bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation and Treatment of Monogenic Forms of Inflammatory Bowel Diseases
Authors: Shouval Dror S
Published: January 2021

Inflammatory bowel diseases (IBDs) are complex disorders that develop in genetically susceptible hosts due to dysregulated immune responses to microbial dysbiosis and environmental changes. Although in the vast majority of cases, the genetic contribution to development of these diseases is small, in rare cases, IBD develops directly as a result of deleterious mutations in the genes involved in immune and epithelial cell function. In these cases, intestinal inflammation is usually severe, which develops in most cases in the first years of life and occasionally is accompanied by recurrent or atypical infections. In this review, the approach to different monogenic disorders that cause IBD is discussed, including mutations in the IL-10 pathway, neutrophil defects, regulatory T-cell disorders, autoinflammatory conditions, epithelial cell diseases, and disorders affecting B- and T-lymphocyte dysfunction. Moreover, a multidisciplinary diagnostic approach is suggested, which highlights in which cases a monogenic disorder should be suspected.

This review contains 3 figures, 3 tables, and 42 references.
Key Words: inflammatory bowel disease, IL-10, chronic granulomatous disease, common variable immune deficiency, epithelial cells, genetics, immune cells, mucosal homeostasis, pathogenesis, very early–onset disease.
Oral Health and Nutrition
Authors: Palmer Carole. A. , Cheng Zhangmuge
Published: January 2021

Oral diseases are among the most prevalent diseases affecting global health. In his report on the crisis in oral disease in America, the Surgeon General warned that one cannot be truly healthy without oral health. Oral health means freedom from all oral health problems; tooth decay (dental caries), periodontal diseases, tooth loss, oral-facial pain, oral cancer and the effects of its treatment, oral infections, craniofacial birth defects and more. The relationships between oral conditions and systemic health and disease are many and synergistic, and most involve dietary and/or systemic nutritional factors. Diet and nutrition can play important roles in the etiology, prevention, and/or management of oral conditions, as they do in overall health and disease. Today, all health professionals and educators need to be aware of and consider oral issues and their possible diet/nutritional implications as a component of optimal health care and education. This review article provides a brief overview of how diet and nutrition impact and are impacted by oral conditions, and offers general guidelines and resources for providing meaningful interventions throughout the life cycle.

This review contains 3 figures, 3 tables, and 57 references
Key Words: biofilm, cariogenic, dental caries, dental plaque, ECC-early childhood caries, lactobacillus, mucositis, non-cariogenic, periodontal disease, Streptococcus mutans
Behavior Modification In The Treatment Of Obesity
Authors: Davidson Paul
Published: January 2021

This review addresses the three most common components used in helping individuals deal with weight loss from a behavioral perspective. Relevant literature and recent findings are reviewed and summarized, showing that programs containing behavioral techniques, along with an emphasis on diet and exercise, tend to lead to improved results. Factors related to better weight loss outcomes include assessing empathically, setting reasonable goals, enhancing a sense of self-determination, seeing a patient more frequently, focusing on decreasing caloric intake, and encouraging regular physical activity. Newer technologies, such as Internet- and smartphone-based interventions, seem promising but lack sufficient research evidence at this point. It is also clear that just as reasons for weight gain are patient specific, treatments likely do best when they are more highly individualized.

This review contains 3 figures, 2 tables and 33 references
Key words: behavior, cognitive restructuring, decision tree, 5As, intervention, mindfulness, modification, motivation, obesity, relapse prevention, self-monitoring, stages of change, stimulus control, treatment, weight loss
Approach to the Patient with Glomerular Disease
Authors: Glassock Richard J. , Vriese An S De , Fervenza Fernando C.
Published: January 2021

Glomerular diseases of the kidneys are associated with a limited array of clinical syndromes, including asymptomatic hematuria and/or proteinuria, acute nephritis, nephrotic syndrome, rapidly progressive glomerulonephritis, and chronic glomerulonephritis. The specific diseases that underlie these syndromes are numerous and heterogeneous. Broadly, they may be divided into primary and secondary disorders depending on whether the kidneys are the sole organs affected or whether other organ systems are also involved in the disease processes. A systematic approach involving a careful history, physical examination, assessment of renal function, and urinalysis (composition and microscopy) and protein excretion, combined with biochemical and serologic testing, can provide important clues to diagnosis and prognosis. Renal biopsy is often required for a complete and accurate diagnosis as well as a prognosis and therapeutic decision making.

This review contains 4 figures, 6 tables and 92 references
Key words: glomerular filtration rate, glomerulonephritis, hematuria, nephrotic syndrome, proteinuria, renal biopsy, serum complement
Health of Immigrant and Refugee Women
Authors: Annamalai Aniyizhai
Published: January 2021

Providers encounter increasingly diverse patient populations, as migration of people continues to increase worldwide. Health of migrant women is influenced by factors before migration as well as those affecting the migratory process and resettlement. Cultural factors influence patient beliefs and attitudes toward all facets of reproductive health including contraception. Providers may also encounter sequelae of traditional practices such as female genital cutting. Migrant women may be at a higher risk of violence both due to intimate partner violence and risks encountered during migration. They are also at risk for psychological sequelae resulting from stressors before and after displacement. Posttraumatic stress disorder prevalence is higher compared to local populations. Whereas migrants still carry a high burden of infectious disease, chronic health conditions are becoming increasingly common in many groups. Healthcare providers with an awareness of health issues faced by migrants can contribute to improving overall health of migrants and ease the process of resettlement for these people.
This review contains 53 references, 1 figure, and 10 tables.
Key Words: female genital cutting, immigrant, intestinal parasites, intimate partner violence, migration, nutrition, posttraumatic stress disorder, refugee, reproductive health, tuberculosis
Asthma in Pregnancy
Authors: Li Lily , Laidlaw Tanya , Smith Nicole A
Published: January 2021

Asthma is one of the most commonly seen medical conditions in pregnancy, with 3 to 8 percent of all women carrying the diagnosis. Physiologic changes of pregnancy may make evaluation of breathing symptoms more challenging, and pregnancy may contribute to asthma exacerbation for some women, increasing risks of fatal or near fatal asthma. Some medications used commonly in pregnancy may also worsen asthma symptoms. Uncontrolled asthma is associated with both maternal and fetal complications, with more severe disease associated with a greater risk profile. Medication safety data is available for a wide spectrum of asthma treatments and in general, risks of medication exposure are outweighed by the risks of untreated maternal disease. Thus, optimal obstetric outcomes depend upon an understanding of asthma symptoms, risk evaluation, and pharmacologic safety and management.
This review has 4 tables, 3 figures, and 40 references.
Keywords: Asthma, pregnancy, medication, preterm birth, pharmacotherapy, NSAIDs, perinatal, management
Viral Infections in Pregnancy – Part 1: CMV, Ebola Virus, Viral Hepatitis, HSV, and HIV
Authors: Duff Patrick
Published: January 2021

A number of viral etiologies contribute to morbidity and mortality in pregnancy and the perinatal period. Here we discuss some of the major viral infections that occur in pregnancy. This review focuses on infections of cytomegalovirus (CMV), viral hepatitis, herpes simplex virus (HSV), and human immunodeficiency virus (HIV); other viral etiologies are discussed in part 2 of this topic. It is imperative to understand the risks, clinical course, diagnostic methodology, and management of these illnesses.
This review contains 1 figure, 12 tables, and 71 references.
Keywords: viral infection, pregnancy, prenatal, perinatal, cytomegalovirus, Ebola virus, viral hepatitis, herpes simplex virus, HIV, management
Head and Neck Melanoma: An Overview
Authors: Kim Samuel
Published: January 2021

Melanoma is one of the most common cancers in the United States, and its incidence has been steadily rising. Despite the increasing incidence, 5-year survival rates are over 90%, in large part due to early detection and advances in treatment. Head and neck melanomas encompass up to a quarter of all melanomas despite the head and neck making up only 9% of total body surface area. Although under the overall classification of melanoma, head and neck melanomas are distinct in many ways that influence their management. In this review, we provide current concepts in the risk factors, genetics, classifications, diagnosis, surgical and nonsurgical management, and future therapies of head and neck melanoma.
This review contains 26 figures, 9 tables and 123 references
Key words: Checkpoint inhibition therapy; Head and neck melanoma; Imiquimod; NF1; Oncogene-targeted therapy; Parotid-sparing sentinel lymph node biopsy; RAC1; Selective neck dissection
Imaging of the Temporal Bone
Authors: Pruitt Peter
Published: January 2021

As the structure of the ear is made of little more than cartilage, a limited blood supply, and a thin layer of skin, trauma in this area can easily manifest from a variety of causes. Some common examples of trauma involve laceration, piercing (intentional or otherwise), infection causing chondritis, blunt trauma causing necrosis, rupture of the tympanic membrane, perforation of the ear drum, and acoustic trauma that may result in hearing disorders such as tinnitus and high-frequency hearing loss. Acute hearing loss shows in two forms: conductive hearing loss and sensorineural hearing loss, the latter of which is caused by damage to the anatomic or neurologic structures of the ear dedicated to hearing. Sensorineural hearing loss generally has a poor prognosis and mandates prompt referral to an otolaryngologist. 
This review contains 4 figures, 13 tables, and 32 references.
Keywords: Ear, auricular canal, trauma, otitis media, otitis externa, hearing loss, mastoiditis, cerumen, impaction
Penile Reconstruction
Authors: Shakir Afaaf , Morrison Shane D , Crowe Christopher S , Lee Gordon K
Published: January 2021

Total penile reconstruction aims to either reestablish a functioning phallus in men who have suffered traumatic amputation or are born with congenital anomalies or to create a neophallus in female to male transgender patients as part of their gender-confirmation surgery. Reconstructive and functional goals include the ability to void while standing, having erogenous sensation of the tissue, and having the ability to engage in penetrative sexual intercourse. Several techniques for total phalloplasty exist, which include both microsurgical and non-microsurgical approaches. In this review chapter, we outline the most common techniques, provide recent data on patient outcomes, and review operative considerations.
This review contains 14 figures, 1 table, and 84 references.
Key Words: aphallia, bottom surgery, female-to-male, neophallus, penile reconstruction, perineal reconstruction, phallus, transgender surgery
Treatment of Sternal Wound Infections
Authors: Orgill Dennis P
Published: January 2021

Sternal wound complications are a serious consequence of cardiac surgery. The use of muscle and/or omental flaps has been particularly important to treat these complications. The pectoralis major muscle is the most commonly used muscle to treat these infections. The greater omentum provides a potential rich source of vascularized tissue. Innovation in sternal union techniques provide surgeons with options to further prevent these complications in high risk patients. These complications remain with substantial morbidity and mortality and a multidisciplinary approach can minimize complications and reduce time in the hospital. 
This review contains 4 figures, 2 tables, and 20 references. 
Key words: sternum, wound, infection, mediastinitis, pectoralis major, omentum, sternal plates, sternal rewiring
Reconstruction of the Abdominal Wall with Mesh I: Component Separation Techniques
Authors: Ross Samuel W. , Heniford B. Todd , Augenstein Vedra A.
Published: January 2021

Truly complex hernias which are multiply recurrent, have active infections, loss of domain, presence of stomas, require component separation or panniculectomy, and/or have other exacerbating factors, are truly challenging to manage operatively, and the multidisciplinary operations to repair them have become known collectively as abdominal wall reconstruction (AWR). Component separation techniques and panniculectomy, to name a few, have become commonly used techniques for operative management for complex hernias. Herein, we describe the history and technical aspects of component separation, panniculectomy and other adjunct techniques in abdominal wall reconstruction. In particular, a focus on patient specific clinical outcomes such as hernia recurrence, wound complications, and quality of life has been made in regards to use and types of component separation. Our goal is to provide a comprehensive review of the state of the literature and our recommendations for AWR, for the Plastic, General, and Hernia surgeon alike.
This review contains 7 figures, 1 video, 1 table, and 79 references.
Keywords: ventral hernia repair, incisional hernia, abdominal wall reconstruction. component separation, transversus abdominis release (TAR), surgical site infection, advances in hernia repair, robotic hernia repair, robotic component separation, botulinum toxin
Calvarial and Scalp Reconstruction
Authors: Hanasono Matthew M
Published: January 2021

Scalp reconstruction involves nearly the entire spectrum of reconstructive surgery, including skin grafting, local flaps, and microvascular free flaps. Additionally, tissue expansion can play important role in maximizing outcomes. In recent years, reconstructive algorithms specific to scalp reconstruction have been developed that consider not only the size of the defect, but the quality of local tissues.  Many materials have been used for calvarial reconstruction and most modern alloplasts are as reliable as autologous bone, although each as its own advantages and disadvantages.  Simultaneous scalp and calvarial reconstruction is now routinely performed.  Remaining challenges include management of wound complications over alloplasts and of the infected cranial bone flap following neurosurgical procedures.
This review contains 15 figures, 5 tables, and 41 references.
Keywords: scalp, calvarium, cranioplasty, free flap, tissue expander, skin graft, bone graft, titanium mesh, methylmethacrylate, polyetheretherketone (PEEK)
Breast Augmentation
Authors: Culbertson Eric J. , Adams Jr William P.
Published: January 2021

Breast augmentation is a complicated process that goes far beyond placing an implant in a pocket. The implants and techniques of breast augmentation have undergone significant evolution over the past 50 years, and this is now one of the most commonly performed cosmetic procedures worldwide. Advancements in shell barrier technology and silicone form stability have improved implant functional characteristics and mechanical properties. Tissue-based planning uses measurable patient characteristics to match an implant to the patient’s tissue for greater control of the aesthetic result while minimizing complications. The realization of three-dimensional modeling systems allows a more sophisticated approach to implant selection and establishment of patient expectations. Specific surgical techniques, including pocket plane and incision location, ensure ideal implant placement. Optimal patient outcomes are achieved by integrating patient education, implant selection with tissue-based planning, refined surgical technique, and detailed postoperative recovery. 
This review contains 12 figures, 6 tables, 1 video, and 74 references.
Key Words: breast augmentation, breast implants, breast implant-associated anaplastic large cell lymphoma, dual plane, capsular contracture, saline implants, silicone implants, tissue-based planning, three-dimensional imaging
Dermatologic Wounds
Authors: Borda Luis J , Kallis Penelope J , Jaller Jose A , Kirsner Robert S
Published: January 2021

A wound is characterized as a disruption on the epidermis continuity of either skin or mucosa as a result of physical damage or an underlying disease. Dermatologic wounds may be produced by infection, prolonged pressure, malignancy, neuropathy, ischemia, venous insufficiency, inflammatory conditions, drugs, and external causes. The most common etiologies of chronic wounds are venous leg ulcers, diabetic foot ulcers, pressure ulcers, and arterial ulcers. These types of wounds are called typical wounds, whereas wounds that do not belong to this group are called atypical. We present a comprehensive review in which we describe the concept, epidemiology, clinical manifestations, diagnosis, and treatment of dermatologic wounds.
 This review contains 2 figures, 2 tables and 82 references
Key Words: atypical wounds, unusual wounds, chronic wounds, typical wounds, dermatological wounds, wound healing, hard-to-heal wounds, trauma, infection.
Complementary, Alternative, and Integrative Medicine
Authors: Langevin Helene M.
Published: January 2021

Complementary and alternative medicine (CAM) refers to a group of diverse medical and health care systems, practices, and products that are not considered to be part of conventional or allopathic medicine. Common CAM practices (e.g., acupuncture, meditation, and therapeutic massage) are gradually becoming incorporated into conventional care in response to patients looking to alternative sources for information and advice about health matters and increased understanding of various CAM methods through evidence-based testing. However, although the claims of some methods are supported with academic research, well-founded concerns remain in many popularized CAM practices regarding the lack of evidence and placebo effects. It is thus imperative for physicians to be comfortable in discussing CAM-related topics with patients and be able to appropriately and informatively guide them in a way that harnesses potential benefits and avoids potential harm. In this review, the major CAM therapies in the United States are examined, including the settings in which they are being used, evidence base status, and efficacy of some of the most commonly used modalities. 
This review contains 5 figures, 21 tables, and 123 references.
Keywords: Alternative medicine, complementary medicine, acupuncture, homeopathy, osteopathy, chiropractic, massage therapy, naturopathy
Sleep Well to Be Well: Importance of Healthy Sleep during Medical Training
Authors: Kritikou Ilia , Rosen Ilene
Published: January 2021

Sleep is vital for our survival and wellness; lack of sleep is associated with significant cognitive, behavioral and physical health consequences, including increased mortality. In resident physicians and other health care providers, scheduled in-house calls, frequent pager/phone calls, and work required during nights are the norm. These phenomena along with the normal pull for work/life balance lead to acute and chronic partial sleep restriction, sleep disruption and circadian misalignment. As is true for the general population, residents are not immune to sleepiness and performance deficits associated with curtailed sleep. Residents are also at risk for metabolic dysregulation, including increased risk of obesity, cardiovascular disease, and mood disturbances that accompany disrupted sleep and circadian misalignment. Initial data suggesting worse patient outcomes when residents work >80 hours weekly, pushed Accreditation Council for Graduate Medical Education (ACGME) to limit resident duty-hours to 80 weekly, 30 per shift; newer data fail to show improved patient outcomes under the new limited work schedule. Nevertheless, recent studies suggest extended work schedules and circadian misalignment negatively affect well-being of resident physicians, increase risk of motor vehicle accidents. Long-term effects are yet to be determined.Implementing educational programs that foster programmatic, individual responsibility for fatigue management, GME programs and their leadership may mitigate negative consequences on safety and wellness.

This review contains 2 figures, 3 tables, and 36 references.
Keywords: sleep, sleep deprivation, sleepiness, circadian rhythms, residency, health care, patient outcomes, ACGME, wellness
Encephalitis
Authors: Bhattacharyya Shamik , Lyons Jennifer L.
Published: January 2021

In 2013, the International Encephalitis Consortium proposed clinical criteria for acute encephalitis consisting of 24 hours of altered level of consciousness, lethargy, or personality change and at least three additional supportive features. Although viruses are the most common cause of acute encephalitis, not all encephalitides are acute, viral, or even infectious. Chronic encephalitis can be pathologically similar to acute encephalitis, but the causative agents and clinical manifestations vary. Management of encephalitis is largely supportive; however, for many common encephalitides primary preventive approaches exist. This module reviews the epidemiology, manifestations, diagnosis, management, and prevention of various encephalitides, including herpes family encephalitis (herpes simplex virus, varicella-zoster virus, cytomegalovirus, human herpesvirus 6), arbovirus encephalitis (West Nile virus, eastern equine encephalitis virus, tick-borne encephalitis virus, Japanese encephalitis virus), other encephalitides associated with viruses (influenza virus, human immunodeficiency virus, John Cunningham virus, rabies virus), encephalitides associated with bacteria (Mycoplasma pneumonia, Listeria monocytogenes), and autoimmune encephalitis (acute disseminated encephalomyelitis, paraneoplastic and other autoimmune encephalitides, immune reconstitution inflammatory syndrome). Tables include the International Encephalitis Consortium’s supportive feature of encephalitis, differential diagnosis for magnetic resonance imaging (MRI) findings in the patient with suspected encephalitis, diagnostic considerations for triaging workup of infection-associated encephalitis, differential diagnosis of arboviral infections by location of travel or residence, and preventive strategies for select infectious encephalitis. Figures include MRIs showing patients with herpes simplex encephalitis, varicella-zoster virus, eastern equine encephalitis, HIV, Listeria monocytogenes, acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, and immune reconstitution inflammatory syndrome.
This module contains 8 highly rendered figures, 5 tables, 78 references, and 5 MCQs.
Cognitive Disorders Other than Alzheimer Disease
Authors: Gale Seth A , Daffner Kirk R.
Published: January 2021

Higher cognitive functions, such as abstract reasoning, complex decision making, and language, are the mental faculties that separate our species from other animals. When these faculties become impaired as a result of neurologic disease, striking and devastating behavioral changes result. Many neurologic diseases are associated with impaired cognition and behavior, and their etiologies are as varied as their clinical presentations. In this review, the focus is on dementia with Lewy bodies (DLB), the frontotemporal dementias (FTDs), and vascular cognitive impairment (VCI). The review covers the epidemiology and diagnosis of  DBB, FTDs, and VCIs, as well as the etiology and genetics. Figures show neuroimaging in DLB, management of DLB, FTLD clinical syndromes, FTLD clinicopathologic correlations: approximate distribution of pathotypes for behavioral-variant FTD and primary progressive aphasia (PPA) variants, PPA-semantic subtype, PPA-logopenic subtype, post-stroke VCI, and subcortical ischemic vascular disease subtype of VCI. Tables list diagnostic criteria for DLB, FTD genetics: gene/protein relationship, clinical syndrome, salient geatures, VCI: clinical and pathologic features of the main subtypes, summary guidance based on VCI prevention studies, and summary guidance based on VCI treatment studies.
 
This review contains 8 highly rendered figures, 5 tables, and 254 references.
Tension-Type Headache: Epidemiology, Diagnosis, and Pathophysiology
Authors: Rizzoli Paul
Published: January 2021

Tension-type headache (TTH) is a significant but underappreciated condition that is much more frequent than migraine, 42% versus 11%, and produces significant socioeconomic burden. Why then do research advances in this condition seem to lag?
One reason is that precise epidemiologic data are lacking, with lifetime prevalence estimates varying from about 13 to 78%. Also, classification is confounded by whether or not to include the occasional but universal headache as TTH. Furthermore, TTH pathophysiology is debated, with some feeling that the pathophysiology of TTH is similar to and on a spectrum with migraine, and some feeling that it is entirely separate and related to peripheral and muscular mechanisms. More recently, central pain mechanisms have also been implicated in the pathophysiology. In addition, a large body of information connects stress and TTH.
Although TTH varies widely in frequency and severity among and within patients, TTH pain, compared with pain in other headache types, could be characterized generally as more mild in severity and more generalized in location. This review discusses the current epidemiologic data and diagnostic challenges in TTH and the current pathophysiologic mechanisms.
Stress Urinary Incontinence Assessment and Conservative Treatments
Authors: Kalra Sidhartha , Brucker Benjamin M
Published: January 2021

Stress urinary incontinence (SUI) is a prevailing condition affecting women’s physical, psychological, and social well-being. SUI is the most common type of urinary incontinence, with an estimated prevalence of 8 to 33%. Despite increased awareness, it is still commonly underreported. Identifying the problem and developing an individualized assessment and treatment plan are essential for achieving the best outcome and quality of life for these women. Numerous tools exist that may aid clinicians in making an appropriate diagnosis and then selecting the optimal treatment, including behavioral, medical, and surgical approaches. Although a plethora of treatment options exist for SUI, conservative management is considered an effective first-line option for most patients. The purpose of this review is to discuss the current understanding of SUI in women and to outline the evaluations and conservative management options with the best available scientific evidence.
This review contains 3 highly rendered figures, 2 tables, and 57 references
Key words: Stress Urinary Incontinence, Conservative management, Pelvic Floor Exercises, Pessary, Vaginal inserts, medical treatment
Management of Small Renal Masses
Authors: Lawson Keith A , Finelli Antonio
Published: January 2021

The rise in incidentally discovered enhancing solid renal tumors has spurred the development of new approaches to managing this unique clinical entity known as the small renal mass (SRM). These approaches are grounded on a better understanding of the natural history of SRM, with the goal to reduce the morbidity associated with their management and avoid overtreatment. In this chapter, we review the body of evidence pertaining to the classification and clinical management of SRMs with respect to diagnosis, treatment, and follow-up. In addition, we discuss the controversies and active areas of development for this rapidly evolving field that strides towards a precision medicine paradigm. 

This review contains 6 figures, 6 tables and 63 references
Keywords: Small renal mass, renal cell carcinoma, radical nephrectomy, renal tumor biopsy, active surveillance, natural history, oncocytoma, robotic surgery, partial nephrectomy
Role of Radiotherapy in Localized Prostate Cancer
Authors: Helou Joelle , Loblaw Andrew
Published: January 2021

Radiation is a standard treatment approach in the treatment of prostate cancer, in either a definitive or postoperative setting. There is mounting evidence of improved cancer outcomes with higher doses of radiation in all risk categories, including low-risk prostate cancer patients. Technical advances with the emergence of inverse planning intensity-modulated techniques combined with image guidance have allowed for dose escalation using external-beam radiation therapy (EBRT). However, despite more accurate treatment delivery, dose-escalated radiation has consistently translated into increased toxicity. Stereotactic body radiotherapy and brachytherapy offer great means of dose escalation to the prostate without increasing the dose to the surrounding organs. Radiation options for low-risk patients include hypofractionated EBRT and brachytherapy monotherapy. Intermediate-risk patients can be divided into favorable and unfavorable groups. For favorable-risk disease, monotherapeutic approaches could be considered, whereas for unfavorable intermediate-risk and high-risk disease, a combination of therapies must be considered. In the postoperative setting, adjuvant radiation improves biochemical outcomes in patients with adverse pathologic features (pT3 and/or positive margins).
 
This review contains 2 figures, 5 tables, 1 video and 135 refereces
Key words: prostate cancer, radiation therapy, brachytherapy, stereotactic ablative body radiation, hypofractionation, hormonal therapy
Peptic Ulcer Diseases
Authors: Lew Edward A
Published: January 2021

Peptic ulcers are defects or breaks in the inner lining of the gastrointestinal (GI) tract. Although the pathogenesis is multifactorial they tend to arise when there is an imbalance between protective and aggressive factors, such as when GI mucosal defense mechanisms are impaired in the presence of gastric acid and pepsin. Peptic ulcers extend through the mucosa and the muscularis mucosae, a thin layer of smooth muscle separating the mucosa from the deeper submucosa, muscularis propria, and serosa. Peptic ulcer disease affects up to 10% of men and 4% of women in Western countries at some time in their lives. This chapter discusses the pathogenesis of peptic ulcer disease and the etiologic contribution of Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs, and gastrinoma or other hypersecretory states. Also addressed are rare and unusual causes for ulcers and GI bleeding. A section on the diagnosis of peptic ulcers discusses clinical manifestations, physical examination findings, laboratory and imaging studies, and surgical diagnosis. Differential diagnosis is also reviewed. Tests to establish the etiology of peptic ulcer disease include endoscopy, quantitative serologic tests, the urea breath test, and the fecal antigen test. Discussed separately are treatments for uncomplicated duodenal ulcers, uncomplicated gastric ulcers, intractable duodenal or gastric ulcers, complicated peptic ulcers (bleeding ulcers, acute stress ulcers, perforated ulcers, obstructing ulcers, fistulizing ulcers, and Cameron ulcers), H. pylori ulcers, and gastric cancer. Figures illustrate the etiopathogenesis of peptic ulcers, prevalence of H. pylori infection in duodenal and gastric ulcer patients compared with normal controls, the approach to a patient with new and undiagnosed ulcerlike symptoms refractory to antisecretory therapy, an upper GI series showing an uncomplicated duodenal ulcer, a chest x-ray showing pneumoperitoneum from a perforated duodenal ulcer, gastric biopsy samples showing H. pylori organisms, and the approach to treatment and follow-up in patients with either complicated or uncomplicated duodenal or gastric ulcer. Tables list differential diagnoses of peptic ulcer disease, commonly used regimens to eradicate H. pylori, additional antimicrobial agents with activity against H. pylori, and FDA-approved antisecretory drugs for active peptic ulcer disease. This chapter contains 76 references.
Conservative Management of Acute Kidney Injury
Authors: Claure-Del Granado Rolando , Macedo Etienne , Mehta Ravindra L.
Published: January 2021

Acute kidney injury (AKI) is one of the most common complications occurring among intensive care unit (ICU) patients and is independently associated with a higher risk of mortality. In critically ill patients, AKI presentation is heterogeneous, varying from asymptomatic elevations in serum creatinine to the need for dialysis in the context of multiorgan failure. Within this range of clinical presentation, the kidney is often overlooked because improving and maintaining cardiac performance are the focus. In addition, aggressive fluid resuscitation may impose significant demands on the kidney wherein the normal excretory capacity may be overwhelmed. ICU patients often have underlying comorbidities, including chronic kidney disease and heart failure, which further limit the range of renal capacity. Drug and nutritional administration contribute to the demand for fluid removal to maintain fluid balance. The dissimilarities of the critical care environment and the extra demand kidney capacity highlight the need for different strategies for management and treatment of AKI in the critically ill patients. We focus this review on the general and nondialytic therapy of AKI.

This reference contains 5 figures, 3 tables and 90 references
Key words: Acute kidney injury, fluid resuscitation, loop diuretics, vasoactive agents, fluid overload, hiperkalemia, and metabolic acidosis.
Clinical Aspects of Alzheimer Disease
Authors: Knopman David
Published: January 2021

The clinical diagnosis of Alzheimer disease (AD) has been well established, but there is a widespread misunderstanding about the relationship between dementia (a syndrome) and AD (a cause of dementia). AD is the most common etiology that causes dementia in mid- and late life. The prototypical clinical presentation is that of a gradually worsening problem with learning new information, that is, a short-term memory deficit, accompanied by cognitive impairment in other domains, including language, spatial cognition, and executive functioning, as well as changes in personality and behavior. A key element of the diagnosis of dementia is that daily functioning is impaired. The concept of mild cognitive impairment (MCI) as the earliest symptomatic presentation of a dementing illness is now widely accepted. MCI due to AD typically presents with isolated problems with learning and memory without substantial loss of ability to function in daily life.  Less common variants of AD are now recognized and include a disorder in which spatial and visual cognitive dysfunction occurs or in which word-finding problems predominate at the onset of symptoms. Although AD as a cause of dementia is the most common among etiologies, AD often co-occurs with other neurodegenerative diseases and with cerebrovascular disease. The presence of multietiology dementia in which AD is a contributor is particularly common in the eighth decade of life and beyond. 
This review contains 1 figure, 3 tables, and 28 references
Keywords: Alzheimer disease, cognitive impairment, dementia, mild cognitive impairment
Specific Antibiotic Agents
Authors: Letourneau Alyssa R. , Calderwood Michael S.
Published: January 2021

The simultaneous use of multiple antibiotics in a shotgun fashion should be avoided because of the problems of drug toxicity and hypersensitivity reactions, microbial superinfections, and antagonisms between certain agents. Most bacterial infections can be treated satisfactorily with a single antibiotic agent. There are a limited number of situations, however, in which the simultaneous administration of different antibiotics is warranted. This review covers specific antimicrobial agents, including β-lactam antibiotics, aminoglycosides, polymyxins, tetracyclines, macrolides, clindamycin, nitroimidazoles, chloramphenicol, vancomycin, lipoglycopeptides, oxazolidinones, daptomycin, streptogramins, sulfonamides and trimethoprim, fluoroquinolones, nitrofurantoin, fosfomycin, rifamycins, and fidaxomicin, and provides empirical therapy recommendations. Figures show an overview of penicillin antibiotics, an overview of β-lactam/β-lactamase inhibitor combinations, and a positive D-zone test for inducible clindamycin resistance. Tables list antibacterial guidelines for initial inpatient empirical therapy and empirical sepsis guidelines.
 
This review contains 3 highly rendered figures, 2 tables, and 48 references.
Keywords: β-Lactam Antibiotics ,penicillins,Cephalosporins, Carbapenems , monobactams, Gentamicin, Tobramycin, Polymyxins, Tetracyclines, Clarithromycin, Clindamycin
Abnormal Menstrual Bleeding
Authors: Hsiao Chu , Dumeny Leanne , Holliday Candice P. , Spiryda Lisa
Published: January 2021

Abnormal uterine bleeding (AUB) is a common presentation that can occur in all age groups. AUB is an umbrella term for any uterine bleeding that occurs outside a woman’s normal pattern in volume, regularity, and/or timing. AUB is described by using frequency, regularity, duration, and volume or by using PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy and premalignant conditions; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified). Workup for AUB comprises a history (with a detailed menstrual history), physical examination (including a pelvic and bimanual examination), lab tests, and imaging (primarily transvaginal ultrasonography). For treatment, medical therapies should be considered before surgical therapies, especially when fertility is desired. The decisions for treatment are based on etiology, fertility concerns, contraindications, or patient preference. Of the medical therapies, there are hormonal and nonhormonal therapies. The most common treatments for AUB are levonorgestrel intrauterine device, tranexamic acid, oral contraceptives, and nonsteroidal anti-inflammatory drugs. The most common surgical treatments are myomectomy, endometrial ablation, uterine artery embolization, and hysterectomy.
 
This review contains 7 figures, 10 tables and 45 references
Key words: abnormal uterine bleeding, adenomyosis, contraceptives, endometrial, fibroids, hysterectomy, menorrhagia
Gastrointestinal Diseases in Pregnancy
Authors: Cai Jennifer X , S. de Silva Punyanganie
Published: January 2021

During pregnancy many chronic gastrointestinal disorders can undergo exacerbations. In addition, pregnant women are often susceptible to new gastrointestinal symptoms. The goal of care is to control symptoms, minimize exposure to excessive tests and medications and rule out any urgent need for surgery.  Efforts should be made to minimize risk to mother and fetus when performing diagnostic endoscopic and radiologic tests. In this chapter, we will review the current management of common gastrointestinal disorders during pregnancy, including gastro-esophageal reflux disease, constipation, appendicitis, inflammatory bowel disease and gall stone disease. The safety of medications used to treat gastrointestinal disease will be reviewed and new treatment guidelines and concepts will be discussed.
This review contains 5 tables, 4 figures and 55 references.
Key words: appendicitis, cholelithiasis, constipation, Crohn’s disease, gall stones, gastrointestinal disease, gastro-esophageal reflux disease, jaundice, pregnancy, ulcerative colitis
Food Allergies
Authors: Hooker Edmond A. , Kircher Charles
Published: January 2021

Food allergies are responsible for a considerable number of emergency department visits. Food allergy can be divided into classic (i.e., IgE-mediated) reactions to specific allergens after exposure via skin or mucosal membrane and non–IgE-mediated food allergies, which include T cell–mediated immunity, enteropathies to specific proteins, and mixed disorders (e.g., eosinophilic esophagitis). Food-induced anaphylaxis can be life threatening and requires immediate treatment with epinephrine, even if the causative agent has not been identified. This review describes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with food allergies. Figures show IgE-mediated allergic reactions to food and other allergens, classification of adverse reactions to foods, commercially available epinephrine autoinjectors, a sample anaphylaxis action plan, and a map showing school access to epinephrine in the United States as of September 4, 2014. Tables list potential food allergies with estimated self-reported prevalence, National Institute of Allergy and Infectious Disease clinical criteria of anaphylaxis, non–IgE-mediated food intolerance disorders, Rome III diagnostic criteria for irritable bowel syndrome, food allergy mimickers, and potential criteria for prolonged observation.
This review contains 5 highly rendered figures, 6 tables, and 54 references.
Pneumonia and Other Pulmonary Infections
Authors: Serrano Karen D. , Fruhan Scott A.
Published: January 2021

Pulmonary infections span a wide spectrum, ranging from self-limited to life threatening.  Pneumonia refers to infection of lung parenchyma, specifically the alveolar or gas-exchanging portions of the lung. Taken together, pneumonia and influenza rank as the sixth leading cause of death in the United States and the leading infectious cause of death in the United States and the world. Tuberculosis (TB) is a bacterial disease caused by Mycobacterium tuberculosis. TB, historically a leading cause of death worldwide, remains an enormous global public health epidemic in much of the developing world. Rates of coinfection with HIV are high, and HIV increases the morbidity and mortality associated with TB. This review details the pathophysiology, epidemiology, clinical presentation, and treatment of pulmonary infection, including pneumonia, empyema, pulmonary abscess, and tuberculosis (TB). Figures show chest radiographs of reactivation pulmonary tuberculosis, HIV-infected patients with proven culture-confirmed tuberculosis, prominent hilar adenopathy with clear lung fields, and bilateral interstitial changes; and treatment of drug-susceptible pulmonary tuberculosis. Tables list major causes of pulmonary infection, host defence mechanisms against pulmonary infection, initial empirical antibiotic therapy in patients with suspected community-acquired pneumonia, initial antibiotic therapy for community-acquired pneumonia in outpatients, initial antibiotic therapy for community-acquired pneumonia in patients who require hospitalization, antibiotic choices for aspiration pneumonia, pneumonia severity index scoring, and mortality by pneumonia severity index point score.

This review contains 2 figures, 9 tables, and 87 references 
Key words: Pulmonary infections; Pneumonia; Tuberculosis; Lung infection; Mycobacteria; Community-acquired pneumonia; Health care-associated pneumonia; Aspiration pneumonia; Empyema; Legionnaires disease
Ventilator Weaning
Authors: Brajcich Brian , Hwalek Ann , Posluszny Joseph
Published: January 2021

Ventilator weaning/liberation is a complex process that requires focus on a patient’s respiratory mechanics, strength, awareness, airway patency, and secretions while also keeping in mind a patient’s overall clinical status and critical illness. The recommendations in the chapter are based on evidence-based medicine when available. When no clear data can definitively guide patient management, clinical guidelines and accepted practices are described.  Our hope is that the reader finds this chapter as a reliable and safe way to approach ventilator liberation.

This review contains 4 figures, 6 tables and 77 references
Key Words: ABCDE bundle, diaphragm dysfunction, negative inspiratory force, reintubation, RSBI, sedation, spontaneous breathing trial, tracheostomy, ventilator liberation, ventilator weaning
Diet And Nutrition In The Treatment Of Prediabetes And Diabetes
Authors: Villasmil Priscilla Escalona , Siegel Richard D
Published: January 2021

The incidence of type 2 diabetes has been increasing dramatically throughout the world, closely linked to Westernized dietary patterns, physical inactivity, and rising rates of obesity, and has become a challenging health problem. Lifestyle changes are effective measures to prevent diabetes, and diet is one of the most important components of diabetes treatment. There is now strong evidence from epidemiologic studies and randomized controlled trials (RCTs) that type 2 diabetes can be prevented or at least delayed in those at high risk for progressing to diabetes by a combination of diet and physical activity resulting in weight loss. Medical nutrition therapy (MNT) is the process by which the nutrition prescription is customized for patients with diabetes. RCTs have demonstrated a positive effect of MNT in diabetes management. Studies documenting the effectiveness of MNT for type 1 and 2 diabetes report improvements in hemoglobin A1C and in other outcomes. A nutrition prescription should be individualized for each patient based on individual preferences, cultural background, and social and financial context. Lifestyle interventions should be considered monotherapy in prediabetes and the initial treatment of type 2 diabetes. Evidence from prospective cohort studies and RCTs has shown the importance of eating patterns in the prevention and management of diabetes. With the worldwide increase in obesity, it will be important to get further evidence of how lifestyle interventions affect clinical outcomes such as microvascular and macrovascular disease.

This review contains 6 figures, 6 tables and 90 references
Key words:  Diabetes mellitus, nutrition, prevention, obesity, lifestyle, glucose, diet, physical activity
Management of Ureteral Strictures and Ureteropelvic Junction Obstruction
Authors: McAdams Sean , Abdul-Muhsin Haidar , Humphreys Mitchell R.
Published: January 2021

The goals for management of ureteropelvic junction obstruction (UPJO) and ureteral stricture are to resolve obstruction, restore continuity, and preserve renal function while minimizing morbidity. The management of UPJO can be challenging and represents a spectrum of options that vary in the invasiveness and effective. These options include observation, long-term internal or external urinary drainage, and endoscopic or minimally invasive management. Mismanagement can potentially results in deterioration of loss of kidney function. This chapter discusses the foundations for successful management of UPJO and ureteral strictures. It also highlights the special clinical situations related to this disease entity and discusses the key advances in the field.
This review contains 8 figures, 4 tables, and 73 references.
Key Words: Boari flap, dismembered pyeloplasty, endopyelotomy, psoas hitch, pyeloplasty, ureteropelvic junction obstruction, ureteral obstruction, ureteral reconstruction, ureteral stricture, uretero-ureterostomy