bluuebunny/crossref_metadata_2025 huggingface dataset:
Colon Cancer
Authors: Hoehn Richard S , Quezada-Diaz Felipe , Smith Jesse J
Published: January 2021

Colon cancer is a leading cause of cancer-related death in the United States and worldwide. Routine screening has led to early diagnosis and improved survival for many patients but is still greatly underused. Complete surgical resection provides the best opportunity for cure of localized disease and requires removal of a defined segment of colon along with its lymphovascular pedicle, including a minimum of 12 lymph nodes. Minimally invasive approaches have been shown to provide better perioperative outcomes and patient recovery, with oncologic outcomes equivalent to those of traditional open surgery. Patients with lymph node metastases are at an increased risk of distant metastases and disease recurrence. Survival for these patients has improved in the recent years with the advent of oxaliplatin-based adjuvant chemotherapy. In addition, surgical resection is increasingly being used to control and sometimes cure distant metastases. In this chapter, we review the current strategies for diagnosing and managing colon cancer.
 
This review contains 1 video, 5 figures, 4 tables and 48 references
Key Words: adjuvant chemotherapy, anastomosis, colectomy, colon cancer, neoadjuvant chemotherapy, surgery, survival, laparoscopic, robotic
Synovial Sarcoma
Authors: Tan Marcus
Published: January 2021

Synovial sarcomas are a common extremity soft tissue sarcoma, typically arising in the para-articular regions of young adults. All synovial sarcomas are considered high grade. Distinctive clinical features are the two common histologic variants (monophasic and biphasic) and more frequent incidence of nodal metastasis. In addition to the sheets of spindle cells seen in monophasic tumors, biphasic tumors have interspersed areas of glandular differentiation. Synovial sarcomas are characterized by the SS18-SSX translocation. Most biphasic tumors contain the SS18-SSX1 translocation, whereas almost all SS18-SSX2 tumors are monophasic. Radical resection is the mainstay of therapy. Synovial sarcomas are chemosensitive, and ifosfamide-doxorubicin is often used neoadjuvantly. Adjuvant radiation should be considered for tumors greater than 5 cm.
This review contains 7 figures, 2 tables, and 35 references.
Key Words: E-cadherin, extremity sarcoma, ifosfamide, neoadjuvant chemotherapy, nomogram, SS18-SSX fusion, synovial sarcoma, translocation-associated sarcoma
Desmoplastic Small Round Cell Tumor
Authors: Saltsman III James A , Heaton Todd E
Published: January 2021

Desmoplastic small round cell tumor (DSRCT) is a relatively recently identified, rare, aggressive cancer that arises from the peritoneal lining of the abdominal cavity and predominantly affects male adolescents and young adults. DSRCT is included in the Ewing family of tumors and harbors a unique translocation between EWSR and WT1 genes. Patients characteristically present with advanced disease, including widespread involvement of the abdominal cavity and pelvis, with frequent extraperitoneal metastases involving liver, spleen, and thoracic lymph nodes. Five-year overall survival remains approximately 15 to 20% in recent series despite aggressive multimodal therapy. Neoadjuvant chemotherapy, complete resection, defined as less than 1 cm3 of residual tumor, and consolidative whole abdominopelvic radiotherapy (WAP-RT) appear to play important role in curative treatment. The rarity of DSRCT makes large randomized trials difficult and consensus statements about clinical approach impossible. However, this chapter summarizes the best available data on the pathogenesis, diagnosis, and treatment of DSRCT; highlights the major advances made in these areas; and discusses the addition of local therapy to the treatment paradigm.
This review contains 3 figures, 1 table, and 51 references.  
Key Words: DSRCT, peritoneal malignancy, desmoplastic round cell tumor, surface malignancies of the peritoneum, desmoplastic small round cell tumor of the abdomen, surgical oncology, rare malignancies, surgical therapy of abdominal malignancies
Pediatric Lower Respiratory Tract Emergencies: Bronchiolitis, Pneumonia, and Asthma
Authors: Richards Amber M
Published: January 2021

Respiratory illnesses account for a significant proportion of pediatric morbidity and mortality. Respiratory complaints are a common cause of emergency department visits and hospital admissions. They range from mild and self-limited to severe and rapidly progressive. This review discusses the pathophysiology, assessment, stabilization, and management of asthma, community-acquired pneumonia, and bronchiolitis. Given the prevalence of these conditions and the morbidity and mortality attributed to them, it is important for clinicians to be familiar with their presentations and up to date on evidence-based management recommendations.

This review contains 7 figures, 25 tables and 80 references
Keywords: antibiotics, asthma, bronchiolitis, community-acquired pneumonia, pediatric respiratory, pneumonia, respiratory emergency, respiratory illness, respiratory syncytial virus
Malnutrition in Cirrhosis and Its Management
Authors: Syed Shareef , E Lebsack Adrienne , Lai Jennifer C
Published: January 2021

The World Health Organization defines malnutrition as a term referring to deficiencies, excesses, or imbalances in a person’s intake or energy and/or nutrients. Malnutrition is a nearly universal complication of end-stage liver disease, with a prevalence of up to 90%. Given their hepatic synthetic dysfunction, patients with cirrhosis are at a particularly high risk for protein-calorie depletion, which has been reported in over half of patients with cirrhosis and worsens with disease severity. Undernutrition is a potent predictor of adverse outcomes in cirrhotic patients, including lower survival rates, hepatic decompensation, longer length of days in the hospital and intensive care unit (ICU), increased number of infection episodes, and higher resource utilization. On the other hand, excess energy intake, or overnutrition, is increasingly being recognized as an important determinant of long-term outcomes in this population, particularly those with nonalcoholic steatohepatitis. Nearly one quarter of patients with cirrhosis are overnourished and up to 72% show excessive daily intake of energy and protein. In this review, we will consider the full spectrum of malnutrition in patients with end-stage liver disease and highlight key areas in need of further investigation.

This review contains 4 figures, 4 tables, and 54 references.
Key Words: frailty, inflammation, nocturnal feeding, nutritional assessment, nutritional risk, nutritional screening, protein-energy malnutrition, sarcopenia
Viral Hepatitis E
Authors: Nelson Kenrad E , Kmush Brittany L
Published: January 2021

Hepatitis E Virus (HEV) infections are among the most frequent causes of viral hepatitis globally. They are especially common in southern Asia where large epidemics of waterborne hepatitis, primarily affect adults with increased mortality in pregnant women, occur frequently during and after monsoon rains when there is contamination of the drinking water supply. These epidemics have been recognized throughout modern history. Similar epidemics have been reported from Sub-Saharan Africa during humanitarian crises, when the water supply is compromised. The causal virus, HEV, was discovered in 1983. About a decade later, similar HEV viruses were found to be transmitted as a foodborne infection from infected pigs, deer, wild boar, and other zoonotic reservoirs. There are 4 genotypes of HEV that infect humans: genotypes 1 and 2 are strictly human pathogens, and genotypes 3 and 4 have zoonotic reservoirs and are transmitted as a foodborne infection or from contact with the zoonotic reservoir. Although most HEV infections cause asymptomatic infections or acute selflimited hepatitis in humans, in recent years, chronic infections among immunocompromised patients after solid organ transplants or other immunocompromising conditions have been reported among persons with genotype 3 infections.

This review contains 4 figues, 4 tables and 162 references
Key Words: epidemiology, global impact, Hepatitis E Vaccine, HEV, prevention, reservoirs, risk factors, treatment
Crohn Disease in Childhood and Adolescence
Authors: Zimmerman Lori
Published: January 2021

Crohn disease (CD) is a chronic inflammatory condition that can occur throughout the gastrointestinal tract (the mouth to the anus). CD is classified by location within the gastrointestinal tract and behavior of the disease (inflammatory, penetrating, and/or stricturing). It can also affect the extraintestinal tissue and cause perianal disease. It occurs from a complex interplay of genetic predisposition, altered gut microbiota, immunologic dysregulation, and likely environmental triggers. Children with CD often present with signs and symptoms related to the inflammation within their gastrointestinal tract. Most children with CD will present with diarrhea and abdominal pain, whereas some will present with rectal bleeding, fevers, weight loss, perianal disease, or joint disease. There is no single test to confidently diagnose a patient with CD. Instead, clinicians rely on a combination of biomarkers in the serum and stool, imaging studies, and endoscopic evaluation to make the diagnosis. The general aims of treatment of children with CD are to induce and maintain clinical remission of disease, optimize nutrition and growth, minimize adverse effects of therapies, and ultimately target mucosal healing.
This review contains 3 figures, 3 tables and 34 references.
Key Words: biologics, child, chronic diarrhea, Crohn disease, hematochezia, inflammatory bowel disease, immunodeficiency, pediatric, weight loss
Endoscopic Management of Lower Gastrointestinal Hemorrhage
Authors: Kosowicz Rebecca , Strate Lisa L.
Published: January 2021

Lower gastrointestinal bleeding (LGIB) is a common gastrointestinal emergency. Colonoscopy is the initial diagnostic and therapeutic procedure for most patients with LGIB. The optimal timing of colonoscopy is uncertain, but earlier examinations are associated with higher diagnostic yield. In patients with severe bleeding, colonoscopy should be performed within 24 hours of presentation after an adequate orally administered colon preparation. Additional washing during colonoscopy and careful inspection should be performed to identify high-risk stigmata. Endoscopic therapy should be attempted if high-risk bleeding stigmata are identified. The endoscopic treatment modality depends on the bleeding source, location, operator expertise, and the need for ongoing anticoagulation or antiplatelet therapy.
This review 5 tables, 5 figures, and 50 references.
Keywords: argon plasma coagulation, clipping, colonoscopy, diverticular bleeding, endoscopic band ligation, endoscopic hemostasis, postpolypectomy bleeding, stigmata of recent hemorrhage, vascular ectasias
Unhealthy Alcohol Use
Authors: Holt Stephen R , Donroe Joseph H.
Published: January 2021

Unhealthy alcohol use refers to a spectrum of alcohol consumption ranging from at-risk drinking to alcohol use disorder. It is associated with both a high cost to society and to individuals. Globally, alcohol is a leading cause of death and disability, and despite the high prevalence of unhealthy alcohol use, diagnosis, and treatment of alcohol use disorder remains disproportionately low. Risk for unhealthy alcohol use and alcohol related harms is multifactorial and includes genetic factors, gender, age, socioeconomic status, cultural and societal norms, and policies regulating alcohol consumption among others. Excessive alcohol use is associated with a myriad of poor physical and mental health outcomes, and screening for unhealthy alcohol use is universally recommended and effective.
This review contains 1 figures, 2 tables, and 76 references. 
Key Words: addiction, alcohol, cancer, diagnosis, drinking, liver disease, screening, stigma, use disorderImportant Advances
Management of the Geriatric Patient
Authors: Martinchek Michelle
Published: January 2021

Geriatric syndromes are complex conditions in older adults that often have many contributing factors. Examples of common geriatric syndromes include cognitive impairment, delirium, falls, frailty, weight loss, and pressure ulcers. Identifying the patients at risk for these syndromes and enacting preventive measures are also important to try to reduce the impact that many of these syndromes may have on outcomes. These syndromes can happen across many different care settings including in the community, outpatient setting, hospital, and nursing facilities. Once these syndromes are identified, management techniques often include multifactorial approaches and use both nonpharmacologic and pharmacologic means. Management strategies may include assistance from interdisciplinary team members, families, and caregivers of the patient.
This review contains 30 references, 4 figures, and 4 tables.
Key Words: cognition, delirium, dementia, fall, frailty, gait, geriatric, malnutrition, pressure ulcer, weight loss
Medical Management of Pulmonary Arterial Hypertension
Authors: Singh Inderjit , Waxman Aaron B
Published: January 2021

The medical management of pulmonary arterial hypertension (PAH) has advanced considerably over the years. Once the diagnosis of PAH is made, the medical management includes both conventional and PAH-pathway specific therapies. Five different classes of drugs are now available targeting the endothelin, prostacyclin, and nitric oxide pathways (i.e. endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase stimulators, prostacyclin analogues, and prostacyclin receptor agonists). These targeted therapies are approved for treatment of patients with PAH and chronic thromboembolic pulmonary hypertension (CTEPH) only. Long-term and event-driven studies of novel drugs have led to further improvement in the medical management of PAH and CTEPH. In this review, we will focus on the medical management of patients with PAH and CTEPH.

This review contains 4 figures, 6 Tables and 30 references

Keywords: Pulmonary arterial hypertension, Chronic thromboembolic pulmonary hypertension, Medical management, Pulmonary vasodilators, Phosphodiesterase inhibitor, Soluble guanylate cyclase stimulator, Endothelin receptor antagonist, Prostacyclin receptor agonist
Heritable and Acquired Thrombophilias in Clinical Practice
Authors: Al-Samkari Hanny , Connell Nathan T.
Published: January 2021

Thrombosis is common in clinical practice. Venous thromboembolism in particular raises questions of a possible underlying hereditary or acquired thrombophilic state. Despite considerable data describing the impact of various thrombophilic states on risks of initial and recurrent thromboembolic events, thrombophilia testing is not standardized. An understanding of the utility and pitfalls of clinical thrombophilia testing is necessary to employ this testing properly. When utilized appropriately, thrombophilia testing can be vital in informing an individual patient’s thrombosis risk and pursuing optimal anticoagulant management. Hereditary thrombophilia testing involves investigation for factor V Leiden, the prothrombin G202010A gene mutation, and deficiencies of the natural anticoagulants protein C, protein S, and antithrombin. Assessment for acquired thrombophilias is perhaps even more important, recognizing the possibility for myeloproliferative neoplasms, antiphospholipid antibody syndrome, occult malignancy and other important acquired thrombotic predispositions. Timing of thrombophilia testing in relation to anticoagulation, acute thrombosis, and use of hormonal agents or pregnancy is critical to ensure accurate diagnosis. This review describes each of the most important hereditary and acquired thrombophilias, explains their relationship to venous and arterial thrombosis, delineates evidence-based indications for thrombophilia testing, identifies potential testing pitfalls, and synthesizes the key points in outlining algorithms for thrombophilia testing in clinical practice.
This review contains 4 figures, 4 tables, and 48 references.
Key words: thrombophilia, venous thromboembolism, pulmonary embolus, deep vein thrombosis, factor V Leiden, prothrombin gene mutation, protein C deficiency, protein S deficiency, antiphospholipid antibody syndrome, hypercoagulability of malignancy
Achondroplasia and Hypochondroplasia
Authors: Gooch Catherine , Subramaniam Akila , Robin Nathaniel
Published: January 2021

Many women with skeletal dysplasias, such as achondroplasia and hypochondroplasia, choose to become pregnant. These women and their partners should receive pre-conception genetic counseling. Once the woman becomes pregnant, a multidisciplinary team at a tertiary care hospital should mange her antepartum care and birth process. An anesthesia plan should be in place that addressed kyphosis, weight based medications and the possibility of a Cesarean Section. Patients should be monitored for respiratory compromise from the gravid uterus on a smaller body frame.  Neonatology must be available to help care for the infant. With a supportive antepartum and postpartum care plan, most women with skeletal dysplasia do well and resume routine OBGYN care after birth.
This review contains 5 figures, and 21 references.
Keywords: Maternal Achondroplasia, Maternal Hypochondroplasia, Inheritance patterns, short limb dwarfism, high risk pregnancy, autosomal dominant inheritance
Fiber and Nutritional Health
Authors: Slavin Joanne L
Published: January 2021

Populations that consume more dietary fiber have less chronic disease. According to the 2002 Dietary Reference Intakes (DRIs), dietary fiber includes carbohydrates and lignin that are intrinsic and intact in plants that are not digested and absorbed in the small intestine. Functional fiber consists of isolated or purified carbohydrates that are not digested and absorbed in the small intestine that confer beneficial physiologic effects in humans. Total fiber is the sum of dietary fiber and functional fiber. Fibers alter laxation, attenuate the rise in blood glucose, and normalize blood cholesterol. The solubility of fibers was originally thought to determine physiologic properties, with soluble fiber linked to cholesterol-lowering properties and insoluble fiber linked to laxation effects. The DRI Committee recommended that other descriptors for fiber be developed, suggesting viscosity and fermentability. Manufacturers are allowed to list total dietary fiber, soluble fiber, and insoluble fiber on the Nutrition Facts panel. DRIs recommend consumption of 14 g of dietary fiber per 1,000 kcal based on epidemiologic studies showing protection against cardiovascular disease. Usual intake of dietary fiber is only 15 g/day. Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into the recommended range. Dietary messages to increase consumption of high-fiber foods such as whole grains, pulses, fruits, and vegetables should be broadly supported by the medical profession.
 
This review contains 3 Tables and 38 references

Key words: constipation, diarrhea, dietary fiber, health claims, laxatives, plant foods, stool weight, transit time
Nutrition and Fetal Origins of Diseases in Adults
Authors: Barks Amanda K , Tran Phu V , Georgieff Michael K , Maliszewski-Hall Anne
Published: January 2021

Accumulating evidence suggests that the early-life environment has lasting effects on health and disease into adulthood. The current concept of developmental origins of adulthood disease has expanded beyond the original observation by Barker and colleagues correlating low birth weight with adulthood cardiovascular and metabolic disorders. Notably, the fetal-neonatal nutritional environment has a significant role in influencing an individual’s wellness in adulthood. During critical periods of fetal and neonatal development, tissues and organ systems are most vulnerable to nutrient deficiencies. Through fetal programming mechanisms such as epigenetic modification, a biochemical process that regulates gene expression without altering the genetic code, developing tissues adapt to nutrient-poor environments to preserve normal development of critical organ systems, including the brain. However, these programmed adaptations can have negative long-term health consequences if the postnatal environment does not match the fetal-neonatal environment in which the programming occurred. These long-term adverse health outcomes constitute the true cost to society, in both increased medical costs and the indirect cost of lost productivity. Here we review the effects of nutrient deficiencies on fetal programming and subsequent health outcomes, as well as the potential mechanisms that underlie fetal programming.
This review contains 3 Figures, 2 Tables and 115 references
Key words: critical period, epigenetics, fetal programming, iron, long-chain polyunsaturated fatty acids, neurodevelopment, nutrient deficiency, protein-energy, vitamins, zinc
Determining Protein Requirements In The Acutely Ill Patient
Authors: Hoffer L John
Published: January 2021

This review discusses protein requirements in disease. It begins by explaining how protein requirements are determined in normal health and the process of nutritional adaptation. It points out the salient features of diseases that increase a patient’s protein requirement, with detailed attention to the effect of systemic inflammation both to increase protein requirements and prevent normal adaptation to starvation. The review also explains and reconciles problems of uncertainty about how much protein to provide to acutely ill patients. Finally, it provides the clinical information and physiologic reasoning necessary to choose appropriate amounts of protein to provide to individual acutely ill patients.

This review contains 1 figure and 59 references
 Key words: adaptation, cachexia, frailty, hypoalbuminemia, inflammation, malnutrition, muscle atrophy, nutritional requirements, protein-energy malnutrition, protein requirements, systemic inflammation
Indications for Dialysis in Acute Kidney Injury
Authors: Patel Ankit , Christopher Kenneth B
Published: January 2021

Renal replacement therapy (RRT) can be used to support patient’s kidney function in cases of acute kidney injury (AKI). However, timing, modality, and dosing of RRT continue to remain in question. Recent studies have begun to provide data to help guide clinicians on when to initiate RRT, what form of RRT to use ranging from continuous venovenous hemofiltration (VVH) to intermittent hemodialysis, and the impact of high versus low-intensity dosing. Additionally, the risks associated with temporary vascular access with regard to thrombosis and infection, the impact of high efficiency and flux versus low efficiency and flux membranes, and options for anticoagulation in RRT for AKI are also discussed.
This review contains 75 references. 
Key words: acute kidney injury, chronic kidney disease, continuous venovenous hemofiltration, continuous venovenous hemodialysis, renal replacement therapy, venovenous hemofiltration,
Peritoneal Dialysis
Authors: François Karlien , Bargman Joanne M.
Published: January 2021

In peritoneal dialysis (PD), the peritoneum serves as a biological dialyzing membrane. The endothelium of the vast capillary network perfusing the peritoneum functions as a semipermeable membrane and allows bidirectional solute and water transfer between the intravascular space and dialysate fluid dwelling in the peritoneal cavity. PD is a renal replacement strategy for patients presenting with end-stage renal disease. It can also be offered for ultrafiltration in patients with diuretic-resistant fluid overload even in those without advanced renal failure. PD can also be used for patients with acute kidney injury, although in the developed world this occurs rarely compared to the use of extracorporeal therapies.
This review contains 9 videos,  8 figures, 4 tables, and 73 references. 
Keywords: peritoneal dialysis, peritoneal cavity, catheter, dialysis fluid, ultrafiltration, tunnel infection, osmotic pressure, renal failure
Medical Management of Transplant Patients
Authors: Vadivel Nidyanandh , Goes Nelson B
Published: January 2021

Kidney transplant is the best form of renal replacement therapy for most end-stage kidney disease patients due to improved quality of life and superior patient survival compared to chronic maintenance dialysis. Long-term outcome of kidney allograft recipients depends on the longevity of the allograft and optimal management of their comorbidities such as cardiovascular disease risk factors. According to organ procurement and transplant data in the United States, 14.5% of the deceased donor kidney wait list comprised patients who failed their first allograft and were awaiting second kidney transplant. Optimal immunosuppression management is key to both short- and long-term outcomes of allograft transplant by preventing rejection while avoiding or minimizing risk of over immunosuppression such as with infections and neoplasia. Cardiovascular disease is the leading cause of mortality after kidney transplant. It accounts for approximately 50% of deaths in the post transplant period and 30% of deaths among patients with preserved renal allograft function. Hence, it is crucial to optimally manage cardiovascular risk factors such as hypertension and diabetes post transplant. In this chapter, we review medical management of kidney transplant recipients, including commonly used induction therapies, maintenance immunosuppressive agents, and posttransplant medical complications such as posttransplant diabetes mellitus, hypertension, cardiovascular disease, bone disease, and BK viral infection.
This review contains 1 table and 47 references
Key Words: kidney transplantation, immunosuppression, rejection, post transplant diabetes mellitus (PTDM), BK viral infection,  calcineurin inhibitors,
Hematologic Abnormalities in Chronic Kidney Disease
Authors: Auerbach Michael , Anderson John , Al Talib Khalid
Published: January 2021

The focus of this review is on information practical to the practicing nephrologist and internists managing patients with chronic kidney disease (CKD), with an emphasis on the quantitative aspects of risk, diagnosis, treatment, and prognosis. Consequently, anemia associated with non–dialysis-associated CKD is emphasized, with special attention to the role of erythropoiesis-stimulating agents and intravenous (IV) iron in treating the anemia of CKD, as well as sections on uremic bleeding and anticoagulation in CKD patients. Figures show a patient before and after a minor infusion reaction, an algorithm outlining grading and management of acute hypersensitivity reactions to IV iron infusions, and an algorithm for the management of uremic platelet dysfunction. Tables list Food and Drug Administration-recommended dose adjustments for novel oral anticoagulant (NOACs) in CKD patients, evidence for preprocedural withholding of NOACs, and management guidelines for anticoagulation in nonvalvular atrial fibrillation and venous thromboembolism.
This review contains 2 highly rendered figures, 3 tables, and 101 references.
Key words: Chronic kidney disease; CKD; Anemia of chronic kidney disease; Anemia of CKD; Uremic bleeding; Anticoagulation in CKD; Novel oral anticoagulants in CKD; NOAC CKD
Vaginal Birth After Cesarean: Contemporary Update and Ongoing Controversies for the Clinician in the Trenches
Authors: Rosner Mara , Zelop Carolyn M
Published: January 2021

Mounting evidence underscoring serious maternal complications such as hemorrhage, emergent hysterectomy, thromboembolic disease and even death from multiple cesarean deliveries has refocused attention upon trial of labor after cesarean birth.  Research over the last thirty years has provided insight into some of the clinical and demographic factors associated with uterine rupture and successful trial of labor after cesarean delivery. Clinical application of these strategies has the potential to mitigate the dilemma for physicians in the trenches caused by fear of uterine rupture during a trial of labor after cesarean.  Individual risk stratification of candidates that optimizes success and minimizes uterine rupture during a trial of labor after cesarean shows promise for implementation of best practices leading to favorable maternal and neonatal outcomes.
This review contains 4 figures, 6 tables, and 97 references.
Key Words: Vaginal birth after cesarean (VBAC), Trial of labor after cesarean (TOLAC), uterine rupture, uterine scar, lower uterine segment, repeat cesarean, placenta accreta, uterine dehiscence
In Vitro Fertilization
Authors: Zolton Jessica R , Chattopadhyay Rhea , DeCherney Alan H.
Published: January 2021

Assisted reproductive technology (ART) encompasses all procedures that manipulate the oocytes, sperm, and embryos outside of the body. Decades of research have allowed the field to emerge as a reliable and safe treatment for infertile men and women. Indications for in vitro fertilization (IVF) include tubal factor infertility, anovulation, male factor infertility, and decreased ovarian reserve. Treatment is not limited to the infertile population, as IVF with preimplantation genetic diagnosis also offers patients an opportunity to prevent transmission of a genetic condition for which they have been found to carry. The field of ART continues to rapidly evolve, as more knowledge is gained from studies reporting on ovarian stimulation protocols, reproductive techniques such as intracytoplasmic sperm injection, and blastocyst transfer. Techniques are aimed to improve live birth rates while ensuring the optimal health of children conceived using IVF.

This review contains 8 figures, 5 tables and 63 references

Key Words: assisted reproductive technology, blastocyst, decreased ovarian reserve, embryo transfer, gonadotropin-releasing hormone agonist, gonadotropin-releasing hormone antagonist, intracytoplasmic sperm injection, luteal phase support, ovarian hyperstimulation syndrome, vitrification
Adolescent Vulvovaginitis
Authors: Romano Mary
Published: January 2021

Vulvovaginitis is a common complaint in adolescents. There are specific and nonspecific causes. Specific causes include sexually transmitted infections and so it is important to take a sexual history in any adolescent presenting with vulvovaginal complaints. A sexual history should be taken in a sensitive and confidential manner. Diagnosis of vulvovaginitis requires an external genital examination and may require a pelvic examination based on other presenting symptoms. Microscopy is typically used to make a diagnosis. More sensitive or specific point of care tests are commercially available, but they can be cost prohibitive. Treatment of vulvovaginitis is based on underlying pathology and often a review of vaginal hygiene may be necessary.In special patient populations, extended or repeat treatment may be necessary.
This review contains 3 figures, 2 tables, and 21 references.
Key Words: adolescent, bacterial vaginosis, candidiasis, confidentiality, discharge, dysuria, sexually transmitted infections (STIs), trichomonas, vaginitis, wet prep
Adjuvant Radiation for Gynecologic Cancers
Authors: Jang Joanne
Published: January 2021

Radiation therapy plays a significant role in the treatment of nearly all gynecologic cancers, including endometrial cancer, cervical cancer, vaginal cancer, and vulvar cancer. Radiotherapy can be given as the primary modality for curative treatment of gynecologic cancers, most often for cervical, vaginal, and vulvar cancers, but can also be used adjuvantly in the postoperative setting. Radiation can be delivered in the form of external beam radiation therapy or as gynecologic implants for brachytherapy, which is radiation that is delivered internally. This review highlights the data supporting radiation therapy for gynecologic cancers and explains the different methods of radiation delivery.
This review contains 5 figures, and 4 tables, and 40 references. 
Key Words: adjuvant treatment, brachytherapy, cervical cancer, endometrial cancer, IMRT, ovarian cancer, radiation therapy, vaginal cancer, vulvar cancer
Reconstructive Approaches to Nasal Defects
Authors: Bentz Michael L.
Published: January 2021

Nasal reconstruction is commonly performed for treatment of defects arising from excision of nonmelanoma skin cancers, although other tumors, trauma, or infection may also result in significant nasal deformities necessitating corrective surgery. Patients being evaluated for nasal reconstruction should have a functional assessment of airflow through both the internal and external nasal valves to determine the need for reconstructive maneuvers that will maintain or improve the nasal airway. Aesthetic considerations relate to which nasal subunits are missing and how local, regional, and sometimes free tissue transfer can be used to optimize the final appearance of the nose. Reconstruction must incorporate a plan for reestablishing nasal lining, support, and cover depending on which elements are missing. Postoperative considerations include the need for nasal splints and interventions to optimize nasal scarring and contour such as scar massage, steroid injection, and laser treatments. Patients who are not good candidates for autologous nasal reconstruction may be considered for prosthetic reconstruction.
This review contains 13 figures and 67 references
Key words: Nasal reconstruction, Nasal airway, Mohs surgery, Skin cancer, Nasal aesthetic subunits, Facial flaps, Skin graft, Forehead flap, Nasal cover, Nasal lining, Nasal support, Prosthetic rehabilitation
Thyroid Diseases
Authors: Borman Karen R. , Felger Erin A.
Published: January 2021

The thyroid plays a key role in normal metabolic and homeostatic processes, including thermomodulation, protein synthesis, carbohydrate and lipid metabolism, and modulation of adrenergic regulation. Surgical consultations are most often requested for control of hyperthyroidism or for treatment of euthyroid nodular disease. This review describes the approach to the patient with hyperthyroidism and with euthyroid nodular disease, including papillary, follicular, anaplastic, medullary, and primary thyroid cancer, and oncocytic (Hürthle cell) carcinoma. Operative techniques of thyroidectomy are described and include positioning, incisions-making, and troubleshooting. Postoperative care, including thyroid hormone management, is described. Complications and outcome evaluation are discussed. Tables list the etiologies of hyperthyroidism, benign and malignant etiologies of euthyroid nodular disease, familial syndromes of thyroid disease, the Bethesda classification of fine needle aspiration cytology and associated malignancy risk, the elements of common prognostic schemes for well-differentiated thyroid cancer, and the staging of differentiated, medullary, and anaplastic thyroid cancer. Figures show the six levels of cervical lymph nodes, the initial incision in a thyroidectomy, a midline incision, the superior pole vessels, the upper and lower parathyroid glands, the recurrent laryngeal nerve, and Delphian lymph nodes. An algorithm shows the approach to the patient with thyroid disease
This review contains 7 figures, 8 tables, and 64 references.
Pediatric Upper Airway Obstruction
Authors: Chan Michael W. , Schmidt Suzanne M.
Published: January 2021

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.
 
This review contains 5 figures, 13 tables, and 32 references
Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor
Pediatric Upper Airway Obstruction
Authors: Chan Michael W. , Schmidt Suzanne M.
Published: January 2021

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.
 
This review contains 5 figures, 10 tables, and 32 references
Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor
Replantation
Authors: Crowe Christopher
Published: January 2021

The advent of microsurgery has profoundly impacted the field of hand surgery, providing a means for precise coaptation of vessel and nerve, consequently allowing salvage of amputated parts. Despite these technical advances, the overall goal of management following amputation remains the same – provide the most functional outcome for each patient’s individual occupational and vocational needs. Therefore, it is not only the surgeon’s task to competently perform a replantation when necessary, but also understand in which patients and injuries a revision amputation may ultimately provide a superior outcome. Candidacy for replantation should be resolved by way of a focused history, physical examination, radiographic imaging, and a thorough discussion regarding the need for rehabilitation and potential for secondary procedures. Ultimately, there are very few absolute indications or contraindications for replantation, and each case must be considered on an individual basis.
This review contains 3 figures, 4 tables, and 28 references.
Key words: amputation, upper extremity, hand, digit, salvage, replant, replantation, revascularization, surgery of the hand
Cleft Palate
Authors: Jackson Oksana A , Kaye Alison E , Low David W
Published: January 2021

A cleft of the palate represents one of the most common congenital anomalies of the craniofacial region. Palatal clefting can occur in combination with a cleft of the lip and alveolus or as an isolated finding and can vary significantly in severity. The intact palate is a structure that separates the oral and nasal cavities, and the function of the palate is to close off the nasal cavity during deglutition and to regulate the flow of air between the nose and mouth during speech production. An unrepaired cleft palate can thus result in nasal regurgitation of food and liquid, early feeding difficulties, and impaired speech development. The goals of surgical repair are to restore palatal integrity by closing the cleft defect and repairing the musculature to allow for normal function during speech. The secondary goal of cleft palate repair is to minimize deleterious effects on growth of the palate and face, which can be impacted by standard surgical interventions. This review describes two of the most commonly performed cleft palate repair techniques in use today, as well as highlighting special anatomic considerations, summarizing perioperative care, and reviewing postoperative complications and their management.

This review contains 11 figures, 2 videos, 3 tables and 63 references
Key words: cleft, cleft team, Furlow, orofacial, oronasal fistula, palatoplasty, speech, submucous cleft, velopharyngeal insufficiency
Hair Transplantation: Biochemical Basis and Surgical Treatment
Authors: Ehrlichman Richard J. , Parungao Allan J.
Published: January 2021

Modern day hair transplantation has undergone tremendous advances since the understanding of the patterns of male hair loss and miniaturization related to androgenic alopecia caused by DHT (dihydrotesterone).  The concept of donor dominance, in which hairs genetically resistant to the effects of DHT can be moved to other locations where hair has been lost due to sensitivity to this hormone, is the basis for modern day hair transplantation.  Early hair transplantation based on this knowledge involved moving plugs of hair from DHT resistant hairs posteriorly to the anterior hairline.  These however resulted in abnormal hairlines which did not appear natural.  Presently, hair transplantation is placed on the use of 1, 2, 3, and 4 hair follicular units to create more natural hairlines.  In addition, knowledge of the biochemistry of hair loss has resulted in nonsurgical treatments that can regrow and maintain hair.  Finasteride (Propecia) and minoxidil (Rogaine) are now important adjuncts before, during and after hair transplantation.  Advances have been made in the harvesting of donor hair including the use of follicular unit extraction which removes individual 1, 2, 3 or 4 hair follicular units and the use of robots for extraction.  Because of the limitations of donor sites and the fact that hair loss is progressive, future research will involve the use of stem cells.

This review contains 27 figures and 106 references.
Key Words: androgenic alopecia, cicatricial alopecia, DHT, donor dominance, follicular units, miniaturization, stem cells, telogen effluvium, trichophytic
Chest Wall Reconstruction Following Tumor
Authors: Shahzad Farooq , Matros Evan
Published: January 2021

Plastic surgeons are typically called upon to reconstruct the chest wall in four situations: oncologic resection, infections, trauma and osteoradionecrosis. In this chapter we will discuss post-oncologic reconstruction. Chest wall reconstruction following tumor resection is typically performed at the same setting as the ablative surgery; this results in quicker patient recovery and overall better outcomes. The reconstruction should be planned with the ablative surgeon so that an assessment can be made of the extent of resection and available donor sites for reconstruction. The major components of reconstruction are 1) skeletal support and 2) soft tissue coverage. Skeletal support is indicated if the defect is >5 cm, 4 or more ribs are removed or more than 2/3rd of the sternum is resected. Prosthetic mesh is most commonly used. Soft tissue reconstruction is performed with regional pedicled flaps in the vast majority of cases. Free flaps are used when regional flaps are not sufficient (large defects) or not available. 
This review contains 11 figures, 3 tables, and 49 references.
Keywords: chest wall, tumor, skeletal reconstruction, soft tissue reconstruction, mesh, acellular dermal matrix, titanium osteosynthesis systems, resorbable plates, pedicled flaps, free flaps
Abdominal Wall Reconstruction
Authors: Dumanian Gregory A.
Published: January 2021

The closure of the abdominal wall defects is a fascinating field within surgery. The combined strength of sutures and scar after simple approximation of tissues in many cases does not suffice to contain the abdominal viscera and an incisional hernia results. Surgical failure can be seen immediately in the dramatic form of a dehiscence or can emerge slowly over time with a change in the abdominal shape and contour. This chapter delves into the theory and practicum of how a surgeon can approximate two halves of an abdominal wall together to resist the inherent tensile forces that exist and create a durable closure.

This review contains 19 figures and 35 references
Key Words: bioprosthetic, bridging, component release, force distribution, foreign body reaction, gap formation, hernia, laparotomy, mesh, perforator preservation, rectus diastasis, suture pull-through, TAR release
Midface Reconstruction
Authors: Rifkin William J. , Diaz-Siso Jesus Rodrigo , Rodriguez Eduardo D.
Published: January 2021

Composite defects of the midface present a formidable reconstructive challenge. Progress in craniomaxillofacial surgery has led to improved understanding of the functional role of skeletal subunits, whereas microsurgical free tissue transfer has become a reliable means for soft tissue coverage of large facial wounds. Although historically divergent, the intersection of these subspecialties has provided surgeons with the resources to undertake complex reconstructive problems in an anatomic location where functional and aesthetic concerns are equally critical. Technological advances have allowed teams to plan procedures in precise detail, increasing surgical accuracy and creating optimal conditions for long-term oral rehabilitation. Interestingly, far from obsoleting them, these innovations reinforce the age-old surgical principles that have guided facial reconstruction for the past century. Perhaps the ultimate representation of these principles, facial transplantation has transformed even the most severe craniomaxillofacial defects into reconstructible problems; special considerations must be recognized when reconstructing the skeletal structures of the midface in the context of allotransplantation.
 
This review contains 7 figures and 29 references.
Key Words: aesthetic units, composite facial defects, facial transplantation, free fibula flap, free iliac bone flap, midface reconstruction, skeletal buttresses, staged reconstruction
Primary Repair of Soft Tissue Facial Trauma
Authors: Seu Michelle , Dorafshar Amir H. , Liang Fan
Published: January 2021

Craniofacial trauma can result in a wide variety of injuries that cause soft tissue injury of face. However, despite the enormous diversity in presentation of these injuries, they tend to follow certain patterns. Most facial injuries are either contusions, abrasions, lacerations, or avulsions. The extent of injury and approach to repair can be further assessed by the size, depth, and number of facial subunits involved. A plastic surgeon in the setting of acute craniofacial trauma, armed with certain principles of facial anatomy and primary repair methods, can drastically restore function and cosmesis to the face, while also mitigating the chance of future deformity and functional deficit.
This review contains 3 figures and 26 references
Keywords: facial trauma, craniofacial surgery, primary repair, facial soft tissue defects, soft tissue, facial injury, plastic surgery, facial lacerations, facial avulsions