bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioethics and the Culture Wars
Authors:   Wake Forest University, Winston-Salem, North Carolina (USA), Iltis Ana S.
Published: January 2021

The term “culture wars” has been used to describe deep, apparently intractable, disagreements between groups for many years. In contemporary discourse, it refers to disputes regarding significant moral matters carried out in the public square and for which there appears to be no way to achieve consensus or compromise. One set of battle lines is drawn between those who hold traditional Christian commitments and those who do not. Christian bioethics is nested in a set of moral and metaphysical understandings that collide with those of the dominant secular culture. The result is a gulf between a moral life and an approach to bioethics framed in the face of a transcendent God and a final judgment versus a moral life and an approach to bioethics framed as if the world were without ultimate meaning and as if death were the end of personal existence. These approaches are separated by a moral and metaphysical gulf that sustains incompatible life worlds and incompatible understandings of bioethics. Attempts to bridge the gulf with secular reason are ineffective because there is no shared conception of reason or standard of evidence. Efforts to use the state to enforce a particular set of metaphysical and moral commitments, whether secular or religious, lead to public disputes with a war-like character.
O candomblé na Europa: fluxos e refluxos entre Brasil, Itália e Portugal
Authors: Golfetto Tatiana
Published: January 2021

Este artigo investiga a transnacionalização do candomblé na Europa a partir das relações entre os membros de uma mesma linhagem religiosa que se encontram no Brasil, na Itália e em Portugal. Utilizando-se do conceito de campo social transnacional, pretende evidenciar a circulação e a direção dos fluxos de bens materiais e simbólicos entre os países, que nos podem revelar dinâmicas e estratégias dos seus integrantes. Em seguida visa discutir as percepções desses membros em relação aos irmãos de santo e parentes de nacionalidades diferentes, percepções estas decorrentes das estadias e dos períodos de convivência, a fim de compreender os modos como esses integrantes constroem diferenças e semelhanças entre si.
Entre pernadas e possessões: encruzilhadas da umbanda e da capoeira nos espaços circulares afro-lusófonos
Authors: Nascimento Ricardo Carvalho
Published: January 2021

O presente artigo pretende problematizar a inserção partilhada das práticas da umbanda e da capoeira em território português, tomando como base uma etnografia realizada em um templo de umbanda e um grupo de capoeira no norte de Portugal, com a pretensão de averiguar como estas práticas e seus líderes concertaram estratégias de fixação na sociedade portuguesa e se beneficiaram de fatores conjunturais e históricos comuns aos processos de transnacionalização. Na tentativa de compreender os desdobramentos destes fenômenos, mobilizaremos os conceitos de contracolonização e espaços circulares afro-lusófonos.
Àwọn Ìyà Awo, as senhoras do segredo na big apple: mulheres nas práticas de Candomblé na cidade de Nova Iorque (EUA)
Authors: Niel Marcelo Máximo , Pereira Pedro Paulo Gomes
Published: January 2021

Durante a realização de uma etnografia sobre o Candomblé na cidade de Nova Iorque, destacou-se a presença de três mães de santo brasileiras que, levadas a dialogar e repensar as suas práticas no contexto norte-americano, reinventam as configurações religiosas tradicionais ou, melhor dizendo, inventam tradições, conforme o pensamento de Roy Wagner. Ao narrar as histórias dessas mulheres, pôde-se demonstrar de que forma elas reinventam o Candomblé, articulando segredos, permissões e traduções das suas práticas, fazendo, paradoxalmente, com que ele permaneça o mesmo, contribuindo para a propagação e para o estabelecimento da religião nesse novo lugar. Um dos pontos importantes encontrados nessa reinvenção foi a mudança no aspecto hierárquico, uma vez que as mães de santo adotam um sistema de interação mais horizontal com seus adeptos e clientes, em contraposição ao modelo mais verticalizado, como o prevalente nos terreiros brasileiros.
Ladrões e caçadores: sobre um carro roubado em São Paulo
Authors: Feltran Gabriel , Fromm Deborah
Published: January 2021

Trabalhos seminais como os de Knowles (2014) e de Tsing (2005) elevaram a tradição do estudo da trajetória de objetos a uma escala transnacional, e teoricamente inovaram ao focar não apenas nas jornadas como conectores fundamentais para a compreensão do mundo social, mas nos efeitos teóricos dessa operação metodológica. Para muito além da ideia de fluxos, assemblages e linhas de força descarnadas, as autoras propõem uma teoria imersa em situações empíricas concretas. Neste artigo, buscamos analisar as relações entre violência, mercados ilegais, desigualdades, seguro e proteção patrimonial, a partir da trajetória de um carro roubado, recuperado por uma das principais seguradoras do país.
A Reforma Trabalhista de 2017 à luz institucionalismo socioeconômico: evidências para uma análise isomórfica.
Authors: Dias Hamdan Tarik , Lemos Walmrath Lucas
Published: January 2021

Este trabalho discute a reforma trabalhista brasileira de 2017 à luz da teoria institucionalista na Sociologia Econômica. A discussão teórica mobiliza os conceitos de isomorfismo coercitivoe mimético (DIMAGGIO; POWELL, 2005) para entender a aprovação da reforma e  problematizar a relação da mesma com a noção de eficiência econômica. Metodologicamente, conduzimos uma análise dos discursos promovidos por alguns dos principais agentes envolvidos na aprovação da reforma trabalhista a partir de fontes secundárias. Concluímos que esta análise evidencia a importância de pressões políticas e da instabilidade para impulsionar mudanças nas relações de capital-trabalho.
“E só assim então, serei feliz, bem feliz”: uma análise das relações sociais a partir do choro no Projeto Centro de Ópera Popular de Acari.
Authors: Batista de Lima André Cesari
Published: January 2021

O presente trabalho pretende discutir a relação entre o ensino de música, mais precisamente do gênero choro, em projetos sociais, usando como objeto de análise o Centro de Ópera Popular de Acari. Será apresentado primeiramente uma análise do processo históricodesse gênero musical, compreendendo as relações sociais e culturais do mesmo. Posteriormente, será apresentado o projeto Centro de Ópera Popular de Acari, um projeto social que surgiu nos anos 2000, com o nome ABC & Arte, idealizado pela professora Avamar Pantoja, dentro da Escola Municipal Alexandre de Gusmão, e que, a partir de 2005, mudoude nome para Centro de Ópera Popular de Acari, além da sua localização, passando para um salão próximo à escola onde o projeto começou e que, devido à falta de recursos, encerrou as suas atividades no ano de 2017, no qual eu fui aluno e professor durante os anos de atividade do projeto.
A modernidade como destino e como questão: a cidade em Max Weber e Georg Simmel
Authors: Marins Morettoni Marina
Published: January 2021

No esforço para compreender a vida social, ospensadores clássicos se debruçaram sobre três questõesnorteadoras: i) como o mundo social se mantém, ii) como estudaro mundo social e iii) a compreensão da modernidade. Neste texto,buscamos demonstrar de que maneira a cidade, como meio de entender a modernidade, aparece na obra de dois desses pensadores: Max Weber e Georg Simmel. De diferentes maneiras, Weber e Simmel tratam da dicotomia entre o campo e a cidade. Também refletem sobre a centralidade da riqueza, a emergência de novos tipos sociais e o tema da liberdade na cidade. Por fim, sinalizamos possibilidades para a compreensão da cidade contemporânea à luz da sociologia clássica.
Partidos en el gobierno: activismo político, centralización interna y subordinación al liderazgo gubernamental
Authors: Marcuzzi Rosa Maria
Published: January 2021

Este estudo analisa a mudança na organização interna dos partidos do governo. Seguindo a orientação teórica proposta pelo cientista político norueguês Kaare Strom sobre o comportamento dos partidos políticos nas democracias contemporâneas, a análise compara o Partido dos Trabalhadores brasileiro, o Frente para la Victoria da Argentina, o Frente Amplio do Uruguai e o Movimiento Alianza Patria Altiva I Soberana do Equador em seus primeiros períodos de governo. O objetivo do estudo é analisar as mudanças organizacionais dos partidos no exercício do governo. O estudo conclui que os partidos no exercício do governo apresentam uma combinação de crescente ativismo político, centralização interna e subordinação à liderança governamental, contrariando a teoria desenvolvida por Strom.
Gentrification and Racial Transformation in One Neighborhood in the City of Cincinnati during the Great Recession
Authors: Ravuri Evelyn
Published: January 2021

This article examines the process of gentrification and racial transition in one neighborhood in Cincinnati between 2000 and 2016. Madisonville (Tract 55) was defined as a racially integrated middle-class neighborhood in the 1970s. In the early 2000s, substantial private and public investments in the neighborhood initiated the process of gentrification and an in-migration of wealthier (mostly white) residents. This revitalization of Madisonville coincided with the Great Recession of 2008 and with a massive exodus of the middle-class African American population. Median housing values and median rent in Madisonville increased significantly between 2010 and 2016, indicating that cost of living had become too expensive for a percentage of the population. In 2000, the white and African American population in Tract 55 had comparable median household incomes, but by 2016, white median household income was 3.5 times that of African Americans, suggesting that two separate and unequal housing markets had emerged. Using Google Street View and a gentrification index designed by Hwang (2015), this article undertakes documentation of the process of gentrification between 2009 and 2016 to visually support that gentrification occurred in the built environment after the Great Recession.
Pharmacologic Management for Cancer Pain
Authors: Murphy Casey A. , Roig Randolph , Faciane Jr. John , Gould, III Harry J.
Published: January 2021

Chronic pain is a major factor that impairs functionality and compromises quality of life.  Unfortunately, this type of pain is often under-treated due to lack of education about the use and range of effective non-pharmacologic modalities, about how to use and monitor pharmacologic modalities, and the fear about real and imagined adverse effects that are associated with its management.  Cancer is diagnosed in approximately 40% of the population with up to 89% experiencing some form of pain in the later stages of the disease. Unfortunately, a significant portion of this population receives inadequate treatment for their pain.  Here we provide a review of the evidence-base for determining the best approach for managing the pain of malignancy in the hope of providing a basic framework for the physician to better utilize the pharmacological options that comprise an important component of comprehensive pain care for the cancer patient.  
This review contains 2 figures, 7 tables, and 106 references.
Keywords: Cancer pain, malignant pain, opioids, chronic pain, analgesic options, adjuvant options, cancer pharmacology, evidence-based pain treatment
HER-2-Amplified Breast Cancer
Authors: Al-Hilli Zahraa , Boughey Judy C
Published: January 2021

Amplification of the human epidermal growth factor receptor–2 (HER-2) gene is found in approximately 15 to 30% of breast cancers. Historically, HER-2 overexpression has been associated with aggressive disease and a poor prognosis. However, the use of targeted anti-HER2 therapy has revolutionized the treatment of HER-2-positive disease, and the use of the monoclonal antibody trastuzumab in combination with chemotherapy is now standard of care for tumors greater than 1 cm in size and in node-positive disease. More recently, the value of dual-agent anti-HER-2 therapy has been demonstrated in large clinical trials. This review provides an overview of HER-2-positive breast cancer, its molecular basis, methods of identification, and treatment options and strategies.

This review contains 2 figures and 70 references

Key words: anti-HER-2 therapy, breast cancer, HER-2-positive breast cancer, HER-2 resistance, lapatinib, neoadjuvant chemotherapy, pertuzumab, small HER-2-positive breast cancer, trastuzumab
Appendiceal Neoplasm
Authors: Samdani Tushar , Nash Garrett M.
Published: January 2021

Appendiceal neoplasms are rare and are typically found in the setting of metastatic disease or, less commonly, as an incidental finding in an appendectomy specimen in cases of appendicitis or an unrelated condition. The World Health Organization classifies appendiceal neoplasms as benign or malignant. The management of the mucinous variety of appendiceal neoplasms is influenced by the presence of peritoneal involvement. Selected patients with metastatic appendiceal neoplasms are treated with surgical cytoreduction and intraperitoneal chemotherapy and/or systemic chemotherapy. Nonmetastatic appendiceal adenocarcinoma is typically managed with staging right colectomy and adjuvant fluorouracil-based chemotherapy based on colon cancer guidelines. Neuroendocrine tumors (NETs) constitute 50 to 77% of all appendiceal neoplasms and 19% of all gastrointestinal NETs. Right hemicolectomy is indicated if the size of the NET is more than 2 cm, the base of the appendix is involved, it is a high-grade tumor, or the depth of invasion of the mesoappendix is more than 3 mm.
This review contains 7 figures, 9 tables and 36 references
Key Words: appendiceal adenocarcinoma, appendiceal adenoma, appendiceal neoplasm, diffuse peritoneal adenomucinosis, Goblet cell carcinoid of appendix, low-grade appendiceal mucinous neoplasm, mucocele of appendix, neuroendocrine tumor of appendix, peritoneal mucinous carcinomatosis (PMCA), pseudomyxoma peritonei
Endoscopic Management of Barrett’s Esophagus and Early Esophageal Neoplasia
Authors: Singh Amanpal , Bain Andrew J , Rivera Ramon
Published: January 2021

Gastroesophageal reflux disease is common in North America, affecting around 25% of the population. A small fraction of these patients develop Barrett esophagus and thus are at a risk of developing esophageal cancer. The progression of Barrett esophagus to esophageal cancer can be prevented with timely examinations and, when necessary, by performing treatments to eradicate it. This review describes the use of endoscopy techniques to diagnose and classify Barrett esophagus among high-risk patients and the use of ablative techniques in patients with dysplasia. The review also describes endoscopic resection techniques for early esophageal cancer, which can provide staging information as well as can be therapeutic in selected cases.
This review contains 8 figures and 49 references.
Key Words: acid reflux, Barrett esophagus, cryoablation, endoscopic mucosal resection, endoscopic submucosal dissection, esophageal cancer, esophagus ablation, GERD, radiofrequency ablation
Perihilar Cholangiocarcinoma
Authors: Gage Michele M. , Weiss Matthew J.
Published: January 2021

Hilar cholangiocarcinomas (HCs) are a diverse group of aggressive tumors often diagnosed late in disease due to their typically longitudinal spread along the biliary system. Only approximately one-third of HCs are the candidates for resection, which offers the only chance for cure. However, even following resection, recurrence is common, and 5-year survival rates after surgery remain dismal at 20 to 42%. A thorough preoperative work-up and risk stratification for major surgery are critical to treatment success and maximizing the likelihood of an R0 resection. Due to the relatively few large phase III randomized controlled trials for HC, data are lacking on the optimal adjuvant treatment. Recent results of the BILCAP trial are promising for improved survival after surgery with adjuvant therapy, particularly capecitabine. When resection is not an option, prognosis is poor with median survival of less than 12 months. However, there are multiple chemotherapy-based treatment options that have demonstrated prolonging survival, with combined gemcitabine and cisplatin as first-line therapy. Liver transplantation should be considered on protocol for unresectable HC in the absence of metastatic disease. Palliative options, such as photodynamic therapy or radiation, may also be considered in advanced disease.

This review contains 2 figures, 5 tables, and 41 references.
Key Words: adjuvant therapy in cholangiocarcinoma, hilar cholangiocarcinoma, Klatskin tumor, metastatic cholangiocarcinoma, perihilar cholangiocarcinoma, portal dissection, surgery for hilar cholangiocarcinoma, outcomes in hilar cholangiocarcinoma
Laparoscopic Right Hepatectomy
Authors: Salehi Omid , Vega Eduardo A. , Conrad Claudius
Published: January 2021

Laparoscopic right hepatectomy (LRH) is an important technique in a modern hepatobiliary surgeon’s arsenal. It’s application extends to many different disease processes including both malignant and benign tumors as well as infections and in trauma. The procedure involves using minimally invasive methods to remove Couinaud segments 5-8 delineated by the portion of the liver right and lateral to Cantlie’s line. In this chapter, we explain the approach to performing this operation by delving into preoperative considerations with a focus on high quality imaging, 3D reconstruction, and virtual hepatectomy, optimizing the future liver remnant (FLR) with PVE and use of parenchymal sparing methods, and detailed intraoperative steps emphasizing caudal view, Glissonian approach, MHV roadmap, and communication with anesthesia. We also give context to LRH by discussing the two most common diseases addressed by it, namely colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC), as well as historical perspectives and how LRH use has evolved. We also address complication management such as post-operative liver failure and intra-operative bleeding accidents, variants on exposure with hand assist and transthoracic view, and comparing the advantages and disadvantages between open and laparoscopic right hepatectomy.
This review contains 12 figures, 4 tables, and 111 references.
Keywords: augmented reality, laparoscopic right hepatectomy, laparoscopic PVE and ALPPS, low CVP anesthesia, MHV roadmap, minimally invasive liver resection, parenchymal sparing right hepatectomy, Takasaki caudal approach, virtual hepatectomy,
Type I Diabetes Mellitus
Authors: Wolfsdorf Joseph I. , Garvey Katharine
Published: January 2021

Type 1 diabetes mellitus is characterized by severe insulin deficiency, making patients dependent on exogenous insulin replacement for survival. These patients can experience life-threatening events when their glucose levels are significantly abnormal. Type 1 diabetes accounts for 5 to 10% of all diabetes cases, with type 2 accounting for most of the remainder. This review details the pathophysiology, stabilization and assessment, diagnosis and treatment, disposition and outcomes of patients with Type 1 diabetes mellitus. Figures show the opposing actions of insulin and glucagon on substrate flow and plasma levels; plasma glucose, insulin and C-peptide levels throughout the day; the structure of human proinsulin; current view of the pathogenesis of Type 1 autoimmune diabetes mellitus; pathways that lead from insulin deficiency to the major clinical manifestations of Type 1 diabetes mellitus; relationship between hemoglobin A1c values at the end of a 3-month period and calculated average glucose levels during the 3-month period; different combinations of various insulin preparations used to establish glycemic control; and basal-bolus and insulin pump regimens. Tables list the etiologic classification of Type 1 diabetes mellitus, typical laboratory findings and monitoring in diabetic ketoacidosis, criteria for the diagnosis of Type 1 diabetes, clinical goals of Type 1 diabetes treatment, and insulin preparations.
This review contains 10 figures, 9 tables, and 40 references.
Keywords: Type 1 diabetes mellitus, optimal glycemic control, hypoglycemia, hyperglycemia, polyuria, polydipsia, polyphagia, HbA1c, medical nutrition therapy, Diabetic Ketoacidosis
Headache
Authors: Friedman Benjamin W
Published: January 2021

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine.
This review contains 1 figure, 9 tables, and 58 references.

Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache
Aortic Dissection
Authors: Lee Christine E , Naraghi Leily , Hoffmann Beatrice
Published: January 2021

Aortic dissections are associated with high morbidity and mortality and thus are important diagnoses to consider, as delaying diagnosis can have drastic consequences. Emergency physicians should consider dissection in patients with the classic presentation of tearing chest and/or back pain but should also be aware that its presentation can be varied based on the location of the dissection. This review summarizes the pathophysiology, presentation, stabilization and assessment, diagnosis, treatment, disposition, and outcomes for patients with aortic dissection.
 
This review contains 6 figures, 2 tables, 1 video, and 78 references.
Key Words: aortic dissection, ascending aortic dissection, descending aortic dissection, intimal tear, intramural hematoma
Evaluation and Treatment of Pediatric Obesity
Authors: Desai Nirav K , Softic Samir
Published: January 2021

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. Contributors to obesity are multifactorial, including genetic and environmental factors. Environmental factors associated with obesity include increased availability of inexpensive fast food, sugar-sweetened beverages, and high-fat and -sugar convenience foods; decreased exercise; and increased screen time. Treatment begins with behavioral interventions focusing on dietary modifications and increasing physical activity. Although medications to treat obesity are an area of increased interest, options in the pediatric population are limited. Currently, orlistat is the only FDA-approved option. For the treatment of severe obesity, bariatric surgery should be considered, based on age, weight, and associated comorbidities. Weight loss associated with surgery is robust and long-lasting and results in improvement in/resolution of multiple comorbidities. However, benefits should also be weighed against the long-term risks of vitamin deficiency.
This review contains 73 references, 3 figures, and 3 tables.
Key words: bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery
Obstructive Sleep Apnea: Diagnosis and Management
Authors: Lim Diane C , Schwab Richard J
Published: January 2021

As part 2 of three chapters on sleep disordered breathing, this chapter reviews obstructive sleep apnea (OSA) diagnosis and management. OSA should be considered in all patients who have loud habitual snoring, excessive daytime sleepiness, and witnessed apneas. On physical examination, craniofacial abnormalities that can lead to sleep apnea include retrognathia, micrognathia, a narrow hard palate, nasal obstruction, an overjet, and an overbite. Enlargement of the upper airway soft tissue structures (the tongue, soft palate, lateral walls, and parapharyngeal fat pads) also increases the risk of OSA. The gold standard for making the diagnosis of OSA is overnight polysomnography, but home sleep apnea tests (HSAT) are rapidly gaining acceptance, especially in patients with a high probability of OSA. The first line of therapy for OSA remains positive airway pressure (PAP), with the second line of therapy being oral appliances. Another alternative to PAP therapy is hypoglossal nerve stimulation, which has been shown to decrease the Apnea-Hypopnea index by 67.4%.
This review contains 6 figures, 3 tables, and 52 references.
Key Words: craniofacial abnormalities, Epworth Sleepiness Scale, home sleep apnea test, hypoglossal nerve stimulation, obstructive sleep apnea, oral appliances, oral pharyngeal crowding, polysomnography, positive airway pressure, STOP-BANG
The Natural History Of Chronic Liver Disease
Authors: Schaefer Esperance A K
Published: January 2021

The natural history of chronic liver disease is that of a slowly progressive course, in most cases evolving over the course of years to decades. The rate of progression varies by disease state and comorbid conditions, but fibrosis advances on average by one stage every 7 to 10 years. While the development of fibrosis is reversible when the underlying etiology is successfully treated, a large number of patients present to medical attention once advanced fibrosis has already developed. The ultimate clinical and pathological manifestation of chronic liver disease is cirrhosis. Cirrhosis has long been clinically divided into “compensated” and “decompensated” disease, with an estimated 12-year survival in compensated disease and 2-year survival in decompensated disease. Additional clinical stratifications have been proposed, including a five-stage model progressing from cirrhosis without portal hypertension (hepatic venous pressure gradient below 10 mm Hg) to cirrhosis with portal hypertension, and then cirrhosis complicated by bleeding or other decompensating events. These clinical stages correspond to a step-wise increase in mortality and, with the presence of more than one decompensating event, the five-year mortality approaches 90%. The major complications of cirrhosis include varices with or without hemorrhage, ascites, hepatic encephalopathy, immune dysfunction, renal impairment, and hepatocellular carcinoma. Liver transplantation has provided an avenue to alter the course and outcomes in chronic liver disease, with graft survival rates that reach 80% at 5 years.
 This review contains 4 figures, 6 tables and 51 references
Key Words: natural history, cirrhosis, mortality, hepatocellular carcinoma, acute-on-chronic liver failure
Sexually Transmitted Infections
Authors: Farid Huma , Brown Elinor , Golen Toni Huebscher
Published: January 2021

Sexually transmitted infections (STI’s) are relatively common. Their presentations range from symptom-free to highly painful, debilitating and life-threatening. The approach to each type of infection varies, and depends on the ability to screen, the availability and effectiveness of treatment, and the likelihood of long-term sequelae. For many infections, prophylaxis is possible; other infections are more challenging to prevent. Unless sexual partners are also treated, re-infection is a concern, as is the further spread of disease to subsequent sexual contacts. Some infections, once effectively treated, lead to an asymptomatic carrier state that may or may not re-emerge as an active problem and/or cause sexual contacts to become ill. 
This review contains 10 tables, and 44 references.
Key Words: sexually transmitted infections, chlamydia, gonorrhea, syphilis, HIV, herpes simplex, granuloma inguinale, lymphogranuloma venereum, chancroid, trichomoniasis
The Menopause Transition: Physiology, Definition, Symptoms, Diagnosis, and Evaluation
Authors: Bauer Jessica L , Santoro Nanette F
Published: January 2021

The menopause transition is a gradual physiologic process characterized by an intricate interplay between hypothalamic-pituitary axis dysfunction and ovarian follicle failure. Clinically, symptoms are variable and can range from minimal to severe. The hallmark symptom of the perimenopause and postmenopause is the hot flash; however, systemically low estrogen has widespread effects in the aging woman, including important changes in the cardiovascular, musculoskeletal, genitourinary, and central nervous systems. The diagnosis of menopause is a clinical one. Although there is no single laboratory marker that can predict the final menstrual period, an elevated follicle stimulating hormone is the classic marker of a menopausal state. Newer evidence suggests that antimullerian hormone may be more predictive of the final menstrual period; however, more studies are needed. An understanding of the physiology and symptomatology of the menopausal transition is crucial for educating women about their health risks later in life.

This review contains 2 figures and 30 references
Key Words: hot flashes, menopause, perimenopause, postmenopause, race/ethnicity in menopause, stages of transition in menopause, stress/psychological complications, women’s health
Vulvar Lesions in the Pediatric Patient
Authors: Troutman Michele , Thieu Hong-Thao
Published: January 2021

Vulvar lesions are a common complaint for which pediatric patients seek medical attention. Please refer to the chapter on Prepubertal Vulvovaginitis for more details. A careful history and physical exam, including full skin exam should be performed when pediatric and adolescent patients present with vulvar complaints. The chief complaint and chronicity of the symptoms can narrow the differential. The chronicity and areas of dermatologic involvement can also be key to diagnosing a systemic condition versus a primary vulvar dermatosis. When the latter is assumed, a referral to an appropriate specialist such as a Pediatric and Adolescent Gynecologist or Dermatologist should be considered. Treatment for vulvar dermatoses should be etiology dependent with consideration of systemic treatment as appropriately indicated. Vulvar hygiene should be considered in all patients as restoring the skin barrier and removing potential irritants is imperative to healing and preventing further irritation.
This review contains 1 figure, 2 tables, and 25 references.
Keywords: vulva, vulva dermatosis, vulvovaginitis, lichen sclerosus, atopic dermatitis, psoriasis, streptococcus vulvovaginitis, irritant dermatitis, contact dermatitis
Amenorrhea: A Systematic Approach to Diagnosis and Management
Authors: Cron Julia A.
Published: January 2021

Amenorrhea, the absence of menses, occurs in approximately 3 to 4% of women.4,7 It may be present as primary amenorrhea (the absence of menarche) or secondary amenorrhea (the absence of menses after menarche). The evaluation of the patient with amenorrhea requires an understanding of female anatomy and embryology as well as the hypothalamic-pituitary-ovarian axis. A logical systematic approach to adolescents and women with amenorrhea leads to the appropriate diagnosis and management. When considering the appropriate evaluation and management of amenorrhea, several classification schemes may be considered. The following review outlines the necessary background to understand the various clinical conditions.  In addition, the step-wise approach to diagnosis and management is presented.
This review contains 4 figures, 3 tables, and 45 references.
 Key Words: amenorrhea, anomalies, embryologic development, hyperandrogenism, hyperprolactinemia, hypothalamic dysfunction, ovarian insufficiency, puberty, thyroid dysfunction
Hypopharyngeal, Esophageal, and Neck Reconstruction
Authors: Chinn Steven B
Published: January 2021

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations.

This review contains 23 figures, 3 tables and 39 references
Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap
Developmental Biology I: Bone Development, Repair, and Regeneration
Authors: Borrelli Mimi R. , Ngaage Ledibabari M. , Wan Derrick C. , Longaker Michael T. , Lorenz H. Peter
Published: January 2021

Defects of the skeletal system are extremely common and amount to a significant biomedical burden. Bone is a unique tissue that retains its regenerative potential into adulthood. The biology behind bone development, repair, and regeneration is thus of considerable interest, and may lead to advances in patient care. There are two distinct forms of osteogenesis; bones of the craniofacial skeleton develop via intramembranous ossification, whilst bones of the appendicular skeleton form by endochondral ossification. In this review, bone regenerative mechanisms based on skeletal stem cell function during fracture repair and during distraction osteogenesis are reviewed.  Skeletal stem cell function more closely follows developmental mechanisms during distraction osteogenesis compared to fracture osteogenesis. 
This review contains 5 figures and 50 references.
Keywords: skeletal stem cell, osteogenesis, skeletogenesis, mechanotransduction, regeneration, remodeling, focal adhesion kinase, ossification
Anesthetic Principles
Authors: Orgill Britlyn D. , Helm Douglas L.
Published: January 2021

Advances in anesthesia have expanded the field of plastic surgery by allowing more procedures to be done, while also increasing the safety of the patient. Anesthesia is a spectrum ranging from local anesthetic injected by the surgeon, to regional and neuraxial blocks or general anesthesia with an anesthesia team. Anesthesiologists work with the surgeon to assess a patient’s preoperative risk and make joint decisions to determine if additional medical optimization is needed prior to surgery. New peripheral blocks allow alternatives to general anesthesia or serve as adjuncts to improve post-operative pain. Selection of drugs used to induce and maintain anesthesia are changing with the advent of Enhanced Recovery After Surgery Protocols and emphasis on decreasing opioids. Teamwork and excellent communication are imperative to navigate anesthetic and surgical emergencies. 
This review contains 3 figures, 4 tables, and 29 references.
Keywords: sedation, general anesthesia, regional anesthesia, peripheral nerve blocks, local anesthetic toxicity syndrome, ASA physical status, preoperative fasting guidelines, opioids, multi-modal analgesia, ERAS, crisis checklists
Hand Infections
Authors: Lifchez Scott D , McNichols Colton
Published: January 2021

Hand infections are a common concern in the emergency, outpatient, and inpatient setting. It is important to accurately diagnose and treat these infections to minimize the risk of spread or functional deficit that could be permanent if not addressed in a timely manner. In this chapter, we aim to cover the epidemiology and etiology of hand infections along with how they tend to present in the clinical setting. This chapter is written so that each encounter can be analyzed in a logical, step-wise fashion from formulating a differential diagnosis to treatment. Upon evaluation, it is important to perform a thorough clinical examination in addition to knowing which imaging modalities can help elucidate the pathology when the initial presentation is unclear. These and other diagnostic studies are covered so that the differential diagnosis can be narrowed down. Each of the possible scenarios is clarified further to help confirm the most likely diagnosis. Finally, we touch on each treatment (whether surgical or medical) recommended for the suspected disease process. Overall, it is important to discern whether the patient will need a small procedure, surgery, or medication alone so that the appropriate management is performed and optimal healing is possible.

This review contains 25 Figures, 10 Tables and 26 references

Key Words: acute infection, chronic infection, paronychia, felon, flexor tenosynovitis, septic joint, hand infection, hand surgery
Principles and Practice of Palliative Care
Authors: Schaefer Kristen G , Bernacki Rachelle E
Published: January 2021

The trajectories of serious illness and dying have changed in the last century; in the past, patients lived shorter lives and often died quickly of infectious disease, whereas patients in the 21st century live longer and often with prolonged debility in the advanced stages of illness. As a result, patients with serious illness can suffer undertreated symptoms and often feel poorly prepared for the final stages of disease. With more options for advanced life support and other aggressive interventions at the end of life, patients and families face increasingly complex medical decisions in the terminal phase of illness, and the treatments they receive do not always align with their goals and values. Emerging evidence suggests that integrating palliative care into the treatment of advanced illness can improve outcomes, decrease costs, and improve both patient and family satisfaction. Consequently, patient access to high-quality specialty-level palliative care is becoming standard of care at most academic cancer centers and more available in the community. This chapter describes the practice and principles of specialty-level palliative care and outlines specific "generalist" palliative care competencies essential for all physicians caring for patients with serious illness, including prognostication, patient-centered communication, and the navigation of ethical dilemmas in the field of palliative care. Tables outline the philosophy of palliative care, domains of suffering, location of death of hospice patients, the palliative performance scale, median survival times for cancer syndromes, indicators associated with a poorer prognosis in congestive heart failure, the NURSE mnemonic for accepting and responding to emotion, palliative care communication competencies in the intensive care unit, and the SPIKES mnemonic for breaking bad news. Figures depict causes of death in 1900 versus 2010, palliative care through the trajectory of serious illness, theoretical trajectories of disease, life expectancies for women and men, mortality at 1 year post discharge, and a model for patient-centered communication. 
This chapter contains 6 highly rendered figures, 9 tables, 169 references, 1 teaching slide set, and 5 MCQs.
Headache and Facial Pain
Authors: Loder Elizabeth W.
Published: January 2021

Headaches are a near-universal experience, with a 1-year prevalence of 90% and a lifetime prevalence of 99%. Headaches and pain to the head account for roughly 3% of visits to US emergency departments annually, making them the fourth most common reason for seeking emergency care. There are numerous types of headaches, and although the majority are benign, types exist that may result from serious and potentially life-threatening causes. As such, it is important for the physician to consider a broad differential diagnosis for every headache patient. This review discusses the classification of headaches, identifies pain-sensitive structures in the head, discusses the history and examination in patients with headache, and describes many of the primary and secondary headaches. Figures show the areas of the brain sensitive to pain; 1-year prevalence of migraine in men, women, and children; frequency of attacks in migraineurs; prevalence of headaches by age group and in patients with cerebrovascular disorders; and symptoms of idiopathic intracranial hypertension. Tables list the major categories of headache disorders, key elements of the headache history, helpful questions to ask, features of selected primary and secondary headaches, reasons to consider neuroimaging, efficacy of selected over-the-counter medications, triptans available in the United States, medication options for urgent or emergency treatment of migraine, selected preventive medications for migraine, generally accepted indications for preventive treatment, general principles for the use of preventive medications, titration schedules for preventive medication, interval or short-term preventive treatment of menstrual migraine, strategies for managing increase in migraines in patients starting estrogen replacement therapy, transition medications for rapid, temporary suppression of headaches, medications possibly effective for cluster and hypnic headaches, differential diagnosis of the acute, severe, new-onset headache, and etiologies of papilledema and headache.
This review contains 6 highly rendered figures, 23 tables, and 115 references.
A Wellness Roadmap for Medical Trainees: What a Program Director Should Know
Authors: Joseph Richard , Berkowitz Lori
Published: January 2021

This review contains 2 figures, and 25 references.
Management of Chronic Kidney Disease and its Complications
Authors: Hundert Joshua S. , Singh Ajay K
Published: January 2021

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease.

This review contains 3 figures, 10 tables and 50 references
Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia
Urticaria and Angioedema
Authors: Chen Justin R , Khan David A.
Published: January 2021

Urticaria and angioedema are common diseases with diverse origins that constitute a substantial component of medical practice. Urticaria, or hives, refers to one or more areas of intensely pruritic papules or plaques with swelling of the superficial dermis (wheal) surrounded by local erythema (flare). Angioedema refers to deep dermal subcutaneous swelling that may manifest as swelling of the mucosa of the face, tongue, pharynx, larynx, or intestines that can be alarming and, in some cases, life threatening. These conditions are heterogeneous in their presentation and chronicity. Although allergies are responsible for some cases, autoimmunity and dysregulation of the bradykinin system often play a significant role, leading to challenging diagnostic and therapeutic dilemmas. This review discusses the epidemiology, natural history, pathophysiology, diagnosis, and treatment of acute and chronic urticaria and angioedema. Emphasis is placed on physical triggers, the role of proper laboratory testing, and alternative agents for refractory cases. Emerging therapies for hereditary and acquired angioedema syndromes are also covered. Tables list the causes of acute and chronic urticaria, an escalating treatment approach for difficult cases, and a comparison of available parenteral therapies specific to bradykinin-mediated angioedema. Figures illustrate the mechanisms of urticaria, photographs of typical presentations, and an evidence-based diagnostic algorithm for clinicians. 
This review contains 9 figures, 8 tables, and 104 references.
Acute Pneumonia
Authors: Hogan John I , Davis Benjamin
Published: January 2021

Acute pneumonia continues to represent a major source of morbidity, mortality, and healthcare expenditure in the U.S. It is imperative that clinicians at all levels of training have a firm understanding of this potentially deadly infection and its numerous complications. The current state of our diagnostic capabilities often dictates that clinicians will need to make important therapeutic decisions in patients presenting with acute pneumonia before identifying a culprit pathogen. Only after understanding the pathogenesis of pneumonia under different clinical circumstances can one devise rational empiric therapeutic regimens. In this practical review we offer a succinct description of the epidemiology and pathogenesis of acute pneumonia. We then proceed to discuss the evaluation and management of patients presenting with acute pneumonia with emphasis on the most valuable clinical trials and major guidelines that we use to inform our clinical decisions. Despite significant advances in the field of infectious disease over the past century, clinicians continue to recognize pneumonia, the infection of the pulmonary parenchyma, as a major source of morbidity and mortality. In this article we attempt to provide the general practitioner with a practical review of acute pneumonia and its complications. Prioritizing the needs of the general practitioner, we most thoroughly address community acquired pneumonia (CAP). Though we do not intend for this review to be completely comprehensive, in this article we also briefly discuss healthcare associated pneumonia (HCAP), hospital associated pneumonia (HAP), and ventilator associated pneumonia (VAP). Focusing much of our attention on the most important clinical trials and guidelines underpinning the diagnosis and management of this common problem, we hope that this publication will serve as a useful review to aid in clinical decision making.
This review contains 45 references, 1 figure and 5 tables.
Key Words: Pneumonia, viral pneumonia, bacterial pneumonia, community-acquired pneumonia, ventilator-associated pneumonia, VAP, healthcare-associated pneumonia, hospital-acquired pneumonia