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1
Nosachev, Igor', and Dmitriy Romanov. Semiotics of mental illness. General psychopathology. ru: INFRA-M Academic Publishing LLC., 2021. http://dx.doi.org/10.12737/1027396.
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The methodology and systematics of the diagnostic process in psychiatry are given, information is given about psychopathological symptoms and dynamics of the main productive and negative syndromes, including addictive, as well as the most significant forms of norm and pathology of personality. The leading features of clinical and psychopathological research in general psychopathology are substantiated.
The section "Symptomatology" reveals the psychological and clinical features of the main mental processes. The section "Syndromology" describes the clinical features of the main positive and negative syndromes, their features in children and adolescents.
Meets the requirements of the federal state educational standards of higher education of the latest generation.
It is intended for psychiatrists, psychiatrists, narcologists, psychotherapists, clinical psychologists undergoing pre- and postgraduate training, students of higher medical and psychological educational institutions, interns, clinical residents, graduate students and doctors of related disciplines.
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Ferguson, Deborah Helen. Production of chimeric viral genomes for the analysis of tobraviral symptom determinants. Birmingham: University of Birmingham, 1998.
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3
Eliasson-Selling, Lena. Puberty and oestrous symptoms in gilts with special reference to the relationship with production traits. Uppsala: Sveriges Lantbruksuniversitet, 1991.
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4
Wilson, John W., and Lynn L. Estes. Respiratory Tract Infections. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199797783.003.0067.
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Diagnostic criteria include productive cough, symptoms of upper respiratory infection, and negative findings on chest radiographs. Viral agents are the most common cause; antibiotics are therefore not beneficial.•Viral causes: Influenza, parainfluenza, and other respiratory viruses affect >70% of patients•Less common but potentially antibiotic-responsive infectious agents...
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Thompson-Brenner, Heather, Melanie Smith, Gayle E. Brooks, Dee Ross Franklin, Hallie Espel-Huynh, and James Boswell. The Renfrew Unified Treatment for Eating Disorders and Comorbidity. Oxford University Press, 2021. http://dx.doi.org/10.1093/med-psych/9780190947002.001.0001.
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This treatment program is designed to address any type of eating disorder along with the other emotional problems that people with eating disorders also commonly experience. Eating disorders are related to emotional functioning in many important ways. The overall goal of this treatment is for clients to become more accepting of their emotions in order to respond to them in more productive ways. Each chapter of this workbook teaches clients the skills to manage their emotions. This workbook was developed to help people who have eating disorders and who are also struggling with intense and difficult emotions like anxiety, sadness, anger, and guilt. Having an eating disorder is a difficult emotional experience, and many people develop depression and anxiety in reaction to their eating disorder symptoms. So, emotions create the context in which eating disorders develop, emotions are a part of what drives eating disorder symptoms on a daily level, and emotional experience become worse as a result of having an eating disorder.
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Granacher, Robert P. Neuropsychiatric Aspects Involving the Elderly and the Law. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0002.
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Neuropsychiatry has generally been concerned with the diagnosis and management of syndromes with productive symptoms (positive symptoms) such as hallucinations, mood changes, and delusions. This chapter focuses on the brain-based forensic issues before the law concerning the neuropsychiatry of the older patient. These include the forensic infinitives of legal cognitive capacity to be competent to be tried, enter a plea, be a witness, consent generally, enter a contract, make a will, resist undue influence, refuse treatment, give informed consent, have general competence, have specific competence, be fit for duty, be criminally responsible, be civilly committable, and resist elder abuse. Fundamentally, the forensic neuropsychiatric question is: does a brain disorder remove the individual capacity to understand, decide or act in a specific circumstance before the law? Thus, a well-planned forensic assessment of a geriatric person usually requires a neuromedical psychiatric examination model. This may include examinations, laboratory testing, structural neuroimaging, cognitive screening, and neuropsychological testing. It also may involve lumbar puncture functional neuroimaging and other neurodiagnostic testing.
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Jones, Andrew M., and Rowland J. Bright-Thomas. Bronchiectasis. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0137.
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Bronchiectasis may be defined clinically as the chronic daily production of copious mucopurulent sputum. Pathologically, the disease is characterized by inflamed, thick-walled, dilated bronchi. Bronchiectasis has many potential underlying causes and associations with other diseases but in individual cases the underlying cause is often unknown. The typical symptom is cough with sputum. Bronchiectasis is a chronic condition; systemic complications are common and include tiredness, malaise, and weight loss. The aim of therapy should be to control symptoms, prevent complications and disease progression, while minimizing treatment burden. This chapter discusses bronchiectasis, including its etiology, symptoms, demographics, natural history, complications, diagnosis, prognosis, and treatment.
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Wray, Shirley H. Eye Movement Disorders in Clinical Practice. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199921805.001.0001.
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This resource offers comprehensive instruction on the diagnosis and treatment of all varieties of eye movement disorders, and reflects the importance of correlating clinical signs of disorders in the oculomotor system with their neuroanatomic and neurophysiologic architecture. With its focus on signs and symptoms, it advances lesion localization of eye movement disorders as the central clinical concern, and presents a fresh review of bedside examination techniques in the ER, ICU, and walk-in clinic; productive ways of taking a clinical history; sign interpretation; source lesion localization; and, where appropriate, therapy. This resource is arranged according to objective signs - like ptosis, neuromuscular syndromes, dizziness, vertigo, and syndromes of the medulla - rather than disease entities, and features over 50 clinical cases, each one providing the anatomical guidance needed to make critical diagnostic and management decisions in patients who often present with abnormal eye movements.
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Allen, Shelley J. Pathophysiology of Alzheimer’s disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198779803.003.0002.
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We now know that the onset of the pathological processes leading to Alzheimer’s disease (AD) may be 15–20 years before symptoms appear. This focuses attention on synaptic changes and the early role of tau, and less on the hallmark amyloid plaques (Aβ) and neurofibrillary tau tangles. Sensitive biomarkers to allow early screening will be essential. Familial autosomal AD is the result of mutations in one of three genes (APP, PSEN1, or PSEN2), each directly related to increased Aβ, and informs pathological mechanisms in common sporadic cases, but are also subject to influence by many risk genes and environmental factors. The essential role of apolipoprotein E in neuronal repair and Aβ clearance provides a therapeutic target but also a challenge in carriers of the risk gene APOE4. Current treatments are symptomatic, derived from neurotransmitter deficits seen; particularly cholinergic, but emerging data suggest alternative targets which may prove more productive.
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Burdick, Katherine E., Luz H. Ospina, Stephen J. Haggarty, and Roy H. Perlis. The Neurobiology and Treatment of Bipolar Disorder. 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/9780190681425.003.0020.
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Bipolar disorder (BPD) is a severe mood disorder that often has psychotic features. Its most severe forms are more common and significantly more likely to cause disability than originally thought. Studies of high-risk children have found them to be at increased risk for a variety of symptoms and neurobiological abnormalities. In contrast to schizophrenia, there is no formal prodromal syndrome that has been identified, and cognitive abnormalities do not precede the onset of the disorder. Abnormal sleep and circadian rhythms are prominent and have led to intriguing biological models. Neurobiological experiments have primarily focused on candidate pathways and include circadian abnormalities, epigenetic processes including histone modification, WNT/GSK3 signaling, other modulators of neuroplasticity, and mitochondrial dysfunction. Recent data suggest that BPD is a highly polygenic disease and that integration of prior modeling and data with the wide variety of new genetic risk loci will be productive in the future.
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Chan, Kin-Sang, Doris M. W. Tse, and Michael M. K. Sham. Dyspnoea and other respiratory symptoms in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0082.
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Dyspnoea is prevalent among palliative care patients with increased severity over time. There are two patterns of dyspnoea-breakthrough dyspnoea and constant dyspnoea-and three separate qualities of dyspnoea-air hunger, work or effort, and tightness. The measurement of dyspnoea includes three domains: sensory-perceptual experience, affective distress, and symptom impact. The management of dyspnoea includes specific disease management, non-pharmacological intervention, pharmacological treatment, and palliative non-invasive ventilation. Cough is prevalent and disturbing in patients with cancer and chronic lung diseases, and is often associated with airway hypersecretion and impaired mucociliary clearance. Management includes specific treatments for underlying non-cancer and cancer-related causes, symptomatic treatment by antitussives, mucoactive agents, and airway clearance techniques for expectoration and reduction in mucus production. Anticholinergics may be indicated for death rattles to facilitate a peaceful death. Haemoptysis occurs in 30-60% of lung cancer patients and initial management of haemoptysis includes airway protection and volume resuscitation. Localization of the site and source of bleeding may determine the choice of treatment. If a life-threatening haemoptysis occurs, sedation should be given as soon as possible. Support should be given to the family, and debriefing provided to team members.
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Keshav, Satish, and Alexandra Kent. Chronic abdominal pain. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0024.
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Separating chronic and acute abdominal pain is often difficult, and an arbitrary time limit of 4 weeks is often used. However, many chronic conditions (e.g. chronic pancreatitis) can cause relapsing symptoms, which may be acute during each episode. Pain receptors in the abdomen respond to chemical and mechanical stimuli. Stretch is the commonest mechanical stimulus to the viscera, although distension, torsion, and contraction are also sensed. Chemical receptors are stimulated by inflammation and infection, and this stimulation leads to the production of various substances, including serotonin, bradykinin, substance P, prostaglandins, and histamine. There are inter-individual differences in pain perception, with some people (e.g. patients with irritable bowel syndrome) being more sensitive to painful stimuli. Chronic abdominal pain occurs in 9%–15% of all children, and is present on questioning in 75% of adolescents and 50% of adults who are otherwise healthy. It is often a non-specific symptom that alone has a poor sensitivity for organic disease. Usually, it is the associated symptoms, and/or abnormal blood tests, that direct the doctor to a diagnosis. This chapter covers the approach to the diagnosis of chronic abdominal pain, key diagnostic tests, therapies, prognosis, and dealing with uncertainty.
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Lipman, Jeffrey, and Robert J. Boots. Diagnosis, assessment, and management of tetanus, rabies, and botulism. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0245.
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Tetanus, rabies and botulism are all infections characterized by the production of a neurotoxin, and generally do not give rise to a systemic inflammatory response. Typically tetanus result from the infection of wounds by the ubiquitious soil-borne bacteria Clostridium tetanii, botulism is most commonly due to toxin produced in food contaminated with Clostridium botulinum. Rabies usually results from an animal bite infected with the rabies virus of the Lyssavirus group. Neurological involvement by all three infections is characterized by paralysis and autonomic instability with tetanus also being associated with muscular rigidity. Importantly, the autonomic dysfunction of tetanus can be severe and may necessitate prolonged treatment in an intensive care unit (ICU). Active immunization can prevent or minimize the symptoms of tetanus and rabies, while passive immunization may slow symptom progression in botulism. Intensive care support is often required to manage respiratory failure and autonomic dysfunction. Rabies is typically fatal in the absence of prior immunization.
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Namerow, Norman S. Multiple Sclerosis and Pain. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199341016.003.0019.
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Pain is one of the most prevalent symptoms in persons with MS, and may also complicate other symptoms due to MS such as fatigue, impaired mobility and sleep disturbances. Thus, diagnosis and treatment of pain has become an increasingly important aspect in MS management. The epidemiology of pain in patients with multiple sclerosis is reviewed in this chapter, and a pain classification is presented. Pain syndromes are also reviewed, and appropriate treatments are described. Neuropathic pain in particular is discussed, including current views on the pathophysiology of pain production. An algorithm for medication use is presented that illustrates the utility of pharmacology with multiple agents in treating this condition.
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Sedlack, Robert E., Conor G. Loftus, Amy S. Oxentenko, and Thomas R. Viggiano. Gastroenterology. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0210.
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Part 1 reviews the major portions of the gastrointestinal system (esophagus, stomach, small intestine, colon, and pancreas), their function (motility, acid production, enzymatic function, and absorption), and various disorders associated with them (dysmotility, ulceration, malabsorption, inflammation, and dysplasia). Symptoms, diagnostic testing, and treatment of common gastrointestinal conditions, such as gastroesophageal reflux disease, peptic ulcer disease, diarrhea, constipation, inflammatory bowel disease, and pancreatitis, are reviewed.
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Grundy, Seamus. Pleural effusion. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0019.
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Pleural effusion is a common clinical problem which can present both to primary and secondary care. The process by which fluid accumulates can be divided into transudative or exudative. Transudative effusions occur in the presence of normal pleura and are caused by increased oncotic or hydrostatic pressures. Exudative effusions are associated with abnormal pleura and are caused either by increased pleural fluid production due to local inflammation or infiltration or by decreased fluid removal which is caused by obstruction of the lymphatic drainage system. Patients may be entirely asymptomatic or they may present with breathlessness, particularly if the effusion is large. Other symptoms include a cough and systemic symptoms such as weight loss, anorexia, and fever. Chest pain is suggestive of inflammation/infiltration of the parietal pleura and points towards malignancy or empyema. This chapter describes the assessment and diagnosis of the patient with pleural effusion.
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Langendonk, Janneke G., and Timothy M. Cox. Porphyrias. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0043.
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The porphyrias are disorders caused by overproduction of metabolites involved in heme biosynthesis. The four acute porphyrias— acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and Doss Porphyria—present with severe abdominal pain, often accompanied by agitation, hypertension, and tachycardia associated with neuropathy and sometimes paralysis. Painful and disabling neurovisceral attacks are due to excess production of the heme precursor ALA (delta-aminolevulinic acid).While 90% of individuals with an inherited defect in heme biosynthesis will never develop symptoms, acute attacks in those affected are provoked by drugs, fasting, and alcohol; in women of reproductive age, they usually occur in the progestagenic phase of the menstrual cycle. All other porphyrias are considered cutaneous porphyrias. They present with blisters or pain on light exposed areas, toxic porphyrins accumulate and give rise to skin symptoms. The cutaneous porphyrias (PCT, EPP, XLEPP, and HEP) do not present with acute neurovisceral attacks (e.g., abdominal pain). However, severe systemic complications can occur.
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Persley, Denis, Tony Cooke, and Susan House, eds. Diseases of Vegetable Crops in Australia. CSIRO Publishing, 2010. http://dx.doi.org/10.1071/9780643100435.
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Diseases of Vegetable Crops in Australia provides a diagnostic guide and a key reference for diseases affecting vegetable crops in Australia.
This is an extensively revised and expanded edition of a previous publication that was a standard reference for the Australian vegetable industry.
Authors from across Australia provide essential information about the important diseases affecting most vegetable grown across Australia’s diverse horticultural production areas. The book includes an account of the causes of plant diseases and the principles underlying their control. It provides an overview of important diseases common to many Australian vegetable crops. Causal pathogens, symptoms, source of infection, how the diseases are spread and recommended management are described for 36 major and specialty crops. Special reference is made to exotic diseases that are biosecurity threats to Australian vegetable production.
The text is supported by quality colour images to help growers diagnose diseases.
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Grundy, Seamus. Pleural infection and malignancy. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0143.
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Pleural infection transitions from simple parapneumonic effusion, to complex parapneumonic effusion, to empyema. Primary empyema occurs without an underlying pneumonic process. Pleural infection commonly presents identically to pneumonia with dyspnoea, purulent sputum, and fevers. It may be associated with pleuritic chest pain. Empyema can cause systemic sepsis, leading to cardiovascular instability and multi-organ failure. A malignant pleural effusion arises when malignant cells infiltrate the pleura, resulting in increased production and decreased lymphatic drainage of pleural fluid. Malignant pleural effusions are either metastatic or primary mesothelioma. This chapter discusses pleural infection, malignant pleural effusion, and mesothelioma, focusing on etiology, symptoms, demographics, diagnosis, prognosis, and treatment.
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Felberg, Mary A. Mitochondrial Disease and Anesthesia. 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/9780190678333.003.0042.
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Mitochondrial disease is a genetically, biochemically, and clinically heterogeneous group of disorders that arise from defects in cellular oxidative phosphorylation, most commonly within the electron transport chain. All mitochondrial diseases involve disruption in energy production; clinical symptoms usually manifest in tissues with high energy demands although all organs may be affected. The extent of disease depends not only on the mitochondrial defect but on the numbers of dysfunctional mitochondria present in each tissue. Despite in vitro evidence that almost every anesthetic agent studied has been shown to decrease mitochondrial function, all anesthetic agents have been used safely. Discussion of the implications of mitochondrial disease for anesthetic management includes preoperative preparation, volatile and intravenous anesthetic agents, avoidance of succinylcholine, risk of malignant hyperthermia, perioperative fluids, and postoperative management.
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Crosson, Bruce A., Anastasia Ford, and Anastasia M. Raymer. Transcortical Motor Aphasia. Edited by Anastasia M. Raymer and Leslie J. Gonzalez Rothi. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199772391.013.11.
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The defining symptoms of transcortical motor aphasia (TCMA) are nonfluent verbal output with relatively preserved repetition. Other symptoms, such as naming difficulties, agrammatic output, or even some paraphasias, may occur, but these are not cardinal symptoms defining TCMA and are not necessary for the diagnosis. The core anatomy involved in TCMA is a lesion of the medial frontal cortex, especially the left presupplementary motor area (pre-SMA) and adjacent Brodmann’s area 32; a lesion of the left posterior inferior frontal cortex, especially pars opercularis and ventral lateral premotor cortex; or a lesion of the pathways between these frontal structures. TCMA occasionally has been reported with a lesion of the left basal ganglia, the left thalamus, or the ascending dopaminergic pathways. From a cognitive standpoint, TCMA can be conceptualized as a disorder of intention, in other words, as a disorder of initiation and continuation of spoken language that is internally motivated. The medial frontal cortex provides the impetus to speak; this impetus to speak is conveyed to lateral frontal structures through frontal–subcortical pathways where it activates various language production mechanisms. The influence of the ascending dopaminergic pathways may occur either through their heavy connections with the pre-SMA region or through their influence on the basal ganglia. The influence of the basal ganglia and thalamus probably occurs through their connections with the medial frontal cortex. Assessments for TCMA should involve a thorough evaluation of conversational or narrative language output and repetition. New treatments are available that attempt to engage right-hemisphere intention mechanisms with left-hand movements and may be effective in TCMA. Although dopamine agonists have also shown some positive effects in increasing verbal output in TCMA, trials have been small, and some caution must be exercised in interpreting these findings.
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Sahetya, Sarina. Acute Uncomplicated Bronchitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0029.
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Acute bronchitis is a respiratory illness characterized predominantly by cough with or without sputum production that lasts for up to 3 weeks in the presence of normal chest radiography. Additional presenting symptoms include rhinorrhea, congestion, sneeze, sore throat, wheezing, low-grade fever, myalgia, and fatigue. Causative organisms include viral and bacterial pathogens. The disease course is characterized by self-limited inflammation of the airways. Chest radiographs should be utilized to distinguish acute bronchitis from pneumonia or interstitial disease. Therapeutic recommendations are typically supportive; however, studies reveal that between 60% and 80% of patients receive unwarranted antibiotic therapy. Only those patients at high risk for serious complications (including patients over 65 with a history of hospitalization, diabetes mellitus, congestive heart failure, or current use of oral glucocorticoids) usually require routine antibiotic therapy directed toward both typical and atypical bacterial pathogens.
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Cooke, Tony, Denis Persley, and Susan House, eds. Diseases of Fruit Crops in Australia. CSIRO Publishing, 2009. http://dx.doi.org/10.1071/9780643098282.
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Diseases of Fruit Crops in Australia is the new standard reference in applied plant pathology in Australia covering important diseases affecting the broad range of fruit and nut crops grown throughout Australia. It is an essential tool for growers, horticulturists, crop consultants, research scientists, plant pathologists, quarantine officers, agribusiness representatives, pest management personnel, educators and students.
The book is generously illustrated with high quality colour images to help diagnose diseases and explains how to identify and manage each disease, describing the symptoms of the disease, its importance, the source of infection and spread and control measures.
Based on the highly regarded 1993 edition of Diseases of Fruit Crops, this new work updates management practices that have evolved since then. Importantly, it contains the latest information on diseases that have recently emerged in Australia as well as exotic diseases that are biosecurity threats to Australian fruit and nut production.
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Cuttle, Lisa. Dermatologic Manifestations of Infectious Disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0044.
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Toxic infectious exfoliative conditions include staphylococcal toxic shock syndrome (TSS), streptococcal toxic shock syndrome (STSS), and staphylococcal scalded skin syndrome (SSSS). All three are mediated by bacterial toxin production and are considerations in the differential diagnosis of a febrile, hypotensive patient with a rash. Meningococcemia is potentially fatal and extremely contagious with a short incubation period. Disseminated gonococcal infection (DGI) presents with tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis or with purulent arthritis but without skin lesions. Ecthyma gangrenosum (EG) is a cutaneous manifestation of Pseudomonas aeruginosa infection. Rocky Mountain Spotted Fever (RMSF) is caused by Rickettsia rickettsii, most commonly transmitted by the American dog tick. Patients present with nonspecific symptoms, such as fever, headache, myalgias, arthralgias, nausea, vomiting, and abdominal pain. Finally, vibrio vulnificus is a gram-negative bacterium that causes serious wound infections, sepsis, and diarrhea in patients exposed to shellfish or marine water.
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Boxall, Peter, and Bryan Cheyette. The Future of the Novel. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198749394.003.0035.
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This chapter addresses the future of the novel. It also reflects on the possibility and nature of historical change. The push and pull between the novel as an expressive symptom of an ailing culture, and the novel as the engine for the production of new cultural possibilities, runs through the long history of novelists’ reflections on the future of the novel. From our perspective in the early decades of the twenty-first century, the perception of a watershed triggered by 1973, and a new understanding of the relationship between style, fiction, and knowledge, seems remarkably prescient. Moreover, the new generation of novelists that have emerged since the turn of the century have collectively registered the re-emergence of a kind of historical vitality in the culture.
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Thornton, Kevin, and Michael Gropper. Diagnosis, assessment, and management of hyperthermic crises. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0247.
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Malignant hyperthermia, the neuroleptic malignant syndrome (NMS), and the serotonin syndrome are the principal disorders associated with life-threatening hyperthermia in the intensive care unit. While each is a clinically unique entity, all can progress to multisystem organ dysfunction with acidosis, shock, and death. MH usually results from exposure to halogenated volatile anaesthetics and/or succinylcholine and symptoms of increased CO2 production and respiratory acidosis progress rapidly without prompt intervention, including the administration of dantrolene. NMS is a syndrome of rigidity and altered mental status seen most commonly in patients being treated with antipsychotic medications. The serotonin syndrome is seen in patients treated with serotonergic agents including selective serotonin reuptake or monoamine oxidase inhibitors and tricyclic antidepressants. The salient clinical finding is clonus, but agitation, altered mental status and autonomic dysfunction are common. Recognizing the non-specific features of these syndromes presents a challenge as they are life-threatening if not treated promptly and correctly with specific therapies.
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Neligan, Patrick J., and Clifford S. Deutschman. Pathophysiology and causes of metabolic acidosis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0255.
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Critical illness is typically characterized by changes in the balance of water and electrolytes in the extracellular space, resulting in the accumulation of anionic compounds that manifests as metabolic acidosis. Metabolic acidosis manifests with tachypnoea, tachycardia, vasodilatation, headache and a variety of other non-specific symptoms and signs. It is caused by a reduction in the strong ion difference (SID) or an increase in weak acid concentration (albumin or phosphate). Increased SID results from hyperchloraemia, haemodilution or accumulation of metabolic by-products. A reduction in SID results in a corresponding reduction is serum bicarbonate. There is a corresponding increase in alveolar ventilation and reduced PaCO2. Lactic acidosis results from increased lactate production or reduced clearance. Ketoacidosis is associated with reduced intracellular glucose availability for metabolism, and is associated with insulin deficiency and starvation. Hyperchloraemic acidosis is associated with excessive administration of isotonic saline solution, renal tubular acidosis and ureteric re-implantation. Renal acidosis is associated with hyperchloraemia, hyperphosphataemia, and the accumulation of medley nitrogenous waste products.
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Ross, Ellen M. “Liberation Is Coming Soon”. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252038266.003.0002.
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This chapter examines the eighteenth-century Quaker reform Joshua Evans. Evans was an important voice in Quaker antislavery, Indian rights advocacy, and American peace history. He was a critic of the developing capitalist economy. He perceived that people were increasingly implicated in the exploitation and oppression of enslaved people, the poor, Indians, even animals, and the land itself. For Evans, war was the fundamental symptom of humans' alienation from God and the most potent catalyst for the ills afflicting eighteenth-century society. He objected to an interconnected market system that perpetuated war: an economy increasingly dependent upon slavery and overreliant on tariffs and foreign trade, the oppression of Indians, the export of grain to import rum, the cultivation of tobacco, and the production and consumption of luxury goods.
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Langer, Thomas, and Pietro Caironi. Pathophysiology and therapeutic strategy of respiratory alkalosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0114.
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Respiratory alkalosis is a condition characterized by low partial pressure of carbon dioxide and an associated elevation in arterial pH caused by an imbalance between CO2 production and removal, in favour of the latter. Conditions that cause increased alveolar ventilation, without having a reduction in pH as input stimulus, will cause hypocapnia associated with a variable degree of alkalosis. The major effect of hypocapnia is the increase in pH (alkalosis) and the consequent shift of electrolytes that occurs in relation to it. As a general law, in plasma, anions will increase, while cations will decrease. The acute reduction in ionized calcium, due to the change in extracellular pH, may cause neuromuscular symptoms ranging from paraesthesias, to tetany and seizures. The effect on urine is an increase in urinary strong ion difference/urinary anion gap and a consequent increase in urinary pH. Finally, acute hypocapnic alkalosis causes a constriction of cerebral arteries that can lead to a reduction of cerebral blood flow. The clinical approach to respiratory alkalosis is usually directed toward the diagnosis and treatment of the underlying clinical disorder.
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Chakera, Aron, William G. Herrington, and Christopher A. O’Callaghan. Disorders of acid–base balance. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0178.
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Normal metabolism results in a net acid production of approximately 1 mmol/kg day−1. Physiological pH is regulated by excretion of this acid load (as carbon dioxide) by the kidneys and the lungs. A series of buffers in the body reduces the effects of metabolic acids on body and urine pH. For acid–base disorders to occur, there must be excessive intake (or loss) of acid (or base) or, alternatively, an inability to excrete acid. For these changes to result in a substantially abnormal pH, the various buffer systems must been overwhelmed. The pH scale is logarithmic, so relatively small changes in pH signify large differences in hydrogen ion concentration. Most minor perturbations in acid–base balance are asymptomatic, as small changes in acid or base levels are rapidly controlled through consumption of buffers or through changes in respiratory rate. Alterations in renal acid excretion take some time to occur. Only when these compensatory mechanisms are overwhelmed do symptoms related to changes in pH develop. This chapter reviews the causes and consequences of acid–base disorders.
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Williams, Gareth. Infrapolitical Passages. Fordham University Press, 2020. http://dx.doi.org/10.5422/fordham/9780823289882.001.0001.
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This book clears a way through some of the dominant political determinations and violent symptoms of contemporary globalization. It considers globalization as a new, and increasingly unmoored, ordering for which modern political theory, including its theories of political subjectivation, has proven largely obsolete. Globalization is the hollowing out and expiration of the political-theological imagination of the modern juridical system of states. In this regard Infrapolitical Passages provides (1) a theory of globalization as a crisis of symbolic organization and (2) a theory of global economic warfare as the positing itself of both directionlessness and facticity. In contrast, the work of clearing proposes “infrapolitics” as a distance from the biopolitical, which it understands as the contemporary forms of domination, that is, as the production of specific forms of subjectivity that pertain to the age of the ontology of the commodity. It is the relation of the subject to domination—and the subsequent obscuring of any question for being—that signals the need to circumvent the instrumentalization of life as a relation of subordination to the metaphysics of subjectivity, representation, and politics.
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Beach, Steven R. H., Heather M. Foran, Richard E. Heyman, Amy M. Smith Slep, Anthony R. Cordaro, Marianne Z. Wamboldt, David Reiss, and Nadine J. Kaslow. Relational Processes. Edited by Erika Lawrence and Kieran T. Sullivan. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199783267.013.11.
Full textAbstract:
Efforts to expand and update the description of relational processes in theDiagnostic and Statistical Manual of Mental Disorders(DSM) to enhance its clinical utility began with DSM-IV, but met with limited success. The current effort to revise the description of relational problems has focused on both the DSM-V and theInternational Classification of Diseases(ICD)-11, with an emphasis on (1) documenting a solid empirical foundation for inclusion of relational processes in these diagnostic systems and (2) creating categories and symptom sets that reflect that empirical foundation. In this chapter we describe the process that led to the current revisions, along with steps that were taken to ensure broad consensus and relevance for a range of countries and cultures. We also briefly recap several arguments for continued attention to relational processes as well as additional changes that might be considered in future revisions. Finally, we also briefly discuss the issue of whether some relational processes are better thought of as categories in addition to being dimensions. Scientific aspects of the project have been very productive. However, revision of relational problem descriptions in DSM-V was limited and final revisions to the ICD-11 are still underway.
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Nilipour, Reza. Neurolinguistics. Edited by Anousha Sedighi and Pouneh Shabani-Jadidi. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780198736745.013.18.
Full textAbstract:
This chapter summarizes some first neurolinguistic studies conducted in Persian, using patholinguistic data taken from monolingual and bilingual brain-damaged patients, as well as five first neuroimaging studies in healthy native speakers of Persian. The patholinguistic data are extracted from formal clinical linguistic assessments of a heterogeneous group of brain-damaged patients with different etiologies and brain lesion sites. The data are indicative of general agrammatic features of ‘syntactic simplification’ and ‘morphological regression’ reported in cross-language studies, along with language-particular agrammatic features in spoken and written modalities for Persian consequent to brain damage. The present patholinguistic data are also suggestive of a ‘non-unitary’ model of aphasia as a symptom complex phenomenon with disruptions of independent linguistic levels consequent to different lesion sites. The data are not supportive of independent production and comprehension language centres claimed in ‘classical model’ of brain and language but in support of new non-narrow localization brain–language models.
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Mease, Philip. Neurobiology of pain in osteoarthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0013.
Full textAbstract:
Significant advances in our understanding of the neurobiology of pain in osteoarthritis (OA) have occurred in the last decade and are herein summarized. Pain is the predominant symptom of OA and occurs at multiple levels from non-cartilage peripheral tissues to spinal cord, and brain and back. At each level, nerve function is regulated by complex ionic channels, neuropeptide expression, and cytokine and chemokine activity. Previously considered a non-inflammatory condition, it is now recognized that cell proliferation and inflammatory cytokine production occurs in OA synovium, contributing to peripheral sensitization. Genetic profile influences nociceptive neuropeptide expression and thus, pain perception. Both peripheral and central sensitizing factors, including increased neuropeptide and microglial activity, lead to pain augmentation and persistence. Pain processing in brain centres such as the somatosensory cortex and insula are influenced by affective areas such as the amygdala. Descending receptor pathways through the midbrain to the dorsal horn, such as norepinephrine, serotonin, opioid, and cannabinoid, normally provide pain inhibitory function but this function may be diminished in chronic pain states such as OA, leading to allodynia and hyperalgesia. Functional neuroimaging has contributed to our understanding of the complex interplay of peripheral and central mechanisms. Recent evidence that grey matter volume decrease in chronic pain states may be reversible (e.g. after pain relief post OA hip arthroplasty) illuminates the potential for central neuroplasticity. Greater understanding of the neurobiology of OA pain provides evidence for therapeutic approaches that address peripheral and/or central pain mechanisms and provides a guide for future targeted pain therapeutics.