bluuebunny/crossref_metadata_2025 huggingface dataset:
Syncope
Authors: Baker Annalee M
Published: January 2021

Syncope is a common presenting complaint in the emergency department, accounting for approximately 1 to 3% of presentations and up to 6% of admissions. Syncope is properly defined as a brief loss of consciousness and postural tone followed by spontaneous and complete recovery. Often syncope must be distinguished from other etiologies of transient loss of consciousness, such as seizures and hypoglycemia. Comprehension of the pathogenesis, clinical presentation, and prognosis of the varied causes of syncope is essential if emergency physicians are to succeed in identifying patients at risk for adverse events while also reducing unnecessary syncope admissions. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of syncope. Figures show heart block, prolonged QTc and torsades de pointes, Wolff-Parkinson-White syndrome, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, and Brugada syndrome. 
This review contains 6 figures, 15 tables, and 58 references.
Keywords: Syncope, near-syncope, pre-syncope, arrhythmia, dysrhythmia, sudden cardiac death, vasovagal, passing out, neurocardiogenic
Polycythemias
Authors: Broudy Virginia C
Published: January 2021

Polycythemia, also called erythrocytosis, is an increase in the number of circulating red blood cells per volume of blood, as reflected by an elevated hematocrit or hemoglobin level. The three major categories of polycythemia are relative polycythemia, secondary polycythemia, and polycythemia vera. Included in this chapter are discussions on initial evaluation; familial polycythemia; and polycythemia caused by renal and hepatic disorders, drug use, and appropriate increases in erythropoietin production. A flowchart depicts an approach to the evaluation of a patient with polycythemia. Other figures depict the oxygen-hemoglobin dissociation curve characteristic of various polycythemias and a gene mutation associated with familial polycythemia.
This review contains 3 highly rendered figures and 27 references.
Congenital Heart Disease in Adults
Authors: Haynes Susan E. , Bartlett Heather L. , Skorton David J , Lamers Luke J
Published: January 2021

With advances in medical and surgical care, an increasing number of children with congenital diseases of the heart and vasculature now survive to adulthood. The proportion of adults who are affected by congenital heart disease is expected to continue to increase. Thus, it is important for clinicians to be knowledgeable about the care of these patients. This review examines acyanotic disorders (shunts and valvular lesions), vascular anomalies, cyanotic disorders, and women’s health issues. Figures show the anatomy of atrial septal defects, transcatheter closure of atrial septal defects, an anatomic cross section showing the atrioventricular septum, the anatomic positions of ventricular septal defects, a computed tomography scan of aortic coarctation, angiogram of a persistent left superior vena cava draining into the right atrium, systemic artery-to-pulmonary artery shunts, magnetic resonance image of a patient with repaired tetralogy of Fallot and long-standing pulmonary valve insufficiency, treatment of pulmonary valve regurgitation with a transcatheter pulmonary valve, computed tomographic images of a patient with atrial switch palliation of transposition of the great arteries and multiple baffle obstructions, stages in the repair of functional single ventricles, and echocardiograms of a patient with Ebstein anomaly. Tables list recommendations for pulmonary valve replacement in repaired tetralogy of Fallot, conditions in which pregnancy is high risk, and cardiac indications for fetal echocardiography.
This review contains 12 highly rendered figures, 4 tables, and 62 references.
Diseases of Calcium Metabolism and Metabolic Bone Disease
Authors: Becker Carolyn
Published: January 2021

The precise regulation of body calcium stores and of the calcium concentration in both extracellular and intracellular compartments is critically important. Calcium is the chief mineral component of the skeleton; calcium serves major roles in neurologic transmission, muscle contraction, and blood coagulation; and calcium is a ubiquitous intracellular signal.

This review contains 5 figures, 9 tables, and 114 references.
Key Words: hyperglycemia, hypoglycemia, macrovascular, microvascular, neuropathic
Management of Poisoning and Drug Overdose
Authors: Wiegand Timothy J , Patel Manish M , Olson Kent R.
Published: January 2021

Drug overdose and poisoning are leading causes of emergency department visits and hospital admissions in the United States, accounting for more than 500,000 emergency department visits and 11,000 deaths each year. This chapter discusses the approach to the patient with poisoning or drug overdose, beginning with the initial stabilization period in which the physician proceeds through the ABCDs (airway, breathing, circulation, dextrose, decontamination) of stabilization. The management of some of the more common complications of poisoning and drug overdose are summarized and include coma, hypotension and cardiac dysrhythmias, hypertension, seizures, hyperthermia, hypothermia, and rhabdomyolysis. The physician should also perform a careful diagnostic evaluation that includes a directed history, physical examination, and the appropriate laboratory tests. The next step is to prevent further absorption of the drug or poison by decontaminating the skin or gastrointestinal tract and, possibly, by administering antidotes and performing other measures that enhance elimination of the drug from the body. The diagnosis and treatment of overdoses of a number of specific drugs and poisons that a physician may encounter, as well as food poisoning and smoke inhalation, are discussed. Tables present the ABCDs of initial stabilization of the poisoned patient; mechanisms of drug-induced hypotension; causes of cardiac disturbances; drug-induced seizures; drug-induced hyperthermia; autonomic syndromes induced by drugs or poison; the use of the clinical laboratory in the initial diagnosis of poisoning; methods of gastrointestinal decontamination; methods of and indications for enhanced drug removal; toxicity of common beta blockers; common stimulant drugs; corrosive agents; dosing of digoxin-specific antibodies; poisoning with ethylene glycol or methanol; manifestations of excessive acetylcholine activity; common tricyclic and other antidepressants; seafood poisonings; drugs or classes that require activated charcoal treatment; and special circumstances for use of activated charcoal.
This review contains 3 figures, 22 tables, and 198 references.
Contact Dermatitis and Related Disorders
Authors: Aneja Savina , Taylor James S
Published: January 2021

Contact dermatitis is an acute or chronic skin inflammation resulting from interaction with a chemical, biologic, or physical agent. This chapter discusses the major types of contact dermatitis, including irritant contact dermatitis and allergic contact dermatitis (ACD), and their predisposing factors, pathogenesis, diagnosis, risk reduction, and treatment. Also reviewed are specific etiologic forms of contact dermatitis (including topical medication allergy dermatitis, systemic contact dermatitis, clothing, textile and shoe dermatitis, and occupational contact dermatitis) as well as subtypes of contact dermatitis (including photosensitivity and latex allergy dermatitis). Figures show different types of dermatitis (such as chronic eczematous dermatitis, acute and ACD, and photocontact dermatitis), along with specific reactions from causes such as wearing a bib, a leather hatband, or sandals and from poison oak, glyceryl thioglycolate, tosylamide formaldehyde resin, rosin applied to a violin bow, bacitracin, and powdered natural rubber latex gloves. Tables list body sites affected by contact allergens, misconceptions about ACD, criteria for determining who should be given a patch test, key points in diagnosis of ACD, North America patch-test results from 2003 through 2004, topical sensitizers and potential systemic cross-reactants, substances that may cause systemic contact dermatitis, clinical features of systemic contact dermatitis, criteria for establishing occupational causation of contact dermatitis, topical and systemic photosensitizers, and distinguishing features of phototoxic versus photoallergic contact dermatitis. A sidebar lists Internet resources on contact dermatitis.
This review contains 12 highly rendered figures, 11 tables, and 160 references.
Diseases Producing Malabsorption and Maldigestion
Authors: Mukherjee Rupa , Kelly Ciarán P
Published: January 2021

Malabsorption refers to the impaired intestinal absorption of nutrients. It can result from congenital defects in absorption and the transport of ions and nutrients, defects in hydrolysis within the intestinal lumen, acquired defects in the intestinal absorptive cells that line the surface of the intestine, impaired bile production, or interruption of enterohepatic circulation or secondary to pancreatic insufficiency. Maldigestion, another factor in nutrient absorption, refers to the impaired digestion of nutrients within the intestinal lumen or at the terminal digestive site of the brush border membrane of mucosal epithelial cells. Although malabsorption and maldigestion are pathophysiologically distinct, they are interdependent, and in clinical practice, malabsorption has come to signify derangements in either or both processes. This chapter discusses the clinical manifestations of malabsorption and tests for suspected malabsorption. The diseases that can cause malabsorption, their diagnosis, and treatment recommendations are included. Figures illustrate the diagnosis and management of celiac disease; an approach to gluten challenge for the diagnosis or exclusion of celiac disease in patients maintained on a gluten-free diet without previous definitive diagnostic testing; and the histologic features of celiac disease, Crohn disease, collagenous sprue, autoimmune enteropathy, eosinophilic gastritis, and intestinal lymphangiectasia. 
This review contains 9 figures, 25 tables, and 116 references.
Keywords: Malabsorption, maldigestion, Crohn disease, celiac disease, tropical sprue, diarrhea, endoscopy, short bowel syndrome, bacterial overgrowth
Occupational Medicine
Authors: Guidotti Tee L.
Published: January 2021

Occupational medicine concerns keeping workers healthy, screening for early signs of health problems, and promoting good health through workplace initiatives. According to recent estimates, 55,000 deaths and 3.8 million disabling injuries per year result from occupational illness at a cost of $125 to $155 billion. This chapter covers the basic principles and clinical evaluation of occupational disease, guidelines for taking a patient’s occupational history, and exposure assessment. Major occupational disorders in developed countries are discussed, including respiratory tract disorders, skin disorders, disorders of the kidneys, liver disease, central and peripheral nervous systems, organs of sensation, occupational cancer, musculoskeletal disorders, hematologic disorders, endocrine and reproductive effects, stress and psychogenic effects, and nonspecific illness. Tables outline critical dimensions of occupational medicine, the conceptual approach to a patient with a suspected workplace injury or illness, common hazards with widely available tests for exposure, historically common occupational disorders, and established occupational carcinogens. Figures includes a chest film of asbestosis, a sample occupational and environmental history questionnaire, lungs in various states of pneumoconiosis, a photograph of contact dermatitis, and a graph showing hearing decline at 4,000 Hz frequency. Illustrations demonstrate the impact of occupational exposure on the kidneys and liver and the anatomy of the hearing mechanism.
This review contains 9 highly rendered figures, 5 tables, and 112 references.
Papulosquamous Disorders
Authors: Abel Elizabeth A
Published: January 2021

Papulosquamous disorders comprise a group of dermatoses that have distinct morphologic features. The characteristic primary lesion of these disorders is a papule, usually erythematous, that has a variable amount of scaling on the surface. Plaques or patches form through coalescence of the primary lesions. Some common papulosquamous dermatoses are pityriasis rosea, lichen planus, seborrheic dermatitis, tinea corporis, pityriasis rubra pilaris, psoriasis, and parapsoriasis. The etiology, diagnosis, and treatment of pityriasis rosea, lichen planus, and seborrheic dermatitis (including seborrheic dermatitis associated with AIDS) are discussed in this chapter. Also discussed are the diagnosis and treatment of pityriasis rubra, parapsoriasis (pityriasis lichenoides and small- and large-plaque parapsoriasis), and erythroderma. This chapter includes color photographs of the aforementioned dermatoses plus the Koebner phenomenon, lichen planus of the mucous membranes, and erythroderma in Sézary syndrome.
This review contains 11 highly rendered figures and 79 references.
Infections due to Brucella, Francisella, Yersinia pestis, and Bartonella
Authors: Liles W. Conrad
Published: January 2021

Brucellosis, tularemia, (bubonic) plague, and bartonellosis are zoonoses (i.e., infectious diseases that can be transmitted from animals to humans) caused by gram-negative bacilli. The causative agents of these diseases are Brucella species, Francisella tularensis, Yersinia pestis, and Bartonella species, respectively. Infected arthropods, such as ticks or fleas, can serve as vectors for the transmission of tularemia, (bubonic) plague, and bartonellosis. In general, the diagnosis of these zoonoses requires the physician to consider the clinical presentation (which is not always distinctive) in light of the epidemiology of these diseases. This chapter contains discussions of epidemiology, etiology, pathogenesis, diagnosis and differential diagnosis, treatment, complications, and prognosis of brucellosis, tularemia, plague, and Bartonella infections (including trench fever, cat-scratch disease, and bacillary angiomatosis). Also included are tables outlining diagnosis and treatment and a figure showing the distribution of tularemia in the United States from 1990 to 2000. 
This review contains 1 highly rendered figure, 2 tables, and 81 references.
Helminthic Infections
Authors: Van Voorhis Wesley C
Published: January 2021

Helminthic parasites are multicellular worms that possess differentiated organ systems. They (with a few exceptions) do not replicate in the human host, and they tend to elicit eosinophilia within the tissues and blood of infected humans. Helminthic parasites include nematodes (roundworms), cestodes (tapeworms), and trematodes (flukes). The major intestinal nematodes are roundworm, pinworm, hookworm, whipworm, and Strongyloides stercoralis. Trichinellosis is caused by five species of the nematode Trichinella and develops after ingestion of infected meat, usually pork or the meat of certain carnivores. Nematode infections of the major tissue are anisakiasis, visceral larva migrans,Angiostrongylus cantonensis infection, mammomonogamosis (syngamosis), gnathostomiasis, dracunculiasis, and filariasis. Trematode and cestode infections are also described in this chapter, including infections by fish, beef, and pork tapeworms, as well as cysticercosis. Disease from Paragonimus, Clonorchis, Fasciola, Fasciolopsis, and Schistosoma is covered. Echinococcus infection and hydatid cyst disease are discussed. Tables describe intestinal nematode infection and treatment and filarial parasites of humans. Figures illustrate a variety of helminthic parasites and their life cycles.
This review contains 136 references.
Glomerular Diseases - Part I
Authors: Bonegio Ramon G.B. , Salant David J.
Published: January 2021

Some disease processes that affect the glomerulus are acute and self-limited, whereas others lead to progressive loss of renal function. Glomerular diseases cause more than half the cases of chronic kidney disease. This chapter first briefly reviews normal glomerular structure and function, clinical classifications, terminology, diagnosis, and epidemiology of glomerular disease. Pathogenesis of glomerular injury is discussed, and then more detailed approaches to diagnosis. General principles in the management of glomerular diseases are presented. Specific glomerular diseases and their management, discussed at length, are divided into nephritic, nephrotic, and nephritic-nephrotic syndromes. Figures illustrate the pathogenesis and findings on light microscopy, electron microscopy, and immunostaining of a variety of glomerular diseases, including poststreptococcal glomerulonephritis, IgA nephropathy, anti–glomerular basement membrane disease, focal and segmental glomerulosclerosis (FSGS), membranous nephropathy, and membranoproliferative glomerulonephritis (MPGN). 
This review contains 9 figures, 25 tables, and 68 references.
Keywords: Glomerulonephritis, nephritic syndrome, nephrotic syndrome, microscopy, urinalysis, proteinuria, hematuria, nephropathy, Henoch-Schönlein purpura, nephritis
Acute Kidney Injury - Part I
Authors: Sanders Paul W , Agarwal Anupam
Published: January 2021

Acute renal failure (ARF) has been defined as a syndrome in which an abrupt decrease in renal function produces retention of nitrogenous waste products. Translating this abstract description into a clinically useful, accurate, and widely accepted definition has been challenging, in large part because of the focus on serum creatinine concentration, which is easily obtained but has the inherent limitation of poor detection of rapid or subtle, but clinically important, changes in the glomerular filtration rate (GFR). In recent years, therefore, the term acute kidney injury (AKI) has replaced ARF because AKI denotes the entire clinical spectrum from mild increases in serum creatinine to overt renal failure. AKI is defined by the Risk-Injury-Failure-Loss-ESRD (RIFLE) criteria, based on serum creatinine concentration and urine flow rate. The Acute Kidney Injury Network (AKIN) subsequently modified the definition further and divided AKI into three stages. This chapter includes discussions of the etiology and diagnosis of AKI in hospitalized patients and community-acquired AKI. The specific causes, management, and complications of AKI are also discussed. Figures illustrate the pathophysiologic classification of AKI and the effect of hyperkalemia on cardiac conduction—electrocardiogram (ECG) changes. A worksheet for following patients with AKI is provided. 
This review contains 3 figures, 21 tables, and 46 references.
Keywords:Acute kidney injury, dialysis, contrast, rhabdomyolysis, nephropathy, urinalysis, multiple myeloma, ethylene glycol, sepsis, hepatorenal syndrome
Cardiovascular Disease in Patients with Kidney Disease
Authors: Mandel Ernest I , Charytan David M.
Published: January 2021

Cardiovascular disease (CVD) is prevalent in patients with chronic kidney disease (CKD) and is the leading cause of morbidity and mortality in dialysis patients. Clinical practice guidelines established by the National Kidney Foundation identify five stages of CKD defined by estimated glomerular filtration rate (eGFR) as determined by the abbreviated Modification of Diet in Renal Disease (MDRD) study equation. The National Health and Nutrition Epidemiology Survey (NHANES III) estimated that 13% of adults in the United States have CKD. An estimated 5 to 10% of the world's population—a staggering 300 to 600 million people—have CKD. This chapter covers the epidemiology, clinical spectrum, pathogenesis, and management of CVD in patients who have CKD. The clinical spectrum of CVD in patients with CKD is divided into four major categories: arterial disease, myocardial disease, disorders of cardiac rhythm, and valvular disease. Sections discuss some or all of the following: epidemiology/pathophysiology, diagnosis, management, risk factors, intervention, prevention. The chapter includes 4 tables and 6 figures. Figures present age-standardized rates of death, Kaplan–Meier estimates of rates of death, mortality by stage of CKD, hazard ratios and 95% confidence intervals for all-cause and cardiovascular mortality, cardio-renal syndrome pathophysiology, and ratios for actual to expected number of occurrences of sudden death. Tables list the five stages of CKD, types of CVD associated with CKD, risk factors for CVD in patients with CKD/end-stage renal disease (ESRD), and factors contributing to platelet dysfunction and enhanced bleeding risk in CKD/ESRD. This chapter contains 191 references.
Approach to the Patient with Endocrine Disorders
Authors: McMahon Graham T , Dluhy Robert G.
Published: January 2021

The distribution of hormones throughout the human body results in presentations of endocrine disease that are diffuse and variable. Although some endocrine syndromes result in characteristic sets of symptoms and features, most patients experience a limited number of components of the syndrome and may note symptoms that are not typically syndromic. This review discusses presentations of endocrine diseases and the endocrine patient. Specific attention is given to endocrine testing, which can be achieved by measuring the hormone itself, stimulating or suppressing a hormone feedback loop, or measuring peripheral hormone receptor function. The chronic care relationship is explored as many patients with endocrine diseases require extended chronic care to achieve control of abnormal hormonal systems. The dependency on chronic care necessitates that endocrinologists develop particular expertise in managing illnesses over the long term. Tables list hormones and their associated syndromes, clusters of contrasting symptoms and signs of over- and underactivity of the thyroid and adrenal glands, approaches to endocrine testing and treatment, and variability in selected hormone concentrations over time. Figures show diagnostic criteria related to hypercalcemia, growth hormone deficiency, acromegaly, and adrenal incidentaloma. The chronic care model is also represented.
This review contains 4 highly rendered figures, 4 tables, and 12 references.
Autoinflammatory Syndromes
Authors: Diaz Arturo
Published: January 2021

The autoinflammatory syndromes are a group of diseases characterized by apparently spontaneous episodes of fever and inflammatory manifestations in several organs. Some of these conditions, such as familial Mediterranean fever (FMF), have been known for over a century, but others have only recently been defined. The discovery of the genetic defects underlying the pathophysiology of these diseases has been critical for their understanding and eventual grouping in a new category of diseases. Despite their rarity, the monogenic autoinflammatory syndromes are relevant because identification of the causative genetic variants has greatly expanded our understanding of the inflammatory process and the innate immune system and defined new diseases and their treatment. In addition, the autoinflammatory syndromes have been incorporated in the differential diagnosis of fever of unknown origin. In this chapter, the following selected syndromes are reviewed: FMF; cryopyrin-associated periodic syndromes; tumor necrosis factor–associated periodic fever syndrome; hyper-IgD syndrome; pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome; Blau syndrome; deficiency of the interleukin-1 receptor antagonist; Majeed syndrome; cherubism; joint contractures, muscular atrophy, macrocytic anemia, and panniculitis-associated lipodystrophy (JMP) syndrome; CANDLE syndrome; systemic-onset juvenile idiopathic arthritis; and adult-onset Still disease. Each syndrome is broken down by epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis, management, complications, and prognosis.
This review contains 4 highly rendered figures, 5 tables, and 96 references.
Adjustment Disorders
Authors: Strain James J , Friedman Matthew
Published: January 2021

The adjustment disorder (AD) diagnosis has clinical appeal to both doctors and patients. The idea of temporary emotional symptoms resulting directly from a stressful life event is viewed as a more normal human reaction than an idiopathic pathologic psychiatric state and is therefore less stigmatizing. Additionally, the disorder's more benign course (especially in adults) encourages a clinician to be more prognostically optimistic. This chapter discusses the prevalence, epidemiology, course and prognosis, and etiology of ADs. Also reviewed are AD subtypes proposed but not accepted for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), including the acute stress disorder/posttraumatic stress disorder subtype and the bereavement-related subtype. Treatment options are covered, including psychotherapy, pharmacotherapy, and primary care. Tables outline diagnostic criteria for ADs in DSM-IV, stress-related disorders in DSM-5, DSM classifications, ADs in mental illness and medical settings, and subtypes of DSM-IV, text revision adjustment disorders. Graphs categorize patients diagnosed with ADs according to type of illness and the prognosis for recovery from ADs in adolescents and adults.This chapter contains 2 highly rendered figures, 6 tables, 109 references, and 5 MCQs.
Hemodynamic Monitoring in the ICU
Authors: Lim Sunny , Luks Andrew M
Published: January 2021

This review examines the most commonly used hemodynamic monitoring devices in the intensive care unit. After a brief review of some important issues in hemodynamic monitoring, a variety of monitoring systems are considered, including arterial catheters, pulmonary artery catheters (PACs), less invasive hemodynamic monitors, central venous oxygen saturation (ScvO2) monitors, and point-of-care (POC) echocardiography. For each system, the basic operating principles, indications and limitations of use, complications, key issues in data interpretation, and evidence regarding utility in patient care are reviewed. Figures depict the distinction between correlation and agreement, a representative Bland-Altman plot, a square wave test, PAC waveforms, principles of pulmonary artery occlusion pressure measurement, measuring pulmonary artery occlusion pressure at end-exhalation, right atrial and ventricular pressure waveform, pulmonary artery pressure waveform, potential pulmonary artery occlusion waveforms, west zones of the lung and the pulmonary artery occlusion pressure measurements, and POC echocardiography. Tables outline landmarks during insertion of the PAC from the internal jugular and subclavian vein insertion sites; indications, contraindications, and complications of PAC insertion; a comparison of less invasive hemodynamic monitors; reasons for decreased mixed or ScvO2; and indications and contraindications for transesophageal echocardiography.
This review contains 12 highly rendered figures, 7 tables, and 95 references.
IgG4-Related Disease and Retroperitoneal Fibrosis
Authors: Stone John H.
Published: January 2021

IgG4-related disease (IgG4-RD) has been observed to affect almost every organ system, with consistent histopathologic findings across systems. IgG4-RD can mimic malignant, infectious, and inflammatory disorders; accordingly, consideration of the histopathologic features of tissue biopsies and rigorous clinicopathologic correlations are essential to avoid misdiagnosis. Since the early 2000s, IgG4-RD has increasingly been recognized as a cause of what was previously referred to as “idiopathic” retroperitoneal fibrosis (RPF), and this IgG4-related RPF is now considered to comprise an important subset of IgG4-RD. This review includes an overview of IgG4-RD and discusses the pathology, pathophysiology, and clinical manifestations of IgG4. IgG4-related RPF is also discussed in this review, with topics including IgG4-related RPF versus RPF of other causes, the differences between RPF and other subsets of IgG4-RD, and treatment of both IgG4-RD and IgG4-related RPF. Figures show the histopathology features of IgG4-RD, immunostaining of tissue for IgG4, IgG4-related RPF and chronic periaortitis, “Mikulicz disease”, IgG4-RD of the lung, IgG4-related renal disease, and type 1 (IgG4-related) pancreatitis. The table lists conditions known previously by other names that often fall within the spectrum of IgG4-RD.
This review contains 7 highly rendered figures, 1 table, and 66 references.
Central Nervous System Diseases Due to Slow Viruses and Prions
Authors: González-Scarano Francisco
Published: January 2021

Several central nervous system diseases whose common elements include a long incubation period and a progressive clinical course were once called slow virus infections, because most of them are in fact caused by viruses. However, one group of these CNS diseases is now believed to be caused by abnormally configured proteins known as prions; rather than an etiologic designation, therefore, on the whole these diseases are better characterized by their chronicity, their transmissibility, and at this point, their inexorably deteriorating natural history. This chapter reviews the more common of these: HIV-associated dementia (HAD or HIVD), human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy, Creutzfeldt-Jakob disease (CJD), progressive multifocal leukoencephalopathy (PML), and subacute sclerosing encephalitis (SSPE), which is associated with a variant of measles virus. Figures illustrate the pathogenesis and the pathology of HIV dementia, propagation of scrapie prion protein (PrP) in brain neurons, and spongiform brain changes of CJD. Tables list the stages of HAD and the clinical and pathologic characteristics distinguishing classic CJD and varient CJD.
This module contains ­5 highly rendered figures, 2 tables, 57 references, and 5 MCQs.
Acute Bacterial Meningitis
Authors: Roos Karen L.
Published: January 2021

Acute bacterial meningitis is a life-threatening infection. By definition, meningitis is an infection of the meninges and the subarachnoid space. Bacterial meningitis is associated with an inflammatory response that involves the meninges, the subarachnoid space, the brain parenchyma, and the cerebral arteries and veins. As such, bacterial meningoencephalitis is the more accurate descriptive term. This chapter discusses the epidemiology, etiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, complications, and prognosis of the disease. The discussion of diagnosis covers clinical manifestations, physical examination findings, laboratory tests, and imaging studies. The discussion of treatment covers empirical therapy, specific antimicrobial therapy, and dexamethasone therapy. Graphs compare causative organisms and clinical manifestations of community-acquired meningitis. Illustrations depict proper patient positioning for detecting nuchal rigidity, Kernig sign, Brudzinski sign, and lumbar puncture, as well as a sagittal view of a lumbar puncture needle as it is advanced into the subarachnoid space. An algorithm delineates the approach to the patient with symptoms and signs of bacterial meningitis. Tables outline bacterial pathogens based on predisposing and associated conditions, cerebrospinal fluid diagnostic studies for meningitis, the appearance of the organism on a Gram stain, empirical antimicrobial therapy based on predisposing and associated conditions, recommendations for specific antibiotic therapy in bacterial meningitis, and recommended doses for antibiotics commonly used in the treatment of bacterial meningitis.
 
This chapter contains 8 highly rendered figures, 6 tables, 75 references, 1 teaching slide set, and 5 MCQs.
Spinal Disorders
Authors: Rainville James
Published: January 2021

Physicians of many disciplines encounter patients complaining of neck pain, back pain, and radicular symptoms. Although the prognoses for spinal problems are generally favorable and most patients recover quickly, in many cases, symptoms recur or persist over time. Sharing information with patients can help health care providers develop a rationale for treatment that stresses the role of patients in their recovery. This chapter discusses spine anatomy and function, age-related degeneration of spine structures, the epidemiology and natural history of degenerative spine disorders, the basic neurology of pain, and treatment choices that may optimize recovery. A table describes common patterns of symptoms and signs of radiculopathies. A graph illustrates pain scores for leg pain from acute lumbar radiculopathies.
This chapter contains 1 highly rendered figure, 1 table, 323 references, and 5 MCQs.
Wound Management and the Utility of Adjunctive Technologies in Diabetic Limb Salvage
Authors: Elmarsafi Tammer , Steinberg John S
Published: January 2021

As the projected prevalence of diabetes worldwide advances, the need for comprehensive treatments becomes paramount. Diabetes is estimated to afflict over 430 million people by the year 2030. It is without question that complications associated with poorly managed diabetes become a threat to the limbs and lives of this cohort. A targeted, specific, and comprehensive algorithm toward the management of lower extremity pathology related to diabetes is an essential public health endeavor. This review is aimed at addressing three key areas: surgical and adjunctive management options for diabetic lower extremity ulcerations, the challenges of lower extremity salvage, and to provide an introduction to the utility of advanced wound management technologies. An emphasis directed at understanding risks and benefits of each modality is discussed. An analysis of available biologic allografts and skin substitutes will be provided in the context of our working knowledge in regenerative medicine and wound treatments.
 
This review has 5 figures and 45 references
Key Words: amputation, biologics, debridement, diabetes, infection, , limb salvage, negative pressure wound therapy, peripheral arterial disease, , ulcer
Substance Use Disorders
Authors: Levinsohn Erik A. , Hill Kevin P.
Published: January 2021

Given the incredible scope of substance use disorders, this chapter will primarily focus on alcohol and opioid use disorders, while also discussing substance use broadly. Furthermore, this chapter does not provide detailed guidelines for managing patients with a substance use disorder. Instead, this review aims to provide the reader with conceptual background of the biology of addiction as well as a general framework for its diagnosis and management. While this chapter primarily focuses on physicians in the role of caregiver, it is important to note that physicians also struggle with SUDs, at a rate near that of the general population.25

This review contains 3 tables and 25 references.
Iliac Artery Aneurysms
Authors: Politano Amani D , Cherry Kenneth J.
Published: January 2021

The terminal abdominal aorta divides into the common iliac arteries at the L4 level. At the level of the sacrum, the common iliac arteries divide into the external iliac arteries and internal iliac (hypogastric) arteries.  This review covers aneurysms of the iliac arteries, with discussion of the anatomy, clinical evaluation, investigative studies, management, and follow-up imaging. Figures show common presenting configurations of iliac artery aneurysms, examples of open repair techniques for common iliac artery aneurysms, example of internal iliac artery revascularization in the setting of common iliac artery aneurysm repair, examples of endovascular repair techniques for common iliac artery aneurysms, complex hybrid repair of multiple iliac aneurysms, examples of open repair techniques for internal iliac artery aneurysms, and examples of endovascular repair for internal iliac artery aneurysms. Tables list normal diameters reported by the Subcommittee on Reporting Standards for Arterial Aneurysms, rate of growth of aneurysms based on size at presentation, presenting signs and symptoms of iliac artery aneurysm, and location, rupture, and mortality reported in the literature.
This review contains 7 highly rendered figures, 4 tables, and 91 references
Keywords: Iliac artery aneurysms; IAA; Common iliac artery aneurysms; Internal iliac artery aneurysm; IIAA; External iliac artery aneurysm
Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts
Authors: Chen Zhangling , Drouin-Chartier Jean-Philippe , Li Yanping , Baden Megu Y. , Manson JoAnn E. , Willett Walter C. , Voortman Trudy , Hu Frank B. , Bhupathiraju Shilpa N.
Published: January 2021

Objective

We evaluated the
associations between changes in plant-based diets and subsequent risk of type 2
diabetes.

Methods

We prospectively
followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569
women in NHS II (1991-2017), and 34,468 men in the Health Professionals’
Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every
4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI),
and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards
models to estimate hazard ratios (HRs). Results of the three cohorts were
pooled using meta-analysis.

Results

We documented 12,627
cases of type 2 diabetes during 2,955,350 person-years of follow-up. After adjustment for initial BMI, initial and 4-year
changes in alcohol intake, smoking, physical activity, and other factors, compared with participants whose indices remained
relatively stable (±3%), participants with the largest decrease (>10%) in PDI and hPDI
over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled
HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). Each
10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk
(PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not
associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the
associations between changes in PDI and hPDI and diabetes risk.

Conclusions

Improving adherence
to overall and healthful plant-based diets was associated with a lower risk of
type 2 diabetes, whereas decreased adherence to such diets was associated with a
higher risk.
Seguimiento de egresados, telebachillerato comunitario Campeche. Estudio de caso
Authors: Núñez Amaro Thelma
Published: January 2021

El presente documento contiene los resultados obtenidos de un estudio de seguimiento de egresados del servicio educativo telebachillerato comunitario del estado de Campeche, el cual se llevó a cabo con el propósito de valorar la pertinencia del servicio mediante el análisis de la trayectoria de sus egresados y el tránsito que han tenido al nivel superior . La metodología que se ha seleccionado fue el estudio de casos múltiples, con un enfoque cualitativo y un alcance descriptivo. Para ello se consideraron 516 egresados de las generaciones 2013-2016, 2014-2017, 2015-2018 y 2016-2019 de los 19 planteles que conforman el servicio educativo. Los resultados muestran que han egresado durante las cuatro generaciones 516 jóvenes, de los cuales 279 son hombres y 237 mujeres; asimismo, 139 egresados se encuentran estudiando, lo que corresponde a 26.93 % del total. Este dato es particularmente importante por la necesidad de facilitar el tránsito a nivel superior. Igualmente, se registró que 316 egresados se encuentran laborando en actividades diferentes a su formación profesional (es decir, desarrollo comunitario), pues principalmente realizan labores del campo, del hogar o trabajan de forma independiente.

Los resultados obtenidos plasman la necesidad de establecer mecanismos para fortalecer la formación integral que reciben para incidir positivamente en su comunidad y para transitar al nivel superior de forma satisfactoria.
Analisis Karakteristik Elektrik Onggok Singkong Fermentasi yang Diawetkan sebagai Pasta Bio-Baterai
Authors:   Departement of Physics, University of Lampung, Indonesia, 35141, Erviana Yuli , Supriyanto Amir ,   Departement of Physics, University of Lampung, Indonesia, 35141, Suciyati Sri Wahyu ,   Departement of Physics, University of Lampung, Indonesia, 35141, Pauzi Gurum Ahmad ,   Departement of Physics, University of Lampung, Indonesia, 35141
Published: January 2021

Bio-battery is defined as an energy storage device where the energy source comes from organic compounds. The electrical characteristics of the bio-battery can be obtained using to copper (Cu) and zinc (Zn) electrode pairs. Cassava pulp is used as the electrolyte. Cassava pulp is being fermented for 48 hours, 96 hours, and 144 hours and added 4% formalin. The electrolyte cell consists of 20 cell batteries in series with each mass is ±30 grams. The electrical characteristics of fermented cassava pulp are measured with 4 watts LED load and without load. The results show that the highest voltage is 20.66 V which is obtained by 144 hours fermented cassava pulp. The electrical characteristics in this research tend to constant due to the addition of preservatives (formalin).
Pengaruh Variasi Waktu Sintering Terhadap Pertumbuhan Fase Bahan Superkonduktor BSCCO-2212 dengan Kadar Ca=1,10 Menggunakan Metode Pencampuran Basah
Authors:   Departement of Physics, University of Lampung, Indonesia, 35141, Rahmah Karlina , Suprihatin Suprihatin ,   Departement of Physics, University of Lampung, Indonesia, 35141, Karo Pulung Karo ,   Departement of Physics, University of Lampung, Indonesia, 35141
Published: January 2021

This research was conducted to determine the effect of sintering time on the formation of the superconducting phase BSCCO-2212 by calculating the level of purity of the phases formed and looking at the microstructure. The variation of sintering time was 10, 20, 30 and 40 hours using the wet mixing method. The sample was calcinated with 800 °C for 10 hours and sintered with 830 °C. The XRD’s characterization result shows a decrease in phase purity with increasing the sintering time. The relative high volume fraction of the BSCCO-2212/ts10 sample is 90,48% while, the lowest volume fraction of BSCCO-2212/tc40 is 50,74%. The relative high orientation degree of BSCCO-2212/ts20 is 18,47% and the lowest orientation degree of BSCCO-2212/ts10 is 8,4%. The SEM’s characterization result shows of all samples have been oriented and have relatively little space between slabs (voids).
Sintaxis de los clíticos no concordantes del español de Teopantlán, Puebla
Authors: García González Renato
Published: January 2021

El presente artículo estudia el marcador de objeto (MO) de tercera persona en un dialecto subrepresentado del español hablado en Teopantlán, Puebla (México). Aún cuando este marcador de objeto tiene la forma familiar del clítico pronominal de tercera persona masculino singular lo, aquél presenta varias tendencias divergentes con respecto a los clíticos pronominales de otras variantes del español: tendencia proclítica, ausencia casi total de marcadores-a en contextos de doblado, carencia de evidencia de concordancia entre la forma clítica y el conjunto nominal al que doblan y una baja o nula interacción entre las propiedades semánticas de la frase léxica doblada y el marcador de objeto. En este artículo presento algunos datos descriptivos de la variante bajo estudio y propongo un análisis basado en la operación concordancia y en las especificaciones léxicas del núcleo v-ligera que todavía no ha sido propuesto en la literatura de clíticos del español para esta variante u otras similares.
Biochemical Controversies Regarding the Use of Vegetal Proteins in Performance Athletes
Authors: Bătrînu Mădălina-Georgiana , Tero-Vescan Amelia , Miklos Amalia
Published: January 2021

Consumption of animal proteins is increasingly contested by those who choose a vegetarian diet, but for athletes, protein quality is a key component in optimizing athletic performance. The purpose of this article is to provide a nutritional guide for the vegetarian athlete who does not have to give up nutritional preferences to achieve performance in sports, and well-informed counseling by respecting principles of biochemistry can overcome the already known deficiencies of vegetal proteins in certain amino acids. The second aim of this paper is to recommend methods to assess protein quality by consulting the recommendations of the world’s most important regulatory agency in the field of nutrition and food quality: the World Health Organization (WHO) and the Food and Agriculture Organization (FAO). In conclusion, even though vegetal proteins have a lower anabolic effect due to their low digestibility and a limited quantity of essential amino acids (especially leucine) and that amino acids of vegetal origin are more likely directed towards oxidative metabolism than towards anabolic processes, recent studies present strategies (consuming higher amounts of vegetal proteins, dietary supplements with amino acids) through which a well-planned vegetarian diet can have similar benefits to omnivorous diet regarding stimulating endogenous protein synthesis.
Implementing choice-based models of social service: The importance of involving people who use services in reform processes
Authors: Healy John , Clarke Madeleine
Published: January 2021

This article focuses on the opportunities and challenges of introducing choice-based models of social services. Research has found that these models often provide better outcomes and are cost-effective, but the pace of their introduction is generally slow. There are often very deeply held assumptions about the capacity of the people using these services and the potential for change within the existing social service system. Using institutional and social movement theory, the authors seek to explain these barriers to change. Drawing on the experience of supporting the national roll-out of choice-based models in Ireland, the authors propose a number of strategies to accelerate the introduction of these types of models into social services. The authors find that one of the key ways to accelerate reform and reduce transition costs is design processes which have the voice of service users at the centre of the reform process.
“Old Techniques for New Times”: the RMaCzek package for producing Czekanowski’s diagrams
Authors: Bartoszek Krzysztof , Västerlund Albin
Published: January 2021

Inspired by the MaCzek Visual Basic program we pprovide an R package, RMaCzek, that produces Czekanowski’s diagrams. Our package permits any seriation and distance method the user provides. In this paper we focus on the “OLO” and “QAP_2SUM” methods from the seriation package. We illustrate the possibilities of our package with three anthropological studies, one socioeconomic study and a phylogenetically motivated simulation study.
Heritability Paterns of Some Agro-Botanical Characters Related to Yield and Drought Tolerance in Two Landraces of Rice
Authors: Abraham Olubukola Grace , Nwokeocha Chinyere Constance , Faluyi Julius Olaoye
Published: January 2021

Two landraces of rice, AWGUII-04 and IJ-124, were characterised and assessed for phenotypic variability, heritability, genetic advance and modes of inheritance of some primary yield and drought-tolerance traits. The target traits for yield were a percentage of filled spikelets, plant form, tillering, and for drought tolerance, leaf rolling, ratooning and maturity. This study was carried out to help both breeders and farmers make a wise choice when carrying out hybridisation and on the field. Hybridisation produced three F1 hybrids that were advanced to F2 generation. Quantitative and qualitative vegetative and reproductive data were taken from each F2 population. The results obtained showed high heritability (62–100%) in all the thirty-eight vegetative and reproductive traits. The genetic advance was high (> 20%) in all the target traits except for leaf rolling. The traits segregated in the following ratio: plant growth form – 9:6:1; the percentage of filled spikelets – 13:3; ratooning – 3:1; maturity – 15:1; the number of tillers – 15:1 and leaf rolling – 15:1. The high heritability of the above traits makes them highly dependable for rice crop improvement.
Finite groups with prime graphs of diameter 5
Authors: Gorshkov Ilya B. , Kukharev Andrey V.
Published: January 2021

In this paper we consider a prime graph of finite groups. In particular, we expect finite groups with prime graphs of maximal diameter.