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1

Duncanson, G. R. Veterinary Treatment of Llamas and Alpacas. Wallingford: CABI, 2012.

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2

Moya, Viviana Ortíz de. En defensa de la carne de llama/alpaca. 2nd ed. Oruro [Bolivia]: Centro Diocesano de Pastoral Social, 1995.

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3

Fowler, Murray E. Medicine and surgery of camelids: Llama, alpaca, vicuña, guanaco, dromedary & Bactrian camels. 3rd ed. Ames, Iowa: Wiley-Blackwell, 2010.

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4

Medicine and surgery of South American camelids: Llama, alpaca, vicuña, guanaco. Ames: Iowa State University Press, 1989.

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5

Medicine and surgery of South American camelids: Llama, alpaca, vicuña, guanaco. 2nd ed. Ames: Iowa State University Press, 1998.

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6

Duncanson, Graham R. Veterinary treatment of llamas and alpacas. Wallingford, Oxfordshire, UK: CAB International, 2012.

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7

Symposium on Diseases of Small Ruminants (1990 Corvallis, Or.). American Association of Small Ruminant Practitioners ... , Western Regional Coordinating Committee-46 (Ram Epididymitis and Ovine Footrot), Oregon State University, College of Veterinary Medicine present Symposium on Diseases of Small Ruminants, Nendels Inn, Corvallis, Oregon, June 7,8,9, 1990. [S.l: s.n., 1990.

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8

Smith, Bradford B. Llama and alpaca medicine and surgery: Short course : March 22-28, 1994, College of Veterinary Medicine, Oregon State University. Corvallis, Or: Oregon State University, College of Veterinary Medicine, 1994.

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9

Periodontal disease. Basel: Karger, 2012.

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10

Foundation, Alpha-1. Welcome to Alphaville: Big fat reference guide for Alphas, their families, and their doctors : Alpha-1 disease management and prevention program. Coconut Grove, Fla: AlphaNet, 2004.

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11

An Alpha-1 COPD love story. Amherst, MA: Small Batch Books, 2011.

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12

International Conference on Tumor Necrosis Factor and Related Cytokines (4th 1992 Veldhoven, Netherlands). Tumor necrosis factor: Molecular and cellular biology and clinical relevance. Edited by Fiers Walter and Buurman Wim A. Basel: Karger, 1993.

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13

Panniculitis. Philadelphia, Pa: Saunders, 2008.

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14

Garmendia, Antonio Efrain. The mechanism, isotypes involved and effect of passive immunoglobulin transfer to the newborn alpaca. 1986.

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15

Chris Cebra VMD MS DACVIM, David E. Anderson DVM MS DACVS, Ahmed Tibary DVM PhD DACT, Robert J. Van Saun DVM MS PhD DACT DACVN, and LaRue Willard Johnson DVM PhD. Llama and Alpaca Care: Medicine, Surgery, Reproduction, Nutrition, and Herd Health. Saunders, 2013.

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16

Anderson, David E., Matt D. Miesner, and Meredyth L. Jones. Veterinary Techniques for Llamas and Alpacas. Wiley & Sons, Limited, John, 2013.

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17

Anderson, David E., Matt D. Miesner, and Meredyth L. Jones. Veterinary Techniques for Llamas and Alpacas. Wiley & Sons, Incorporated, John, 2013.

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18

Anderson, David E., Matt D. Miesner, and Meredyth L. Jones. Veterinary Techniques for Llamas and Alpacas. Wiley & Sons, Incorporated, John, 2013.

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19

Anderson, David E., Matt D. Miesner, and Meredyth L. Jones. Veterinary Techniques for Llamas and Alpacas. Wiley & Sons, Incorporated, John, 2013.

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20

Keshav, Satish, and Palak Trivedi. Genetic liver disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0214.

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This chapter discusses three of the major inherited forms of liver disease (all autosomal recessive): hereditary haemochromatosis, Wilson’s disease, and alpha-1-antitrypsin deficiency. Hereditary haemochromatosis is characterized by excessive absorption of dietary iron, with a pathological increase in total body iron that accumulates in tissues and organs, disrupting their function. Wilson’s disease (hepatolenticular degeneration) is an autosomal recessive genetic disorder in which copper accumulates in tissues. Alpha-1-antitrypsin deficiency is characterized by reduced circulating levels of alpha-1-antitrypsin, a liver-derived protease inhibitor, and accumulation within the hepatocytes of the abnormal, poorly degraded protein; the consequent excessive activity of proteases such as elastase in pulmonary alveoli, unopposed by protease inhibitors, leads to emphysema, and the accumulation of alpha-1-antitrypsin in hepatocytes causes liver dysfunction.
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21

Waldek, Stephen. Fabry disease. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0337.

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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, and nervous system. Painful peripheral (‘acral’) neuropathy is characteristic.Key clinical signs are angiokeratoma found by close examination of skin; characteristic eye lesions may be seen; lipid deposits may be seen in urine. Renal biopsy appearances are characteristic and this is commonly where the diagnosis is first made. Increasingly, cardiologists are suspecting the condition in adults with echocardiographic appearances of left ventricular hypertrophy. Diagnosis in men is usually made by measurement of alpha-galactosidase in either white cells or plasma (or using blood spots). Unfortunately, many female patients can have normal enzyme levels so that genetic testing is the only way to confirm a diagnosis. Non-selective screening strategies (e.g. males on renal replacement therapy with uncertain renal diagnoses) have had low yields.
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22

Soileau, Michael J., and Kelvin L. Chou. Parkinson Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0002.

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Parkinson disease is a neurodegenerative disorder characterized clinically by tremor, rigidity, bradykinesia, and postural instability and pathologically by loss of nigrostriatal neurons and deposition of alpha-synuclein in neuronal cell bodies and neuritis. Non-motor symptoms such as psychiatric disorders, cognitive abnormalities, sleep dysfunction, autonomic dysfunction, and sensory manifestations are also common. This chapter gives a broad overview of this disorder. Sections cover pathophysiology, genetics, clinical manifestations, and disease course. The chapter also briefly discusses how to make the diagnosis, and alternative conditions that should be considered.
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23

Keshav, Satish, and Palak Trivedi. Investigation in liver disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0208.

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This chapter discusses investigations in liver disease, including blood tests (liver chemistry and liver function tests, alpha-fetoprotein, viral serology, antibodies and immunoglobulins), ascetic fluid analysis, imaging (hepatobiliary ultrasound, CT, MRI, endoscopic ultrasound), and liver biopsy.
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24

Jolly, Elaine, Andrew Fry, and Afzal Chaudhry, eds. Gastroenterology and hepatology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199230457.003.0009.

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Chapter 9 covers the basic science and clinical topics relating to gastroenterology and hepatology which trainees are required to learn as part of their basic training and demonstrate in the MRCP. It covers basic science, gastrointestinal investigation, malabsorption and malnutrition, inflammatory bowel disease, acute upper gastrointestinal haemorrhage, lower gastrointestinal bleeding and related disorders, gastrointestinal infections, gastrointestinal cancer, miscellaneous gastrointestinal problems, normal liver and biliary function, variceal disease, hepatic tumours, acute (fulminant) liver failure, haemochromatosis, Wilson disease (hepatolenticular degeneration), Alpha-1 antitrypsin deficiency, alcohol-induced liver disease, hepatitis, biliary diseases, and non-alcoholic fatty liver disease.
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25

Lees, A. J. Parkinson’s disease. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199658602.003.0008.

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The following landmark discoveries in our understanding of Parkinson’s disease are considered in this chapter: the first full medical description of the malady; consistent severe loss of pigmented cells in the substantia nigra; severe depletion of striatal dopamine; the use of high doses of racemic dopa to improve the motor symptoms; a superior animal model for the study of potential new treatments; functional lesioning and deep brain stimulation to relieve symptoms; capability of fetal dopamine cells to reinnervate the striatum and improve handicap; a compensatory phase before the emergence of motor symptoms and nigral cell loss beginning about five years prior to the onset of presenting symptoms; a large autosomal dominant family with Parkinsonism found to carry a genetic mutation of alpha synuclein; and discovery of Lewy bodies in surviving grafted fetal neuronal cells many years after successful implantation.
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26

Waldek, Stephen. Fabry disease. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0335_update_001.

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Fabry disease is a rare X-linked disorder of glycosphingolipid metabolism caused by a deficiency of the lysosomal acid hydrolase enzyme, alpha-galactosidase A. The resulting accumulation of substrate, mostly globotriaosylceramide, leads to a progressive, multiorgan disease affecting predominantly the kidneys, skin, heart, and nervous system. It is one of over 50 lysosomal storage diseases. It is typically diagnosed in young men after many years of ‘acral pain’ syndrome, when the diagnosis is made through identification of characteristic abnormalities of skin, kidney or heart, or of other organs. Renal failure has been a common outcome. Females may also develop manifestations, usually later in life. Renal biopsy shows vacuoles/deposits in podocytes and other renal cell types with progressive scarring. The diagnosis can be made by measuring enzyme levels in men, or by genetic testing. This latter is the more reliable test in women. Fabry disease can now be treated where affordable by regular (every 2 weeks) intravenous infusions of recombinant preparations of the deficient enzyme. These are burdensome and expensive, but are transforming the outlook for the condition.
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27

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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28

Nasimudeen, Abdul. Screening for respiratory disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0352.

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Routine screening for respiratory diseases is currently not available to the general healthy population, with the exception of screening for cystic fibrosis. This chapter discusses the screening strategies in place for cystic fibrosis, TB, and other conditions, such as COPD, lung cancer, alpha-1 antitrypsin deficiency, pulmonary hypertension, pulmonary arteriovenous malformation, and obstructive sleep apnoea, for which screening can be applied. While screening has the potential to improve quality of life through early diagnosis and management, it is not an easy process and cannot offer a guarantee of protection.
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29

Turk, Bela R., and Ali Fatemi. Diagnosis and Therapy for Lewy Body Dementia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0019.

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Almost undistinguished some 30 years ago, dementia with Lewy bodies is now shown to be the second most common neurodegenerative cause of dementia in the elderly. A host of neuroinflammatory mechanisms are attributed to Lewy bodies and their component alpha synuclein, a common pathology shared by Parkinson disease and Parkinson disease with dementia. Accurate diagnosis of patients is essential, as they show unique impairment patterns, which differ from other forms of dementia and show severe adverse reaction to neuroleptic medication, a common treatment in other degenerative diseases.
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30

Helge, Refsum, and Mjøs Ole D. 1939-, eds. [Alpha]-adrenoceptor blockers in cardiovascular disease. Edinburgh: Churchill Livingstone, 1985.

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31

Waldek, Stephen. Fabry disease. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0338_update_001.

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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 (Gb3), which causes a progressive, multiorgan disease affecting predominantly the kidneys, skin, heart, and nervous system. Painful peripheral (‘acral’) neuropathy is characteristic. Proteinuria and estimated glomerular filtration rate (eGFR) are strongly associated with risk of progression, but this may be reduced by treatment with angiotensin-converting enzyme inhibitors as well as by enzyme replacement therapy (ERT). ERT was approved in 2001; it improves pain and other neuropathic symptoms, and well-being, and has been proven to clear deposits of Gb3 from tissues, at variable speeds. There is limited randomized controlled trial data but protective effects have been proven for renal outcomes, death, and better outcomes in some other organ systems. Renal function may be protected if ERT is commenced before there is heavy proteinuria or substantial loss of GFR. It is recommended to start ERT as soon as the diagnosis is made in those with very low or absent enzyme. For those with intermediate levels it is recommended to commence treatment only when signs or symptoms appear. Proteinuria and eGFR give most information from a renal point of view, but renal biopsy is also useful for confirming the renal diagnosis and staging the disease as well as monitoring progress in selected cases. Management should include regular screening for complications including myocardial and neurological assessments. It is likely that registries will show progressive rises in median survival with this condition.
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32

Crystal. Alpha 1 - Antitrypsin Deficiency (Lung Biology in Health and Disease). Informa Healthcare, 1995.

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33

Ferini-Strambi, Luigi, and Sara Marelli. Restless legs syndrome/Willis–Ekbom disease. Edited by Sudhansu Chokroverty, Luigi Ferini-Strambi, and Christopher Kennard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682003.003.0024.

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Restless legs syndrome (RLS)/Willis–Ekbom disease (WED), is a common neurological disorder characterized by uncomfortable and unpleasant sensations in the legs, with an urge to move. The general population prevalence has been estimated at approximately 5%. In 1995, the International RLS/WED Study Group established four clinical criteria for RLS/WED diagnosis, and in 2012 introduced a fifth (that symptoms are not due to another medical or behavioral condition) to improve differential diagnosis. Periodic leg movements causing sleep fragmentation may be observed in almost 80% of RLS/WED patients. Genetics, central nervous system dopamine dysregulation, and brain iron deficiency seem to be the primary involved factors, but peripheral phenomena may also contribute to the pathophysiology. Several medications have demonstrated efficacy in treating RLS/WED, including dopaminergic agents, alpha-2-delta ligands, and opioids. Pharmacological therapy should be limited to those patients who suffer from clinically relevant symptoms with impaired sleep quality or quality of life.
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34

P, Baetcke Karl, and United States. Environmental Protection Agency. Risk Assessment Forum, eds. Alpha[2u]-globulin: Association with chemically induced renal toxicity and neoplasia in the male rat. Washington, DC: The Forum, 1992.

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35

Galvin, James E., and Jose Tomas Bras. Neurobiology of Lewy Body Dementias. 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/9780190681425.003.0055.

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Lewy body dementia (LBD) is the second most common form of neurocognitive disorder after Alzheimer’s disease and covers two related diagnoses: Dementia with Lewy Bodies and Parkinson’s Disease Dementia. Despite being a common disorder, diagnosis outside expert academic centers remains a significant challenge. The core pathological feature of LBD is the cortical Lewy body; however, many cases will have coexistent Alzheimer disease pathology. Genetic risk factors for LBD include mutations in genes for alpha-synuclein (SNCA) and galactocerbrosidase (GBA). Dopamine transporter imaging remains the most sensitive but platforms for measuring alpha-synuclein are being developed. Current therapies focus on symptomatic relief but experimental cell and animal models are providing new insights for the development of disease-modifying therapeutics.
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36

Muche, Marion, and Seema Baid-Agrawal. Hepatitis B. Edited by Vivekanand Jha. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0185_update_001.

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Hepatitis B virus (HBV) has been causally linked to a variety of renal diseases, the most common being glomerular diseases and systemic autoimmune disease. Membranous nephropathy (MN) is the commonest HBV-associated glomerulonephritis (HBV-GN), followed by membranoproliferative glomerulonephritis (MPGN), mesangial proliferative glomerulonephritis, immunoglobulin (Ig)-A nephropathy, and focal segmental glomerulosclerosis (FSGS). Polyarteritis nodosa is a rare manifestation. The incidence of HBV-associated renal diseases seems to be decreasing with the introduction of vaccination programmes.HBV-MN is the most frequent cause of nephrotic syndrome in children in countries with high endemicity of HBV infection. The clinical course is usually benign in children with high rates of spontaneous remission rates and low risk of progression to renal failure. The prognosis is worse in adults. Of the systemic autoimmune disorders associated with HBV infection that involve the kidneys, the strongest link has been found with polyarteritis nodosa (PAN), a lesion that causes arteritis of medium-sized renal vessels. HBV-associated PAN (HBV-PAN) usually manifests in the first year after infection, and is clinically indistinguishable from classic PAN.Diagnosis of HBV-GN or -PAN is based on the clinical picture, histological findings, evidence of viral replication in serum and/or liver and detection of HBV antigens or DNA in the tissue. Besides deposition of immune complexes, other mechanisms such as virus-induced cytopathic damage have been proposed to explain the pathogenesis.HBV-GN and HBV-PAN appear to respond to antiviral treatment. Both show remission after HBeAg seroconversion. The available studies predominantly employed first-generation agents like interferon alpha and lamivudine, which showed suppression of viral replication and clinical remission of HBV-associated renal disease. Immunosuppressive therapy appears to be inevitable for the control of severe HBV-PAN and could be helpful in addition to antiviral treatment for cases of HBV-GN not responding clinically to antiviral treatment.
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37

Heijstek, Marloes, Mario Abinun, and Nico Wulffraat. Vaccination in immunocompromised children. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0095.

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Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying anti-rheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. Although non-live vaccines are safe, it is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals. However, booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and anti-tumour necrosis factor alpha (TNFα‎) may lower vaccine-induced antibody concentrations. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.
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38

Heijstek, Marloes, Mario Abinun, and Nico Wulffraat. Vaccination in immunocompromised children. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0095_update_003.

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Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying antirheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. It is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals, but booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and tumour necrosis factor alpha (TNFα‎) may lower vaccine-induced antibody concentrations and may cause accelerated waning of immunity. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.
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39

M, Cutolo, and New York Academy of Sciences., eds. Basic and clinical aspects of neuroendocrine immunology in rheumatic diseases. Boston, Mass: Blackwell Pub. on behalf of the New York Academy of Sciences, 2006.

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40

Babiloni, Claudio, Claudio Del Percio, and Ana Buján. EEG in Dementing Disorders. Edited by Donald L. Schomer and Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0016.

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This chapter reviews the most relevant literature on qualitative and quantitative abnormalities in resting-state eyes-closed electroencephalographic (rsEEG) rhythms recorded in patients with dementing disorders due to Alzheimer’s disease, frontotemporal lobar degeneration, vascular disease, Parkinson’s disease, Lewy body disease, human immunodeficiency virus infection, and prion disease, mainly Creutzfeldt–Jakob disease. This condition of quiet wakefulness is the most used in clinical practice, as it involves a simple, innocuous, quick, noninvasive, and cost-effective procedure that can be repeated many times without effects of stress, learning, or habituation. While rsEEG has a limited diagnostic value (not reflecting peculiar pathophysiological processes directly), delta, theta, and alpha rhythms might be promising candidates as “topographical markers” for the prognosis and monitoring of disease evolution and therapy response, at least for the most diffuse dementing disorders. More research is needed before those topographical biomarkers can be proposed for routine clinical applications.
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41

National Institutes of Health (U.S.). Clinical Center, ed. Understanding alpha-1 antitrypsin deficiency. [Bethesda, Md.]: National Institutes of Health, Clinical Center, 1994.

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42

Parkinson, Michael, John P. Dalton, and Sandra M. O’Neill. Fasciolosis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0079.

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Liver fluke disease, or fasciolosis, of livestock and humans is caused by endoparasitic trematodes of the genus Fasciola. Fasciola hepatica is responsible for the disease in temperate climates whereas F. gigantica is found in tropical zones. Recently, hybrids between F. hepatica and F. gigantica have been described (Le et al. 2008, Periago et al. 2008). Fasciolosis is a true zoonoses as it is predominantly a disease of animals that can be transmitted to humans at a specific stage of the parasite’s complex life cycle. There are a number of definitive hosts which includes sheep, cattle, and humans but this parasite has evolved to infect many other mammalian hosts including pigs, dogs, alpacas, llamas, rats, and goats (Apt et al. 1993; Chen and Mott 1990; Esteban et al. 1998). While prevalence of infection in humans may be relatively low in relation to animals, in specific geographic locations, for example in Bolivia, the prevalence of fasciolosis is so high in the human populations (hyperendemic) that it contributes to the spread of disease in animals (Esteban et al. 1999; Mas-Coma et al. 1999).Archeological studies showing Fasciola eggs in ancient mummies in Egypt demonstrate that fasciolosis is an ancient human disease (David 1997). Sporadic cases of fasciolosis were reported in Egypt in 1958 (Kuntz et al. 1958). The first to carry out an extensive review on human fasciolosis were Chen and Mott (1990). They reported 2,595 cases in over 40 countries in Europe, the Americas, Asia, Africa and the western Pacifi c from 1970 – 1990. This review raised awareness of fasciolosis in humans and triggered a growth in epidemiological studies and a consequential dramatic increase in reporting of cases in the literature. Now human fasciolosis is recognized by the World Health Organization (WHO) as an important disease in humans with an estimated 2.4 million people infected annually and 180 million at risk to infection in over 61 countries (Haseeb et al. 2002). There have been several cases of large scale epidemics in France (Dauchy et al. 2007), Egypt (Curtale et al. 2007) and Iran (Rokni et al. 2002).However, the only extensive epidemiological studies to determine the rate of infection have been carried out in Egypt and Bolivia (Curtale et al. 2003, 2007; Esteban et al. 2002; Parkinson et al. 2007). These studies have shown that co-infection with other diseases is a common occurrence and this may lead to under-reporting of the incidence of fasciolosis (Esteban et al. 2003; Maiga et al. 1991). In many countries, the overall rates of infection are extrapolated from sporadic reports of the disease and, consequently, worldwide disease prevalence is uncertain. In this chapter we will review the cause and effect of human fasciolosis, and particularly highlight important considerations in designing control strategies to reduce infection in at-risk communities.
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43

Laureno, Robert. Asymmetry. Edited by Robert Laureno. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190607166.003.0012.

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This chapter on “Asymmetry” examines the topic of normal neurological asymmetries and their implications for disease states. Neurologists encounter asymmetry daily. They regularly see asymmetry of pupil diameter, and alpha rhythm amplitude differences are frequently found between the right and left sides on a scalp recording. Not all of the asymmetries are important. However, neurologists must be aware of the anatomic asymmetries that occur. Within limited ranges, these asymmetries are “physiologic.” Asymptomatic developmental asymmetries can become important when disease is superimposed on congenital vascular variants. This chapter comprises discussion of several topics about central nervous system asymmetries and their importance to the neurologist.
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44

Raynal, Gauthier, and Olivier Traxer. Imaging and interventional treatment. Edited by Mark E. De Broe. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0206.

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AbstractUrolithiasis has a great importance in the urologist’s practice: it is a common disease which represent a great part of the urologist’s activity, and stone disease is linked to the beginning of urology as an individual medical specialty and to many technical improvements, from the beginning of endoscopy up to extracorporeal shockwave lithotripsy and modern endourology.Imaging and diagnostic techniques and pain relief are described. Usually stones <5mm will pass spontaneously and are managed conservatively. At 5-10mm medical expulsive therapy with an alpha-adrenergic blocker will shorten symptoms. Stones larger than this are likely to need tailored treatment depending on stone type and location and history, choosing from endoscopy, shockwave lithotripsy, or percutaneous lithotripsy.
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45

G, Crystal Ronald, ed. Alpha 1-antitrypsin deficiency: Biology, pathogenesis, clinical manifestations, therapy. New York: Marcel Dekker, 1996.

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46

Fiers, Walter, and Wim A. Buurman. Tumor Necrosis Factor: Molecular and Cellular Biology and Clinical Relevance. S Karger Pub, 1993.

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47

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Madhumita Bhattacharyya. Gynaecological cancers. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0020_update_001.

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Genitourinary cancers examines the malignancies arising in the kidney, ureter, bladder, prostate, testis, and penis. Renal cancer has high propensity for systemic spread, largely mediated by overexpression of vascular endothelial growth factor (VEGF). Treatments include surgery, immunotherapy, and targeted therapy. Wilms tumour, a childhood malignancy of the kidney, warrants specialist paediatric oncology management to provide expertise in its unique pathology, staging, and treatment, often with surgery and chemotherapy. Cancer of the bladder and ureters, another tobacco related cancer, may present as either superficial or invasive disease. The former is managed by transurethral resection and intravesical therapy. The latter may require radical surgery, preoperative chemotherapy, or radiotherapy. Prostate cancer, the commonest male cancer, is an androgen dependent malignancy. It has attracted controversy with regards to PSA screening, and potential over treatment with radical prostatectomy. Division into low, intermediate, and high risk disease according to tumour grade, stage, and PSA helps in deciding best treatment, antiandrogen therapy for metastatic disease, radiotherapy and adjuvant hormone therapy for locally advanced disease, either surgery or radiotherapy for early intermediate risk disease, and active monitoring for low risk cases. Testicular cancer divides according to pathology into seminoma, nonseminomatous germ cell tumours (NSGCT), and mixed tumours, the latter two frequently producing tumour markers, alpha-fetoprotein (AFP) and/or human chorionic gonadotrophin (HCG). Stage I disease is managed by inguinal orchidectomy and surveillance or adjuvant chemotherapy. More advanced disease is managed by chemotherapy, with high probability of cure in the majority. Penile cancer, often HPV related, can be excised when it presents early, but delay in presentation may lead to regional and systemic spread with poor prognosis.
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48

Lahita, Robert, J. W. J. Bijlsma, Alfonse Masi, and Rainer Straub. Basic and Clinical Aspects of Neuroendocrine Immunology in Rheumatic Diseases (Annals of the New York Academy of Sciences). Blackwell Publishing Limited, 2006.

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49

Sherman, Elias, and Simpson Joe Leigh 1943-, eds. Maternal serum screening for fetal genetic disorders. New York: Churchill Livingstone, 1992.

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50

Alvis, Bret D., and Christopher G. Hughes. Delirium. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0061.

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Delirium in the postoperative period, characterized by inattention, disorganized thinking, disorientation, and/or altered levels of consciousness within the first few days after surgery, has been associated with significant increases in hospital stay, functional decline, prolonged cognitive dysfunction, and mortality. It is underdiagnosed without routine assessments with validated tools such as the Confusion Assessment Method (CAM), the 4AT, the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). Prevention strategies for postoperative delirium include multimodal pain control, judicious use of medications that affect the sensorium, including benzodiazepines and anticholinergics, maintenance of appropriate volume status, and optimization of the patient’s environment. In patients who develop delirium with severe agitation, antipsychotic and alpha-2 agonist medications may be useful. Because postoperative delirium occurs commonly and is associated with worse outcomes, an understanding of its disease process, risk factors, and management is essential for an anesthesiologist.
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