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Author: Grafiati
Published: 11 March 2023

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1

Gabrielsen, Bent. Bent Gabrielsen: 40 år med smykker. [Egtved, Denmark]: Gabrielsens guldsmedie, 1994.

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2

Garnov, Iris. Færdig med 40'rne!: Feriebarn på landet i 1949. København: Høst, 1985.

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3

Gali, André. Kampen med materialet: 1975-2015 : Norske kunsthåndverkere i 40 år. Oslo: Norske Kunsthandverkere, 2015.

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4

Wegelius, Maria. Civilisation kontra inre människa: En studie i "Jag lever" med utgångspunkt i Hagar Olssons 40-tal. [Åbo]: Åbo akademi, 1991.

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5

40 år med skitseblokken i Grønland. panigiit forlag, 2009.

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6

MapquestCom. National Geographic World Map With Flags (Med 40"x24"). Mapquest.com, 1997.

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7

Förhistoriska Djur: Målarbok För Vuxna Med 40 Praktfulla Djur Från Förhistorisk Tid. Independently Published, 2022.

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8

Lockhart, Mark E., and Rupan Sanyal. Case 40. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199975747.003.0040.

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This is a case from the Kidney section of Genitourinary Imaging Cases. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
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9

Scoutt, Leslie M., Ulrike M. Hamper, and Teresita L. Angtuaco. Case 40. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199988105.003.0040.

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This is a case from the Second Trimester section of Ultrasound. The specific content of each case and its diagnosis are necessarily hidden from this abstract. Each case contains case history, followed immediately by the diagnosis, which is supported with findings, differential diagnosis, teaching points, management, and further reading suggestions.
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10

Gustavsson, Tomas, Anna Bengtsson, and Johan Gribbe, eds. Årsrapport 2021. Universitetskanslersambetets publikationer, 2021. http://dx.doi.org/10.53340/ukap-1.

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År 2020 har varit ett annorlunda år för samhället i stort, inte minst för den svenska högskolan. Coronapandemin har inneburit stora utmaningar för högskolans alla verksamheter och kommer att göra så ett bra tag framöver. Men i en tid av osäkerhet och förändring har högskolesektorn visat prov på stor flexibilitet och anpassningsförmåga. En snabb övergång till digital undervisning följdes av en ökad studenttillströmning och omfattande utbyggnader av högskolan, som inneburit ett stort tryck på högskolans alla verksamheter. I tider av ekonomisk osäkerhet och ökad arbetslöshet har högskolan historiskt ofta fungerat som en krockkudde. Så även den här gången. En permanent utbyggnad av högskolans utbildning inleddes redan under våren 2020 tillsammans med tillfälliga resurstillskott för sommarkurser och behörighetsgivande utbildningar. Allt för att lärosätena snabbt skulle kunna ta emot unga personer som riskerade att hamna i arbetslöshet och ge personer som blivit permitterade möjlighet att vidareutbilda sig under permitteringstiden. Det livslånga lärandet har också ytterligare aktualiserats under coronapandemin. Att det finns goda möjligheter att ställa om genom utbildning är viktigt både för individer och samhället. Här spelar universitet och högskolor en central roll. Deras utbildning svarar för viktiga delar i samhällets kompetensförsörjning. Den tillgodoser både arbetsmarknadens behov av kvalificerad arbetskraft inom olika sektorer och individens strävan efter kunskap, bildning och utveckling. I vissa sektorer finns en stor brist på högskoleutbildad personal, och det är en utmaning för lärosätena att lyckas rekrytera studenter till dessa utbildningar. Internationalisering genomsyrar på många olika sätt högskolans verksamhet. Både i utbildning på grundnivå, avancerad nivå och forskarnivå utgör inresande studenter och utländska doktorander en stor andel av nybörjarna. Men under höstterminen 2020 kom långt färre inresande studenter på grundnivå och avancerad nivå till Sverige för att studera. En liknande effekt syns ännu inte på utbildningen på forskarnivå. Precis som året innan var andelen utländska doktorandnybörjare 40 procent. För helåret 2020 fortsatte dessutom trenden med ökande intäkter från betalande studenter, om än i något långsammare takt, trots coronapandemin. Detta kan tyda på att vi ännu inte fullt ut ser effekterna av pandemin i uppgifterna som presenteras i denna rapport, och att det fortfarande är för tidigt att se de långsiktiga effekterna på högskolans internationalisering.
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11

Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 40-Year-Old Female with Increasing Arm Pain and Numbness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0013.

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Neurogenic thoracic outlet syndrome (NTOS) is an uncommon cause of chronic arm pain and numbness but should not be missed. It can lead to chronic pain and disability. Symptoms of NTOS are often aggravated by arm exertion and elevation and tend to occur after exercise rather than activity. A thorough diagnostic evaluation is key, which includes provocative tests, imaging, electromyography/nerve conduction study, and diagnostic injections. Electromyography/nerve conduction study (EMG/NCS) are recommended for NTOS as it is important to exclude an entrapment neuropathy or cervical radiculopathy that may be misdiagnosed as NTOS. EMG/NCS is usually normal in NTOS, however, in severe presentations, the EMG/NCS pattern is most consistent with a lower trunk plexopathy. Treatment options of NTOS are also described in this chapter.
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12

Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0011.

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A number of nutritional causes of peripheral neuropathy have been identified. Patients who have gastrointestinal disease or who have undergone bariatric surgery are at risk, although frequently the specific cause is not ascertained. Vitamin B12 and thiamine deficiencies are the most common causes in bariatric surgery patients. The classic clinical picture of Vitamin B12 deficiency is a myelopathy with a concomitant peripheral neuropathy. Thiamine deficiency is the classic triad of mental status changes, opthalmoplegia, and ataxia. Copper deficiency is often unrecognized. Its presentation can be similar to Vitamin B12 deficiency. It is important that bariatric surgery patients receive continual follow up of their nutritional status and adherence to vitamin supplementation. Alcohol may cause a peripheral neuropathy through nutritional deficiency or perhaps direct toxic effects. Other deficiency states are discussed.
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13

Parnas, Josef. Introduction to “A DSM insiders’ history of premenstrual dysphoric disorder”. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198725978.003.0040.

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Chapter 40 is an introduction to Chapter 41, which covers an ‘insiders’’ history of premenstrual dysphoric disorder and a case study of the interactions between science and extra-scientific processes involved in the construction of nosological categories of psychiatry.
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14

Keshav, Satish, and Alexandra Kent. Dyspepsia. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0025.

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Dyspepsia is a term encompassing several symptoms of the upper gastrointestinal (GI) tract, including acid reflux, heartburn, nausea, vomiting, and abdominal pain or discomfort. Up to 40% of the population suffer with dyspepsia; 5%–10% will consult their GP, and 1% will undergo endoscopic assessment. Over-the-counter medications cost patients £100 million annually, and prescribed drugs cost the NHS over £463 million annually. There is a steady rise in incidence with increasing age. Helicobacter pylori is present in 40% of the UK population, with many individuals acquiring the infection in childhood and remaining asymptomatic. It has been associated with peptic ulcer disease and distal gastric cancer. This chapter covers the approach to diagnosis, key diagnostic tests, therapies, and prognosis as well as dealing with uncertainty when it comes to the initial diagnosis.
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15

Tolfrey, Keith. Maximal intensity exercise and strength training. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199232482.003.0040.

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Chapter 40 focuses specifically on the scientific evidence that has come from studies involving children or adolescents who have completed maximal (high-) intensity exercise training and resistance exercise training. The aim is not to explore health gains but those that might be important when considering participation in sport.
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16

Ajithkumar, Thankamma, Ann Barrett, Helen Hatcher, and Natalie Cook. Paediatric malignancies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199235636.003.0015.

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Leukaemia is the commonest cancer (accounting for >40% of cases) in children. It is a clonal proliferation of stem cells which leads to bone marrow failure and tissue infiltration.• Acute lymphoblastic leukaemia (ALL): 4/100,000• Acute myeloid leukaemia (AML): 0.7/100,000• Chronic myeloid leukaemia (CML): 0.2/100,000...
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17

Omran, Yasser Al, and Qasim Aziz. Mechanisms of visceral pain in irritable bowel syndrome. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0016.

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Throughout history, symptoms of nausea, vomiting, constipation, diarrhoea, bloating, and pain have been described in relation to diseases of the gastrointestinal tract. Gastrointestinal disorders that give rise to these symptoms are broadly characterized as one of two types: structural or functional. Although structural diseases can be easily identified, and even cured by means of medical or surgical intervention, functional gastrointestinal disorders (FGIDs) remain a medical enigma. Irritable bowel syndrome (IBS) constitutes one of the 40 or so conditions under the FGIDs umbrella. It is characterized by abdominal pain and altered bowel habits and has an estimated prevalence of 5%–20% in the Western world. Around 40 years ago, little was known about the mechanism behind visceral pain in IBS. Ritchie’s landmark study was one of the first to begin to elucidate some of the mechanisms involved (and therefore provide some insight into putative treatments) in the difficult area of FGIDs.
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18

Beattie, R. Mark, Anil Dhawan, and John W.L. Puntis. Alagille syndrome. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569862.003.0050.

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Genetics 358Clinical features 358Differential diagnosis 359Investigations 359Management: multidisciplinary approach 360Prognosis 360Alagille syndrome is a complex multisystem disorder with a prevalence of 1:40 000–1:100 000, characterized by hepatic, cardiac, renal, and ocular involvement. At least three of the following five major criteria are required to establish the diagnosis: ...
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19

Campbell, Douglas A., and Peter Burge. Ganglia of the wrist and hand. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.006013.

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♦ Ganglia are common; typically age 20–40, in women more so than men♦ Cause: unclear but associated with underlying ligament or tendon ‘irritation’ or joint osteoarthritis♦ Diagnosis: usually obvious. Investigations are generally not needed♦ Most recover spontaneously especially in children♦ Good operative techniques are generally successful.
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20

Smedley, Julia, Finlay Dick, and Steven Sadhra. Musculoskeletal disorders. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199651627.003.0009.

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Low back pain 254Work-related upper limb disorders 1 256Work-related upper limb disorders 2 258Osteoarthritis of the hip 260Bursitis 262• LBP has a lifetime prevalence of 60–80%, point prevalence of 15–40%, and annual incidence of 5%. It is:• the second most common cause of work-related ill health (prevalence 207 000, annual incidence 51 000)...
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21

Lai, Kar Neng, and Sydney C. W. Tang. Immunoglobulin A nephropathy. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0065.

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Immunoglobulin A (IgA) nephropathy is the most common primary glomerulonephritis. It runs a slow and sometimes relentless clinical course with consequent end-stage renal failure in 35–40% of patients 25–30 years after first clinical presentation. The pathology is characterized by deposition of macromolecular (polymeric) IgA1 in the glomerular mesangium, proliferation of mesangial cells, increased synthesis of extracellular matrix, and infiltration of macrophage, monocytes, and T cells.
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22

Kliger, Alan S., and Rita Suri. Frequent haemodialysis. Edited by Jonathan Himmelfarb. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0262_update_001.

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Haemodialysis is a renal replacement treatment, an ‘artificial kidney’ that performs some of the functions of the normal kidney. It is an inelegant device, providing only a fraction of native kidney’s ability to filter toxins from the blood, but with none of the responsiveness to volume, fine feedback control to regulate solute concentrations, or endocrine functions of the healthy organ. Conventional haemodialysis performed three times a week for 4 hours per treatment filters the blood for only 12 of 168 hours each week, and removes less than 10 per cent of small solutes like urea than does the normal kidney. It is therefore not surprising that haemodialysis patients suffer high morbidity and mortality. A dialysis patient’s expected remaining lifetime is substantially shorter than a comparable person with normal kidney function. For example, a woman aged 40–44 years old in the general population can expect on average 40 more years of life, but if she is on dialysis her life expectancy is only 8.1 years. She is also more likely to have co-morbid disease, including hypertension, cardiovascular disease, metabolic bone disease, anaemia, sepsis, depression, malnutrition and inflammation, and physical and cognitive impairment.
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23

Thorne, Sara, and Sarah Bowater. Heart failure in ACHD. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759959.003.0019.

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Despite the advances in surgical techniques, very few ACHD patients have a truly curative procedure, with the majority being at lifelong risk of complications, including ventricular dysfunction, arrhythmias, and premature death. Ventricular dysfunction, leading to heart failure, remains a major cause of morbidity and mortality, with some studies showing that it accounts for up to 40% of deaths in adults with CHD. This chapter discusses drug therapy, transplantation, and end-of-life care in ACHD.
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24

Thorne, Sara, and Sarah Bowater. Contraception and pregnancy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759959.003.0021.

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Heart disease is the largest single cause of maternal death in the UK. The number and complexity of survivors of congenital heart disease well enough to consider pregnancy are growing. The maternal risk amongst this population varies from being no different to that of the general population, to carrying a high risk of long-term morbidity and >40% risk of death. This chapter discusses contraception, preconception, pregnancy and delivery, and post-partum care.
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25

Sprigings, David. The physical examination. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0004.

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Notwithstanding the advances of the past 40 years in imaging—which is, in effect, an extension of the examination—physical signs remain central to the physician’s assessment of patients, especially those with acute illness. Failure to detect these signs contributes to misdiagnosis. To be effective clinicians, physicians must have a competent examination technique, and also need a clear understanding of what the signs can and can’t reveal in a given clinical situation.
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26

Thorne, Sara, and Paul Clift, eds. Contraception and pregnancy. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199228188.003.0028.

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Introduction 208General principles 208Contraception 210Preconception 214Pregnancy and delivery 218Post-partum 220Heart disease is the largest single cause of maternal death in the UK4. The number and complexity of survivors of congenital heart disease well enough to consider pregnancy is growing. The maternal risk amongst this population varies from being no different to that of the general population, to carrying a high risk of long-term morbidity and >40% risk of death....
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27

Ajithkumar, Thankamma, Ann Barrett, Helen Hatcher, and Natalie Cook. Genito-urinary cancer. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199235636.003.0009.

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Renal cell carcinoma (RCC) accounts for approximately 2% of cancer diagnosis worldwide. It has the highest mortality of any urological cancer. Clear-cell renal cell carcinoma (CC-RCC) is the commonest RCC. CC-RCC has the highest prevalence in Eastern Europe and is the fifth commonest solid tumour in the UK. Incidence of primary CC-RCC rises after the age of 40 years old and there is a 2:1 male to female ratio....
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28

Bunch, Chris. Normal blood function. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0277.

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This chapter reviews normal blood function and disorders of haemopoiesis. Blood consists of cells of three main types, suspended in plasma. The cellular component comprises about 40%–50% of the total volume and consists of red cells (erythrocytes), white cells (leucocytes), and platelets. Blood cells are formed from progenitor cells in the bone marrow by haemopoiesis, a process of proliferation and differentiation. Failure of haemopoiesis usually results from damage to proliferating marrow cells by cytotoxic drugs or radiation, haemopoietic malignancy, or a combination of the two.
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29

Keshav, Satish, and Alexandra Kent. Jaundice. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0031.

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Jaundice, also known as icterus, is the yellowish discolouration seen in skin, mucous membranes, and sclerae when the plasma bilirubin concentration is >40 μ‎mol/l. Jaundice may arise from increased production of bilirubin, for instance, in haemolysis; from reduced conjugation in the liver, as in Gilbert’s syndrome; or from reduced excretion via bile, as in intra-hepatic cholestasis. Jaundice also occurs when the flow of bile is obstructed, for instance, by gallstones or pancreatic cancer (extra-hepatic cholestasis). The clinical approach to the jaundiced patient is described in this topic.
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30

Chambers, John. Aortic aneurysm. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0102.

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The epidemiology and natural history of thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) are different. The thoracic aortic diameter is dependent on age and body habitus as well as the level at which it is measured. Average diameters are 2.1 cm/m2 for the ascending thoracic aorta, and 1.6 cm/m2 for the descending thoracic aorta, giving approximate thresholds for the diagnosis of a TAA of 40 mm and 35 mm, respectively. AAAs are defined by a diameter >30 mm and are mainly infrarenal, with only 2%–5% in a suprarenal position.
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31

Halliday, Catriona L., and Sarah E. Kidd. Cryptococcus species. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0012.

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Cryptococcus neoformans and Cryptococcus gattii are the principal pathogenic species within the genus Cryptococcus and the causative agents of cryptococcosis. Although rare, the incidence of infection due to other Cryptococcus species previously regarded as saprophytes, has increased over the last 40 years. Irrespective of the infecting species, infections are acquired following inhalation from the environment, causing localised or disseminated disease. The severity of disease is dependent on the organism’s virulence factors and the host’s immune response, and the clinical manifestations are indistinguishable. Accurate identification of the pathogenic species relies on rDNA sequencing
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32

Harber, Mark. Urinary tract infection in a patient with a kidney transplant. Edited by Neil Sheerin. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0179.

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Urinary tract infection is the commonest bacterial infection and cause of septicaemia post kidney transplant, accounting for 40–50% of all infectious post-transplant complications. The risk of a urinary tract infection post transplant is very high with most studies recording at least 50%, and rates as high as 86% have been reported. Clinically overt urinary tract infections are a major cause of morbidity post transplant and are associated with worse graft outcome and increased mortality. This chapter discusses the epidemiology, aetiology, pathology, clinical presentation, investigations, consequences, treatment, and prophylaxis of post-transplant urinary tract infections.
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33

Kahn, S. Lowell. Managing Unilateral or Bilateral Common Iliac Artery Aneurysms with Preservation of the Hypogastric Artery. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0007.

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Isolated common iliac artery aneurysms are uncommon, occurring in 0.03% of the population, and are responsible for less than 2% of clinically significant aneurysm disease. However, the incidence of iliac artery aneurysms is much higher in patients with abdominal aortic aneurysms, with an incidence close to 40% in this population. The presence of bilateral iliac aneurysms in this population is common. This chapter describes two techniques to manage unilateral or bilateral common iliac artery aneurysms with preservation of the hypogastric artery: use of an Endologix AFX stent graft with snorkel placement and use of two bifurcated Gore Excluder stent grafts.
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34

Makker, Himender K., Adam Ainley, Sanjay Popat, Julian Singer, Martin Hayward, and Antke Hagena. Oxford Case Histories in Lung Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198813033.001.0001.

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Oxford Case Histories in Lung Cancer contains 40 well-structured cases from clinical practice that give a comprehensive coverage of both commonly faced situations in clinical practice and incidents that pose particular challenges. Split into five sections, covering epidemiology, medical and clinical oncology, thoracic surgery, and palliative care, each case comprises a brief clinical history with relevant clinical examination findings. Questions are based on clinical investigations and aspects of management. Detailed answers follow, based on the best available evidence from the latest research, systematic reviews, meta-analyses, and guidelines. The resource is illustrated with over 75 pictures and diagrams.
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35

Shaibani, Aziz. Electromyogram (EMG) Findings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0028.

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While this chapter, and even this book, are not intended to be a textbook in electrodiagnosis, we have chosen video samples of typical abnormal discharges that often are faced by neuromuscular specialists, such as myopathic units, myotonic discharges, myokymia, fibrillation, and neurogenic firing. Other electromyogram (EMG) clips are embedded in other chapters. Firing frequency of the motor unit potentials can be calculated and it is increased in denervation. Observation for 40–60 seconds may be needed to detect infrequent fasciculations after needle placement. Mixed short and long duration is a features of chronic myopathy and can be confused with chronic denervation.
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36

Raine, Tim, James Dawson, Stephan Sanders, and Simon Eccles. Prescribing. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199683819.003.0004.

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Prescribing – general considerationsHow to prescribe – best practiceDrug interactionsReporting adverse drug reactionsSpecial considerationsControlled drugsEnzyme inducers and inhibitorsEndocarditis prophylaxisNight sedationSteroid therapyTopical corticosteroidsEmpirical antibiotic treatmentClostridium difficile (C. diff)Prescribing medicines is rarely taught well in medical school, yet it is one of the first tasks you’ll be asked to do on day one. Even the most experienced of doctors will only know by heart the dose and frequency of a maximum of 30–40 drugs, so do not worry if you cannot even remember the dose of paracetamol; for adults it’s 1g/4–6h PO max 4g/24h in divided doses (...
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37

Reinecke, Holger. Epidemiology and global burden of peripheral arterial disease and aortic aneurysms. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0068.

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Peripheral artery disease (PAD) and aortic aneurysms are common diseases which show an increasing prevalence and incidence. From community-based trials assessing ankle–brachial indices, 2–4% of the general population have been shown to be affected by PAD, which increases up to 15% in those above 70 years of age. About 30–40% of the in-hospital cases with PAD have critical limb ischaemia and suffer from a 1-year mortality of 20–40%. Abdominal aortic aneurysms (AAAs) also show a relatively high prevalence of about 1–2% in the general population as found by large-scale, systematic duplex screening. Of these, about 5% come to hospital admittance with a ruptured AAA which is still associated with an in-hospital mortality of up to 50%. The prevalence of thoracic aortic aneurysms (TAAs) was reported to be at about 0.16–0.34% in selected subgroups of the general population. The incident cases of TAAs have risen from 10/100,000 cases in the late 1980s up to about 17/100,000 cases in the first decade of this millennium. It is noteworthy that PAD and aortic aneurysms as well as their associated co-morbidities remain in many cases underdiagnosed and undertreated. This leads to a high cardiovascular morbidity and mortality which could not be obviously markedly reduced in the recent decades. Since nearly all vascular disorders are systemic diseases, not only the specific vessel bed which leads to a presentation should be assessed but also all other possible vascular manifestations should be thoroughly examined to reduce adverse events.
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38

Delcourt, Candice, and Craig Anderson. Management of parenchymal haemorrhage. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0237.

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Parenchymal intracerebral haemorrhage (ICH) affects several million people in the world each year, most of whom reside in developing countries. ICH accounts for 10-40% of strokes and is the least treatable form of stroke with a 30-day mortality of 30-55%, with half of these deaths occurring within the first few days of onset. . High blood pressure is both a causal and prognostic factor for ICH, with early control of hypertension being the only medical treatment which may improve recovery and the level of residual functioning. The role of surgery remains controversial. Management is largely supportive and aimed at reducing further brain injury and preventing complications.
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39

Ajzensztejn, Daniel. Breast cancer. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0327.

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Breast cancer is the commonest female cancer, with a lifetime risk of approximately 1 in 9. There are approximately 40 000 new cases and 11 000 deaths from the disease in England and Wales each year. Breast cancer is an adenocarcinoma which arises from the glandular tissue of the breast. Its etiology is complex, with hormonal, genetic, and modifiable lifestyle factors all involved in developing the disease. Prognosis is related to the anatomical extent of the cancer, and other factors. This chapter discusses the definition and etiology of breast cancer, as well as its typical symptoms, less common symptoms, demographics, natural history, complications, diagnosis, treatment, and prognosis.
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40

Lamari, Foudil, and Jean-Marie Saudubray. Disorders of Complex Lipids Synthesis and Remodeling. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0066.

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Defective lipid catabolic pathways are involved in numerous inherited metabolic diseases such as lysosomal storage diseases and peroxisome biogenesis disorders. We recently described a new classification of a rapidly growing group of inherited metabolic disorders involving biosynthesis and remodeling of complex lipids including phospholipids and sphingolipids. The remarkable progress achieved over the last decade in high throughput gene sequencing and in lipid analysis technologies have enabled the description of more than 40 diseases linked to defects in enzymes involved in these pathways. Some of these defects present in infancy or childhood but most of them are diagnosed in adolescence or adulthood. In this review we focus on those with adult presentation.
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41

Chan, Emily Ying Yang. Epilogue. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198807179.003.0011.

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As of 2010, the global population has transited from rural-based to urban-based settlement patterns. While urbanization poses much pressure to city residents, ‘rural living’ continues to represent more than 40% of the way our global citizens will be living for the coming century. This chapter provides some concluding remarks for Building Bottom-up Health and Disaster Risk Reduction Programmes, highlighting the importance of building bottom-up health and disaster risk reduction programmes in rural Asia that strengthen resilience in rural communities, and how careful planning, coordination, and contribution from international bodies, national governments, local communities, and the volunteer sector are also required.
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42

Lewis, Cara C., Kayne D. Mettert, Caitlin N. Dorsey, and Bryan J. Weiner. Measures and Outcomes in Implementation Science. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0005.

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This chapter provides an overview of the state of implementation outcome measurement in general and specific to the cancer control continuum. A novel conceptualization of the timing of implementation outcome assessment is presented as it pertains to the Exploration, Preparation, Implementation, and Sustainment model. An environmental scan revealed 40 measures across eight implementation outcomes in use across the cancer control continuum. The quality of measures in use is either poor or not yet established. Five key measurement challenges are broached, with recommendations for resolving them provided wherever possible. The chapter closes with emerging advances in implementation outcome, context, and process measurement and a list of resources for the field.
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43

Levinson, Douglas F., and Walter E. Nichols. Genetics of Depression. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0024.

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Major depressive disorder (MDD) is a common and heterogeneous complex trait. Twin heritability is 35%–40%, perhaps higher in severe/recurrent cases. Adverse life events (particularly during childhood) increase risk. Current evidence suggests some overlap in genetic factors among MDD, bipolar disorder, and schizophrenia. Large genome-wide association studies (GWAS) are now proving successful. Polygenic effects of common SNPs are substantial. Findings implicate genes with effects on synaptic development and function, including two obesity-associated genes (NEGR1 and OLFM4), but not previous “candidate genes.” It can now be expected that larger GWAS samples will produce additional associations that shed new light on MDD genetics.
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44

Rodriguez-Romaguera, Jose, and Gregory J. Quirk. Extinction of Conditioned Fear and Avoidance: Relevance for OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0030.

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The compulsions seen in obsessive-compulsive disorder (OCD) often reflect a state of elevated fear and anxiety; ritualistic behaviors and/or avoidance may arise as a strategy to manage this anxiety. Treatment for OCD can include exposure-based therapies that attempt to extinguish compulsions. Exposure with response prevention(ERP) is an effective therapy, but approximately 40% of patients fail ERP or drop out. This chapter reviews the role of the medial prefrontal and orbitofrontal cortices in the extinction of conditioned fear and avoidance, in both rodents and humans. Special emphasize is given to how the rodent literature can provide new insights into the pathophysiology and treatment of OCD.
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45

Guffanti, Guia, Milissa L. Kaufman, Lauren A. M. Lebois, and Kerry J. Ressler. Genetic Approaches to Post-Traumatic Stress Disorder. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0026.

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Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder with an estimated genetic component accounting for 30%–40% of the variance contributing to risk for the disease. This chapter starts with a review of the biological hypotheses and related genetic mechanisms currently proposed to be associated with PTSD and trauma-related disorders. It will follow with a description of the state-of-the-art on the methodologies and their application to map genetic loci and identify biomarkers associated with PTSD. Finally, we will review the latest results from genome-wide association studies of genetic variants as well as those derived from the emerging fields of epigenetics and gene expression.
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46

McKenzie, Alistair G. Historic timeline of obstetric anaesthesia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0001.

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Foremost in the history of obstetric anaesthesia was the introduction of inhalational analgesia by James Simpson in 1847, first with ether and then chloroform. Nitrous oxide was first used in obstetrics in 1880. Neuraxial anaesthesia in obstetrics began with spinal block by Oskar Kreis in 1900, and within 25 years included pudendal, caudal, and paracervical blocks. From 1902 there was a vogue for ‘twilight sleep’, which remained in use until the 1950s. Spinal anaesthesia only became popular with the advent of procaine in 1905; favour declined in the United Kingdom from 1948 and did not return until 40 years later. In 1930, Aburel described the pain pathways of labour. Continuous caudal analgesia for labour was popularized from 1942; it was superseded by the lumbar epidural approach in the 1960s. The arrival of lidocaine in 1950 was a major advance. Another important event in the 1960s was the elucidation of the supine hypotensive syndrome of late pregnancy. In the 1940s, intravenous barbiturates became popular. Mendelson published on the acid aspiration syndrome in 1946. It took 40 years to establish a reliable system of prevention, including fasting, antacids, and rapid sequence induction. This developed piecemeal, aided by recommendations from the British Confidential Enquiries into Maternal Deaths reports beginning in 1957. Neuraxial anaesthesia advanced: 24-hour epidural services (1960s), bupivacaine (1970s), epidural opioids (1980s), use of low-concentration bupivacaine with fentanyl mixtures, patient-controlled epidural and combined spinal–epidural analgesia (1990s), and pencil-point spinal needles (1990s). From the 1980s obstetric anaesthetists have assumed key roles in management of labour, preeclampsia/eclampsia, major haemorrhage, and perioperative care.
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47

Shahrokhi, Shahriar, and Marc G. Jeschke. Management of burns in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0347.

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Outcomes of burn patients have significantly improved over the last two decades. A recent study in The Lancet showed that a burn size of over 60% total body surface area (TBSA) burned is now recognized as being associated with high risks; a decade ago similar risks resulted from a 40% TBSA burned. Similar data have been obtained in severely-burned adults and the elderly. This chapter discusses current standards, recent evidence, and future developments in burn care to improve outcomes of these patients. Critical components in the management of patients with burns are early adequate resuscitation, recognition and management of airway burns and appropriate treatment of the different stages of burn care—prehospital, early, and late management.
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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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Ramamoorthy, Jagan, and Noreen E. Murphy. Cocaine Intoxication and Hypertensive Emergency. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0089.

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Cocaine is a highly addictive, illegal drug with sympathomimetic properties that is responsible for nearly 500,000 emergency room visits per year. In at least one study, nearly 40% of trauma surgery patients and 1% of patients presenting for elective surgery tested positive for recent cocaine use. Given these numbers, anesthesiology providers must understand the physiological effects of cocaine and be able to safely manage these patients in both the intraoperative and perioperative phases. Anesthetic management of cocaine-using patients should focus on avoiding hemodynamic extremes and minimizing the ischemic consequences of vasospasm. This chapter reviews the basic pharmacology of cocaine, the physiologic effects of cocaine use, and the anesthetic management of the cocaine-using patient.
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50

Jordan, Joanne M., Kelli D. Allen, and Leigh F. Callahan. Age, gender, race/ethnicity, and socioeconomic status in osteoarthritis and its outcomes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0010.

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Osteoarthritis (OA) is the most common joint condition worldwide. It can impair mobility and result in significant disability, need for total joint replacement, and healthcare utilization. OA is unusual in those younger than 40 years, then commonly the result of an underlying metabolic disorder or a prior joint injury. Some geographic and racial/ethnic variation exists in the prevalence and incidence of OA for specific joints, likely due to variation in genetics, anatomy, and environmental exposures. Many OA outcomes vary by socioeconomic status and other social factors. This chapter describes demographic and social determinants of knee, hip, and hand OA, including how these factors impact radiographic and symptomatic OA, OA-related pain and function, and its treatment.
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