bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic Therapy for Colorectal Cancer
Authors: Varghese Anna M.
Published: January 2021

Colorectal cancer remains the second most common cause of cancer-related deaths in this country. Although colorectal cancer is best managed by a multidisciplinary team of surgical, radiation, and medical oncologists, cytotoxic therapy remains the backbone of treatment in the metastatic disease setting. In addition to cytotoxic therapies, vascular-targeted therapies and epidermal growth factor receptor (EGFR)–targeted therapies for selected patients with metastatic colorectal cancer improve outcomes for patients with metastatic colorectal cancer. Growing understanding of various biological subsets of colorectal cancer, including BRAF V600E mutant and mismatch repair–deficient colorectal cancers, is expanding treatment opportunities for patients and is the focus of ongoing research.
This review contains 4 tables and 57 references.
Key Words: chemotherapy, colorectal cancer, fluoropyrimidines, immunotherapy, metastatic, mismatch repair–deficient colorectal cancer, targeted therapy, topoisomerase inhibitors
Aortic Aneurysm
Authors: Lee Christine E , Naraghi Leily , Hoffmann Beatrice
Published: January 2021

Aortic diseases are relatively rare but are associated with high morbidity and mortality. Emergency physicians (EPs) should consider aortic disease in all patients with pain in the torso, particularly those with other diverse or seemingly unconnected complaints. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with abdominal aortic aneurysms (AAAs), thoracic aortic aneurysms (TAAs), and aortic dissection. Figures show a transverse image of an AAAs with a transmural hematoma, a three-dimensional computed tomographic angiogram (CTA) rendering of a thoracic aneurysm associated with a bicuspid aortic valve in the typical ascending aortic location, a chest x-ray film demonstrating prominent and blurred aortic knob due to TAA, acute aortic dissection subtypes, an electrocardiogram and transesophageal echocardiography of a patient with acute ascending aortic dissection, magnetic resonance images of a patient with dissection of the proximal descending aorta, CT representations of a type A dissection involving a dilated ascending aorta and a type B dissection involving the descending thoracic aorta, and a decision algorithm for evaluation and treatment of a suspected aortic dissection. Tables list normal aortic dimensions by CTA and echocardiography, average annual rate of expansion and rupture of AAA based on current diameter, and the etiology of TAA.
This review contains 3 figures, 3 tables, 4 videos and 66 references.
Key words: AAA, aorta, aortic dissection, ascending aortic dissection, descending aortic dissection, intimal tear, intramural hematoma, thoracic aortic aneurysm
Drug Hepatotoxicity
Authors: Bessone Fernando , Andrade Raúl J
Published: January 2021

Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals, and dietary supplements) is an elusive liver disease presenting with a range of phenotypes and severity, including acute hepatitis that is indistinguishable from viral hepatitis, autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes, asymptomatic liver test abnormalities,and acute liver failure. Case definition and characterization using liver biochemistry and histology are crucial for appropriate phenotyping. The incidence of DILI is probably higher than expected by the cases that are identified in clinical practice because of misdiagnosis and underreporting.The pathogenesis of DILI is complex, depending on the interaction of a drug’s physicochemical properties and host factors. Genome-wide association studies have identified several alleles from the major histocompatibility complex system, indicating a fundamental role of the adaptive immune system in DILI pathogenesis. As specific biomarkers for hepatotoxicity are still not available, the diagnosis of DILI remains one of exclusion of the alternative causes of liver damage. Structured causality assessment using the Roussel Uclaf Causality Assessment Method (RUCAM) or previously Council for International Organizations of Medical Sciences (CIOMS) instrument adds consistency to the diagnostic process, although there is room for improvement in the scale domains and score weighting. The therapy for idiosyncratic hepatotoxicity is supportive and relies on the prompt withdrawal of the offending agent. Corticosteroid therapy for hypersensitivity reactions or ursodeoxycholicacid for prolonged cholestasis is empirically used, although the degree of evidence is low. Existing databases have enabled a better prediction of immediate and long-term DILI prognosis. Multivariate models have identified clinical and analytical variables as predictive of acute liver failure and mortality as well as of chronic DILI.

This review contains 2 figures, 5 tables, and 55 references
Key Words: adaptive immune system; causality assessment; drug-induced liver injury; epidemiology; HLA alleles; pharmacogenetics; registries; risk factors
Acute and Chronic Rejection in Liver Transplantation
Authors: Coelho Little Ester , Berenguer Marina
Published: January 2021

Advances in immunosuppression have improved the outcome of transplantation. Although early cellular rejection does not adversely impact transplantation outcome, late cellular rejection appears to behave differently from both a clinical and a histologic point of view, potentially resulting in poor outcomes. Histologic assessments continue to play an important role in the diagnosis and management of liver allograft rejection. Former conditions known as “de novo autoimmune hepatitis” and “idiopathic posttransplantation chronic hepatitis” are currently labeled “atypical cases of rejection” and late T cell–mediated rejection. There is increasing evidence to suggest that central perivenulitis may be an important manifestation of these immune conditions. In addition, although the liver appears relatively resistant to donor-specific antibody–mediated injury, alloantibody-mediated adverse consequences are increasingly being recognized, including cases of acute and chronic antibody-mediated rejection and the potential implication of atypical immune-mediated manifestations of rejection, particularly late and chronic rejection. Judicious immunosuppression appears to be a common protective factor against these complications.
This review contains 5 figures, 5 tables, and 72 references.
Key words: antibody-mediated rejection, chronic rejection, de novo autoimmune hepatitis, fibrosis, idiopathic posttransplantation hepatitis, late rejection, liver transplantation, plasma cell–rich rejection, T cell–mediated rejection
Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19
Authors: Ison Michael G.
Published: January 2021

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review.
This review contains 3 figure, 11 tables, and 47 references.
Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction
Drug Hepatotoxicity
Authors: Bessone Fernando , Andrade Raúl J
Published: January 2021

Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals, and dietary supplements) is an elusive liver disease presenting with a range of phenotypes and severity, including acute hepatitis that is indistinguishable from viral hepatitis, autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes, asymptomatic liver test abnormalities,and acute liver failure. Case definition and characterization using liver biochemistry and histology are crucial for appropriate phenotyping. The incidence of DILI is probably higher than expected by the cases that are identified in clinical practice because of misdiagnosis and underreporting.The pathogenesis of DILI is complex, depending on the interaction of a drug’s physicochemical properties and host factors. Genome-wide association studies have identified several alleles from the major histocompatibility complex system, indicating a fundamental role of the adaptive immune system in DILI pathogenesis. As specific biomarkers for hepatotoxicity are still not available, the diagnosis of DILI remains one of exclusion of the alternative causes of liver damage. Structured causality assessment using the Roussel Uclaf Causality Assessment Method (RUCAM) or previously Council for International Organizations of Medical Sciences (CIOMS) instrument adds consistency to the diagnostic process, although there is room for improvement in the scale domains and score weighting. The therapy for idiosyncratic hepatotoxicity is supportive and relies on the prompt withdrawal of the offending agent. Corticosteroid therapy for hypersensitivity reactions or ursodeoxycholicacid for prolonged cholestasis is empirically used, although the degree of evidence is low. Existing databases have enabled a better prediction of immediate and long-term DILI prognosis. Multivariate models have identified clinical and analytical variables as predictive of acute liver failure and mortality as well as of chronic DILI.

This review contains 2 figures, 5 tables and 55 references
Key Words: adaptive immune system;causality assessment;drug-induced liver injury; epidemiology; HLA alleles; pharmacogenetics; registries; risk factors
Stable Ischemic Heart Disease: Medical Therapy With or Without Revascularization
Authors: Sarraju Ashish , Maron David J
Published: January 2021

Coronary artery disease (CAD) poses a significant global public health burden. Patients with CAD who do not present with acute coronary syndromes are considered to have stable ischemic heart disease (SIHD). Options for the management of SIHD are medical therapy including pharmacologic therapy and lifestyle modification and revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Guideline-directed medical therapy is recommended for all patients with SIHD. Aside from severe stenosis in an unprotected left main coronary artery, the role of routine revascularization in the management of SIHD is unclear. Early CABG trials from the 1970s and 1980s demonstrated prognostic benefit with CABG versus medical therapy, but these results have limited applicability in the setting of modern medical therapy, including the widespread use of statins and aspirin and intensive lifestyle interventions. Contemporary strategy trials examining PCI plus medical therapy versus medical therapy alone have not demonstrated prognostic benefit with the addition of PCI. The addition of revascularization offers consistent symptom and quality-of-life benefit compared with medical therapy alone based on trial data, though this benefit may be time limited with PCI. Thus, there is a state of equipoise regarding the addition of revascularization to guideline-directed medical therapy in the management of SIHD. Therefore, shared decision-making is key when determining the best management strategy for a patient with SIHD and should include discussion of expected risks and benefits based on high-quality evidence, costs, and patient preferences.
This review contains 6 figures, 8 tables, and 55 references. 
Key Words: angina, antianginal therapy, coronary artery disease, coronary artery bypass grafting, guideline-directed medical therapy, ischemia, optimal medical therapy, percutaneous coronary intervention, revascularization
Pulmonary Arterial Hypertension: Advancing Insights into a Historically Neglected Disease
Authors: Genuardi Michael V. , Chan Stephen Y.
Published: January 2021

Pulmonary arterial hypertension (PAH) is a rare spectrum of closely related diseases with myriad genetic, infectious, toxic, and immunologic triggers characterized by pathologic pulmonary vascular remodeling. While the natural history of PAH is marked by progressive dyspnea, hypoxia, right ventricular failure, and death, modern insights into disease pathogenesis, combined with breakthroughs in therapeutics, has greatly improved morbidity and time to disease worsening over the past two decades. Traditionally thought of as a disease of imbalance between vasodilators, such as nitric oxide and prostacyclin, and vasoconstrictors such as endothelin-1, more recent investigations have revealed important roles for perturbations in cellular metabolism, fibroblast activity, extracellular matrix maintenance, and apoptosis which contribute to pulmonary artery smooth muscle cell proliferation. Careful history and physical exam, along with echocardiography and right heart catheterization, remain essential for accurate workup and diagnosis. Cardiopulmonary exercise testing, cardiac magnetic resonance, and genetic testing have important ancillary roles. The number of approved pulmonary vasodilator therapies for PAH continues to expand, with evidence demonstrating the survival benefits of up-front combination therapy. Future prospects of next generation therapies that address the molecular origins of disease combined with comprehensive molecular profiling may usher in a new era of precision medicine for PAH.
This review contains 7 figures, 5 tables, and 57 references.
Keywords: pulmonary hypertension, vascular biology, therapeutics, hemodynamics, epidemiology, exercise physiology, genetic basis of disease, connective tissue disease, cardiac magnetic resonance imagining
Pediatric Infectious Diarrhea and Dehydration
Authors: Martel John W. , McCorvey Scott
Published: January 2021

Diarrhea is a common emergency department (ED) complaint, leading to more than 1.5 million outpatient visits and 200,000 hospital admissions in the United States alone. Although concomitant dehydration also exists in some cases, there are no standard clinical criteria to aid in identifying those children who merit intravenous resuscitation. Current pediatric volume repletion guidelines are based primarily on the estimated degree of volume depletion per the World Health Organization, Centers for Disease Control and Prevention, and American Academy of Pediatrics criteria. These practice guidelines stratify patients into mild (3 to 5% volume depletion), moderate (5 to 10% volume depletion), and severe (> 10% volume depletion). 

This review contains 5 figures, 9 tables, and 64 references.
Key Words: Clostridium difficile, dehydration, diarrhea, gastroenteritis, hemolytic-uremic syndrome, pediatrics
Determination of Energy Expenditure
Authors: Phelan Grace
Published: January 2021

Nutrition interventions are often designed to influence energy balance, ultimately optimizing the health of individuals or groups. Goals include weight loss in obese and overweight individuals or weight gain in growing children, pregnant women, and the underweight. In some cases, weight maintenance is the intention for healthy weight adults or children who have the opportunity to grow into their current weight. Determining the energy requirements for each person can help explain the presence or absence of weight changes and direct subsequent nutrition goals and interventions. Quantifying energy requirements also helps to avoid over- and under- feeding. This is particularly relevant in people suffering from acute or chronic disease or illness. In the acute care setting overfeeding can worsen metabolic disturbances including, but not limited to, hyperglycemia and hypercarbia while underfeeding can negatively impact immunity, organ function, and activities of daily living.
This review contains 3 Figures, 5 Tables and 66 references
Key words: nutrition, energy expenditure, body composition, calorimetry, bioelectrical impedance analysis (BIA), doubly-labeled water (DLW), reverse Fick equation, Harris-Benedict equation, Millfin-St. Jeor Equation, Owen Equation, Ireton-Jones Equations, Penn State Equations, hypocaloric feeding
Endocrine Aspects of Kidney Disease
Authors: Adamczak Marcin , Kuczera Piotr , Wiecek Andrzej
Published: January 2021

Kidneys play the major role in the synthesis and degradation of several hormones. Different coexisting conditions such as inflammation, malnutrition and metabolic acidosis and applied treatment may also cause endocrine abnormalities in chronic kidney disease (CKD) patients. A tendency towards decreased thyroxin and triiodothyronine with normal serum concentrations of reversed triiodothyronine (as opposed to other chronic non-thyroid, non-kidney diseases) and thyroid stimulating hormone are observed. As far as the somatotopic axis is concerned, in CKD normal serum concentration of growth hormone and its effector – the insulin-like growth factor are observed. Nevertheless, due to the phenomenon of GH/IGF-1 “resistance” CKD patients usually present a phenotype resembling GH deficiency. Serum prolactin concentrations are often elevated in CKD women and men. This leads to the dysregulation of the pituitary-gonadal axis causing hypogonadism and it’s clinical consequences regardless of patient’s gender. The alterations in hormones of gonadal origin caused by uremia, together with hyperprolactinemia lead to the development of sexual dysfunction and infertility in men and women. The alterations of thyroid, pituitary gland and gonads associated with CKD are discussed in this chapter.
This review contains 4 tables, and 64 references.
Keywords: chronic kidney disease, hypothyroidism, hyperthyroidism, growth hormone, recombinant human GH, insulin-like growth factors, hemodialysis
Metabolic Encephalopathy - Part II
Authors: Gill Rick , McCoyd Matthew , Ruland Sean , Biller José
Published: January 2021

Normal neurologic function requires a constantly balanced environment of electrolytes.  Normal hepatic and renal function is critical in maintaining this balance while removing toxins, maintaining a physiologic pH and regulating the excretion of electrolytes.  Nutritional intake provides essential nutrients but deficiencies can lead to characteristic syndromes such as Wernicke's encephalopathy and pellagra and exposure to neurotoxic substances such as heavy metals can lead to encephalopathy.  Thyroid and adrenal dysfunction are common endocrine causes of encephalopathy and symptoms can often improve rapidly with treatment.  A subset of idiopathic encephalopathy is increasingly being recognized as having an autoimmune basis, often presenting as a paraneoplastic process, and having a constellation of symptoms which can aide in the diagnosis.  Timely recognition and treatment of the autoantibodies which target neural structures, with immunosuppressive therapy, can improve outcome in these patients.  
This review contains 4 figures, 3 tables, and 42 references.
Key words: osmotic demyelination syndrome,hepatic encephalopathy, renal failure, triphasic waves, dialysis disequilibrium syndrome, Wernicke encephalopathy, Korsakoff syndrome, myxedema coma, Hashimoto encephalopathy
Infections Caused by Spirochetes: Syphilis, Lyme Disease, Leptospirosis
Authors: Duff Patrick
Published: January 2021

Syphilis is caused by the spirochete Treponema pallidum. It is classified as primary, secondary, tertiary, and latent infection. If left untreated, syphilis can cause devastating injury to the fetus. The drug of choice for treatment of syphilis in pregnancy is penicillin. Lyme disease is caused by Borrelia burgdorferi and is transmitted by the Ixodes scapularis tick. The principal clinical manifestation of Lyme disease is erythema migrans, but patients may also develop arthritis and cardiac and neurologic abnormalities. Congenital Lyme disease has not been reported. The drug of choice for treatment of Lyme disease in pregnancy is amoxicillin. Leptospirosis is usually acquired from direct contact with urine of infected animals or through contaminated water, soil, or vegetation. Pregnant women with mild disease should be treated with oral amoxicillin. Patients with severe disease should be hospitalized and treated with intravenous penicillin or ampicillin.

This review contains 5 figures, 5 tables, and 19 references.
Key Words: clinical infection, congenital syphilis, latent infection, leptospirosis, Lyme disease, syphilis
Fetal Malpresentation in Pregnancy
Authors: Azimirad Afshin , Norwitz Errol R.
Published: January 2021

Fetal presentation refers to that anatomical part of the fetus that presents at the maternal pelvic inlet. The most common and most desirable fetal presentation is cephalic (head first). Any presentation other than cephalic is referred to as a malpresentation. Breech is the most common fetal malpresentation. The prevalence of breech presentation varies with gestational age (25% at 28 weeks and 3-5% of at term). Ultrasound evaluation is the gold standard for the diagnosis of fetal presentation. External cephalic version (ECV) refers to a series of manual manipulations designed to convert a malpresenting fetus to cephalic to promote vaginal delivery. There are two strategies around the timing of ECV; at 36-37 weeks and/or at or shortly after 39 weeks’ gestation. Each has advantages and disadvantages. Currently, most breech pregnancies at term are delivered by cesarean at 39 weeks prior to the onset of labor. Malpresentation is the second most common indication for planned cesarean (behind elective repeat cesarean). Vaginal delivery for a breech fetus at term should only be attempted if the mother is strongly motivated, if the obstetric care provider is experienced, and if the medical center has the requisite facilities to manage any and all complications.
This review contains 3 figures, 2 tables, and 66 references.
Keywords: fetal presentation, malpresentation, breech presentation, ultrasound evaluation, external cephalic version (ECV), cesarean delivery, vaginal breech delivery
Abnormalities of the Fetal Chest
Authors: Davidson Karen M.
Published: January 2021

The normal and abnormal development of the organs lying within the fetal thorax is discussed.  The abnormalities reviewed include more common findings of pulmonary hypoplasia, congenital diaphragmatic hernia, congenital pulmonary airway malformation, bronchopulmonary sequestration, as well as the rarer conditions of congenital fetal hydrothorax, congenital high airway obstruction syndrome, bronchogenic cysts, neurenteric cysts, and lung agenesis.  With each abnormality, the clinical implications for the fetus, best methods for prenatal diagnosis, as well as possible additional anomalies, syndromes, and aneuploidies are described.  In utero and postnatal treatments are also reviewed.  
This review contains 10 figures, and 37 references.
Key Words: Pulmonary hypoplasia, lung-head ratio, congenital diaphragmatic hernia, congenital pulmonary airway malformation, congenital fetal hydrothorax, bronchopulmonary sequestration, congenital high airway obstruction syndrome, bronchogenic cyst, neurenteric cyst, lung agenesis
Malignant Vaginal Neoplasms
Authors: Roque Dario R , Wang Victoria
Published: January 2021

Vaginal cancer is a rare neoplasm, accounting for only 3% of gynecologic cancers. Most cases of vaginal cancer are squamous cell carcinomas, with adenocarcinoma being the second most common histopathology. As the pathophysiology of vaginal squamous cell carcinoma is thought to be due to HPV infection, treatment strategies are largely based on the treatment of cervical cancer, with radiation therapy being the primary method of definitive treatment. The role of surgery also has been shown to improve survival outcomes but should be evaluated on an individualized basis. While there continues to be no existing randomized control trials on the treatment of vaginal cancer, recent studies have explored the benefits of combination chemoradiation for advanced stage disease. Five-year survival of vaginal cancer in Stage I or II has been shown to be as high as 80-90% with treatment, while advanced disease survival rates continue to be around 30%.
This review contains 2 figures, 7 tables, and 53 references.
Key words: vaginal cancer, squamous cell carcinoma, brachytherapy, external beam radiation, HPV
Biomaterials
Authors: G Pietramaggiori , Scherer Saja
Published: January 2021

With the critical advances in material science and bioengineering, the clinical availability of biomaterials is rapidly expanding. Biomaterials are used to restore or correct function of tissues that have been modified by injury, malformation, pathology, or aging. Materials used in contact with living tissues should meet the criteria of biocompatibility, which are (1) biosafety, (2) biofunctionality, and (3) biointegration. Depending on the function they are asked to perform and the target tissue, the choice is among nonresorbable or resorbable biomaterials, metallic or polymeric, and natural or synthetic. Although some materials such as titanium are able to osteointegrate inducing minimal scarring at the interface with living tissues, it seems that a common limitation across all biomaterials is to induce some extent of foreign body reaction and scar encapsulation, which affects negatively the function of the device. Novel surface technologies at the micro- or nano-scale and advanced biomaterials will improve the biointegration of medical devices and allow for permanent implantation of functional biomaterials.
 
This review contains 9 figures, 9 tables and 63 references
Key Words: biocompatibility, biofilm, biofunctionality, biointegration, biomaterials, encapsulation, foreign body reaction, wound healing
Head and Neck Tumors in Children
Authors: Lopez Joseph , Yu Jason W. , Afshar Salim
Published: January 2021

The following chapter will provide a broad overview of the most common osseous lesions a surgeon will encounter when a pediatric patient presents with a bone-like head and neck tumor. The selected topics discussed below will be benign and malignant odontogenic cysts and tumors, and non-odontogenic benign (giant cell tumors, fibrous dysplasia, and juvenile ossifying fibroma) and malignant (osteosarcoma and ewing sarcoma) osseous tumors.
This chapter has  4 figures, 3 tables, and 40 references
Key Words: odontogenic cyst, non-odontogenic cysts, odontogenic tumors, giant cell tumor, fibrous dysplasia, juvenile ossifying fibroma, osteosarcoma, ewing sarcoma
Nerve Reconstruction and Tendon Transfers for Treatment of Brachial Plexus Injuries
Authors: Dy Christopher J. , Brogan David M. , Boyer Martin I. , Loeb Carol B. , Loeb Jerome T.
Published: January 2021

The complexity of each brachial plexus injury (BPI) pattern and physiologic limitations of nerve regeneration create challenges for BPI patients and their surgeons. Detailed assessment via physical examination, electrodiagnostic studies, and advanced imaging can aid the surgeon in predicting the prognosis for each patient’s neurologic recovery and provide an outline for reconstructive priorities. Surgical exploration of the brachial plexus confirms the injury pattern and guides the overall treatment strategies. A multimodal reconstructive strategy including nerve grafting, extraplexal nerve transfers, distal intraplexal nerve transfers, and free-functioning muscle transfers is designed for each patient to accomplish the goals of providing a pain-free helper hand. Additional reconstructive procedures such as tendon transfers and selective joint arthrodeses are used after the results of the initial reconstructive efforts have been declared. Beyond the neurologic components of BPI, the surgeon must be attuned to the social and psychological sequelae of this devastating injury.
 This review contains 10 figures, 1 table, and 60 references.
Key Words: brachial plexus injury, elbow flexion, free-functioning muscle transfer, nerve grafting, nerve transfer, reconstruction, shoulder abduction, , tendon transfer
Gay, Lesbian, and Transgender Issues in Psychiatry
Authors: Hester Jonathan R. , Praus Julie M.
Published: January 2021

This review is intended to give an overview of psychiatric considerations for the lesbian, gay, bisexual, and transgender (LGBT) population. The history of LGBT-related diagnoses in the DSM is discussed along with the epidemiology of various mental disorders in the LGBT population, with several diagnoses having a higher incidence including depression, anxiety, substance use disorders, self-harm, and suicidal ideation or attempt. To explain these discrepancies, several theories and models are explored, specifically the minority stress model and adverse childhood events. Additionally, recommendations for clinical psychiatric practice are explored including affirmative therapy and transgender-affirming cognitive behavioral therapy, two interventions specifically studied in the LGBT population as well as overall goals of treatment when treating patients struggling with their gender identity.
This review contains 5 tables, and 35 references. 
Key Words: adverse childhood events, affirmative therapy, bisexual, gay, lesbian, LGBT, minority stress, transgender, transgender-affirming cognitive behavioral therapy
Creating a Culture of Wellness - No Jerks Allowed
Authors: Ricciotti Hope A
Published: January 2021

The culture of a health care system influences physician wellness; in turn, physician wellness is an indicator of the health care system quality. A career as a physician was traditionally viewed as a calling where patients came first, even to the personal detriment of the physician. Organizational cultures that support work-life integration allow flexibility and cooperative scheduling for the activities of work, home, family, community and self. Today’s health care challenges require collaboration, teamwork and the collective intelligence to get to the solutions that our complex environment requires. Open workspace is one method that can transform culture; academic medicine is following the model of the business world with spaces that flatten hierarchy, enhance communication among faculty and trainees, and foster a culture of civility and greater attachment to the organization. Top-down hierarchical leadership is outdated and counterproductive. Organizations with a flat structure are nimble, innovative and tend to outperform those with more traditional hierarchies. Adopting the humble attitude of a servant leader is essential to building positive department and organizational culture. Effective leaders have self-awareness, self-regulation, motivation, empathy and social skills, qualities collectively known as emotional intelligence. We need to move away from a physician centric culture and replace it with a new brand of department or health care organization that is just and collaborative, that promotes innovation and teamwork, iterates quickly and nurtures individuals at all levels to voice ideas and demonstrate leadership. These same ingredients promote joy in work and align with safe care models.

This review contains 27 references.
Keywords: Culture change, emotional intelligence, flattened hierarchy, innovation, leadership, servant leader, work-life integration
Chorea: Classification, Differential Diagnosis, and Treatment
Authors: Battista James P , Walker Ruth H
Published: January 2021

Chorea is a common hyperkinetic movement disorder that can have a large differential diagnosis. Causes can include genetic and sporadic etiologies, including metabolic abnormalities, autoimmune, structural, paraneoplastic, psychogenic, and iatrogenic causes. The workup can be challenging due to this large number of possible causes, and can include basic metabolic and specialized blood analysis such as genetic testing, in addition to imaging studies and cerebrospinal fluid analysis. Treatment of symptoms outside the realm of reversible causes can be challenging, and is a major focus of current research. This review covers sporadic causes, genetic causes, and management. Figures show a flowchart for evaluation of patients with chorea, a computed tomography scan of a Huntington disease patient showing caudate head atrophy, brain computed tomography scan showing calcification, and acanthocytosis. Videos show mild and moderate Huntington disease, Huntington disease-like 2,  and chorea-acanthocytosis. Tables list metabolic abnormalities that can manifest as chorea, paraneoplastic and nonparaneoplastic syndromes associated with chorea, and reported successful therapies for chorea.
Systemic Lupus Erythematosus
Authors: Kirou Kyriakos A. , Lockshin Michael D.
Published: January 2021

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune illness characterized by autoantibodies directed at nuclear antigens that cause clinical and laboratory abnormalities, such as rash, arthritis, leukopenia and thrombocytopenia, alopecia, fever, nephritis, and neurologic disease. Most or all of the symptoms of acute lupus are attributable to immunologic attack on the affected organs. Many complications of long-term disease are attributable to both the disease and its treatment. Intense sun exposure, drug reactions, and infections are circumstances that induce flare; the aim of treatment is to induce remission. This chapter is divided into sections dealing with SLE’s definitions; epidemiology; pathogenesis; disease classification, diagnosis, and differential diagnosis; and treatment.

This review contains 10 figures, 12 tables, and 97 references.
Key Words: Systemic lupus erythematosus, Dermatomyositis, Sjögren syndrome, rheumatoid arthritis, systemic sclerosis, Discoid lupus erythematosus, truncal psoriasiform, annular polycyclic rash
Hypertension
Authors: Bonaca Marc P
Published: January 2021

Hypertension is a common chronic disorder with an increasing prevalence in the context of an aging population. Patients with hypertension are at risk for adverse cardiovascular, renal, and neurologic outcomes. Treatment of hypertension reduces this associated risk; therefore, early diagnosis and systematic management are critical in reducing morbidity and mortality. Although hypertension is multifactorial, a large component is related to lifestyle, including excess sodium intake, lack of physical activity, and obesity. Lifestyle intervention and education, therefore, are critical to both prevention and treatment of hypertension. Patients diagnosed with hypertension should be evaluated for their overall risk, with specific therapies and treatment targets guided by their characteristics and comorbidities. Several professional and guideline societies have published recommendations with regard to the diagnosis and treatment of hypertension, which have many similarities but also several areas of discussion and ongoing debate. Recent evolutions in the field include the expanded indications for home-based and ambulatory blood pressure monitoring and outcomes trials, which add important data regarding optimal treatment targets. These evolutions are likely to be addressed in ongoing guideline updates.
Key words: ambulatory blood pressure monitoring, antihypertensive therapy, blood pressure, blood pressure targets, cardiovascular risk, high blood pressure, home blood pressure monitoring, hypertension, screening, secondary hypertension
This review contains 9 figures, 13 tables, and 59 references.
Venous Thromboembolism
Authors: Goldhaber Samuel Z.
Published: January 2021

Venous thromboembolism, which involves venous thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in hospitalized patients and is being seen with increasing frequency in outpatients. This chapter discusses the risk factors, etiology, classification, pathophysiology, natural history, prognosis, diagnosis (including venous thrombosis, recurrent venous thrombosis, and pulmonary embolism), prophylaxis, and treatment of venous thromboembolism (including the pharmacology of antithrombotic agents), as well as venous thromboembolism in pregnancy and miscellaneous thromboembolic disorders (including thrombosis of unusual sites). 
This review contains 8 figures, 16 tables, and 79 references.
Keywords: Venous thromboembolism, pulmonary embolism, deep vein thrombosis, embolectomy, thrombolysis, hypercoagulability, duplex ultrasonography, D-dimer, anticoagulation
Introduction to Ureteroceles: Presentation, Diagnosis, and Initial Management
Authors: McQuaid Joseph W , Diamond David A
Published: January 2021

The diagnosis and treatment of ureteroceles continue to evolve. Not only are the majority of patients diagnosed prenatally, but a significant proportion of cases can be dealt with in a minimally invasive, endoscopic fashion. Although a single treatment strategy for all ureteroceles is an unrealistic expectation, more valuable to the practicing urologist is an understanding of the variable anatomy and presentation of this entity and an appreciation for the breadth of treatment options at his or her disposal. This, the first of our two reviews on ureteroceles, provides the necessary background.
 
This review contains 10 figures, 6 tables and 35 references
Key words: bladder trigone, cecoureterocele, ectopic ureterocele, extravesical ureterocele, intravesical ureterocele, lower tract approach, obstructed ureterocele, reflux, transurethral incision, transurethral puncture, upper tract approach, ureterocele, ureterocele algorithm
Chronic Obstructive Pulmonary Disease
Authors: Schissler Andrew J , Washko George , Come Carolyn E.
Published: January 2021

Chronic obstructive pulmonary disease (COPD) is a leading cause of disability and death worldwide. This edition reviews the epidemiology and etiologies of COPD, including the gender effects, racial differences, and more recently identified genetic factors associated with this condition. It details the many pathogenetic mechanisms thought to be associated with this disease state, such as increased airway inflammation and turnover of extracellular matrix. There is a detailed discussion about diagnosis, classification, and the therapeutic options available for both stable disease and acute exacerbations. The recent evidence supporting various treatments, such as vaccinations, inhaled bronchodilators, inhaled corticosteroids, oral corticosteroids, antibiotics, supplemental oxygen, pulmonary rehabilitation, and surgery, is reviewed in depth. There is further evaluation of experimental approaches, such as bronchoscopic lung reduction procedures and the use of extracorporeal carbon dioxide removal for hypercapnic respiratory failure. The many complications associated with COPD are described, acknowledging that evidence continues to suggest that COPD has a significant systemic component associated with increased rates of psychiatric illness, cardiovascular disease, osteoporosis, and skeletal muscle dysfunction along with lung cancer. Overall this text serves as an excellent evidence-based guide to better understand, diagnose, and manage COPD and its array of associated complications.
Key words: chronic obstructive pulmonary disease (COPD), COPD complications, COPD diagnosis, COPD management, COPD pathophysiology, Global Initiative for Chronic Obstructive Lung Disease (GOLD)
This review contains 6 highly rendered figures, 4 tables, and 239 references.
Approach to the Diagnosis of Skin Disease
Authors: Brodell Robert T , Helms Stephen E , Dolohanty Lindsey B
Published: January 2021

The diagnosis of skin disease is not something that changes radically year to year. In fact, for hundreds of years physicians have been assessing the skin to diagnose and treat skin diseases and  to “view” internal diseases. The latest edition of this review provides several updates that enhance our approach to the diagnosis of skin disease with active links to updated digital references and atlases. These will be valuable to students, residents, and physicians interested in improving their dermatologic diagnostic skills. A new algorithm highlights our suggested approach to cutaneous diagnoses. It is our hope that readers will begin to “think like dermatologists” as they digest the contents of this review. 
Key words: Macule, papule, vesicle, bulla, plaque, excoriation, scale, ulceration, diagnosis, errors
This review contains 13 figures, 5 tables, 17 references, and 7 additional readings.
Overview of Schizophrenia and Other Psychotic Disorders
Authors: Wilcox James A. , Black Donald W.
Published: January 2021

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments.  
This review contains 3 tables, and 34 references.
Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder
Imaging of Malignant and Benign Tumors of the Pancreas
Authors: Altun Ersan , Semelka Richard C
Published: January 2021

Pancreatic cross-sectional imaging has been widely used to diagnose and stage pancreatic neoplasms. The most commonly used techniques include multidetector CT, MRI, and endoscopic ultrasonography. Hybrid imaging including positron emission tomography combined with CT has a limited role. Dedicated imaging applications of these modalities for the evaluation of pancreatic neoplasms and their accuracies for different neoplasms are summarized in this review. Critical and differential imaging findings of the most common neoplasms of the pancreas, including adenocarcinoma, neuroendocrine tumors, cystic neoplasms, lymphoma, and metastases, emphasizing the most accurate imaging techniques are also discussed. Additionally, the most common mimics of the pancreatic neoplasms and their imaging findings are reviewed.
This review contains 32 references, 13 figures, and 5 tables.
Key words: adenocarcinoma, CT, EUS, intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, MRI, neuroendocrine tumors, PET-CT, serous cystadenoma
Sepsis
Authors: Filbin Michael R.
Published: January 2021

Sepsis accounts for approximately one in three hospital deaths and is associated with very high health care costs due to prolonged lengths of stay in the intensive care unit and hospital. Sepsis is essentially an immunologic response to infection that is propagated systemically, leading to diffuse cellular and microcirculatory dysfunction, vasodilation, vital organ hypoperfusion, and eventual failure. This review covers the pathophysiology, stabilization/assessment, diagnosis, treatment, and disposition and outcomes of sepsis. Figures show the inflammatory and thrombotic response to infection, the action of nitric oxide on vascular smooth muscle cells, accelerated glycolysis and increased lactate production as a result of the catecholamine surge seen in septic shock, sepsis mortality associated with number of organ failures identified in the emergency department (ED), and protocolized therapy for septic shock. Tables list definitions of sepsis syndromes; frequently cited scoring systems for mortality prediction in ED patients with sepsis; Sequential Organ Failure Assessment (SOFA) score; current recommendations regarding treatment bundles at 3 and 6 hours of resuscitation; antibiotic recommendations based on suspected source; and vasopressors used in septic shock with recommended dosing, mechanism of action, and indications.
This review contains 5 highly rendered figures, 6 tables, and 42 references.
Aortic Aneurysm
Authors: Lee Christine E , Naraghi Leily , Hoffmann Beatrice
Published: January 2021

Aortic diseases are relatively rare but are associated with high morbidity and mortality. Emergency physicians (EPs) should consider aortic disease in all patients with pain in the torso, particularly those with other diverse or seemingly unconnected complaints. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with abdominal aortic aneurysms (AAAs), thoracic aortic aneurysms (TAAs), and aortic dissection. Figures show a transverse image of an AAAs with a transmural hematoma, a three-dimensional computed tomographic angiogram (CTA) rendering of a thoracic aneurysm associated with a bicuspid aortic valve in the typical ascending aortic location, a chest x-ray film demonstrating prominent and blurred aortic knob due to TAA, acute aortic dissection subtypes, an electrocardiogram and transesophageal echocardiography of a patient with acute ascending aortic dissection, magnetic resonance images of a patient with dissection of the proximal descending aorta, CT representations of a type A dissection involving a dilated ascending aorta and a type B dissection involving the descending thoracic aorta, and a decision algorithm for evaluation and treatment of a suspected aortic dissection. Tables list normal aortic dimensions by CTA and echocardiography, average annual rate of expansion and rupture of AAA based on current diameter, and the etiology of TAA.
Key words: AAA, aorta, aortic dissection, ascending aortic dissection, descending aortic dissection, intimal tear, intramural hematoma, thoracic aortic aneurysm
Management of Metastatic Castrate-sensitive Prostate Cancer
Authors: Tilki Derya , Dall’era Marc A , Evans Christopher P
Published: January 2021

Oncologic outcome of patients with newly diagnosed metastatic prostate cancer (mPCa) is poor. The treatment paradigm for newly diagnosed mPCa has changed. The standard of care for men with metastatic hormone-naive prostate cancer has been systemic androgen deprivation therapy (ADT). Previous randomized studies demonstrated an overall survival benefit by the addition of early chemotherapy with six cycles of docetaxel. More recently, results from randomized trials also demonstrated a survival benefit by the addition of abiraterone acetate to the ADT in men with metastatic disease. The aim of this review is to summarize the results from most recent studies, including men with newly diagnosed metastatic hormone-naive prostate cancer, focusing on chemotherapy and ADT.

This review contains 1 figure, 2 tables, and 47 references. 
Key Words: abiraterone acetate, androgen deprivation therapy, androgen deprivation, castrate sensitive, chemotherapy, continuous androgen deprivation, docetaxel, hormone-naive, intermittent androgen deprivation, metastatic prostate cancer