation have a better prognosis. ACEIs should be continued even after dialysis is established as the latter increases the chance of late recovery. Average time to coming off dialysis is 11 months but recovery is uncommon after 24 months. After a crisis renal function continues to improve for several years.
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Ruiz-Villalba, Adrián, Nikolaos Frangogiannis, and José Maria Pérez-Pomares. Origin and diversity of cardiac fibroblasts: developmental substrates of adult cardiac fibrosis. Edited by José Maria Pérez-Pomares, Robert G. Kelly, Maurice van den Hoff, José Luis de la Pompa, David Sedmera, Cristina Basso, and Deborah Henderson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757269.003.0012.
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Cardiac connective tissues are primarily formed by cardiac fibroblasts (CF) of diverse embryonic origins. Whereas CF specific roles in cardiac morphogenesis remain under-researched, their involvement in adult cardiac fibrosis is clinically relevant. Cardiac fibrosis is a common element of several chronic cardiac conditions characterized by the loss of ventricular wall mechanical function, ultimately driving to heart failure. In the ischaemic heart early reparative fibrosis evidences the very restricted regenerative potential of the myocardium. In non-ischaemic diseases fibrosis is activated by unknown signals. We summarize current knowledge on the origin of CFs and their developmental roles, and discuss the differential disease-dependent response of different CF subpopulations to various pathological stimuli. We also describe the characteristic cell-cell and cell-matrix interactions that determine the fibrotic remodelling of the myocardium. We analyse experimental models for the study of cardiac fibrosis, and suggest future directions in the search for new markers and therapeutic targets.
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Deen, Jason F., and Karen K. Stout. Causes and diagnosis of valvular problems. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0158.
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While valvular heart disease encountered in developing countries is primarily rheumatic in aetiology, in industrialized countries it is largely comprised of degenerative valvular disease. Although less prevalent than ischaemic heart disease, its prevalence increases with older age and increased life expectancy, and therefore represents significant disease burden in aging populations. Transthoracic echocardiography remains the imaging modality of choice for timely delineation of the anatomy and severity of the lesion,although, once identified, may not correlate with symptoms due to clinical latency of disease onset to disease manifestation. Variations of disease severity, which may not meet criteria for intervention, lead to chronicity of disease, while clinically silent lesions may remain undiagnosed—both of these situations may lead to acute illness requiring intensive care management. Stabilization through medical intervention may be required, although many patients with severe disease will need emergent surgical repair, therefore collaborative involvement between intensivists, cardiologists, and cardiovascular surgeons is needed to minimize patient mortality and morbidity.
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Arbustini, Eloisa, Valentina Favalli, Alessandro Di Toro, Alessandra Serio, and Jagat Narula. Classification of cardiomyopathies. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0348.
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For over 50 years, the definition and classification of cardiomyopathies have remained anchored in the concept of ventricular dysfunction and myocardial structural remodelling due to unknown cause. The concept of idiopathic was first challenged in 2006, when the American Heart Association classification subordinated the phenotype to the aetiology. Cardiomyopathies were classified as genetic, acquired, and mixed. In 2008, the European Society of Cardiology proposed a phenotype-driven classification that separated familial (genetic) from non-familial (non-genetic) forms of cardiomyopathy. Both classifications led the way to a precise phenotypic and aetiological description of the disease and moved away from the previously held notion of idiopathic disease. In 2013, the World Heart Federation introduced a descriptive and flexible nosology—the MOGE(S) classification—describing the morphofunctional (M) phenotype of cardiomyopathy, the involvement of additional organs (O), the familial/genetic (G) origin, and the precise description of the (a)etiology including genetic mutation, if applicable (E); reporting of functional status such as American College of Cardiology/American Heart Association stage and New York Heart Association classification (S) was left optional. MOGE(S) is a bridge between the past and the future. It allows description of comprehensive phenotypic data, all genetic and non-genetic causes of cardiomyopathy, and incorporates description of familial clustering in a genetic disease. MOGE(S) is the instrument of precision diagnosis for cardiomyopathies. The addition of the early and unaffected phenotypes to the (M) descriptor outlines the clinical profile of an early affected family member; the examples include non-dilated hypokinetic cardiomyopathy in dilated cardiomyopathy and septal thickness (13–14 mm) in hypertrophic cardiomyopathy classes.
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Vester, Udo, and Stefanie Weber. Townes–Brocks syndrome. Edited by Adrian Woolf. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0359.
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Townes–Brocks syndrome (TBS) is an autosomal dominant disease with variable expression. Classical features are imperforate anus, dysplastic ears with congenital hearing deficit, and triphalangeal thumbs in most cases. A variety of other malformations (renal, genitourinary, heart, central nervous system, eyes) or hypothyroidism has been described. Mutations in SALL1 have been identified in patients with TBS and genetic testing allows confirmation of the diagnosis. Familiar and sporadic forms (caused by de novo mutations) seem to be equally distributed. Renal involvement in TBS is not uncommon and includes renal agenesis, hypo-/dysplasia, and renal cysts and may eventually lead to chronic renal failure. As renal function may not deteriorate before adulthood, renal function should be monitored in all patients. As cases with TBS can be oligosymptomatic, TBS should be suspected in every case with unexplained renal failure, minor abnormalities, or indicative family history. Genetic counselling is mandatory in identified cases.
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Thuny, Franck, and Didier Raoult. Pathophysiology and causes of endocarditis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0160.
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Endocarditis is defined as an inflammation of the endocardial surface of the heart. This may include heart valves, mural endocardium or the endocardium that covers implanted material, such as prosthetic valves, pacemaker/defibrillator leads and catheters. Infective and non-infective-related causes must be distinguished. In most cases, the inflammation is related to a bacterial or fungal infection with oral streptococci, group D streptococci, staphylococci and enterococci accounting for 85% of episodes. Infective endocarditis (IE) is a serious disease with an incidence ranging from 30 to 100 episodes/million patient-years. From various portals of entry (e.g. oral, digestive, cutaneous) and a subsequent bacteraemia, pathogens can adhere and colonize intracardiac foreign material or onto previously damaged endocardium due to numerous complex processes based on a unique host–pathogen interaction. Rarely, endocarditis can be related to non-infective causes, such as immunological or neoplastic. Mortality is high, with more than one-third dying within a year of diagnosis from complications such as acute heart failure or emboli. This disease still remains a diagnostic challenge with many cases being identified and subsequently treated too late. Diagnosis of IE usually relies on the association between an infectious syndrome and recent endocardial involvement. Blood cultures and echocardiography are the main diagnostic procedures, but are negative in almost 30% of cases, requiring the use of more sophisticated techniques. Computed tomography, magnetic resonance imaging and positron emission tomography are promising imaging modalities. Improved understanding of its pathophysiology and the development of relevant diagnostic strategies enables accelerated identification and treatment, and thus an improved prognosis.
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Karatasakis, G., and G. D. Athanassopoulos. Cardiomyopathies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0019.
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Echocardiography is a key diagnostic method in the management of patients with cardiomyopathies.The main echocardiographic findings of hypertrophic cardiomyopathy are asymmetric hypertrophy of the septum, increased echogenicity of the myocardium, systolic anterior motion, turbulent left ventricular (LV) outflow tract blood flow, intracavitary gradient of dynamic nature, mid-systolic closure of the aortic valve and mitral regurgitation. The degree of hypertrophy and the magnitude of the obstruction have prognostic meaning. Echocardiography plays a fundamental role not only in diagnostic process, but also in management of patients, prognostic stratification, and evaluation of therapeutic intervention effects.In idiopathic dilated cardiomyopathy, echocardiography reveals dilation and impaired contraction of the LV or both ventricles. The biplane Simpson’s method incorporates much of the shape of the LV in calculation of volume; currently, three-dimensional echocardiography accurately evaluates LV volumes. Deformation parameters might be used for detection of early ventricular involvement. Stress echocardiography using dobutamine or dipyridamole may contribute to risk stratification, evaluating contractile reserve and left anterior descending flow reserve. LV dyssynchrony assessment is challenging and in patients with biventricular pacing already applied, optimization of atrio-interventricular delays should be done. Specific characteristics of right ventricular dysplasia and isolated LV non-compaction can be recognized, resulting in an increasing frequency of their prevalence. Rare forms of cardiomyopathy related with neuromuscular disorders can be studied at an earlier stage of ventricular involvement.Restrictive and infiltrative cardiomyopathies are characterized by an increase in ventricular stiffness with ensuing diastolic dysfunction and heart failure. A variety of entities may produce this pathological disturbance with amyloidosis being the most prevalent. Storage diseases (Fabry, Gaucher, Hurler) are currently treatable and early detection of ventricular involvement is of paramount importance for successful treatment. Traditional differentiation between constrictive pericarditis (surgically manageable) and the rare cases of restrictive cardiomyopathy should be properly performed.
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Waldek, Stephen. Fabry disease. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0336.
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Fabry disease is a rare X-linked lysosomal storage disorder in which deficiency of alpha-galactosidase A leads to accumulation of substrate, mostly globotriaosylceramide, which causes a progressive, multiorgan disease affecting predominantly the kidneys, skin, heart, gut, and nervous system. Painful peripheral (‘acral’) neuropathy is characteristic. The disease is commonly diagnosed in children and young men often after some years of usually neuropathic symptoms, with exacerbations (Fabry crises), that commonly elude diagnosis for a long time. These usually occur years in advance of overt involvement of other organs. Diagnosis may also be suspected from renal biopsy, echocardiographic evidence of cardiomyopathy commonly beginning as left ventricular hypertrophy, or characteristic angiokeratomas typically in ‘bathing trunk’ distribution on skin. Renal manifestations are of proteinuria leading to progressive chronic kidney disease associated with deposits in podocytes. Diarrhoea is common. Disordered sweating is typical. Corneal lesions are also typical and there may be tortuosity of retinal vessels. Strokes are increased in frequency, and sensorineural deafness may occur. Women have fewer and later overt manifestations but some develop severe disease.
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Rimmington, Anthony. Stalin's Secret Weapon. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190928858.001.0001.
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Stalin's Secret Weapon is a gripping account of the early history of the globally significant Soviet biological weapons program, including its key scientists, its secret experimental bases and the role of intelligence specialists, establishing beyond doubt that the infrastructure created by Stalin continues to form the core of Russia's current biological defense network. Anthony Rimmington has enjoyed privileged access to an array of newly available sources and materials, including declassified British Secret Intelligence Service reports. The evidence contained therein has led him to conclude that the program, with its network of dedicated facilities and proving grounds, was far more extensive than previously considered, easily outstripping those of the major Western powers. As Rimmington reveals, many of the USSR's leading infectious disease scientists, including those focused on pneumonic plague, were recruited by the Soviet military and intelligence services. At the dark heart of this bacteriological archipelago lay Stalin, and his involvement is everywhere to be seen, from the promotion of favored researchers to the political repression and execution of the lead biological warfare specialist, Ivan Mikhailovich Velikanov.
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Hurtado-Torres, Sebastián. The Gathering Storm. Cornell University Press, 2020. http://dx.doi.org/10.7591/cornell/9781501747182.001.0001.
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This novel take on diplomatic history examines the involvement of the United States in Chile during the Eduardo Frei administration (1964–1970) and shows how the engagement between the two nations deepened the process of political polarization in Chile. At the heart of the book is a description of the partnership between Frei's government and that of Lyndon B. Johnson. Both leaders considered modernization to be integral to political and economic development, and the U.S. Embassy in Santiago was recognized by all parties to be the center of this modernizing agenda and the practical work of the Alliance for Progress (AFP). The book portrays the diplomatic and economic relationship between Chile and the United States in a manner that departs from the most militant and conservative interpretations of U.S. foreign policy toward Latin America. By focusing on the active participation of agents of U.S. foreign policy—particularly those associated with the AFP—and not secret operatives of the Central Intelligence Agency, the book offers a fresh narrative about a critical period in Chilean political history and a new understanding of the ways and means through which the foreign policy of the United States was carried out.
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Kuypers, Dirk R. J., and Morie A. Gertz. Light-chain deposition disease. Edited by Giuseppe Remuzzi. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0154_update_001.
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Light-chain deposition disease (LCDD) is characterized by extracellular tissue deposition of non-amyloid monoclonal immunoglobulin light chains (predominantly kappa light chains) in various organs including kidneys, heart, and liver. It is a rare cause of renal insufficiency. In two-thirds of cases it is associated with multiple myeloma, while in the remainder their monoclonal B cell proliferation does not meet the criteria for that diagnosis.Renal involvement occurs almost invariably and dominates the clinical course of the disease: greater than 90% of patients with LCDD have renal functional impairment; acute or rapidly progressive kidney failure usually develops over a period of months. Nephrotic-range proteinuria is present in 40–50% of patients while approximately 20% of patients develop nephrotic syndrome. Arterial hypertension and microscopic haematuria can be present. Extrarenal symptoms are related to affected organs with cardiomyopathy, cachexia, haemorrhages, infections, and MM progression as main causes of death.The diagnosis of LCDD is often delayed and whilst bone marrow examination will often identify associated MM, renal biopsy frequently provides the final diagnostic proof. Abnormal light chains can be detected and quantified by serum or urine protein electrophoresis and immunofixation. Quantification of urine and serum free kappa/lambda light chains has proven a useful screening tool and might also plays a role in therapeutic monitoring.Treatment consists of chemotherapy directed against the monoclonal immunoglobulin-producing plasma cells.
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Borch, Fred L. Trials for Mass Murder and Unlawful Executions. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198777168.003.0007.
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Temporary courts-martial heard evidence of “mass murder” and “unlawful executions” carried out by the Japanese during the occupation. The murders were either in retaliation for general resistance to their authority or else because “military necessity” required it. As for unlawful executions, the gist of this offense was that the accused had killed (or had ordered his subordinates to kill) one or more citizens for some alleged crime or misconduct, but that the execution had occurred without any regularly constituted trial or hearing to determine guilt or innocence. This chapter looks at representative cases in both categories. It also looks at the so-called “Haga Plot” and the “Overakker Plot,” in which prominent Dutch officials were executed for their involvement in so-called “anti-Japanese activities.”
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Mallat, Chibli. The Normalization of Saudi Law. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/oso/9780190092757.001.0001.
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Abstract Saudi Arabia has never commanded more attention and yet it remains one of the world’s least understood countries. The book draws on a systematic study of Saudi law over nearly a decade; the author’s involvement as a legal expert in landmark decisions around the world; and his experience as a law professor in leading universities in the Middle East, Europe, and America. The book also reflects his work with law students and practicing colleagues, particularly in commercial cases but also in those involving government and human rights. The Normalization of Saudi Law goes to the heart of Saudi society, politics, and business by exploring the workings of its courts. 
The Normalization of Saudi Law will interest both readers following the fast-changing world of comparative law and those intrigued by Saudi Arabia. Legal practitioners and scholars will find a comprehensive analysis of the law’s operation in the Kingdom. The practitioner will access full thematic coverage of all important fields: judicial organization, contracts and torts, crime, family, property, administration, commerce, companies, banking, insolvency, the stock market, the constitution, succession, and human rights, with major statutes and a large number of court decisions distilled in 16 chapters. The scholar is presented with an assessment of a dynamic legal process, a “normalization” of Saudi law where developing norms are both “normal” (usual) and “normative” (carrying moral force). This includes judges reshaping Islamic law by applying it in everyday transactions and disputes as they interpret classical treatises and modern statutes. The Normalization of Saudi Law paints a compelling picture of a fast-changing country with a unique legal trajectory.
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Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for major abdominal surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0008.
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Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should be avoided. Elderly patients should receive postoperative care in an environment that is appropriate to the degree of comorbidity and the type of surgery. Effective analgesia is known to improve outcome. Only experienced anaesthetists should manage major and emergency abdominal surgery.
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Marinova, Nadejda K. The State Department’s Multidiaspora IdEA Initiative. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780190623418.003.0009.
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The International Diaspora Engagement Alliance (IdEA) was created by the State Department in 2011 to engage individuals from the group of more than 60 million first- and second-generation immigrants in the United States in homeland development and philanthropy. As argued in this chapter, IdEA is an instance of the US government seeking, with an eye to the long term, to build bridges with diaspora communities and their networks in the countries of origin, eventually strengthening linkages with organizations and individuals in the homeland and winning “hearts and minds” supportive of US policy. This multidiaspora initiative is aimed at diaspora involvement in collaborative economic development in the homeland, and at mentoring and development programs. This collaboration between the State Department and select members of the diaspora communities represents an instance of diasporas serving as a bridge with their homelands, and it is an initiative with future potential for the United States.
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DeLapp-Birkett, Jennifer. Government Censorship and Aaron Copland’s Lincoln Portrait during the Second Red Scare. Edited by Patricia Hall. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199733163.013.20.
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Aaron Copland suffered during the Second Red Scare that swept the United States after World War II. When Congressman Fred Busbey announced that the House Committee on Un-American Activities (HUAC) had compiled “a long record of questionable affiliations” proving Copland a “communist sympathizer” or “fellow traveler,” the 1953 Eisenhower inaugural committee cancelled a planned performance of Copland‘s Lincoln Portrait, and the allegations became national news. Copland’s progressive politics of the 1930s, his involvement in the 1949 Waldorf Peace Conference, and his association with the State Department--which some considered dangerously tolerant of homosexuals--made him a target for anti-communism of the Hearst press, the American Legion, the entertainment industry blacklist Red Channels, J. Edgar Hoover’s FBI, and Senator Joseph McCarthy. Copland narrowly escaped “naming names.” Though his public reputation ultimately recovered, in the early years of the Cold War his creative spark and cultural influence were sadly diminished.
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Tladi, Dire D. Presence of the Accused: Right or Duty? Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198810568.003.0008.
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This chapter examines the legal and political debates concerning the presence of the accused during trial in relation to the International Criminal Court’s involvement with the Kenya situation, and the possibility of amending the relevant provision in its Rules to permit suspects to be heard via video-linked testimony. At a micro level this chapter evaluates the interpretation of ‘presence provisions’ of the Rome Statute by the respective chambers of the ICC. At a macro level the chapter is a reflection, through a description of the contestation over presence of the accused, on the role that politics can play in international criminal justice. The chapter gives an overview of the four ICC decisions regarding presence under the Rome Statute. It then goes on to evaluate these decisions given the rules of interpretation while considering the political climate. Finally, it seeks to consider the outcomes of the Assembly of States Parties’ deliberations on presence and offers some concluding remarks.
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Greenland, Thomas H. Jazz Jobbing. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252040115.003.0007.
Full textAbstract:
This chapter examines jazz jobbing professionals' attraction for and attention to jazz, their roles as creative improvisers and co-performers, and their relationships with other jazz scene participants in New York City. It first considers how jazz entrepreneurs meet the challenges of doing business, suggesting that their lifestyle is an outgrowth of their ongoing enthusiasm for and commitment to the music. It then looks at professionals as co-improvisers and goes on to explain how their attention is influenced by job-related contingencies, and how this affects the way they hear and understand music. It also discusses professionals' active participation in the live music scene as well as their involvement in collaborative expressions of art in improvised jazz communities. The chapter shows that jazz professionals, as workers in the jazz art world, provide crucial services and support for performers, fans, venue operators, and each other while also “performing” off-stage for their own constituencies of viewers and readers.
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Alchi, Bassam, and David Jayne. The patient with antiphospholipid syndrome with or without lupus. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0164.
Full textAbstract:
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by recurrent arterial or venous thrombosis and/or pregnancy loss, accompanied by laboratory evidence of antiphospholipid antibodies (aPL), namely anticardiolipin antibodies (aCL), lupus anticoagulant (LA), and antibodies directed against beta-2 glycoprotein 1 (β2GP1). APS may occur as a ‘primary’ form, ‘antiphospholipid syndrome,’ without any known systemic disease or may occur in the context of systemic lupus erythematosus (SLE), ‘SLE-related APS’. APS may affect any organ system and displays a broad spectrum of thrombotic manifestations, ranging from isolated lower extremity deep vein thrombosis to the ‘thrombotic storm’ observed in catastrophic antiphospholipid syndrome. Less frequently, patients present with non-thrombotic manifestations (e.g. thrombocytopaenia, livedo reticularis, pulmonary hypertension, valvular heart disease, chorea, and recurrent fetal loss).The kidney is a major target organ in both primary and SLE-related APS. Renal involvement is typically caused by thrombosis occurring at any location within the renal vasculature, leading to diverse effects, depending on the size, type, and site of vessel involved. The renal manifestations of APS include renal artery stenosis and/or renovascular hypertension, renal infarction, APS nephropathy (APSN), renal vein thrombosis, allograft vasculopathy and vascular thrombosis, and thrombosis of dialysis access.Typical vascular lesions of APSN may be acute, the so-called thrombotic microangiopathy, and/or chronic, such as arteriosclerosis, fibrous intimal hyperplasia, tubular thyroidization, and focal cortical atrophy. The spectrum of renal lesions includes non-thrombotic conditions, such as glomerulonephritis. Furthermore, renal manifestations of APS may coexist with other pathologies, especially proliferative lupus nephritis.Early diagnosis of APS requires a high degree of clinical suspicion. The diagnosis requires one clinical (vascular thrombosis or pregnancy morbidity) and at least one laboratory (LA, aCL, and/or anti-β2GP1) criterion, positive on repeated testing.The aetiology of APS is not known. Although aPL are diagnostic of, and pathogenic in, APS, a ‘second hit’ (usually an inflammatory event) may trigger thrombosis in APS. The pathogenesis of the thrombotic tendency in APS remains to be elucidated, but may involve a combination of autoantibody-mediated dysregulation of coagulation, platelet activation, and endothelial injury.Treatment of APS remains centred on anticoagulation; however, it has also included the use of corticosteroids and other immunosuppressive therapy. The prognosis of patients with primary APS is variable and unpredictable. The presence of APS increases morbidity (renal and cerebral) and mortality of SLE patients.
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Bowen, Raven. Work, Money and Duality. Policy Press, 2021. http://dx.doi.org/10.1332/policypress/9781447358800.001.0001.
Full textAbstract:
This book provides readers a rare opportunity to hear from some of the most hidden off-street sex workers in the population, those living dual lives, trading sex alongside ‘square’ mainstream employment. Stereotypes about who trades sex, of ‘exiting’ and transitioning to and from sex work as being chaotic, as well as simplistic, binary framings of sex work as something one is either in or out of, trapped or survived, are challenged by these sex workers whose practices uncover a fluid Continuum of Sex Industry Work and Square Work (SIWSQ) Involvement. Sex workers (Contributors) share lived experiences of combating labour precarity and insecure work, concerns about Brexit, and the UK Whorearchy that stratifies the sex industry and influences pricing and value, along with the stress of keeping secrets while living under the constant threat of being outed. Contributors engage in skilful stigma-avoidance, selective disclosure, on-and offline audience/information segregation, and manage people and devices to conceal stigmatised work in the digital age. The phenomenon of duality is thoroughly examined and in doing so we learn about the impacts of constructing a precarious labour markets while legislating poverty, and the lies we propagate about who trades sex and how we treat them. Ultimately, those living dual lives do so in response to economic conditions that we co-create. Our focus must be on reshaping the structures, systems and social forms that circumscribe our social realities and not in the vilification of these innovators.