bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal Depression
Authors: Moore Simas Tiffany A. , McGuiness Bailey , Valant Valerie , Byatt Nancy
Published: January 2021

Perinatal depression includes major and minor depression occurring in pregnancy and one year postpartum. Affecting one in seven women, it is one of the most common pregnancy complications; however, it is often under recognized and undertreated. A personal history of perinatal or non-perinatal depression significantly increases risk. Screening using a validated instrument is recommended in the context of systems to ensure effective diagnosis, treatment, and follow-up. Evidence-based treatment includes psychotherapy and pharmacotherapy. Selective serotonin reuptake inhibitors are well-studied in pregnancy, are associated with low overall absolute risk, and are differentially secreted into breast milk. If left untreated, perinatal depression is associated with significant short- and long-term negative maternal-child consequences including, among many others things, poor bonding. Of note, maternal suicide exceeds hemorrhage and hypertensive disorders as a cause of maternal mortality. It is critical to recognize that one in five women who screen positive for perinatal depression will have bipolar disorder and are at highest risk for postpartum psychosis, suicide, and infanticide, especially if prescribed unopposed anti-depressant monotherapy. Women who screen positive for having bipolar disorder should be referred for psychiatric evaluation.

This review contains 6 figures, 13 tables and 54 references
Keywords: Pregnancy, Postpartum, Perinatal, depression, Mood disorder, Baby blues, Bipolar disorder, Psychosis, Psychotherapy, Psychopharmacology
Injuries to the Face and Jaw
Authors: Engelstad Mark E. , Hopper Richard A.
Published: January 2021

Facial injuries occur most often through violence or vehicular accident. The main priorities after injury are to assess the airway and check for hemorrhage, followed by assessment of vision, a check for bony trauma or malocclusion, followed by assessment for soft tissue injuries. Most facial injury survey will be done via inspection, palpation, or diagnostic imaging, which includes plain radiography, CT scan, or MRI. Injuries to the face and jaw can be of the soft tissue variety. These include injuries to the facial and trigeminal nerve, parotid duct, scalp, eyelid, lacrimal duct, eyebrow, external ear, nasal passages, or lips. Treatment of maxillofacial fractures include dentoalveolar injuries, mandibular fractures, maxillary fractures, zygomatic fractures, orbital fractures, nasal fractures, nasoorbitoethmoid fractures, and frontal sinus fractures. Figures show common injuries and fractures. This chapter includes 28 references.
Intracerebral Hemorrhage
Authors: Kreitzer Natalie P. , Adeoye Opeolu
Published: January 2021

Intracerebral hemorrhage can be classified as either secondary (due to trauma, vascular malformations, aneurysms, tumors, or hemorrhagic transformation of ischemic stroke) or primary (without a clear secondary cause). Intracerebral hemorrhage is a neurologic emergency, and leads to significant death and disability each year; care should be expedited and emergency departments should be equipped to appropriately care for and manage these patients. This review covers the risk factors, natural history, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with intracerebral hemorrhage. Figures show head computed tomographic scans demonstrating a left basal ganglia intracerebral hemorrhage, and an algorithm of management of intracerebral hemorrhage in the emergency department. Tables list some common causes of intracerebral hemorrhage, Boston criteria for diagnosis of cerebral amyloid angiopathy, mechanism of action of common anticoagulants, and suggested reversal agents.

This review contains 2 figures, 6 tables, and 59 references.
Key words: Intracerebral hemorrhage; intracranial hemorrhage; intraparenchymal hemorrhage; hemorrhagic stroke; hypertensive hemorrhage; spontaneous intracerebral hemorrhage; ICH; cerebral bleeds
Nonmalignant Disorders of Leukocytes
Authors: Schram Alison M. , Berliner Nancy
Published: January 2021

Leukocytes, also known as white blood cells, are hematologic cells important for a host’s immune defense. They comprise several diverse cell types including lymphocytes, neutrophils, monocytes, macrophages, and eosinophils. Each plays a unique and important role in fighting infection, cancer surveillance, and maintaining immune homeostasis. Leukocytes exert their effect and interact with host and foreign cells through the release of cytokines, chemokines, enzymes, and vasoactive substances. Altered number and function of these cells can lead to clinical disorders that range from benign to severe and life-threatening. Here we review the diagnosis, natural history, and treatment of nonmalignant disorders of leukocytes.
This review contains 100 references, 6 figures, and 9 tables.
Key Words: eosinophilia, hemophagocytic histiocytosis, Langerhans cell histiocytosis, lymphocytopenia, lymphocytosis mastocytosis, neutropenia, neutrophilia
Emergencies in Hematology and Oncology
Authors: Halfdanarson Thorvardur R. , Hogan William J , Moynihan Timothy J
Published: January 2021

With the rising incidence of malignancies and expanding treatment options, clinicians must learn to recognize and treat emergencies associated with them. Oncologic emergencies can be broadly classified according to organ systems, which can facilitate recognition and management. Pathophysiology, presentation, diagnosis, and treatment are discussed for complications categorized by metabolic emergencies (hypercalcemia of malignancy, tumor lysis syndrome, lactic acidosis), neurologic emergencies (malignant spinal cord compression, brain metastases, and increased intracranial pressure), cardiovascular emergencies (malignant pericardial effusion and tamponade, superior vena cava syndrome), hematologic emergencies (hyperviscosity due to monoclonal proteins, hyperleukocytosis and leukostasis), infectious emergencies (neutropenic fever, neutropenic enterocolitis, fever associated with splenectomy or functional asplenia), and pulmonary emergencies (acute airway obstruction, acute airway hemorrhage). Figures illustrate spinal cord compression, brain metastases, electrical alternans, malignant pericardial effusion, superior vena cava syndrome, hyperleukocytosis, and an algorithm for initial management of fever and neutropenia. Tables cover management of hypercalcemia of malignancy; the Cairo-Bishop definition of laboratory and clinical tumor lysis; grading, risk stratification, and management of tumor lysis syndrome; management of intracranial hypertension and seizures; infection in patients with neutropenic fever; the Multinational Association for Supportive Care in Cancer Risk Index; and indications for the addition of a gram-positive antibiotic to the initial empirical regimen. This chapter contains 181 references.
Red Blood Cell Function and Disorders of Iron Metabolism
Authors: Means Jr Robert T.
Published: January 2021

The red blood cell, or erythrocyte, is an anucleate biconcave disk, approximately 7 µm in diameter. The principal function of the red blood cell is to exchange carbon dioxide for oxygen while in the pulmonary circulation, exchange that oxygen for carbon dioxide in the peripheral tissue, and carry that carbon dioxide back to the lungs. The physicochemical composition of the red cell is aligned to optimize that function. The state of tissue oxygenation, in turn, regulates the production of red cells. This review covers red blood cell function, iron metabolism, iron deficiency, iron overload, and primary iron overload. Figures show a model of the hemoglobin molecule showing the relative alignment of the α chains and β chains; the normal oxygen-hemoglobin dissociation curve shifted by changes in temperature, pH, and the intracellular concentration of 2,3-diphosphoglycerate; body iron supply and storage; regulation of hepcidin expression and its role in disease; blood smear from a patient with iron deficiency; and mechanisms contributing to iron overload in iron-loading anemias. Tables list laboratory results associated with decreased iron balance, causes of iron deficiency, oral iron replacement therapy, parenteral iron replacement therapy, primary iron overload syndromes, secondary iron overload syndromes, laboratory results associated with increased iron stores, and other rare disorders of iron overload.
This review contains 6 figures, 20 tables, and 111 references
Keywords: Red blood cell, iron deficiency anemia, iron overload, hemochromatosis, hemoglobin, iron balance
Principles and Practice of Palliative Care
Authors: Schaefer Kristen G , Bernacki Rachelle E
Published: January 2021

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

Ventricular arrhythmias are common in all forms of heart disease and are an important cause of cardiac arrest and sudden death. Many ventricular arrhythmias are benign but may serve as a marker for underlying disease or its severity. Others are life threatening. The significance of an arrhythmia is determined by the specific characteristics of the arrhythmia and the associated heart disease, and these features guide evaluation and therapy. This review discusses various mechanisms and types of ventricular arrhythmias and management based on clinical presentation (including patients with symptomatic arrhythmia and increased risk of sudden death without arrhythmia symptoms). Genetic arrhythmia syndromes, such as abnormalities of repolarization and the QT interval, catecholaminergic polymorphic ventricular tachycardia (VT), and inherited cardiomyopathies, are discussed in depth. Under the rubric of management of ventricular arrhythmias, drug therapy for ventricular arrhythmias, implantable cardioverter-defibrillators (ICDs), and catheter ablation for VT are also covered. Tables chart out guideline recommendations for ICD therapy, drugs for the management of ventricular arrhythmias, and indications and contraindications for catheter ablation of ventricular arrhythmias. Electrocardiograms are provided, as well as management algorithms for ventricular arrhythmias based on patient presentation, and an algorithm for identifying patients with systolic heart failure and left ventricular ejection less than or equal to 35% who are candidates for consideration of an ICD for primary prevention of sudden cardiac death.
This review contains 5 figures, 8 tables, and 61 references.
Keywords: Ventricular arrhythmias, implanted cardioverter-defibrillator (ICD), Ventricular tachycardia (VT), Premature Ventricular Contractions (PVC), Myocardial Infarction (MI), Brugada syndrome, Arrhythmogenic right ventricular cardiomyopathy (ARVC), electrocardiographic (ECG)
Allergic Rhinitis, Conjunctivitis, and Sinusitis
Authors: Naclerio Robert
Published: January 2021

Allergic rhinitis is an IgE-mediated inflammatory response in the nose to foreign substances known as allergens. It can be classified as seasonal or perennial, depending on the allergens triggering the reaction. This characterization is good for identifying allergen triggers but is limited because it is based on the duration of outdoor exposure (e.g., grass pollinates for 2 months in Chicago and nearly 11 months in Texas). Also, some perennial allergens, such as dust mites, have seasons. The Allergic Rhinitis in Asthma (ARIA) classification was developed to focus on therapy. It assumes that exposure to perennial and to seasonal allergen leads to the same immunologic response. ARIA places patients into the categories of mild intermittent, mild persistent, moderate/severe intermittent, and moderate/severe persistent to recommend treatment and emphasizes the link between allergic rhinitis and asthma.1

This review contains 5 figures, 12 tables, and 59 references.
Key Words: Sinusitis, infection, allergy, antibiotic, decongestant, antihistamine
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 5 figures, 6 tables and 78 references.
Enteral and Parenteral Nutrition
Authors: Mogensen Kris M. , Robinson Malcolm K.
Published: January 2021

Alternative routes of nutrient administration are available for patients who are unable to eat or digest sufficient food to prevent malnutrition. These routes include enteral (administered through the gastrointestinal tract) and parenteral (administered intravenously). This review details the clinical consequences of malnutrition, nutritional assessment, the benefits of nutrition support therapy,  determining the nutrient prescription, special considerations in nutrition support therapy, aspects of obtaining enteral or parenteral access, monitoring of patients receiving nutrition support therapy, and complications and ethical issues associated with enteral and parenteral nutrition. Figures include algorithms showing the identification of malnutrition, the nutrition support decision process, and the approach to gastric residual monitoring; nasogastric tube displacement leading to pneumothorax; proper placement of a long or “midline” catheter versus a peripherally inserted central catheter; and photographs of a 43-year-old man with Crohn disease complicated by enterocutaneous fistula formation, distal small bowel obstruction, and evisceration of the small bowel after developing a pelvic abscess. Tables list acute illness- or injury-related malnutrition; chronic disease−related malnutrition; social or environmental circumstances−related malnutrition; indications and contraindications to enteral and parenteral nutrition; selected examples of predictive equations; electrolyte provision in parenteral nutrition; parenteral vitamin and trace element requirements; complications associated with enteral and parenteral nutrition; and indications, contraindications, and complications of gastrostomy tube placement.
This review contains 6 highly rendered figures, 11 tables, and 167 references.
Hyperthermia, Fever, and Fever of Undetermined Origin
Authors: Simon Harvey B
Published: January 2021

Abnormal elevation of body temperature, or pyrexia, can occur in one of two ways: hyperthermia or fever. In hyperthermia, thermal control mechanisms fail, so that heat production exceeds heat dissipation. In contrast, in fever, the hypothalamic thermal set point rises, and intact thermal control mechanisms are brought into play to bring body temperature up to the new set point. The distinction between fever and hyperthermia is more than academic: hyperthermia is best treated with drugs that lower the thermal set point, such as aspirin, other cyclooxygenase inhibitors, or acetaminophen. Fever of undetermined origin (FUO) presents one of the most challenging and perplexing problems in clinical medicine. Such fevers may persist for weeks or months in the absence of characteristic clinical findings or clues. Ultimately, most such obscure fevers prove to be caused by common diseases presenting in an atypical fashion rather than by rare and exotic illnesses. This chapter discusses fever and hyperthermia and further clarifies the distinction between fever and hyperthermia. The section on hyperthermia discusses the etiology of hyperthermia; the epidemiology, pathophysiology, diagnosis, differential diagnosis, treatment, and prevention of heatstroke; and the diagnosis and treatment of neuroleptic malignant syndrome, serotonin syndrome, and malignant hyperthermia of anesthesia. The section on fever discusses the pathogenesis, diagnosis, and treatment of fever, as well as the possible benefits and complications of elevated body temperature. The section on FUO presents the defining criteria of FUO; the etiologic classification of FUO, including the infections and neoplasms possibly responsible; and the diagnosis of FUO, including laboratory and radiologic studies, biopsies, and the role of exploratory laparotomy. Tables describe the causes of hyperthermia; the causes of FUO as reported in various studies over five decades; and a comprehensive list of causes of FUO. An algorithm depicts the progressive steps in the pathogenesis of fever and hyperthermia.
This review contains 1 highly rendered figure, 26 tables, and 107 references
Key Words: collagen, vascular disease, febrile seizures, fever, heatstroke, hyperthermia, pyrogen
Gestational Diabetes Mellitus
Authors: Seely Ellen W. , Zera Chloe A.
Published: January 2021

Gestational diabetes mellitus (GDM) has historically been defined as glucose intolerance first identified during pregnancy. The definition fails to distinguish overt (pre-gestational) diabetes diagnosed during pregnancy from glucose intolerance induced by pregnancy. Recently, the recognition that overt diabetes may first be identified in pregnancy has led to the recommendation that diabetes diagnosed in the first trimester should be termed type 2 diabetes (T2DM) rather than GDM , a clinically relevant difference in terminology as the outcomes and management of T2DM in pregnancy are distinct from outcomes and management of GDM. This chapter discusses the epidemiology, pathophysiology, screening, diagnosis, treatment and impact of GDM, as well as the obstetric management of GDM and management of GDM after pregnancy. 
This review contains 8 tables, and 56 references.
Keywords: Gestational diabetes mellitus, diabetes mellitus, stillbirth, glucose control, type 2 diabetes mellitus, pregnancy
The Porphyrias
Authors: Anderson Karl E , Kappas Attallah
Published: January 2021

The porphyrias are uncommon disorders caused by deficiencies in the activities of enzymes of the heme biosynthetic pathway. The enzymatic defects that cause porphyrias are inherited, with the exception of porphyria cutanea tarda, which is primarily acquired. In all porphyrias, there is significant interplay between genetic traits and acquired or environmental factors in the expression of clinical symptoms. This review discusses the classification, pathophysiology, and clinical presentations of the porphyrias. These include those associated with neurovisceral attacks (acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and δ-aminolevulinic acid dehydratase [alad] deficiency porphyria) and the porphyrias associated with cutaneous photosensitivity (porphyria cutanea tarda, hepatoerythropoietic porphyria, erythropoietic protoporphyria, and congenital erythropoietic porphyria). Specific emphasis on the epidemiology, molecular defects and pathophysiology, clinical features, diagnosis, and treatment are discussed for each of these disorders. A table lists the safe and unsafe drugs for patients with porphyrias. Figures illustrate the genetic pathways of the disorders and the activities of enzymes of the heme biosynthetic pathway.
This review contains 2 highly rendered figures, 1 table, and 96 references.
Sarcomas of Soft Tissue and Bone
Authors: Lerner Adam , Xu Huihong , Antman Karen H
Published: January 2021

Sarcomas originate from bone or soft tissue. The most common bone sarcomas are osteosarcomas, Ewing sarcomas, and chondrosarcomas. Soft tissue sarcomas develop in fibrous tissue, fat, muscle, blood vessels, and nerves. Historically, soft tissue sarcomas of the trunk and extremities were reported separately from those of visceral organs (e.g., gastrointestinal and gynecologic sarcomas). This chapter discusses the classification, epidemiology, diagnosis, staging, and treatment of sarcomas of bone and cartilage, and classic soft tissue sarcomas. Management of Kaposi sarcoma, gastrointestinal stromal tumors (GISTs), mesothelioma, and rhabdomyosarcoma is also described. Figures include images of patients with osteosarcoma, liposarcoma, uterine leiomyosarcoma, GIST, and osteosarcoma in a patient with Paget disease of bone. Tables list epidemiologic features of sarcomas, a summary of sarcomas by histology, familial syndromes associated with increased risk of sarcoma, survival rates in sarcoma patients, staging of soft tissue sarcomas, and results of a meta-analysis of doxorubicin-based adjuvant chemotherapy for localized resectable soft tissue sarcoma. This chapter contains 126 references.
Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis
Authors: Stephen Michael J
Published: January 2021

Cystic fibrosis (CF) is an autosomal recessive disease characterized by an elevated sweat chloride level, diffuse bronchiectasis, and pancreatic exocrine deficiency. It is the most common lethal inherited disease in whites. Most patients present at birth or early childhood, although later diagnoses are not infrequent. Once CF was uniformly fatal at an early age, but advances in nutrition, airway clearance, and infection management have led to an average survival of 37 years. The newest aspect of care is the advent of protein modulators, which may increase life expectancy even further. This chapter discusses the epidemiology, genetics, pathophysiology and pathogenesis, diagnosis, differential diagnosis, and treatment of CF. The definition, epidemiology, etiology, pathogenesis, diagnosis, management, and prognosis of non-CF bronchiectasis are also covered. Figures illustrate normal and abnormal CF transmembrane conductance regulators, the vicious cycle hypothesis of lung injury, rates of respiratory germs by age, the diagnosis of CF, the therapeutics pipeline for CF, forced expiratory volume in 1 second lung function percent predicted versus body mass index, and the median predicted survival age of patients with CF. A chest x-ray and chest computed tomographic scan of CF are also provided. Tables outline the most common CF mutations in 2011, class mutations of CF, a mnemonic for acute exacerbations of CF, the diagnosis of CF-related diabetes in a stable patient, sweat test values, and the differential diagnosis of bronchiectasis.This chapter contains 9 highly rendered figures, 6 tables, 143 references, 1 teaching slide set, and 5 MCQs.
Rheumatoid Arthritis: Etiology and Pathogenesis
Authors: Firestein Gary S. , Ekwall Anna-Karin H.
Published: January 2021

Rheumatoid arthritis (RA) is among the most common forms of chronic inflammatory arthritis. It affects approximately 1% of adults and is two to three times more prevalent in women than in men. There are no specific laboratory tests for RA; diagnosis depends on a constellation of signs and symptoms that can be supported by serology and radiographs. The disease evolves over many years as a consequence of repeated environmental stress causing inflammation and immune activation followed by a breakdown of tolerance in individuals with a specific genetic background. This review describes the definition of RA; its etiology, including genetics, infections, the role of smoking and citrullination of proteins, and epigenetic mechanisms; and its pathogenesis, including synovial histopathology, bone and cartilage damage, adaptive and innate immunity, and the role of cytokines and intracellular signaling. Tables include the 1987 American Rheumatism Association criteria for the classification of RA and the 2010 American College of Rheumatology/European League Against Rheumatism classification for RA. Figures show citrullinated proteins in airway cells, a section of a proliferative synovium from a patient with a classic RA, and scalloped regions of erosion at the junction between a proliferative inflamed rheumatoid synovium and the bone.
This review contains 3 highly rendered figures, 2 tables, and 71 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 review contains ­5 highly rendered figures, 2 tables, and 57 references.
Pain Syndromes Other Than Headache
Authors: Ross Edgar L.
Published: January 2021

Chronic pain is very common in the United States. Although effective treatments are available, pain remains poorly managed in many patients. This review covers how to assess a patient with pain; the management of acute and chronic pain; and peripheral neuropathy, complex regional pain syndrome (CRPS), fibromyalgia, myofascial pain, back and spine pain, and cancer pain. Figures show how pain transducers (nociceptors) monitor and influence tissue conditions, sensory processing in the spinal cord dorsal horn, and classification of chronic pain syndromes. Tables list the International Association for the Study of Pain’s definitions for the management of pain; differences between acute and chronic pain; physiologic mechanisms sustaining pain; pain descriptors and types of pain; distinguishing hyperalgesia and allodynia; patient classifications and group characteristics; treatments and medication classes used for acute pain as well as chronic pain; two categories of chronic pain, differences between nociceptive and neuropathic pain; behavioral and rehabilitative therapies used for chronic pain; the Budapest diagnostic criteria for CRPS; diagnostic approaches to CRPS; signs and symptoms of fibromyalgia; conditions that can mimic myofascial pain; clinical presentation of myofascial pain; differences between myofascial pain and fibromyalgia; trigger-point examination; myofascial pain treatment; diagnostic categories of spinal pain; spinal pain red flags; the Waddell criteria; and cancer pain syndromes, characteristics, treatment options, and side-effect management options.
This review contains 3 highly rendered figures, 31 tables, and 82 references.
Brain and Spinal Abscesses
Authors: Tunkel Allan R , Scheld W Michael
Published: January 2021

Brain and spinal abscesses are often devastating infections that can lead to substantial morbidity and mortality if not recognized and treated in a timely manner. The clinical presentation depends upon the route of spread of infection to the central nervous system, location of the lesion, and severity of increased intracranial pressure. Brain abscess is defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus that is surrounded by a vascularized capsule; patients most often develop brain abscess by contiguous spread, hematogenous dissemination, or trauma. This chapter discusses the epidemiology, etiology, pathogenesis, diagnosis, management, and prognosis for brain abscess. Also examined are epidemiology and pathogenesis, etiology, diagnosis, management, and prognosis for both cranial subdural empyema and epidural abscess and spinal epidural abscess and subdural empyema. Tables list predisposing conditions and likely etiologic agents in brain abscess; histopathologic findings in the stages of brain abscess formation; presenting symptoms and signs in patients with brain abscess; antimicrobial therapy of brain abscess based on isolated pathogen; predisposing conditions and empirical antimicrobial therapy in patients with presumed bacterial brain abscess; recommended dosages of antimicrobial agents in adults with brain abscess; and normal renal and hepatic function. Figures in this chapter are images of intra-axial fluid collection; a subdural fluid collection; a ring-enhancing subdural empyema; an epidural abscess; a large epidural fluid collection with midline shift; a dorsal epidural collection; and loculated ring enhancement suggesting an epidural abscess. This chapter contains 6 highly rendered figures, 6 tables, 167 references, 5 MCQs.
On Being a Physician
Authors: Nabel Elizabeth G
Published: January 2021

The role of a physician as healer has grown more complex, and emphasis will increasingly be on patient and family-centric care. Physicians must provide compassionate, appropriate, and effective patient care by demonstrating competence in the attributes that are essential to successful medical practice. Beyond simply gaining medical knowledge, modern physicians embrace lifelong learning and need effective interpersonal and communication skills. Medical professionalism encompasses multiple attributes, and physicians are increasingly becoming part of a larger health care team. To ensure that physicians are trained in an environment that fosters innovation and alleviates administrative burdens, the Accreditation Council for Graduate Medical Education has recently revamped the standards of accreditation for today’s more than 130 specialties and subspecialties.
This chapter contains 6 references and 5 MCQs.
Neuro-Ophthalmology
Authors: Prasad Sashank
Published: January 2021

Neuro-ophthalmic disorders are capable of causing significant morbidity, requiring the clinician to develop and maintain nuanced skills that facilitate timely diagnosis and effective management. Virtually any neurologic disease can present with symptoms of either afferent or efferent visual pathway dysfunction. This chapter emphasizes principles of accurate localization and discusses key clinical clues that serve to generate an appropriate differential diagnosis. It specifically addresses acute monocular visual loss from retinal and optic nerve diseases, papilledema, chronicoptic neuropathies, visual field deficits, supranuclear and infranuclear eye movement disturbances, and nystagmus. Figures include an algorithm for the evaluation of acute monocular visual loss, computed tomography scans, and a large gallery of diagnostic photos.
This review contains 49 figures, 14 tables, and 171 references
Keywords: Neurology, ophthalmology, nystagmus, optic field deficit, neuritis, neuropathy, papilledema, visual pathway
Pediatric Minimally Invasive Pyeloplasty
Authors: Finkelstein Julia Beth , Casale Pasquale
Published: January 2021

Ureteropelvic junction obstruction (UPJO) is a common urologic abnormality in children. The diagnosis is typically based on a combination of clinical symptoms, ultrasonographic findings of hydronephrosis without hydroureter, and sometimes diuretic renal scintigraphy. Acceptance of robotic technology is increasing among pediatric urologists, and robotic pyeloplasty is now commonly performed for children with UPJO, with success rates similar to open pyeloplasty and a more efficient learning curve than conventional laparoscopy. The Anderson-Hynes dismembered pyeloplasty is the standard approach for repair. When complex patient anatomy is encountered, alternative techniques can be used to tailor the procedure to the specific case. Overall, robotic pyeloplasty offers strong outcomes, low complication rates, and a minimal rate of conversion to open surgery. Although the initial cost of robotic technology may be high, human capital gain and indirect benefits from shortened hospitalizations, smaller incisions, and parental satisfaction may be valuable. 

This review contains 10 figures, 5 tables and 42 references
Key words: Pediatrics, Minimally invasive surgery, Robotics, Ureteropelvic junction obstruction, Pyeloplasty, Urology
Variant Vascular Anatomy
Authors: Mannoia Kristyn , Hohmann Stephen
Published: January 2021

Knowledge of vascular anatomy is critical for successful vascular surgery. In this chapter, we review the most common variants of arterial and venous anatomy that should be familiar to vascular clinicians. Variants that are seen most frequently are emphasized and others that are less common, but critical to be aware of, are discussed as well. We describe and highlight the clinical relevance of these anomalies. Images of cases we have encountered in practice will be presented as examples. As this is not meant to be a comprehensive review of all vascular variants, we provide references for further reading where appropriate
 
This review contains 16 figures, 1 table and 92 references
Key Words: aberrant,  anatomy, anomalous, arterial, surgery, variant, vascular, venous
Temporal Trends in Incident Hospitalization for Diabetes-Related Foot Ulcer in Type 2 Diabetes: The Fremantle Diabetes Study
Authors: Hamilton Emma J , Davis Wendy A , Siru Ranita , Baba Mendel , Norman Paul E , Davis Timothy ME
Published: January 2021

Objective: To
determine whether, reflecting trends in other chronic complications, incident
hospitalization for diabetes-related foot ulcer (DFU) has declined over recent
decades in type 2 diabetes.

Research design and methods: Participants with type 2 diabetes from
the community-based Fremantle Diabetes Study Phases I (FDS1; 1,296 participants,
mean age 64.0 years, 48.6% males, recruited 1993-1996) and II (FDS2; 1,509
participants, mean age 65.4 years, 51.8% males, recruited 2008-2011) were
followed from entry to first hospitalization for/with DFU, death or 5 years
(whichever came first). Incident rate ratios (IRRs) and incident rate
differences (IRDs) were calculated for FDS2 versus FDS1 overall and in 10-year
age-groups. Cox
proportional hazards modelling determined independent predictors of
first DFU hospitalization in the combined cohort.

Results: Incident DFU hospitalization (95% CI) was 1.9 (0.9-3.3) /1,000
person-years in FDS1 during 5,879 person-years of follow-up, and 4.5 (3.0-6.4) /1,000
person-years in FDS2 during 6,915 person-years of follow-up. The crude IRR (95%
CI) was 2.40 (1.17-5.28), P=0.013)
and IRD 2.6 (0.7-4.5) /1,000 person-years (P=0.010).
The highest incidence rate (IR) for any age-group was 23.6/1,000 person-years
in FDS2 participants aged 31-40 years. Age at diabetes diagnosis (inverse), HbA1c,
insulin use, height, ln(urinary albumin:creatinine), absence of any foot pulse,
previous peripheral revascularization and peripheral sensory neuropathy (PSN) were
independent predictors of incident hospitalization for/with DFU.

Conclusions: Incident
DFU hospitalizations complicating type 2 diabetes increased between FDS Phases,
especially in younger participants, and were more likely in those with PSN,
peripheral arterial disease and suboptimal glycemic control at baseline.
Acid Attacks in India: A Socio-Legal Report
Authors:   National University of Study and Research in Law, India, Kumar Vidhik
Published: January 2021

India has the highest number of acid attacks globally every year, and despite the actions taken by the Indian Government and the Supreme Court of India, the crime is on the rise. This increase can be attributed to the patriarchal ideology that is prevalent in India and to India’s inadequate legal system, which does not deliver efficient remedies to the victims. This article will discuss the prevalence of acid attacks in India, motives behind the attacks, consequences on victims, and shortcomings in measures adopted to prevent the crime and provide justice to victims.
Rancang Bangun Purwarupa Pemilah Nanas Berdasarkan Tingkat Kematangan Menggunakan Mikrokontroler Blue Pill STM32F103C8T6
Authors:   Departement of Physics, University of Lampung, Indonesia, 35141, Desy Friska Tiara , Surtono Arif ,   Departement of Physics, University of Lampung, Indonesia, 35141, Supriyanto Amir ,   Departement of Physics, University of Lampung, Indonesia, 35141, Junaidi Junaidi ,   Departement of Physics, University of Lampung, Indonesia, 35141
Published: January 2021

The research about a design of prototype automatic pineapple sorting has been done with a belt conveyor system using a Blue Pill STM32F103C8T6 microcontroller. This research was conducted to create a prototype that can sort pineapples based on maturity level by classified unripe, ripe, and fully ripe. Sorting pineapple against the pineapple ripeness classification was carried out by a simulation process using serial data of index maturity sent from the PC monitor serial to microcontroller via serial communication. The serial data sent in character format was an integer 1; 2; 3; 4; 5; 6; and 7. The conveyor using a chain with gear transmission system and a DC motor as a drive. The results showed that the instument is capable of carrying a maximum load of pineapple fruit of 1.0 kg with a transport speed of 27,98 cm/s and can perform pineapple ripeness sorting with an accuracy more than 90%.
Analisis Suhu Dan Konsentrasi Karbondioksida dalam Kotak Pendingin Terhadap Susut Bobot dan Umur Simpan Buah Nanas (Ananas Comosus L. Merr) Berbasis MIT App Inventor 2
Authors:   Departement of Physics, University of Lampung, Indonesia, 35141, Nugraeni Yulinda , Suciyati Sri Wahyu ,   Departement of Physics, University of Lampung, Indonesia, 35141, Pauzi Gurum Ahmad ,   Departement of Physics, University of Lampung, Indonesia, 35141, Supriyanto Amir ,   Departement of Physics, University of Lampung, Indonesia, 35141
Published: January 2021

Shrinkage of weight loss and shelf life of pineapples is influenced by high temperatures and CO2 concentrations. This study aims to analyze the influence of temperature and CO2 concentration on weight loss and shelf life pineapple in a fridge cooler. The analysis data is obtained from a monitoring tool that has even the ESP8266 module to connect the Arduino with wifi through an application made with MIT App Inventor 2 so that data can be displayed with android. The downside of this application is that if the cellular data network is weak or non-existent, data recording will stop. The results showed that the monitoring tool was able to send data successfully. During data collection, the temperature was 7.82oC - 11.05oC, the CO2 concentration was 457.20 ppm - 490.77 ppm, the weight loss on ripe pineapple was 1.84%, 2.63%, and the weight loss on raw fruit 1.36% - 3.52%. Then from these data the CO2 concentration affects the respiration process, respiration affects the decay process. Whereas temperature affects the physical changes of pineapple fruit so that the shelf life of pineapples can last up to 22 days.
Distinctive marketing strategies of different industries in India
Authors:   International Management Institute (IMI) Bhubaneswar, Odisha, India, Choudhury Rahul Gupta
Published: January 2021

Different firms follow different strategies. It is partially dependent on the industry they operate in. The objective of the study is to find out whether there are similarities between firms operating in the same industry sector in terms of strategy. Another subsequent objective is to look at the similarities in strategy undertaken by firms in the same industry sector and whether and how the strategies pursued by firms in different industry sectors are different. The study was carried out in India. It was found that there are lot of commonalities in strategy between firms operating in the same industry sector. Also, strategies pursued by firms in different industry sectors are distinctly different. There are certain strategic factors like price and quality which are common to all industry sectors. The bottom line is that consumers want value and firms has to provide value, the composition and factors comprising value differs according to the industry the firm operates in.
Análisis morfológico de la derivación en sánscrito basado en esquemas de palabras
Authors: Hernández Quiroz Anselmo
Published: January 2021

Usualmente, la derivación en sánscrito se describe mediante reglas de segmentación y concatenación según el modelo de análisis morfológico basado en morfemas. Sin embargo, hay ciertos patrones de formación en los que no se analizan satisfactoriamente las relaciones entre la forma y el significado de las subunidades segmentadas teóricamente. Ante esta problemática, se aplica un modelo de análisis basado en esquemas de palabras para realizar un análisis morfológico parcial y aproximativo del léxico sánscrito. Los esquemas de palabras esquematizan correspondencias morfológicas bipartitas (procesos de derivación). El logro más relevante es la obtención de un listado homogéneo que representa el establecimiento de relaciones morfológicas naturales que desde la perspectiva basada en morfemas se dejan de lado. Se concluye que la derivación en sánscrito resulta así un estudio empírico, eficaz e intuitivo, que se beneficia de una perspectiva funcional basada en el uso.
Effects of Priming with Ascorbic Acid, L-Cystein and Triacontanol on Germination of Rapeseed (Brassica napusL.)
Authors: Molnár Katalin , Biró-Janka Béla , Nyárádi Imre-István , Fodorpataki László , Varga Bernadett-Enikő , Bálint János , Duda Marcel-Matei
Published: January 2021

The germination of seed batches of two rapeseed (Brassica napusL.) hybrids (‘Hybrirock’ and ‘Factor’) were investigated in response to priming in aqueous solutions of ascorbic acid (10 mM), L-cysteine (10 mM) and triacontanol (1 μM), respectively tap water (as control treatment). Investigations were focused on seed quality parameters, such as germination percentage, mean germination time, germination index, uniformity of germination, and seedling shoot and root growth. Germinated seeds were counted every 24 hours for a period of seven days, recording the final germination percentage (FGP), mean germination time (MGT), the coefficient of velocity of germination (CVG), germination rate index (GRI), germination index (GI), uncertanty (U), and synchrony (Z). In a separate trial fresh shoot- and root length, respectively the dry weight of the shoots and roots were also determined after a 14 day period. Germination tests were performed to examine the quality of seeds in response to different priming treatments. The results demonstrated that priming improved the germination parameters of seeds of both hybrids. Furthermore, the use of ascorbic acid, L-cysteine and triacontanol also enhanced seedling growth. The results may be used to rank seed lots by vigor, and decisions can be made regarding planting potential of each seed lot.
Suitability Determination of Machine Learning Techniques for the Operational Quality Assessment of Geophysical Survey Results
Authors: Abramov Kirill , Grundspenkis Janis
Published: January 2021

Well logging, also known as a geophysical survey, is one of the main components of a nuclear fuel cycle. This survey follows directly after the drilling process, and the operational quality assessment of its results is a very serious problem. Any mistake in this survey can lead to the culling of the whole well. This paper examines the feasibility of applying machine learning techniques to quickly assess the well logging quality results. The studies were carried out by a reference well modelling for the selected uranium deposit of the Republic of Kazakhstan and further comparing it with the results of geophysical surveys recorded earlier. The parameters of the geophysical methods and the comparison rules for them were formulated after the reference well modelling process. The classification trees and the artificial neural networks were used during the research process and the results obtained for both methods were compared with each other. The results of this paper may be useful to the enterprises engaged in the geophysical well surveys and data processing obtained during the logging process.