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Books on the topic 'Severity scale for the injury'

Author: Grafiati

Published: 4 June 2021

Last updated: 14 February 2022

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1

Barrett, Andrew Martin. Assessment of prognosis and injury severity following thermal injury. University of Birmingham, 1990.

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2

Moudon, Anne Vernez. Managing pedestrian safety I: Injury severity. Washington State Dept. of Transportation, 2007.

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3

Leder, Steven B., and Paul D. Neubauer. The Yale Pharyngeal Residue Severity Rating Scale. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-29899-3.

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4

Christensen, Cathy. Driver and occupant injury severity and restraint usage. Nebraska Dept. of Roads, 1986.

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5

United States. National Transportation Safety Board. Safety report: General aviation crashworthiness project : phase two, impact severity and potential injury prevention in general aviation accidents. The Board, 1985.

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6

A, Gennarelli Thomas, and American Association for Automotive Medicine. Committee on Injury Scaling., eds. Abbreviated injury scale. American Association for Automotive Medicine, 1985.

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7

The Abbreviated injury scale. Association for the Advancement of Automotive Medicine, 1990.

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8

Leder, Steven B. B., and Paul D. Neubauer. The Yale Pharyngeal Residue Severity Rating Scale. Springer, 2016.

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9

AAAM. Abbreviated Injury Scale (AIS) 1990 - Update 98. Association for the Advancement of Automotive Medi, 2001.

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10

Clasper, J. Blast and ballistic injury. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012006.

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♦ Unlike civilian trauma most ballistic injuries are due to penetrating wounds♦ Although weapons may change, the principles of treatment remain the same, prevent death by stopping bleeding, and prevent infection by removing dead and foreign material♦ The severity of the injury is related to the energy transfer to the tissues as well as the specific structures injured♦ Mass casualty situations may require Triage of the casualties.

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11

Diamond, Pamela M. Traumatic brain injury. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0053.

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During the past decade, traumatic brain injury (TBI) has become a frequent topic in the media. It has been a decade of expanding awareness, increased research, and growing concern about TBI of all severity levels. Consistent with this increased attention, researchers and policymakers have made strides toward greater understanding of the risks of TBI, the scope and complexity of the symptom profiles seen after TBI, and the types of treatments that optimize recovery. Recent studies have confirmed a 50 to 60% prevalence of TBI among prisoners. Most have experienced multiple injuries and experienc

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12

McLean, Anthony S., and Stephen J. Huang. Cardiac injury biomarkers in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0301.

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To be clinically relevant, a good cardiac biomarker should have four main characteristics. It should be organ-, disease- and stage-specific to be useful in diagnosis. Its release should be timely and its half-life should be long enough to make measurement possible and meaningful. Its serum or blood concentration should be proportional to disease severity; hence, can be used as a monitoring tool. Finally, their concentrations have implications on long-term outcomes. To date, only a handful of cardiac biomarkers have clinical relevance in the intensive care setting—cardiac troponins (as a marker

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13

Candela-Toha, Angel, Teresa Tenorio, Aurora Lietor, and Fernando Liaño. Scoring systems in acute kidney injury patients. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0236.

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The development of severity of illness scoring systems in the intensive care unit was prompted by the high mortality of patients in this setting. The great changes in the field of intensive care medicine have fostered new and more complex generations of scoring systems. There are several versions of the three major models used, APACHE, SAPS, and MPM. Among them, APACHE II remains the most frequently used. When these generic models are applied to acute kidney injury (AKI) patients, their discrimination ability measured by the area under the receiver operating characteristic curve is about 0.8.

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14

Hoste, Eric A. J., John A. Kellum, and Norbert Lameire. Definitions, classification, epidemiology, and risk factors of acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0220_update_001.

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The lack of a precise biochemical definition of acute kidney injury (AKI) resulted in at least 35 definitions in the medical literature, which gave rise to a wide variation in reported incidence and clinical significance of AKI, impeded a meaningful comparison of studies.The first part of this chapter describes and discusses different definitions and classification systems of AKI. Patient outcome and the need for renal replacement therapy are directly related to the severity of AKI, an observation that supports the use of a categorical staging system rather than a simple binary descriptor. The

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15

Flinders University of South Australia. Diagnosis-Based Injury Severity Scaling: A Method Using Australian and New Zealand Hospital Data Coded to ICD-10-Am. Australian Institute of Health and Welfare, 2003.

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16

Shaun, Stephenson, Australian Institute of Health and Welfare., and Flinders University of South Australia. Research Centre for Injury Studies., eds. Diagnosis-based injury severity scaling: A method using Australian and New Zealand hospital data coded to ICD-10-AM. Australian Institute of Health and Welfare, 2003.

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17

Johnson, Steven B. Pathophysiology and management of abdominal injury. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0334.

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Abdominal injuries are common following blunt and penetrating trauma. They can result in a spectrum of severity from benign to potentially life-threatening conditions. Soon after injury, haemorrhage is the predominant concern, and leading cause of morbidity and mortality. Active haemorrhage resulting in shock requires emergent operative intervention and aggressive haemostatic resuscitation. However haemodynamically-stable patients benefit from non-operative management of solid organ injuries with or without angiographic embolization. Sepsis usually occurs as a result of intra-abdominal infecti

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18

Kaplan, Tamara, and Tracey Milligan. Traumatic Brain Injury (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190650261.003.0022.

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The video in this chapter explores traumatic brain injury (TBI), including common causes and injuries (coup, and contre-coup injuries, diffuse axonal injury, hemorrhages), as well as the use of the Glasgow Coma Scale to evaluate TBI.

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19

The Canadian Acute Respiratory Illness and Flu Scale (CARIFS): The design and assessment of a paediatric disease severity measure. National Library of Canada, 1996.

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20

Ahmed, Mohammed, and Sean M. Bagshaw. Management of oliguria and acute kidney injury in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0213.

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Acute kidney injury (AKI) remains a challenging clinical problem for clinicians caring for critically-ill patients due largely to the paucity of specific therapeutic interventions aimed at mitigating poor outcome. Those patients most at risk for the development of AKI can often be identified by an assessment of demographic, clinical, diagnostic, and procedure-related factors couple with early and intensive bedside monitoring. Importantly, critically-ill patients are often exposed to multiple discrete risks that can accumulate during their course that can negatively impact not only the duration

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21

Nauta, Joske, Willem van Mechelen, and Evert ALM Verhagen. Epidemiology and prevention of sports injuries. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0040.

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Although sports injuries in children are common, prevention of these injuries is paramount. In order to set out effective prevention programmes, epidemiological studies need to be conducted on incidence, severity, and aetiology of sports injuries. Furthermore, the effectiveness of a preventive measure must be assessed, and the eventual implementation of a programme closely evaluated. When conducting epidemiological studies in sports injuries the injury definition used can have a large impact on the outcome, especially as the aetiology of sports injuries is highly multi-causal and recursive. In

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22

Srisawat, Nattachai, and John A. Kellum. Promoting renal recovery in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0379.

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Better understanding the process of renal recovery following acute kidney injury (AKI) is one of the key steps in improving AKI outcome. We are still lacking the standard definition of renal recovery. Recent progress on the pathophysiology of renal injury and recovery is encouraging. Repopulation of surviving renal tubular epithelial cells with the assistance of certain renal epithelial cell and specific growth factors, play a major role in the recovery process. Moreover, accurate prediction would help physicians distinguish patients with poor renal prognosis in whom further therapy is likely

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23

Kambouroglou, Gregoris. Fractures and dislocations of the shoulder girdle. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012036.

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♦ The function of the girdle is to position the hand in space♦ The spectrum of injuries range from common and uneventful to rare and life threatening♦ The functional outcome depends on individual demand, severity of the injury and the presence of complications.

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24

Pitcher, Joseph H., and David B. Seder. Neuroprotection for Cardiac Arrest. Edited by David L. Reich, Stephan Mayer, and Suzan Uysal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.003.0009.

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This chapter reviews the pathophysiology of brain injury after resuscitation from cardiac arrest and describes a pragmatic approach to neuroprotection. Common mechanisms of brain injury in the postresuscitation milieu are discussed and strategies for optimizing physiological variables such as blood pressure, oxygen, ventilation, and blood glucose in order to minimize secondary injury are presented. Neuroprotective therapies, such as targeted temperature management and pharmacologic neuroprotective agents, are covered in detail. Finally, the use of raw and processed electroencephalography and o

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25

Giddins, Grey. Nerve injuries. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012025.

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♦ Nerve injuries are common♦ The history is usually clear but the examination may be less so♦ Neurophysiology is only useful after 3 weeks♦ Imaging is of limited value as yet♦ Treatment is removal of the cause/repair as appropriate♦ Recovery is dependent upon many factors especially patient age, severity of the injury, how proximal the injury is and the type of nerve♦ Post operative therapy is crucial♦ Late reconstruction is primarily for motor function.

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26

Harley, Kim, and Richard Stock. Trauma and orthopaedics. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642663.003.0020.

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The physiological response to traumatic injury protects the individual from deterioration in their condition, conserving body fluids and providing energy to catabolic cells. The trauma patient should undergo an ABCDE assessment, and a full history is also required. An understanding of the circumstances and the various forces involved at the time of injury may give an indication of the type, severity, and location of possible injuries. This chapter covers the assessment, types of injuries, immediate management, ongoing management, and complications associated with traumatic injury. This chapter

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27

Tse, Raymond, and Angelo B. Lipira. Neonatal Brachial Plexus Palsy. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0023.

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Neonatal brachial plexus palsy occurs in approximately 1 in 1000 live births. The extent of involvement and severity of injury are variable. The chapter discusses assessment, nonsurgical treatment, and surgical treatment of neonatal brachial plexus palsy. The approach to surgical exploration is detailed and a number of scenarios are presented so that the principles of primary nerve reconstruction (including nerve graft and nerve transfers) can be illustrated. The scenarios include upper plexus injury, pan-plexus injury, multiple root avulsions, isolated deficits, delayed presentation, and fail

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28

Chong, Ji Y., and Michael P. Lerario. Seizures, Sadness, and Spasticity. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190495541.003.0038.

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Due to the brain’s inherent neuroplasticity, stroke patients can make major functional improvements during the first 3–6 months post-injury. Aggressive physical, occupational, and speech therapies should be focused to address individual patient needs. Depression is very common post-stroke, and if left untreated, it may lead to worsened functional outcomes. The development of spasticity post-stroke can impair motor recovery and should be treated with physiotherapy, oral antispasmodics, or local botulinum toxin injections, depending on the severity.

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29

Shaw, Christopher M., Akin Cil, and Lyle J. Micheli. Upper extremity and trunk injuries. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0044.

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As the rate and level of youth athletic participation continues to rise, so does the frequency of injury to the trunk and upper extremities in these young athletes. Injuries are varied in severity and frequency. Additionally, injury patterns are unique to the growing musculoskeletal system and specific to the demands of the sport. The treatment of these injuries is also varied, ranging from preventative, to non-operative, to operative. Recognition of injury patterns with early activity modification and the initiation of efficacious treatment can potentially prevent invasive treatments, future

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30

Fugate, Jennifer, and Eelco Wijdicks. Coma. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199658602.003.0002.

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Coma is an ominous sign and has been known since antiquity. Over several decades, a much better understanding of the mechanisms of coma, patterns of brain tissue shift, and its clinical correlates has developed. Methods of the examination and the details of approaching a diagnosis of patients in coma have evolved gradually over this time. In this chapter, the key articles that formed the basis of this evaluation are discussed. These articles offer an understanding of how the current level of sophistication regarding determination of the severity of brain injury, of improvement potential, and o

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31

James, Nicholas D., and Elizabeth J. Bradbury. Autotomy. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0065.

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The landmark paper discussed in this chapter is ‘Autotomy following peripheral nerve lesions: Experimental anaesthesia dolorosa’, published by Wall et al. in 1979. This paper was the culmination of a series of studies in which Wall, together with a number of colleagues, investigated the underlying causes of neuropathic pain following peripheral nerve injury. In this paper, the authors used a variety of nerve injury models to show that the extent of resultant anaesthesia combined with ectopic firing from damaged axons in nerve-end neuromas correlated with the severity of self-mutilation (termed

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32

Steiner, Lisa A. Infections of the Hand. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0047.

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Hand infections can be delineated by type and location of infection, by a polymicrobial vs single microbial colonization, and by the type of organism. They are most often caused by superficial injury or trauma. Early identification and timely treatment can significantly improve the morbidity associated with hand infections. In addition to determining the source and mechanism of infection, it is important to identify tetanus immunization status, prior injury to the affected area, immune status, occupation, and hand dominance. Some hand infections (eg, paronychia, felon, herpetic whitlow, and ce

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33

D’Haese, Patrick C., Benjamin A. Vervaet, and Anja Verhulst. Heavy metal-induced tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0088.

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Environmental and occupational exposure to heavy metals should be considered an important health hazard, even more so since evidence has been provided in recent literature for toxic effects occurring even at low levels. The kidney is highly vulnerable to metal toxicity and the extent of renal damage depends on the nature, dose, route, and duration of exposure. Both acute and chronic intoxication have been demonstrated to cause kidney injury, with various levels of severity, ranging from tubular dysfunctions to severe chronic kidney disease. The epidemiology of heavy metals poisoning, their ren

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34

Reffelmann, Thorsten, and Robert Kloner. Adjunctive Reperfusion Therapy Post-AMI. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0009.

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• Reperfusion of the occluded coronary artery in an ST-segment-elevation myocardial infarction is the most effective approach for reducing infarct size, preserving left ventricular ejection fraction, lowering the incidence and severity of congestive heart failure and improving prognosis• Hence, several pharmacologic agents intended to improve target vessel patency as an adjunct to thrombolysis or primary percutaneous coronary intervention have been shown to be beneficial in patients with reperfusion therapy for acute myocardial infarction, namely antiplatelet and anticoagulation agents• Animal

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35

Kiss, Thomas, and Paolo Pelosi. Lung recruitment techniques in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0120.

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Lung recruitment manoeuvres (RMs) have been suggested as a means of homogenizing the lung structure and distribution of the mechanical stress across the lungs. Such effects can be achieved provided enough pressure is applied for enough time at the airways, and maintained if adequate levels of positive end-expiratory pressure (PEEP) are used. When RMs effectively open atelectatic tissue, shear stress, and cyclic collapse/reopening are importantly reduced. The lung response to RMs is mainly determined by cause and severity of lung injury, and the position of the lungs with respect to the gravity

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36

Orlikowski, David, and Tarek Sharshar. Epidemiology, diagnosis, and assessment of neuromuscular syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0243.

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Admission to ICU with severe limb weakness, or the occurrence of a respiratory or motor deficit, and failure to wean from mechanical ventilation while in the intensive care unit are common presentations of a neuromuscular disease. Neuromuscular diseases include neuronopathies, neuropathies, myasthenic syndromes, and myopathies. An accurate neurological examination and complementary investigations are necessary for both diagnosis and for evaluating the severity of the disease. Assessment of respiratory muscle function is a key step in deciding the need for mechanical ventilation and subsequentl

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37

Gray, Andrew C. Orthopaedic approach to the multiply injured patient. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012003.

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♦ Major trauma results in a systemic stress response proportional to both the degree of initial injury (1st hit) and the subsequent surgical treatment (2nd hit).♦ The key physiological processes of hypoxia, hypovolaemia, metabolic acidosis, fat embolism, coagulation and inflammation operate in synergy during the days after injury/surgery and their effective management determines prognosis.♦ The optimal timing and method of long bone fracture fixation after major trauma remains controversial. Two divergent views exist between definitive early intramedullary fixation and initial external fixatio

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38

Kelly, Thomas J., and Mijail Serruya. Integrative Approaches to Cognitive Decline. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0017.

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The ability to remember, plan, communicate, and multitask changes with normal, healthy aging. These cognitive abilities decline more rapidly and with greater severity in the setting of neurodegenerative disease. The most common etiology of neurodegenerative cognitive decline is Alzheimer’s disease, and other processes, such as those triggered by stroke, dementia with Lewy bodies, and traumatic brain injury, also cause significant debility. The purpose of this chapter is to review evidence-based integrative medical interventions that may slow both normal and disease-related cognitive decline in

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39

Orellana, Renán A., and Jorge A. Coss-Bu. Nutrition and Gastrointestinal Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0014.

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Appropriate nutrition must be tailored to the specific needs of individual patients. Needs depend on the child’s baseline nutritional status, the severity of disease, and specific organ dysfunction. Enteral nutrition is preferable whenever possible. Parenteral nutrition may be necessary when efforts to supply adequate nutrition enterally are contraindicated or unsuccessful. Patients with symptoms of acute abdomen require prompt recognition of surgical and nonsurgical disorders. Upper gastrointestinal hemorrhage may require transfusion of blood products, vasoactive drug infusion to minimize ong

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40

Cummings, Jeffrey, and Kate Zhong. Promise and Challenges in Drug Development and Assessment for Cognitive Enhancers. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0001.

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Cognitive disturbances are ubiquitous in neurologic and psychiatric disorders. Schizophrenia, depression, developmental disorders, acquired brain disorders (traumatic brain injury and stroke), and neurodegenerative disorders all have cognitive impairment as a manifestation. Cognitive enhancers can improve intellectual function and have been approved for Alzheimer’s dementia, dementia of Parkinson’s disease, and attention deficit hyperactivity disorder. Cognitive enhancers are being developed for other cognitive disorders. There are many advantages for development of symptomatic cognitive enhan

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41

Nolan, Jerry P., and Michael J. A. Parr. Management after resuscitation from cardiac arrest. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0066.

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Systemic ischaemia during cardiac arrest and the reperfusion response after return of spontaneous circulation (ROSC) cause the post-cardiac arrest syndrome (PCAS). The severity and duration of this syndrome is determined by the cause and duration of cardiac arrest, quality of resuscitation, and interventions after ROSC. Four key clinical components are recognized—post-cardiac arrest brain injury, myocardial dysfunction, other organ ischaemia/reperfusion (e.g. liver, kidney), and potential persistence of the precipitating pathology causing the cardiac arrest. The interventions applied after ROS

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42

van Mechelen, Willem, and Evert A. L. M. Verhagen. Current concepts on the aetiology and prevention of sports injuries. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199232482.003.0042.

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A physically active lifestyle and active participation in sports is important, for adults as well as for children. Reasons to participate in sports and physical activity are many: pleasure and relaxation, competition, socialization, maintenance and improvement of fitness and health, etc. In general, when compared to adults, the risk for sports injury resulting from participation in sports and free play is low in children.1 Despite this relatively low risk, sports injuries in children are a fact of life, which calls for preventive action. In order to set out effective prevention programmes, epi

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43

Ho, Vanessa P., and Philip S. Barie. Acute acalculous cholecystitis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0188.

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Acute acalculous cholecystitis (AAC) may occur in surgical or injured, critically-ill, and systemically-ill patients, with diabetes mellitus, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, shock, and cardiac arrest. Children may also be affected, especially following a viral illness. The pathogenesis of AAC is complex and multifactorial. Ischaemia/reperfusion injury and the associated pro-inflammatory response and oxidative tissue stress, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and parent

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44

Kinsella, Sinead, and John Holian. The effect of chronic renal failure on critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0218.

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The incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) is increasing, reflecting an increase in the incidence and prevalence of hypertension and type 2 diabetes. Patients with CKD and ESKD frequently experience episodes of critical illness and require treatment in an intensive care unit (ICU)setting. Management requires specific consideration of their renal disease status together with their acute illness. Mortality in critically-ill patients with ESKD is frequently related to their co-morbid conditions, rather than their ESKD status. Illness severity scoring systems

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45

Newman, Chris, Christina D. Buesching, and David W. Macdonald. Meline mastery of meteorological mayhem: the effects of climate changeability on European badger population dynamics. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198759805.003.0021.

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Adaptation to climatic conditions is a major ecological and evolutionary driver. Long-term study of European badger population dynamics in Oxfordshire reveals that rainfall and temperature patterns affect food (principally earthworm) availability, energy expended in thermoregulation, and activity patterns, with badgers able to seek refuge in their setts. Cubs prove especially vulnerable to harsh weather conditions, where drought and food shortages exacerbate the severity of pandemic juvenile coccidial parasite infections. Crucially, weather variability, rather than just warming trends, stresse

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46

Yoong, Jaclyn, and Fiona Runacres. Changes in the Last Months of Life (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0008.

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This study aimed to assess symptoms and performance status of cancer patients during the last six months of life. In Ontario, Canada, Edmonton Symptom Assessment System (ESAS) scores and Palliative Performance Scale (PPS) scores of outpatients with cancer were systemically collected. This was an observational cohort study of cancer decedents’ ESAS and PPS scores between 2007 and 2009. Outcomes were the average ESAS and PPS scores per week before death. A total of 10,752 decedents with ESAS and 7,882 with PPS scores were included. General patterns of symptoms scores were observed: (1) generally

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47

Demshuk, Andrew. Demolitions and Dread, 1961–1964. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190645120.003.0004.

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Having learned its lessons in 1960, the State pursued demolitions through the following years without serious architectural competitions or involving the public. Each time the wrecking ball danced through another monument protest letters increased in number and severity, until at last the surprise 1963 toppling of the Baroque Johannis tower, directly east of the University Church, was seen by many to anticipate the destruction of the University Church as foretold in 1960. Extreme letter exchanges unleashed the regime’s open hatred for citizens who failed to correspond to its imagined majority

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48

Hughes, Jeremy. Proteinuria as a direct cause of progression. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0137.

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Proximal tubular cells reabsorb any filtered proteins during health via cell surface receptors such as megalin and cubulin so that very low levels of protein are present in the excreted urine. Significant proteinuria is a common finding in patients with many renal diseases. Proteinuria is a marker of glomerular damage and podocyte loss and injury in particular. The degree of proteinuria at presentation or during the course of the disease correlates with long-term outcome in many renal diseases. Proteinuria per se may be nephrotoxic and thus directly relevant to the progression of renal disease

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49

Speed, Cathy. Pharmacological pain management in sports injuries. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199533909.003.0015.

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The perception of pain is a biological mechanism which warns that damage has occurred and protects against further damage, allowing healing to occur. Acute pain often acts as an indicator of injury severity and progression or healing. The same may apply in some with chronic injuries, but in others pain may not correlate with tissue damage and/or may not be a sign that the tissue needs to be protected from mechanical stress. The management of most sports injuries involves early mobilization where possible, and pain management in the treatment of these injuries is important to allow rehabilitati

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50

Sessler, Curtis N., and Katie M. Muzevich. Sedatives and anti-anxiety agents in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0042.

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Sedative and anti-anxiety agents are administered to many mechanically-ventilated intensive care unit (ICU) patients. While commonly considered supportive care, suboptimal administration of sedatives has been linked to longer duration of mechanical ventilation and longer ICU length of stay. The use of a structured multidisciplinary approach can help improve outcomes. The level of consciousness, as well as the presence and severity of agitation should be routinely evaluated using a validated sedation–agitation scale. The approach to delivery of sedation should be based upon specific goals, part

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